Ultrasonic treatment tool

Abstract

This ultrasonic treatment tool is provided with: an ultrasonic blade that supplies ultrasonic vibration and a high-frequency current to biological tissue; a jaw that opens and closes with respect to the ultrasonic blade; a holder member that is supported by the jaw and that is formed from a first material having electrical insulation properties; and a contact member formed from a first resin material, the contact member being provided to the holder member and coming into contact with the ultrasonic blade when the jaw is closed with respect to the ultrasonic blade. The holder member has: a facing surface that faces the ultrasonic blade; and an electrode surface that is provided on a surface that is retracted in a direction away from the ultrasonic blade with respect to the facing surface, the electrode surface having an electrode for supplying the high-frequency current.

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 the target) by supplying ultrasonic vibrations and high-frequency current as treatment energy to the target area (see, for example, Patent Document 1).

[0003] The ultrasonic treatment device described in Patent Document 1 includes an ultrasonic blade, jaws, and abutment member as shown below. The ultrasonic blade supplies ultrasonic vibrations and high-frequency current to the treatment target. The jaws open and close relative to the ultrasonic blade. The jaws are provided with electrodes that supply high-frequency current to the treatment target. The abutment member is made of a resin material and is provided on the jaws. The abutment member abuts against the ultrasonic blade when the jaws are closed relative to the ultrasonic blade.

[0004] Special table 2019-509775 publication

[0005] However, in ultrasonic treatment instruments, the contact member may wear out due to repeated output of ultrasonic vibrations. When the contact member wears out, the distance between the ultrasonic blade and the electrode on the jaw side becomes small, and the ultrasonic blade may come into contact with the electrode, causing sparks and scratches on the ultrasonic blade.

[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 suppress the generation of sparks.

[0007] In order to solve the above-mentioned problems and achieve the object, an ultrasonic treatment device according to one embodiment of the present invention comprises an ultrasonic blade that supplies ultrasonic vibrations and high-frequency current to biological tissue, respectively, a jaw that opens and closes relative to the ultrasonic blade, a holder member that is supported by the jaw and made of a first material that is electrically insulating, and a contact member that is provided on the holder member and made of a first resin material that contacts the ultrasonic blade when the jaw is closed relative to the ultrasonic blade, wherein the holder member has an opposing surface that faces the ultrasonic blade, and an electrode surface that is provided on a surface that is recessed from the opposing surface in a direction away from the ultrasonic blade and has an electrode that supplies the high-frequency current.

[0008] In addition, in an ultrasonic treatment device according to one aspect of the present invention, the abutment member is provided in the central portion of the holder member in the width direction, and the opposing surface and electrode surface are provided on both sides of the abutment member in the width direction.

[0009] In the ultrasonic treatment device according to one aspect of the present invention, the first material is a resin.

[0010] In the ultrasonic treatment device according to one aspect of the present invention, the first material is polyether ether ketone or polyphenylsulfone.

[0011] In the ultrasonic treatment device according to one aspect of the present invention, the electrodes are formed by a three-dimensional plating process.

[0012] In addition, an ultrasonic treatment device according to one aspect of the present invention further includes a cylindrical pin attached to the jaw and supporting the holder member so that the holder member can swing, and the electrode is electrically connected to the jaw via the pin.

[0013] In addition, in an ultrasonic treatment device according to one aspect of the present invention, the holder member has an insertion hole through which the pin is inserted, and the inner surface of the insertion hole has a first conductive surface that electrically connects the pin and the electrode.

[0014] In the ultrasonic treatment device according to one aspect of the present invention, the holder member is provided with a second conductive surface that electrically connects the first conductive surface and the electrode.

[0015] In the ultrasonic treatment device according to one aspect of the present invention, the holder member is provided to be swingable with respect to the jaw.

[0016] Moreover, the ultrasonic treatment device according to one aspect of the present invention further includes a cylindrical pin, and a pipe to which the pin is attached and which rotatably supports the jaw by the pin.

[0017] In the ultrasonic treatment device according to one aspect of the present invention, the electrode surface is a surface that is recessed from the opposing surface by 0.05 mm to 0.3 mm in a direction away from the ultrasonic blade.

[0018] In the ultrasonic treatment device according to one aspect of the present invention, a coating material that is non-adhesive to the biological tissue is provided on the electrode.

[0019] In addition, an ultrasonic treatment device according to one aspect of the present invention comprises an ultrasonic blade that supplies ultrasonic vibrations and high-frequency current to biological tissue, a jaw made of a first material having electrical insulation properties that opens and closes relative to the ultrasonic blade, and an abutment member that is provided on the jaw and made of a first resin material that abuts against the ultrasonic blade when the jaw is closed relative to the ultrasonic blade, wherein the jaw has an opposing surface that faces the ultrasonic blade, and an electrode surface that is provided on a surface that is recessed from the opposing surface in a direction away from the ultrasonic blade and has an electrode that supplies the high-frequency current.

[0020] According to the present invention, an ultrasonic treatment device capable of suppressing the generation of sparks can be realized.

[0021] FIG. 1 is a diagram showing an ultrasonic treatment device according to a first embodiment. FIG. 2 is a diagram explaining the configuration of a tip portion of the ultrasonic treatment device. FIG. 3 is a diagram explaining the configuration of a tip portion of the ultrasonic treatment device. FIG. 4 is a diagram explaining the configuration of an ultrasonic blade. FIG. 5 is a diagram showing a partial cross section of the base end side of the ultrasonic blade. FIG. 6 is a diagram explaining the configuration of a jaw. FIG. 7 is a diagram explaining the configuration of a holder member. FIG. 8 is a partial enlarged view of the electrode surface of FIG. 3. FIG. 9 is a diagram showing an ultrasonic treatment device according to a second embodiment. FIG. 10 is a partial enlarged view of the electrode surface. FIG. 11 is a diagram showing the top and side surfaces of the jaw of a treatment device according to a third embodiment.

[0022] 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.

[0023] (Embodiment 1) [Schematic Configuration of Treatment System] Fig. 1 is a diagram showing an ultrasonic treatment device according to embodiment 1. The treatment system 1 applies treatment energy to a region of biological tissue to be treated (hereinafter referred to as the treatment target), thereby treating the treatment target. The treatment energy in embodiment 1 is ultrasonic energy and high-frequency energy. Treatments that can be performed by the treatment system 1 according to embodiment 1 include coagulation (sealing) of the treatment target, incision of the treatment target, and the like. Coagulation and incision may also be performed simultaneously. As shown in Fig. 1, the treatment system 1 includes a treatment device 2 and a control device 3.

[0024] [Configuration of Treatment Tool] 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. Furthermore, 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 131, and is also a direction perpendicular to the plane of the paper in FIG.

[0025] 2 and 3 are diagrams illustrating the configuration of the distal end portion of the treatment tool 2. Specifically, Fig. 2 is a perspective view showing the distal end portion of the treatment tool 2. Fig. 3 is a cross-sectional view of the distal end portion of the treatment tool 2 cut along a plane perpendicular to the central axis Ax1.

[0026] The treatment tool 2 is an ultrasonic treatment tool according to the present invention. The treatment tool 2 applies ultrasonic energy and high-frequency energy to a treatment target, thereby treating the treatment target. As shown in FIG. 1 , the treatment tool 2 includes a handpiece 4 and an ultrasonic transducer 5.

[0027] As shown in Figures 1 to 3, 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 (Figures 1 and 2), a jaw 11, an abutment member 12 (Figure 3), an ultrasonic blade 13, and a holder member 14 (Figures 2 and 3).

[0028] The fixed handle 6 supports the entire treatment tool 2 and is a part that is held by an operator (user) such as a surgeon.

[0029] The operating handle 7 is movably attached to the fixed handle 6 and receives an operation of opening and closing the jaw 11 by an operator such as a surgeon.

[0030] 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.

[0031] 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, jaw 11, holder member 14, abutment member 12, and ultrasonic blade 13 to rotate about the central axis Ax1.

[0032] The outer pipe 10 has a tubular shape and corresponds to a pipe according to the present invention. In the first embodiment, the outer pipe 10 is a cylindrical pipe made of a conductive material such as metal.

[0033] A first pin Pi1 (FIGS. 1 and 2) having a cylindrical shape extending in a direction perpendicular to the plane of the paper in Fig. 1 is fixed to the end of the tip side Ar1 of the outer pipe 10. The first pin Pi1 engages with the jaw 11 and rotatably supports the jaw 11. In the first embodiment, the first pin Pi1 is made of a conductive material such as metal.

[0034] The outer peripheral surface of the outer pipe 10 is covered with an electrically insulating outer tube (not shown). 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 opening or closing operation of the operating handle 7 by an operator such as a surgeon. A second pin Pi2 ( FIG. 2 ) having a cylindrical shape extending in a direction perpendicular to the plane of FIG. 1 and engaging with the jaw 11 is fixed to the end of the distal end side Ar1 of the inner pipe PI. In the first embodiment, the second pin Pi2 is arranged on the upper side (the side where the jaw body 111 is arranged with respect to the treatment portion 131) of the first pin Pi1 in FIG. 2 .

[0035] The jaw 11 is connected to the outer pipe 10 by a first pin Pi1. The jaw 11 is also connected to the inner pipe PI by a second pin Pi2. The jaw 11 rotates about the first pin Pi1 relative to the outer pipe 10 in conjunction with the forward and backward movement of the inner pipe PI in response to an opening and closing operation of the operating handle 7 by an operator such as a surgeon. This causes the jaw 11 to open and close relative to a treatment portion 131, which is the distal end of the ultrasonic blade 13, and enables the jaw 11 to grasp a treatment target between the treatment portion 131 and the jaw 11.

[0036] The treatment tool 2 may be configured as a push-close type or a pull-close type.

[0037] The push-close type has the following configuration: The jaw 11 rotates around the first pin Pi1 in a direction approaching the treatment portion 131 in conjunction with the movement of the inner pipe PI toward the distal end side Ar1. That is, the jaw 11 closes relative to the treatment portion 131. Furthermore, the jaw 11 rotates around the first pin Pi1 in a direction away from the treatment portion 131 in conjunction with the movement of the inner pipe PI toward the proximal end side Ar2. That is, the jaw 11 opens relative to the treatment portion 131.

[0038] The pull-close type has the following configuration: The jaw 11 rotates around the first pin Pi1 in a direction approaching the treatment portion 131 in conjunction with the movement of the inner pipe PI toward the base end side Ar2. That is, the jaw 11 closes relative to the treatment portion 131. Also, the jaw 11 rotates around the first pin Pi1 in a direction away from the treatment portion 131 in conjunction with the movement of the inner pipe PI toward the tip end side Ar1. That is, the jaw 11 opens relative to the treatment portion 131.

[0039] The jaw 11 may be configured such that the outer pipe 10 moves forward and backward in response to an opening and closing operation of the operating handle 7. In this case, the jaw 11 rotates about the second pin Pi2 in conjunction with the forward and backward movement of the outer pipe 10, and opens and closes relative to the treatment section 131.

[0040] The detailed configuration of the jaw 11 will be described later in the section "Configuration of the jaw."

[0041] The holder member 14 extends in a direction perpendicular to the plane of the page in FIG. 3 and is supported by a third pin Pi3 ( FIG. 2 ) fixed to the jaw 11 so as to be swingable about the central axis of the third pin Pi3 and rotatable relative to the jaw 11. By allowing the holder member 14 to swing about the central axis of the third pin Pi3, when a treatment target is grasped between the jaw 11 and the treatment portion 131, the position at which the strongest force is applied to the treatment target is positioned approximately at the longitudinal center of the jaw 11, rather than at the base end side Ar2 of the jaw 11. In other words, a substantially uniform force is applied to the treatment target grasped between the jaw 11 and the treatment portion 131. In the first embodiment, the third pin Pi3 is made of a conductive material such as metal.

[0042] The holder member 14 is also provided with an electrode EP and first and second conductive surfaces CS1 and CS2 (see FIG. 7).

[0043] The detailed configuration of the holder member 14 will be described later in the section "Configuration of the Holder Member." The configurations of the electrode EP and the first and second conductive surfaces CS1 and CS2 will be described later in the section "Configuration of the Electrodes and the First and Second Conductive Surfaces."

[0044] The abutment member 12 is made of a first resin material that is electrically insulating and biocompatible. The first resin material is, for example, polytetrafluoroethylene (PTFE). The abutment member 12 has a generally rectangular parallelepiped shape extending along the longitudinal direction of the jaw 11 and the holder member 14. As shown in FIGS. 2 and 3 , the abutment member 12 is fixed to the surface of the holder member main body 141 facing the treatment portion 131, and abuts against the treatment portion 131 when the jaw 11 is closed relative to the treatment portion 131. The abutment member 12 functions to prevent the ultrasonically vibrating treatment portion 131 from colliding with the jaw 11 and being damaged when the incision of the treatment target using ultrasonic vibrations is completed.

[0045] The ultrasonic blade 13 is made of a conductive material and has an elongated shape extending along the central axis Ax1. The ultrasonic blade 13 is inserted into the inner pipe PI with the treatment portion 131 protruding to the outside. At this time, the end of the proximal side Ar2 of the ultrasonic blade 13 is mechanically connected to the ultrasonic vibrator 52 constituting the ultrasonic transducer 5, as shown in FIG. 1 . The ultrasonic blade 13 transmits ultrasonic vibrations generated by the ultrasonic transducer 5 from the end of the proximal side Ar2 to the treatment portion 131. The ultrasonic vibrations are longitudinal vibrations that vibrate in a direction along the central axis Ax1. The outer peripheral surface of the ultrasonic blade 13, excluding the treatment portion 131, is covered by an electrically insulating inner tube.

[0046] FIG. 4 is a diagram illustrating the configuration of an ultrasonic blade. As shown in FIG. 4, the ultrasonic blade 13 has a distal end portion 132 located on the distal side and including a treatment section 131, and a proximal end portion 133 located on the proximal side. The diameter of the distal end portion 132 is, for example, 3 mm or less, and the diameter of the proximal end portion 133 is, for example, 3 mm or more. Furthermore, a gain section 134 having a small diameter is provided between the first node N1, the second node N2, and the third node N3 of the ultrasonic vibration of the ultrasonic blade 13. By providing the gain section 134 closer to the proximal end than the node N2, the rigidity of the distal end portion 132 can be increased compared to a configuration in which the gain section is located distally from the node N2, and lateral vibration at the tip of the ultrasonic blade 13 can be reduced.

[0047] FIG. 5 is a partial cross-sectional view of the proximal end of the ultrasonic blade 13. An inner pipe PI is provided around the proximal end of the ultrasonic blade 13, and a slider 15, a slider receiver 16, and a coil spring 17 are provided around the outer periphery of the inner pipe PI, as shown in FIG. 5 . The slider 15 advances and retreats in response to the opening and closing operation of the operating handle 7. The slider receiver 16 receives a pressing force from the slider 15 via the coil spring 17 disposed between the slider receiver 16 and the slider 15, and advances and retreats in conjunction with the inner pipe PI. As shown in an enlarged view of the dashed line in FIG. 5 , a slider-side shim 18 is provided on the proximal end side of the coil spring 17, and a slider receiver-side shim 19 is provided on the distal end side of the coil spring 17. The slider-side shim 18 and the slider receiver-side shim 19 are disk-shaped with a hole in the center and made of, for example, metal. By providing the slider side shim 18 and the slider receiving side shim 19, sterilization can be improved.

[0048] As shown in FIG. 1 , the ultrasonic transducer 5 includes a TD (transducer) case 51 and an ultrasonic vibrator 52 .

[0049] The TD case 51 supports the ultrasonic transducer 52 and is detachably connected to the fixed handle 6 .

[0050] The ultrasonic vibrator 52 generates ultrasonic vibrations under the control of the control device 3. In the first embodiment, the ultrasonic vibrator 52 is configured by a BLT (bolt-tightened Langevin type vibrator).

[0051] [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 portion 131 via the electric cable C. In other words, the control device 3 treats the treatment target.

[0052] For example, when applying ultrasonic energy 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 131 also vibrates at a desired amplitude due to the longitudinal vibrations. Then, ultrasonic vibrations are supplied from the treatment unit 131 to the treatment target grasped between the jaw 11 and the treatment unit 131. Ultrasonic energy is applied from the treatment unit 131 to the treatment target.

[0053] Furthermore, for example, when applying high-frequency energy to a treatment target, the control device 3 supplies high-frequency power between the electrode EP provided on the holder member 14 and the ultrasonic blade 13 via an electric cable C or the like. When high-frequency power is supplied between the electrode EP and the ultrasonic blade 13, a high-frequency current is supplied to the living tissue, which is the treatment target, grasped between the jaw 11 and the treatment section 131. In other words, high-frequency energy is applied to the treatment target.

[0054] [Regarding the jaw configuration] Fig. 6 is a diagram illustrating the configuration of the jaw 11. Specifically, Fig. 6 is a perspective view of the jaw 11 as seen from the treatment section 131 side. For ease of explanation, the distal end portion is not shown in Fig. 6.

[0055] The jaw 11 is made of a conductive material and is a member in which a jaw body 111 and a pair of bearing portions 112 are integrally formed, as shown in FIG.

[0056] The jaw body 111 is configured as a long, approximately plate-like body. As shown in FIG. 6 , a recess 1111 is provided on the surface of the jaw body 111 facing the treatment section 131, extending from the base end toward the distal end Ar1 along the longitudinal direction of the jaw body 111.

[0057] 6, a through-hole 1113 is provided in each of the widthwise sidewall portions of the jaw body 111, which constitutes the recess 1111, at a position substantially in the center of the longitudinal direction of the jaw 11. A third pin Pi3 is inserted into the through-hole 1113 and fixed thereto by welding.

[0058] A cover RC (FIGS. 2, 3, and 6) made of an electrically insulating resin is integrally formed on the rear surface of the jaw body 111, the rear surface being away from the treatment portion 131, so as to cover the rear surface. In the first embodiment, the cover RC is insert-molded into the jaw body 111, but this is not limiting. For example, a configuration may be adopted in which the cover RC is fixed to the jaw body 111 by a snap fit or a metal pin.

[0059] The pair of bearing portions 112 are respectively provided at the end of the base end side Ar2 of the jaw body 111, and are each composed of a plate body that faces the jaw body 111 in the width direction. The pair of bearing portions 112 have the same configuration. Therefore, the following will describe the configuration of only one bearing portion 112.

[0060] The bearing portion 112 is provided with first and second insertion holes 1121 and 1122 that penetrate the front and back, respectively. The bearing portion 112 is connected to the outer pipe 10 by inserting a first pin Pi1 into the first insertion hole 1121. The bearing portion 112 is connected to the inner pipe PI by inserting a second pin Pi2 into the second insertion hole 1122.

[0061] [Configuration of Holder Member] Fig. 7 is a diagram illustrating the configuration of the holder member 14. Specifically, Fig. 7 is a perspective view of the holder member 14 as viewed from the treatment section 131 side. Note that, for ease of explanation, dots are added to the electrode EP and the first and second conductive surfaces CS1, CS2 in Fig. 7.

[0062] The holder member 14 is made of a first material that is electrically insulating and biocompatible. The first material is, for example, a resin material such as polyetheretherketone (PEEK) or polyphenylsulfone (PPSU), but may also be an electrically insulating material such as ceramic. As shown in FIG. 7 , the holder member 14 is a member in which a holder member main body 141, a plurality of first teeth 142, and a plurality of second teeth 143 are integrally formed.

[0063] The holder member main body 141 is formed of a long plate. The outer shape of the holder member main body 141 is set to be substantially the same as the inner shape of the recess 1111.

[0064] As shown in Figure 7, the multiple first tooth portions 142 each protrude from one side of the width direction on the surface of the holder member main body 141 facing the treatment portion 131 toward the treatment portion 131, and are arranged side by side along the longitudinal direction of the holder member main body 141.

[0065] As shown in Figure 7, the multiple second tooth portions 143 each protrude from the other side of the width direction on the treatment portion 131 side surface of the holder member main body 141, toward the treatment portion 131 side, and are arranged side by side along the longitudinal direction of the holder member main body 141.

[0066] Here, as shown in FIG. 7 , a recess 144 is provided in the widthwise central portion of the surface of the holder member main body 141 facing the treatment unit 131, the recess 144 being recessed on the side away from the treatment unit 131 and extending along the longitudinal direction of the holder member main body 141. Furthermore, claw portions 145, 146 ( FIGS. 3 and 7 ) that protrude toward the widthwise center and extend along the longitudinal direction of the holder member main body 141 are provided on the sidewall portions on both sides of the widthwise direction of the holder member main body 141 that form the recess 144. The abutting member 12 is mechanically fixed to the holder member 14 by being engaged with the claw portions 145, 146. That is, the abutting member 12 is provided in the widthwise central portion of the holder member 14. Furthermore, the side wall portions on both sides in the width direction of the holder member main body 141 that form the recess 144 are provided with insertion holes 147 that penetrate the side wall portions from the front to the back and through which the third pin Pi3 is inserted.

[0067] Fig. 8 is a partial enlarged view of the electrode surface ES in Fig. 3. The second tooth portion 143 of the holder member 14 has an opposing surface OS that faces the ultrasonic blade 13, and an electrode surface ES that is provided on a surface that is set back from the opposing surface OS in a direction away from the ultrasonic blade 13 and has an electrode EP that supplies high-frequency current.

[0068] Similarly, the first tooth portion 142 of the holder member 14 has an opposing surface OS that faces the ultrasonic blade 13, and an electrode surface ES that is provided on a surface that is set back from the opposing surface OS in a direction away from the ultrasonic blade 13 and has an electrode EP that supplies high-frequency current. In other words, the opposing surface OS and the electrode surface ES are provided on both sides in the width direction with the abutting member 12 sandwiched therebetween.

[0069] The length L1 is, for example, 0.1 mm, but may be 0.05 mm to 0.3 mm. That is, the electrode surface ES is a surface that is recessed from the opposing surface OS by 0.05 mm to 0.3 mm in the direction away from the ultrasonic blade 13.

[0070] The length L2 is, for example, 0.33 mm, that is, the width of the electrode EP is 0.33 mm.

[0071] The length L3 may be, for example, 0.07 mm or more. That is, it is preferable that the clearance between the ultrasonic blade 13 and the electrode EP is 0.07 mm or more.

[0072] [Configuration of the Electrode and First and Second Conductive Surfaces] As shown in FIG. 7 , the electrode EP is provided on the electrode surface ES on the widthwise inner side (the second tooth portion 143 side) of the plurality of first tooth portions 142, on the electrode surface ES on the widthwise inner side (the first tooth portion 142 side) of the plurality of second tooth portions 143, and on the tip of the holder member 14 so as to connect these electrode surfaces ES. By providing the electrode EP on the tip of the holder member 14, the treatment target can also be treated at the tip. However, the electrode EP does not have to be connected to the tip of the holder member 14. Furthermore, the electrode EP is coated with a coating material that is non-adhesive to the treatment target. The coating material is an extremely thin coating material containing fluorine or silicon, having a thickness of several hundred nanometers to several micrometers.

[0073] As shown in FIG. 7, the first conductive surface CS1 is provided on the inner surface of the insertion hole 147.

[0074] As shown in FIG. 7, the second conductive surface CS2 is provided on the side wall of the recess 144, and electrically connects the electrode EP and the first conductive surface CS1.

[0075] The electrode EP and the first and second conductive surfaces CS1 and CS2 described above are formed by the following three-dimensional plating process. Specifically, a laser is irradiated at a predetermined position on the holder member 14. Then, electroless plating is used to form the electrode EP and the first and second conductive surfaces CS1 and CS2 at the laser irradiation position. The thickness of the electrode EP and the first and second conductive surfaces CS1 and CS2 is, for example, approximately several micrometers. A structure produced by such a three-dimensional plating process is called a molded interconnect device (MID), as it is a three-dimensional resin molded product with an electrode circuit formed on its surface. The electrode EP and the first and second conductive surfaces CS1 and CS2 are not limited to those formed by the above-described three-dimensional plating process, and may also be formed by other methods.

[0076] When high-frequency power is supplied to the electrode EP to apply high-frequency energy to the treatment target, the high-frequency power is supplied along the electrical path from the electrical cable C to the outer pipe 10 to the first pin Pi1 to the jaw 11 to the third pin Pi3 to the first conductive surface CS1 to the second conductive surface CS2 to the electrode EP.

[0077] The above-described first embodiment provides the following advantages: In the treatment tool 2 according to the first embodiment, the electrode EP is provided on the electrode surface ES that is set back from the opposing surface OS in a direction away from the ultrasonic blade 13. Therefore, even if the contact member 12 is worn away by ultrasonic vibrations, it is possible to prevent the ultrasonic blade 13 and the electrode EP from coming into contact with each other and generating sparks.

[0078] The electrode surface ES is set back from the opposing surface OS by 0.05 mm to 0.3 mm in the direction away from the ultrasonic blade 13. As a result, it is possible to prevent sparks from being generated due to contact between the ultrasonic blade 13 and the electrode EP, and to effectively treat the treatment target.

[0079] The electrodes EP are formed by a three-dimensional plating process, so that even if the holder member 14 is made of an electrically insulating material, the electrodes EP can be easily formed at specific positions on the holder member 14.

[0080] In addition, the electrode EP is provided with a coating material that is non-adhesive to the treatment target, which prevents the treatment target from sticking to the electrode EP and allows the treatment target to be treated well.

[0081] (Embodiment 2) [Schematic Configuration of Treatment System] The overall configuration of a treatment system 1 according to embodiment 2 may be the same as that shown in Fig. 1, and therefore description thereof will be omitted. Components similar to those of the treatment system 1 will be described using the same reference numerals, and components different from those of the treatment system 1 will be described using new reference numerals.

[0082] [Configuration of Treatment Instrument] Fig. 9 is a diagram showing an ultrasonic treatment instrument according to embodiment 2. As shown in Fig. 9, a handpiece 4A of a treatment instrument 2A includes an outer pipe 10A, a jaw 11A, a contact member 12A, and an ultrasonic blade 13A.

[0083] The outer pipe 10A has a tubular shape and corresponds to a pipe according to the present invention. In the second embodiment, the outer pipe 10A is a cylindrical pipe made of a conductive material such as metal.

[0084] In this outer pipe 10A, a first pin Pi1A (FIGS. 1 and 9) is fixed to the end of the tip side Ar1. The first pin Pi1A has a cylindrical shape extending in a direction perpendicular to the plane of the paper in FIGS. 1 and 9, engages with the jaw 11A, and rotatably supports the jaw 11A. In the second embodiment, the first pin Pi1A is made of a conductive material such as metal. This first pin Pi1A corresponds to the pin according to the present invention.

[0085] The outer circumferential surface of the outer pipe 10A is covered with an electrically insulating outer tube TOA ( FIG. 9 ). A tubular inner pipe PIA ( FIG. 9 ) is inserted into the outer pipe 10A and moves back and forth along the longitudinal direction of the outer pipe 10A in response to an opening or closing operation of the operating handle 7 by an operator such as a surgeon. A second pin Pi2A ( FIG. 9 ) having a cylindrical shape extending in a direction perpendicular to the plane of FIGS. 1 and 9 and engaging with the jaw 11A is fixed to the end of the distal end side Ar1 of the inner pipe PIA. In the second embodiment, the second pin Pi2A is disposed on the upper side (the side where the jaw body 111A is disposed relative to the treatment section 131A) of the first pin Pi1A in FIG. 9 .

[0086] The jaw 11A is connected to the outer pipe 10A by inserting the first pin Pi1A into the insertion hole of the bearing portion 114A. The jaw 11A is connected to the inner pipe PIA by inserting the second pin Pi2A into the insertion hole of the bearing portion 114A. The jaw 11A rotates about the first pin Pi1A relative to the outer pipe 10A in conjunction with the advancement and retreat of the inner pipe PIA in response to an opening and closing operation of the operating handle 7 by an operator such as a surgeon. This allows the jaw 11A to open and close relative to the treatment portion 131A, which is the distal end of the ultrasonic blade 13A, and to grasp a treatment target between the jaw 11A and the treatment portion 131A.

[0087] The treatment tool 2A may be configured as a push-close type or a pull-close type, similar to embodiment 1. Furthermore, similar to embodiment 1, the treatment tool 2A may have the jaw 11A opened and closed by the inner pipe PIA moving back and forth in response to the opening and closing operation of the operating handle 7, or the jaw 11A opened and closed by the outer pipe 10A moving back and forth.

[0088] The jaw 11A is made of a first material that is electrically insulating and biocompatible. The first material is, for example, a resin material such as polyetheretherketone (PEEK) or polyphenylsulfone (PPSU), but may also be an electrically insulating material such as ceramic.

[0089] The abutment member 12A is made of a first resin material that is electrically insulating and biocompatible. The first resin material is, for example, polytetrafluoroethylene (PTFE). The abutment member 12A has a generally rectangular parallelepiped shape extending along the longitudinal direction of the jaw 11A. As shown in FIG. 9 , the abutment member 12A is fixed to the surface of the jaw body 111A facing the treatment portion 131A, and abuts against the treatment portion 131A when the jaw 11A is closed relative to the treatment portion 131A. The abutment member 12A functions to prevent the ultrasonically vibrating treatment portion 131A from colliding with the jaw 11A and being damaged when the incision of the treatment target using ultrasonic vibrations is completed.

[0090] The ultrasonic blade 13A supplies ultrasonic vibrations and high-frequency current to biological tissue. The ultrasonic blade 13A is made of a conductive material and has an elongated shape extending along the central axis Ax1. As shown in FIG. 9 , the ultrasonic blade 13A is inserted into the inner pipe PIA with the treatment portion 131A protruding outward. At this time, the end of the proximal side Ar2 of the ultrasonic blade 13A is mechanically connected to the ultrasonic vibrator 52 constituting the ultrasonic transducer 5, as shown in FIG. 1 . The ultrasonic blade 13A transmits ultrasonic vibrations generated by the ultrasonic transducer 5 from the end of the proximal side Ar2 to the treatment portion 131A. The ultrasonic vibrations are longitudinal vibrations vibrating in a direction along the central axis Ax1. The outer peripheral surface of the ultrasonic blade 13A, excluding the treatment portion 131A, is covered by an electrically insulating inner tube TIA ( FIG. 9 ).

[0091] [Regarding the Configuration of the Holder Member] Fig. 10 is a partial enlarged view of the electrode surface ESA. The jaw 11A has a plurality of second teeth 113A that protrude from one widthwise side of the surface of the jaw body facing the treatment section 131A toward the treatment section 131A and are arranged in parallel along the longitudinal direction of the jaw body. The second teeth 113A have an opposing surface OSA that faces the ultrasonic blade 13A, and an electrode surface ESA that is provided on a surface that is recessed from the opposing surface OSA in a direction away from the ultrasonic blade 13A and has an electrode EPA that supplies high-frequency current.

[0092] The length L1A is, for example, 0.1 mm, but may be 0.05 mm to 0.3 mm. That is, the electrode surface ESA is a surface that is recessed from the opposing surface OSA by 0.05 mm to 0.3 mm in the direction away from the ultrasonic blade 13A.

[0093] The length L2A is, for example, 0.33 mm, that is, the width of the electrode EPA is 0.33 mm.

[0094] The length L3A may be, for example, 0.07 mm or more. That is, it is preferable that the clearance between the ultrasonic blade 13A and the electrode EPA is 0.07 mm or more.

[0095] Similarly, the jaw 11A has a plurality of first teeth that protrude from the other widthwise side of the surface of the jaw body facing the treatment section 131A toward the treatment section 131A and are arranged in parallel along the longitudinal direction of the jaw body. The first teeth have an opposing surface OSA that faces the ultrasonic blade 13A, and an electrode surface ESA that is provided on a surface that is set back from the opposing surface OSA in a direction away from the ultrasonic blade 13A and has an electrode EPA that supplies high-frequency current. In other words, the opposing surface OSA and the electrode surface ESA are provided on both sides in the widthwise direction of the abutting member 12A.

[0096] The above-described second embodiment provides the following advantages: In the treatment tool 2A according to the second embodiment, the electrode EPA is provided on the electrode surface ESA that is set back from the opposing surface OSA in a direction away from the ultrasonic blade 13A, and therefore, even if the contact member 12A is worn away by ultrasonic vibrations, it is possible to prevent the ultrasonic blade 13A and the electrode EPA from coming into contact with each other and generating sparks.

[0097] The electrode surface ESA is recessed from the opposing surface OSA by 0.05 mm to 0.3 mm in the direction away from the ultrasonic blade 13A. As a result, it is possible to prevent sparks from being generated due to contact between the ultrasonic blade 13A and the electrode EPA, and to treat the treatment target satisfactorily.

[0098] Furthermore, the electrode EPA is formed by a three-dimensional plating process, so that even if the jaw 11A is made of an electrically insulating material, the electrode EPA can be easily formed at a specific position on the jaw 11A.

[0099] In addition, the electrode EPA is provided with a coating material that is non-adhesive to the treatment target, which prevents the treatment target from sticking to the electrode EPA and allows the treatment target to be treated well.

[0100] (Embodiment 3) In the first and second embodiments, ultrasonic energy and high-frequency energy are used as the treatment energy applied to the treatment target by the treatment tool 2, 2A, but this is not limiting, and only high-frequency energy may be used.

[0101] The treatment tool according to the third embodiment includes a pair of jaws that open and close to sandwich the cutter from above and below. The jaws are parts that grasp a treatment target and apply high-frequency energy to the treatment target to treat the treatment target.

[0102] Fig. 11 shows the top and side surfaces of a jaw of a treatment tool according to embodiment 3. Fig. 11 shows the top and side surfaces of a jaw 11B located below the cutter. The jaw 11B has an opposing surface OSB that faces the cutter, an electrode surface ESB that is provided on a surface that is set back from the opposing surface OSB in a direction away from the cutter and has an electrode EPB that supplies high-frequency current, and a cutter groove portion 111B that extends in the longitudinal direction of the jaw 11B.

[0103] The jaw 11B is made of a first material that is electrically insulating and biocompatible. The first material is, for example, a resin material such as polyetheretherketone (PEEK) or polyphenylsulfone (PPSU), but may also be an electrically insulating material such as ceramic.

[0104] The electrode EPB is a portion to which high-frequency power is supplied between the opposing electrode EPB from the control device 3. This electrode EPB has a U-shape that surrounds the cutter groove portion 111B in a planar manner, and is provided on the cutter-side surface of the jaw 11B with both ends of the U-shape facing the base end side Ar2.

[0105] The electrode EPB is formed by a three-dimensional plating process, similar to the electrode EP described in embodiment 1. Note that the electrode is not limited to one formed by the above-described three-dimensional plating process, and one formed by other methods may also be used.

[0106] In addition, a coating material that is non-adhesive to the treatment target is applied to the electrode EPB. The coating material is an extremely thin coating material of about several hundred nanometers to several micrometers that contains fluorine or silicon.

[0107] The above-described third embodiment has the following advantages: In the treatment tool according to the third embodiment, the electrode EPB is provided on the electrode surface ESB that is set back from the opposing surface OSB in a direction away from the cutter, and therefore, contact between the cutter and the electrode EPB can be suppressed.

[0108] Furthermore, the electrode EPB is formed by a three-dimensional plating process, so that even if the jaw 11B is made of an electrically insulating material, the electrode EPB can be easily formed at a specific position on the jaw 11B.

[0109] In addition, a coating material that is non-adhesive to the treatment target is provided on the electrode EPB, which prevents the treatment target from sticking to the electrode EPB and allows the treatment target to be treated well.

[0110] Further advantages and modifications will readily occur to those skilled in the art. Thus, the invention in its broader aspects is not limited to the specific details and representative embodiments shown and described above. Accordingly, various modifications may be made without departing from the spirit or scope of the general inventive concept as defined by the appended claims and their equivalents.

[0111] 1 Treatment system 2, 2A Treatment tool 3 Control device 4, 4A Handpiece 5 Ultrasonic transducer 6 Fixed handle 7 Operating handle 8 Switch 9 Rotating knob 10, 10A Outer pipe 11, 11A, 11B Jaw 12, 12A Abutment member 13, 13A Ultrasonic blade 14 Holder member 15 Slider 16 Slider receiver 17 Coil spring 18 Slider side shim 19 Slider receiver side shim 51 TD case 52 Ultrasonic vibrator 111, 111A Jaw body 111B Cutter groove portion 112, 114A Bearing portion 131, 131A Treatment portion 132 Distal end portion 133 Base end portion 134 Gain portion 141 Holder member body 142 First tooth portion 143 Second tooth portion 144 Recess 145, 146 Claw portion 147 Insertion hole 1111 Recess 1113 Through hole 1121 First insertion hole 1122 Second insertion hole Ar1 Tip side Ar2 Base side Ax1 Central axis C Electric cable CS1 First conductive surface CS2 Second conductive surface CS3 Third conductive surface EP, EPA, EPB Electrodes ES, ESA, ESB Electrode surface OS, OSA, OSB Opposing surface Pi1, Pi1A First pin Pi2, Pi2A Second pin Pi3 Third pin PI, PIA Inner pipe RC Cover TIA Inner tube TOA Outer tube

Claims

1. An ultrasonic treatment device comprising: an ultrasonic blade that supplies ultrasonic vibrations and high-frequency current to biological tissue, respectively; a jaw that opens and closes relative to the ultrasonic blade; a holder member that is supported by the jaw and made of a first electrically insulating material; and a contact member that is provided on the holder member and made of a first resin material and that contacts the ultrasonic blade when the jaw is closed relative to the ultrasonic blade, wherein the holder member has an opposing surface that faces the ultrasonic blade, and an electrode surface that is provided on a surface that is set back from the opposing surface in a direction away from the ultrasonic blade and has an electrode that supplies the high-frequency current.

2. An ultrasonic treatment device as described in claim 1, wherein the abutment member is provided in the central portion of the holder member in the width direction, and the opposing surface and electrode surface are provided on both sides of the abutment member in the width direction.

3. The ultrasonic treatment device according to claim 1, wherein the first material is a resin.

4. The ultrasonic treatment device according to claim 3, wherein the first material is polyether ether ketone or polyphenylsulfone.

5. The ultrasonic treatment device according to claim 1, wherein the electrodes are formed by a three-dimensional plating process.

6. An ultrasonic treatment device according to claim 1, further comprising a cylindrical pin attached to the jaw and supporting the holder member so that the holder member can swing, and the electrode is electrically connected to the jaw via the pin.

7. An ultrasonic treatment device as described in claim 6, wherein the holder member is provided with an insertion hole through which the pin is inserted, and the inner surface of the insertion hole is provided with a first conductive surface that electrically connects the pin and the electrode.

8. An ultrasonic treatment device according to claim 7, wherein the holder member is provided with a second conductive surface that electrically connects the first conductive surface and the electrode.

9. The ultrasonic treatment device according to claim 1, wherein the holder member is provided so as to be swingable relative to the jaw.

10. The ultrasonic treatment instrument according to claim 1, further comprising: a cylindrical pin; and a pipe to which the pin is attached, the pipe supporting the jaw rotatably by the pin.

11. An ultrasonic treatment device according to claim 1, wherein the electrode surface is a surface that is set back from the opposing surface by 0.05 mm to 0.3 mm in a direction away from the ultrasonic blade.

12. An ultrasonic treatment device according to claim 1, wherein the electrodes are provided with a coating material that is non-adhesive to the biological tissue.

13. An ultrasonic treatment device comprising: an ultrasonic blade that supplies ultrasonic vibrations and high-frequency current to biological tissue, respectively; a jaw made of a first material having electrical insulation that opens and closes relative to the ultrasonic blade; and a contact member that is provided on the jaw and made of a first resin material that contacts the ultrasonic blade when the jaw is closed relative to the ultrasonic blade, wherein the jaw has an opposing surface that faces the ultrasonic blade, and an electrode surface that is provided on a surface that is set back from the opposing surface in a direction away from the ultrasonic blade and has an electrode that supplies the high-frequency current.

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