Medical device and medical system
Patent Information
- Application Number
- PCT/JP2025/012248
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Filing Date
- 2025-03-26
- Publication Date
- 2026-10-01
Smart Images
Figure JP2025012248_01102026_PF_FP_ABST
Abstract
Description
Medical Device and Medical System
[0001] The present invention relates to a medical device and a medical system.
[0002] Conventionally, there has been known a medical system in which an operator operates a robotic device from a remote location to perform surgery on a patient (see, for example, Patent Document 1). In the medical system described in Patent Document 1, a medical device is mounted on the robotic device. This medical device is inserted into a subject to treat a site in biological tissue that is the target of treatment (hereinafter referred to as the treatment target).
[0003] Specifically, the medical device includes first and second end effectors that grip the treatment target by relatively opening and closing. A pair of first sealing electrodes are provided at both ends in the width direction of the first end effector. Further, an elastic receiving member is provided at a central portion in the width direction of the first end effector. A pair of second sealing electrodes respectively facing the pair of first sealing electrodes are provided at both ends in the width direction of the second end effector. Further, a cutting electrode facing the receiving member is provided at a central portion in the width direction of the second end effector.
[0004] Then, when a voltage is applied between the pair of first sealing electrodes, the pair of second sealing electrodes, and the cutting electrode, the treatment target is treated as described below. That is, the treatment target is sealed between the first and second sealing electrodes facing each other (hereinafter referred to as the sealing region). Further, the treatment target is cut between the receiving member and the cutting electrode facing each other (hereinafter referred to as the cutting region).
[0005] US Patent Application Publication No. 2021 / 0153927
[0006] Incidentally, in order to reliably seal and cut the target of treatment, it is necessary to ensure that the sealing region and the cutting region are both completely compressed. However, the medical device described in Patent Document 1 employs an elastic, soft material as the receiving member facing the cutting electrode. Therefore, it is not possible to ensure that the sealing region and the cutting region are both completely compressed. In other words, it is not possible to reliably seal and cut the target of treatment. Therefore, there is a need for a technology that can ensure that the sealing region and the cutting region are both completely compressed, thereby enabling reliably sealing and cutting the target of treatment.
[0007] The present invention has been made in view of the above, and aims to provide a medical device and a medical system that can reliably perform sealing and cutting of a target to be treated.
[0008] To solve the above-mentioned problems and achieve the objective, the medical device according to the present invention comprises a first end effector having a pair of first electrodes, a second end effector having a second electrode and opening and closing relative to the first end effector, and a receiving member made of an electrically insulating material, provided on the first end effector such that the first electrodes are located on both sides in the width direction, and which grips biological tissue between the first end effector and the second electrode when the first end effector and the second end effector are closed, wherein the biological tissue is cut by applying a voltage of a first voltage value between the pair of first electrodes and the second electrode, and the biological tissue is sealed by applying a voltage of a second voltage value between the pair of first electrodes and the second electrode.
[0009] Furthermore, the medical device according to the present invention comprises an end effector for treating a target, a tubular member disposed on the proximal end side of the end effector, and an operating handle provided on the proximal end side of the tubular member for operating the end effector, wherein the end effector comprises a first end effector having a pair of first electrodes, a second end effector having a second electrode and opening and closing relative to the first end effector in response to operation of the operating handle, and a receiving member made of an electrically insulating material, provided on the first end effector such that the first electrodes are located on both sides in the width direction, and gripping biological tissue between the first end effector and the second electrode when the first end effector and the second end effector are closed, wherein the biological tissue is cut by applying a voltage of a first voltage value between the pair of first electrodes and the second electrode, and the biological tissue is sealed by applying a voltage of a second voltage value between the pair of first electrodes and the second electrode.
[0010] Furthermore, the medical system according to the present invention comprises a remotely operated robotic device and a medical device attached to the robotic device, the medical device comprising a first end effector having a pair of first electrodes, a second end effector having a second electrode and opening and closing relative to the first end effector, and a receiving member made of an electrically insulating material, provided on the first end effector such that the first electrodes are located on both sides in the width direction, and gripping biological tissue between the first end effector and the second electrode when the first end effector and the second end effector are closed, the medical system comprising a first voltage value applied between the pair of first electrodes and the second electrode to cut the biological tissue, and a second voltage value applied between the pair of first electrodes and the second electrode to seal the biological tissue.
[0011] According to the medical device and medical system of the present invention, the sealing and cutting of the target to be treated can be performed stably.
[0012] Figure 1 is a diagram illustrating a medical system according to an embodiment. Figure 2 is a diagram illustrating a robotic device. Figure 3 is a perspective view of a medical device viewed from the distal end. Figure 4 is a diagram illustrating the configuration of an end effector. Figure 5 is a diagram illustrating the configuration of an end effector. Figure 6 is a diagram illustrating the configuration of an end effector. Figure 7 is a diagram illustrating the configuration of an end effector. Figure 8 is a diagram illustrating modification 1 of the embodiment. Figure 9 is a diagram illustrating modification 2 of the embodiment. Figure 10 is a diagram illustrating modification 2 of the embodiment. Figure 11 is a diagram illustrating modification 3 of the embodiment. Figure 12 is a diagram illustrating modification 4 of the embodiment. Figure 13 is a diagram illustrating modification 5 of the embodiment. Figure 14 is a diagram illustrating modification 6 of the embodiment. Figure 15 is a diagram illustrating modification 7 of the embodiment.
[0013] The embodiments for carrying out the present invention (hereinafter referred to as "embodiments") will be described below with reference to the drawings. However, the present invention is not limited to the embodiments described below. Furthermore, in the drawings, the same parts are denoted by the same reference numerals.
[0014] [Outline Configuration of the Medical System] Figure 1 is a diagram of a medical system 1 according to an embodiment. Figure 2 is a diagram of a robotic device 2. As shown in Figure 1, medical system 1 is a robotic surgical system in which the surgeon OP1 operates the robotic device 2 from a distance to perform surgery on the patient PA. In addition, one or more assistants OP2, anesthesiologists OP3, and nurses OP4 can also participate in the surgery in medical system 1. As shown in Figures 1 and 2, medical system 1 comprises a robotic device 2, an imaging device 3, a processing device 4, an operating device 5, and a medical device 6.
[0015] The robotic device 2 is installed on the floor of the operating room or similar location. As shown in Figures 1 and 2, the robotic device 2 comprises a plurality of robotic arms 21. The robotic arms 21 support an imaging device 3 or a medical device 6 at their distal ends. The robotic arms 21 have multiple joints, allowing them to move the imaging field of view of the supported imaging device 3 or the position of the distal end of the supported medical device 6 with multiple degrees of freedom.
[0016] The imaging device 3 generates an image by imaging the surgical site. The image generated by the imaging device 3 is then output to the processing device 4.
[0017] The processing unit 4 is installed on the floor of the operating room or elsewhere, and performs predetermined image processing on the image captured by the imaging device 3 to generate a video signal for display. The video signal for display generated by the processing unit 4 is then output to the operating device 5.
[0018] The operating device 5 is installed on the floor of the operating room or elsewhere and includes an input control device that receives operations from the surgeon OP1 and operates the robot device 2 and medical device 6 in response to those operations. The operating device 5 is also equipped with a display device that displays captured images based on display video signals output from the processing device 4. In other words, the surgeon OP1 operates the robot device 2 and medical device 6 by operating the input control device while confirming the captured images displayed on the display device.
[0019] The medical device 6 performs treatment on the area of the patient PA that is to be treated (hereinafter referred to as the treatment target) in response to the operation of the control device 5 by the operator OP 1. The configuration of the medical device 6 will be described below.
[0020] [Regarding the configuration of the medical device] Figure 3 is a perspective view of the medical device 6 as seen from the distal end. In the following, one side (distal end) along the central axis Ax1 of the sheath 20 will be referred to as the tip side Ar1, and the other side (proximal end) as the proximal end side Ar2. Furthermore, the axis parallel to the central axis Ax1 will be defined as the Z-axis (the distal end side will be the +Z-axis side), the axis perpendicular to the Z-axis and parallel to the opening and closing direction of the second end effector 13 relative to the first end effector 11 will be defined as the X-axis (the side on which the second end effector 13 is positioned relative to the first end effector 11 will be the +X-axis side), and the axis perpendicular to the X and Z axes will be defined as the Y-axis.
[0021] The medical device 6 treats the target object by applying treatment energy to the object. In this embodiment, the treatment energy is high-frequency energy. The treatments that can be performed by the medical device 6 in this embodiment include sealing (coagulation) the target object and cutting the target object. Sealing and cutting may also be performed simultaneously.
[0022] As shown in Figure 3, the medical device 6 comprises an end effector 10, a sheath 20, and a connecting portion 30. Here, the sheath 20 is a cylindrical pipe and corresponds to the tubular member according to the present invention. The end effector 10 is provided at the tip end Ar1 of the sheath 20. The connecting portion 30 for connecting to the robot arm 21 is provided at the base end Ar2 of the sheath 20. The configuration of the end effector 10 will be described below.
[0023] [About the End Effector Configuration] Figures 4 to 7 illustrate the configuration of the end effector 10. Specifically, Figure 4 is a view of the end effector 10 from the +Y axis side. Figure 5 is a cross-sectional view of the end effector 10 cut by the XZ plane containing the central axis Ax1. Figure 6 is a cross-sectional view of the end effector 10 cut by a plane perpendicular to the central axis Ax1. Figure 7 is a perspective view of the first end effector 11 from the +X axis side.
[0024] The end effector 10 is located at the distal end (the end of the tip side Ar1) of the medical device 6 and is the part that performs treatment while gripping the object to be treated. As shown in Figures 4 to 7, the end effector 10 comprises a first end effector 11, a receiving member 12, and a second end effector 13.
[0025] The first end effector 11 is a long member made of a conductive material. The end of the first end effector 11, which is the base end side Ar2, is fixed to the end of the tip side Ar1 of the sheath 20. In other words, the first end effector 11 functions as a fixed jaw.
[0026] On the +X axis side surface of the first end effector 11, a recessed groove 111 is provided in the central portion in the Y axis direction (width direction), as shown in Figures 5 to 7, which is recessed on the -X axis side and extends along the longitudinal direction of the first end effector 11.
[0027] Furthermore, on the +X-axis side surface of the first end effector 11, as shown in Figures 6 and 7, inclined surfaces 112 are provided on both sides of the Y-axis direction (width direction) of the recessed groove 111, extending toward the +X-axis side as one side of the recessed groove 111 moves toward the other side in the width direction. These inclined surfaces 112 correspond to the first electrode according to the present invention. Hereinafter, for the sake of explanation, the inclined surfaces 112 will be referred to as the first electrode 112. Note that in Figure 6, for the sake of explanation, the first electrode 112 is shaded. In this embodiment, the first electrode 112 is composed of an inclined surface, but the shape of the first electrode 112 is not limited to this, and may be composed of a plane extending along the width direction. In other words, the shape of the first electrode 112 is not limited as long as it faces the second end effector 13 in the first end effector 11.
[0028] Furthermore, as shown in Figure 6, a first insulating portion 113 made of an electrically insulating material is provided on the surface of the first end effector 11, excluding the grooved 111 and the pair of first electrodes 112. In this embodiment, the first insulating portion 113 is made of a coating layer of 50 μm or less. While the diameter of the end effector 10 can be reduced by using a coating layer of 50 μm or less as the first insulating portion 113, it is not limited to this coating layer and may be made of an insulating member made of other electrically insulating materials.
[0029] The receiving member 12 is made of an electrically insulating material and is provided in the groove 111 as shown in Figures 6 and 7. That is, the receiving member 12 is provided on the first end effector 11 such that the first electrodes 112 are located on both sides in the width direction. In this embodiment, the receiving member 12 is made of polyvinyl chloride with a hardness of A50, polytetrafluoroethylene with a hardness of D30, or silicon with a hardness of 30 or higher. In other words, the receiving member 12 is a rigid material. The receiving member 12 is provided in the groove 111 by, for example, insert molding or snap fitting. The receiving member 12 may be provided in the groove 111 by other methods.
[0030] The second end effector 13 is a long member made of a conductive material. The proximal end Ar2 of the second end effector 13, which is the longitudinal end, is pivotally supported around a rotation axis RAx1 (Figures 4 and 5) which is parallel to the Y-axis, relative to the tip end Ar1 of the sheath 20. The second end effector 13 rotates around the rotation axis RAx1 when the driving force from a motor (not shown) provided in the robot device 2 is transmitted via the sheath 20 and the connection part 30. In other words, the second end effector 13 opens and closes relative to the first end effector 11 by rotating around the rotation axis RAx1, and functions as a movable jaw that grips the object to be processed between itself and the first end effector 11.
[0031] On the -X-axis side surface of the second end effector 13, the central portion in the Y-axis direction (width direction) protrudes more towards the -X-axis than the other portions and is provided with a convex ridge 131 that extends along the longitudinal direction of the second end effector 13. The tip of this convex ridge 131 is the part that grips the object to be treated between the receiving member 12 when the second end effector 13 closes to the first end effector 11, and corresponds to the second electrode 132 according to the present invention. Note that in Figure 6, the second electrode 132 is shaded for ease of explanation. Furthermore, on the -X-axis side surface of the second end effector 13, both sides of the second electrode 132 in the Y-axis direction (width direction) are recessed toward the +X-axis and are each composed of concave curved surfaces that extend along the Z-axis.
[0032] In this embodiment, the following configuration is adopted to improve the performance of cutting the object to be treated. Specifically, the width dimension (length dimension in the Y-axis direction) of the second electrode 132 is set to 0.3 mm or less. The receiving member 12 has a larger width dimension (length dimension in the Y-axis direction) than the second electrode 132. Furthermore, the pressure applied to the object to be treated, which is gripped between the second electrode 132 and the receiving member 12, is configured to be 1 MPa or more over the entire length of the cutting portion. This is achieved, for example, when the receiving member 12 is made of polyvinyl chloride with a hardness of A50, at a load of 12.5 N or more at the point of application F (Figure 4). Also, for example, when the receiving member 12 is made of polytetrafluoroethylene with a hardness of D30, at a load of 10 N or more at the point of application F. Furthermore, for example, when the receiving member 12 is made of silicon with a hardness of 30 or more, at a load of 15 N or more at the point of application F. The point of application F is, for example, a point where the distance D (Figure 4) from the rotation axis RAx1 is 15 mm.
[0033] Furthermore, as shown in Figure 6, a second insulating portion 133 made of an electrically insulating material is provided on the surface of the second end effector 13, excluding the second electrode 132. In this embodiment, the second insulating portion 133 is made of a coating layer of 50 μm or less.
[0034] As shown in Figure 5, the pair of first electrodes 112, receiving member 12, and second electrode 132 described above extend to the tip of the end effector 10.
[0035] The power supply unit (not shown) provided on the robot device 2 applies high-frequency energy to the object to be treated, which is held between the first and second end effectors 11 and 13, via an electrical cable.
[0036] For example, when operator OP1 performs an operation to detach the object to be treated using the operating device 5, the power supply device (not shown) provided on the robot device 2 applies a voltage of a first voltage value (high-frequency voltage) between the first and second end effectors 11 and 13 via an electrical cable (not shown). That is, a voltage of a first voltage value (high-frequency voltage) is applied between the pair of first electrodes 112 and second electrodes 132, causing a high-frequency current to flow. In other words, high-frequency energy is imparted to the object to be treated. Due to the Joule heat generated by the flow of this high-frequency current, the object to be treated begins to contract. Furthermore, the thermal contraction of the object to be treated creates an air layer between the second electrode 132 and the object to be treated. Then, due to the discharge that occurs between the pair of first electrodes 112 and second electrodes 132, the object to be treated, which was gripped between the second electrode 132 and the receiving member 12 (hereinafter referred to as the detachment region), is detached.
[0037] Furthermore, for example, when operator OP1 performs an operation to seal the object to be treated using the operating device 5, the power supply device (not shown) provided on the robot device 2 applies a voltage (high-frequency voltage) with a second voltage value smaller than the first voltage value between the first and second end effectors 11 and 13 via an electrical cable (not shown). That is, a voltage (high-frequency voltage) with a second voltage value is applied between the pair of first electrodes 112 and second electrodes 132, causing a high-frequency current to flow. In other words, high-frequency energy is applied to the object to be treated. The Joule heat generated by the flow of this high-frequency current seals the object to be treated, which is held between the second electrode 132 and the receiving member 12 (hereinafter referred to as the sealing region).
[0038] The embodiment described above provides the following effects. The medical device 6 according to this embodiment grips the object to be treated between the second electrode 132 and the receiving member 12. In addition, the first end effector 11 has first electrodes 112 on both sides in the width direction of the receiving member 12. The medical device 6 separates the object to be treated by applying a voltage of a first voltage value between the pair of first electrodes 112 and second electrodes 132, and seals the object to be treated by applying a voltage of a second voltage value. Therefore, the medical device 6 according to this embodiment can reliably compress both the sealing region and the separation region (between the second electrode 132 and the receiving member 12), and can stably seal and separate the object to be treated.
[0039] In particular, the receiving member 12 is made of a rigid material such as polyvinyl chloride, polytetrafluoroethylene, or silicon. Therefore, both the sealing region and the separation region (between the second electrode 132 and the receiving member 12) can be more reliably compressed.
[0040] Furthermore, in the medical device 6 according to this embodiment, a first insulating portion 113 is provided on the surface of the first end effector 11, excluding the first electrode 112. Also, a second insulating portion 133 is provided on the surface of the second end effector 13, excluding the second electrode 132. Therefore, it is possible to avoid unnecessary effects on parts of the biological tissue other than the target of treatment.
[0041] In particular, the first and second insulating portions 113 and 133 are composed of a coating layer of 50 μm or less. This makes it possible to reduce the diameter of the end effector 10.
[0042] Furthermore, in the medical device 6 according to this embodiment, the pair of first electrodes 112, the receiving member 12, and the second electrode 132 extend to the tip of the end effector 10. Therefore, the tip of the end effector 10 can be used for treatment, improving convenience.
[0043] (Other Embodiments) Heretofore, modes for carrying out the present invention have been described, however, the present invention should not be limited only to the above-described embodiments. In the above-described embodiments, the first end effector 11 is configured as a fixed jaw and the second end effector 13 is configured as a movable jaw; however, conversely, the first end effector 11 may be configured as a movable jaw and the second end effector 13 may be configured as a fixed jaw. Furthermore, both the first and second end effectors 11, 13 may be configured as movable jaws. The same applies to modifications 1 to 7 shown below.
[0044] In the above-described embodiments, the configurations of modifications 1 to 7 shown below may be adopted.
[0045] (Modification 1) Figure 8 is a diagram illustrating modification 1 of the embodiment. Specifically, Figure 8 is a view of the end effector 10 according to the present modification 1 as viewed along the Y-axis direction. Note that in Figure 8, for convenience of explanation, the jaw 14 is represented by an alternate long and short dash line. In the above-described embodiments, as the second end effector 13, the second end effector 13 according to the present modification 1 shown in Figure 8 may be adopted.
[0046] As shown in Figure 8, the second end effector 13 according to the present modification 1 includes a jaw 14 and a swinging member 15.
[0047] The jaw 14 is an elongated member made of a conductive material. Further, the end portion on the proximal end side Ar2, which is an end portion in the longitudinal direction of the jaw 14, is rotatably supported around a rotation axis RAx1 parallel to the Y-axis (not shown in Figure 8) relative to the end portion on the distal end side Ar1 of the sheath 20, similarly to the second end effector 13 described in the above-described embodiments. The jaw 14 rotates about the rotation axis RAx1 when a driving force from a motor (not shown) provided in the robot device 2 is transmitted via the sheath 20 and the connecting portion 30. That is, the jaw 14 functions as a movable jaw that opens and closes relative to the first end effector 11 by rotating about the rotation axis RAx1.
[0048] On the surface of jaw 14 on the -X axis side, at the central portion in the Y-axis direction (width direction), although not specifically illustrated, a recess extending along the longitudinal direction of the jaw 14 from the proximal end toward the distal end side Ar1 is provided. In addition, a cylindrical pin Pi (FIG. 8) extending in the width direction is fixed by welding to the side wall portions on both sides in the width direction of the jaw 14 that constitutes the recess.
[0049] The swing member 15 is constituted by an elongated member similar to the portion on the distal end side Ar1 of the second end effector 13 described in the above embodiment (a configuration including a protruding strip 131, a second electrode 132, and a second insulating portion 133). When the jaw 14 is closed relative to the first end effector 11, the swing member 15 clamps a treatment target between itself and the first end effector 11. This swing member 15 is pivotally supported relative to the jaw 14 so as to be swingable about a rotation axis RAx2 (FIG. 8), which is the central axis (axis along the width direction) of the pin Pi, with the pin Pi penetrating the inside of the recess provided in the jaw 14 in the width direction. That is, by allowing the swing member 15 to swing about the rotation axis RAx2, when the treatment target is clamped between the swing member 15 and the first end effector 11, the position where the strongest force is applied to the treatment target is positioned at approximately the center in the longitudinal direction of the swing member 15 instead of the proximal end side Ar2 of the swing member 15. As a result, force is applied substantially uniformly to the treatment target clamped between the swing member 15 and the first end effector 11.
[0050] According to Modification 1 described above, in addition to the same effects as those of the embodiment described above, the following effects are achieved. In the end effector 10 according to Modification 1, force is applied substantially uniformly to the treatment target clamped between the swing member 15 and the first end effector 11. Therefore, sealing and cutting treatments can be uniformly performed on the treatment target.
[0051] (Modification 2) Figures 9 and 10 illustrate Modification 2 of the embodiment. Specifically, Figure 9 is a perspective view showing the second end effector 13 according to Modification 2. Figure 10 is a cross-sectional view obtained by cutting the second end effector 13 with respect to the XZ plane including the central axis Ax1. In the embodiment described above, the second end effector 13 according to Modification 2 shown in Figures 9 and 10 may be used as the second end effector 13.
[0052] The second end effector 13 according to this modified example 2 comprises a jaw 16, an elastic member 17, and a contact member 18 (Figure 10), as shown in Figures 9 and 10.
[0053] The jaw 16 is a long member made of a conductive material. The base end Ar2, which is the longitudinal end of the jaw 16, is pivotally supported around a rotation axis RAx1 (not shown in Figures 9 and 10) which is parallel to the Y-axis, similar to the second end effector 13 described in the above embodiment. The jaw 16 rotates around the rotation axis RAx1 when the driving force from a motor (not shown) provided in the robot device 2 is transmitted via the sheath 20 and the connection part 30. In other words, the jaw 16 functions as a movable jaw that opens and closes relative to the first end effector 11 by rotating around the rotation axis RAx1.
[0054] In the jaw 16, as shown in Figures 9 and 10, a through hole 161 is provided in the central portion in the Y-axis direction (width direction), which penetrates both the front and back sides in the X-axis direction and extends along the longitudinal direction of the jaw 16 from the base end side Ar2 to the tip end side Ar1.
[0055] The elastic member 17 is supported by the jaw 16 with a portion of it located in the through hole 161. As shown in Figures 9 and 10, the elastic member 17 comprises a fixing portion 171 and an elastic member body 172.
[0056] As shown in Figures 9 and 10, the fixing portion 171 has a substantially ring shape and is the part that is fixed to the end face on the +X axis side of the jaw 16.
[0057] As shown in Figures 9 and 10, the elastic member body 172 protrudes into the through hole 161 from the +Z-axis end of the fixed portion 171, bends approximately 90° to extend toward the -Z-axis, and then bends approximately 90° further to extend toward the +X-axis and connects to the -Z-axis end of the fixed portion 171. The elastic member body 172 functions as a leaf spring with elasticity in the X-axis direction. The elastic member body 172 is configured to have different elastic moduli by changing the material along its longitudinal direction. More specifically, the elastic member body 172 is set so that the elastic moduli increase as it moves toward the +Z-axis.
[0058] The contact member 18 is provided on the portion of the elastic member body 172 that extends along the Z-axis, and is composed of a long member (including a protruding portion 131, a second electrode 132, and a second insulating portion 133) similar to the tip-side Ar1 portion of the second end effector 13 described in the above embodiment. The contact member 18 grips the object to be treated between the first end effector 11 and the jaw 16 when the jaw 16 is closed against the first end effector 11. Here, the elastic modulus of the elastic member body 172 is set to increase as it moves toward the +Z axis. For this reason, when the object to be treated is gripped between the contact member 18 and the first end effector 11, the position where the strongest force is applied to the object to be treated is located not at the base-side Ar2 of the contact member 18, but approximately in the center of the longitudinal direction of the contact member 18. As a result, force is applied almost evenly to the object being treated, which is gripped between the contact member 18 and the first end effector 11.
[0059] According to the modified example 2 described above, in addition to the same effects as the embodiment described above, the following effects are achieved. In the end effector 10 according to this modified example 2, force is applied substantially evenly to the object to be treated that is gripped between the contact member 18 and the first end effector 11. Therefore, sealing and cutting can be performed uniformly on the object to be treated.
[0060] (Modification 3) Figure 11 is a diagram illustrating modification 3 of the embodiment. Specifically, Figure 11 corresponds to Figure 6 and is a cross-sectional view obtained by cutting the end effector 10 according to modification 3 with respect to a plane perpendicular to the central axis Ax1. In the embodiment described above, the first end effector 11 according to modification 3 shown in Figure 11 may be used as the first end effector 11.
[0061] The first end effector 11 in this modified example 3 is a long member made of a conductive material. The end of the base end Ar2, which is the longitudinal end of the first end effector 11, is fixed to the end of the tip end Ar1 of the sheath 20. In other words, the first end effector 11 functions as a fixed jaw.
[0062] On the +X-axis side surface of the first end effector 11, a recessed groove 114 with a semicircular cross-section is provided in the central portion in the Y-axis direction (width direction), recessed toward the -X-axis side and extending along the longitudinal direction of the first end effector 11, as shown in Figure 11. The central portion in the width direction of the recessed groove 114 faces the second electrode 132 and becomes the first electrode 112. In Figure 11, the first electrode 112 is shaded for ease of explanation. A first insulating portion 113 made of an electrically insulating material is provided on the surface of the first end effector 11, excluding the first electrode 112. In this modified example 3, the first insulating portion 113 is made of a coating layer of 50 μm or less. In this modified example 3, unlike the embodiment described above, the first end effector 11 is not provided with a receiving member 12.
[0063] The modified version 3 described above provides the following effects. In the end effector 10 according to this modified version 3, the first and second electrodes 112 and 132 are provided only in the central part in the width direction. Therefore, it is possible to avoid unnecessary effects on parts of the biological tissue other than the target of treatment.
[0064] (Modification 4) Figure 12 is a diagram illustrating modification 4 of the embodiment. Specifically, Figure 12 corresponds to Figure 6 and is a cross-sectional view obtained by cutting the end effector 10 according to modification 4 with respect to a plane perpendicular to the central axis Ax1. In the embodiment described above, the first end effector 11 according to modification 4 shown in Figure 12 may be used as the first end effector 11.
[0065] The first end effector 11 according to this modified example 4 is a long member made of a conductive material. The end of the base end Ar2, which is the longitudinal end of the first end effector 11, is fixed to the end of the tip end Ar1 of the sheath 20. In other words, the first end effector 11 functions as a fixed jaw.
[0066] On the +X-axis side of the first end effector 11, the central portion in the Y-axis direction (width direction) protrudes more towards the +X-axis than the other portions, as shown in Figure 12, and is provided with a protruding ridge 115 that extends along the longitudinal direction of the first end effector 11. The tip of this protruding ridge 115 faces the second electrode 132 and becomes the first electrode 112. In Figure 12, the first electrode 112 is shaded for ease of explanation. Furthermore, on the +X-axis side of the first end effector 11, both sides of the first electrode 112 in the Y-axis direction (width direction) are recessed toward the -X-axis and are each composed of concave curved surfaces that extend along the Z-axis. In other words, the first and second end effectors 11 and 13 have shapes that are symmetrical with respect to the YZ plane. Furthermore, a first insulating portion 113 made of an electrically insulating material is provided on the surface of the first end effector 11, excluding the first electrode 112. In this modified example 4, the first insulating portion 113 is made of a coating layer of 50 μm or less. In this modified example 4, unlike the embodiment described above, the receiving member 12 is not provided on the first end effector 11.
[0067] The modified version 4 described above provides the following effects. In the end effector 10 according to this modified version 4, the first and second electrodes 112 and 132 are provided only in the central part in the width direction. Therefore, it is possible to avoid unnecessary effects on parts of the biological tissue other than the target of treatment.
[0068] (Modification 5) Figure 13 is a diagram illustrating modification 5 of the embodiment. Specifically, Figure 13 is a cross-sectional view obtained by cutting the end effector 10 according to this modification 5 with respect to the XZ plane including the central axis Ax1. In the above-described modifications 3 and 4, the second electrode 132 may be provided in multiple quantities along the longitudinal direction of the second end effector 13 at regular intervals, as shown in this modification 5 in Figure 13. In this case, an insulating portion 134 made of an electrically insulating material is provided between the multiple second electrodes 132.
[0069] The modified version 5 described above provides the same effects as modified versions 3 and 4 described above, as well as the following effects. In the end effector 10 according to modified version 5, multiple second electrodes 132 are provided along the longitudinal direction of the second end effector 13 at regular intervals. That is, by reducing the area of the second electrodes 132, the power of the discharge between the first and second electrodes 112 and 132 can be increased, and the target to be treated can be effectively separated even at low voltages.
[0070] (Modification 6) Figure 14 is a diagram illustrating modification 6 of the embodiment. Specifically, Figure 14 is a cross-sectional view of the end effector 10 according to this modification 6, cut by the XZ plane including the central axis Ax1. In the above-described modification 5, the first electrode 112 may be a plurality of electrodes, as shown in this modification 6 in Figure 14, arranged at regular intervals along the longitudinal direction of the first end effector 11. In this case, an insulating portion 116 made of an electrically insulating material is provided between the plurality of first electrodes 112. More specifically, each first electrode 112 is provided at a position facing each insulating portion 134. Also, each insulating portion 116 is provided at a position facing each second electrode 132.
[0071] As described above, Modification 6 provides the same effects as Modification 5 described above, as well as the following effects. In the end effector 10 according to Modification 6, the first and second electrodes 112 and 132 do not face each other. Therefore, discharge occurs at the edges of the first and second electrodes 112 and 132, increasing the power of the discharge at the edges, and allowing for effective separation of the target even at low voltages.
[0072] (Modification 7) Figure 15 illustrates modification 7 of the embodiment. Specifically, Figure 15 is a view of the medical device 6 according to this modification 7 from a direction along the Y axis. In this modification 7, the medical device 6 can be used as a handpiece by having an operating section 40, as shown in Figure 15.
[0073] As shown in Figure 15, the operating section 40 is provided at the end of the base end Ar2 of the connection section 30. This operating section 40 comprises operating handles 41 and 42 and three switches SW1 to SW3.
[0074] The operating handles 41 and 42 are the parts that the operator grasps. The first and second end effectors 11 and 13 are opened and closed by moving the operating handles 41 and 42 closer together or further apart.
[0075] Three switches SW1 to SW3 are provided on the side of the operating unit 40. When any of the three switches SW1 to SW3 is operated, a procedure is performed that seals only the target object, a procedure that cuts off only the target object, or a procedure that seals and cuts off the target object.
[0076] Even if the configuration of the modified example 7 described above is adopted, the same effects as the embodiment described above will be achieved. Furthermore, if the medical device 6 is configured to be used as a handpiece by attaching the operating unit 40 to the connection unit 30, the following effects will be achieved. That is, if the robotic device 2 malfunctions during surgery, the surgeon can remove the medical device 6 from the robotic device 2, attach the operating unit 40, and use the medical device 6 as a handpiece to continue the surgery.
[0077] 1 Medical system 2 Robot device 3 Imaging device 4 Processing device 5 Operating device 6 Medical device 10 End effector 11 First end effector 12 Receiving member 13 Second end effector 14 Jaw 15 Swiveling member 16 Jaw 17 Elastic member 18 Contact member 20 Sheath 21 Robot arm 30 Connection part 40 Operating part 41, 42 Operating handle 111 Recessed groove 112 First electrode 113 First insulating part 114 Recessed groove 115 Protruding part 116 Insulating part 131 Protruding part 132 Second electrode 133 Second insulating part 134 Insulating part 161 Through hole 171 Fixing part 172 Elastic member body Ar1 Tip side Ar2 Base side Ax1 Central axis OP1 Operator OP2 Assistant OP3 Anesthesiologist OP4 Nurse Pi Pin RAx1, RAx2 Rotation axis SW1-SW3 Switch
Claims
1. A medical device comprising: a first end effector having a pair of first electrodes; a second end effector having a second electrode and opening and closing relative to the first end effector; and a receiving member made of an electrically insulating material, provided on the first end effector such that the first electrodes are located on both sides in the width direction, and gripping biological tissue between the first end effector and the second electrode when the first end effector and the second end effector are closed; wherein the biological tissue is separated by applying a voltage of a first voltage value between the pair of first electrodes and the second electrode, and the biological tissue is sealed by applying a voltage of a second voltage value between the pair of first electrodes and the second electrode.
2. The medical device according to claim 1, wherein the receiving member is made of polyvinyl chloride, polytetrafluoroethylene, or silicon.
3. The medical device according to claim 1, wherein the receiving member has a width dimension larger than that of the second electrode.
4. The medical device according to claim 1, wherein the first voltage value is greater than the second voltage value.
5. The medical device according to claim 1, wherein a first insulating portion made of an electrically insulating material is provided on the surface of the first end effector, excluding the first electrode.
6. The medical device according to claim 5, wherein the first insulating portion is a coating layer of 50 μm or less.
7. The medical device according to claim 1, wherein a second insulating portion made of an electrically insulating material is provided on the surface of the second end effector, excluding the second electrode.
8. The medical device according to claim 7, wherein the second insulating portion is a coating layer of 50 μm or less.
9. The medical device according to claim 1, wherein the pair of first electrodes, the second electrode, and the receiving member extend to the tip of the medical device.
10. The medical device according to claim 1, wherein the receiving member is provided to the first end effector by insert molding or snap fitting.
11. The medical device according to claim 1, wherein one of the first end effector and the second end effector has a jaw that opens and closes relative to the other end effector of the first end effector and the second end effector, and a swinging member that is pivotably supported by the jaw so as to pivot about a pivot axis extending in the width direction, and is provided with the pair of electrodes and one of the receiving member and the second electrode.
12. The medical device according to claim 1, wherein one of the first end effector and the second end effector comprises a jaw that opens and closes relative to the other end effector of the first end effector and the second end effector; an elastic member supported by the jaw; and a contact member provided on the elastic member and having one of the pair of electrodes and the receiving member and the second electrode, and contacting the other end effector when the first end effector and the other end effector are closed, wherein the elastic modulus of the elastic member differs along the longitudinal direction.
13. A medical device comprising: an end effector for treating a target; a tubular member disposed on the base end side of the end effector; and an operating handle provided on the base end side of the tubular member for operating the end effector, wherein the end effector comprises: a first end effector having a pair of first electrodes; a second end effector having a second electrode and opening and closing relative to the first end effector in response to operation of the operating handle; and a receiving member made of an electrically insulating material, provided on the first end effector such that the first electrodes are positioned on both sides in the width direction, and gripping biological tissue between the first end effector and the second electrode when the first end effector and the second end effector are closed, wherein the biological tissue is cut by applying a voltage of a first voltage value between the pair of first electrodes and the second electrode, and the biological tissue is sealed by applying a voltage of a second voltage value between the pair of first electrodes and the second electrode.
14. A medical system comprising a remotely operated robotic device and a medical device attached to the robotic device, wherein the medical device comprises a first end effector having a pair of first electrodes, a second end effector having a second electrode and opening and closing relative to the first end effector, and a receiving member made of an electrically insulating material and provided on the first end effector such that the first electrodes are located on both sides in the width direction, and gripping biological tissue between the first end effector and the second electrode when the first end effector and the second end effector are closed, wherein the biological tissue is cut by applying a voltage of a first voltage value between the pair of first electrodes and the second electrode, and the biological tissue is sealed by applying a voltage of a second voltage value between the pair of first electrodes and the second electrode.