JPH1147150A - Endoscopic surgery appliance - Google Patents
Endoscopic surgery applianceInfo
- Publication number
- JPH1147150A JPH1147150A JP9211986A JP21198697A JPH1147150A JP H1147150 A JPH1147150 A JP H1147150A JP 9211986 A JP9211986 A JP 9211986A JP 21198697 A JP21198697 A JP 21198697A JP H1147150 A JPH1147150 A JP H1147150A
- Authority
- JP
- Japan
- Prior art keywords
- knife
- incision
- living tissue
- gripping
- tissue
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Abstract
Description
【０００１】[0001]
【発明の属する技術分野】この発明は生体組織を把持す
る把持部材及び把持した生体組織を切開する切開部を備
えた内視鏡下手術器械に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic surgical instrument having a grasping member for grasping a living tissue and an incision for cutting the grasped living tissue.
【０００２】[0002]
【従来の技術】一般に、生体組織を把持する一対の把持
部材を備え、各把持部材に高周波通電用の電極が配設さ
れたバイポーラ鉗子が知られている。そして、このバイ
ポーラ鉗子の使用時には一対の把持部材間に処置対象の
生体組織を把持させた状態で、各把持部材の電極間に高
周波電流を通電して把持部材間の生体組織を凝固させる
ようになっている。2. Description of the Related Art In general, there has been known a bipolar forceps having a pair of gripping members for gripping a living tissue, each of which is provided with an electrode for energizing a high frequency. When using the bipolar forceps, a high-frequency current is applied between the electrodes of each gripping member to coagulate the living tissue between the gripping members while the living tissue to be treated is gripped between the pair of gripping members. Has become.
【０００３】この種のバイポーラ鉗子は、通常、生体組
織に含まれる血管の止血、生体組織の表層の病変部、出
血点の焼灼、避妊を目的とした卵管の閉塞等の多種の症
例に用いられる。そして、バイポーラ鉗子が血管の止血
や、卵管の閉塞を目的として用いられ、患者の処置対象
の生体組織を凝固できるようになっており、また凝固し
た生体組織を切開することができるようになっている。[0003] Bipolar forceps of this kind are usually used in various cases such as hemostasis of blood vessels contained in living tissue, lesions on the surface layer of living tissue, cauterization of bleeding points, occlusion of fallopian tubes for contraception, and the like. Can be Bipolar forceps are used for hemostasis of blood vessels and occlusion of fallopian tubes, so that a living tissue to be treated by a patient can be coagulated, and the coagulated living tissue can be incised. ing.
【０００４】従来、この種の内視鏡下手術器械として、
例えば米国特許第４６５５２１６号明細書、米国特許第
５４４５６３８号明細書、米国特許第５４３１６７４号
明細書、米国特許第５４８４４３６号明細書、米国特許
第５５５８６７１号明細書、米国特許第５２６７９９８
号明細書等で知られている。Conventionally, as this kind of endoscopic surgical instrument,
For example, US Pat. No. 4,655,216, US Pat. No. 5,445,638, US Pat. No. 5,431,674, US Pat. No. 5,484,436, US Pat. No. 5,558,671, US Pat. No. 5,267,998.
It is known in the specification of Japanese Patent Application Publication No.
【０００５】米国特許第４６５５２１６号明細書は、開
閉自在な一対の把持部材の間に枢支ピンを支点として回
動自在な略Ｌ字状の切開刃が設けられ、生体組織を把持
して状態で一対の把持部材間に凝固電流を流して生体組
織を凝固させた後、切開刃を回動して生体組織を切開す
るようになっている。In US Pat. No. 4,655,216, a substantially L-shaped incision blade rotatable about a pivot pin as a fulcrum is provided between a pair of openable and closable gripping members to grip living tissue. After the coagulation current flows between the pair of gripping members to coagulate the living tissue, the cutting blade is rotated to cut the living tissue.
【０００６】米国特許第５４４５６３８号明細書及び米
国特許第５５５８６７１号明細書は、シースの先端部か
ら突出する一対の把持部材と、この把持部材間に進退自
在な切開ナイフとを備え、手元操作部の操作によって一
対の把持部材を閉じて処置対象の生体組織を把持した状
態で、一対の把持部材間に凝固電流を流して生体組織を
凝固させた後、切開ナイフを前進させて生体組織を切開
するようになっている。US Pat. No. 5,445,638 and US Pat. No. 5,558,671 are provided with a pair of gripping members projecting from a distal end portion of a sheath, a cutting knife which can be advanced and retracted between the gripping members, and a hand operating unit. With the pair of gripping members closed and the living tissue to be treated gripped by the operation, a coagulation current is passed between the pair of gripping members to coagulate the living tissue, and then the cutting knife is advanced to cut the living tissue. It is supposed to.
【０００７】米国特許第５４３１６７４号明細書は、シ
ースの先端部に固定されたアンビルと進退及び回動自在
な切開刃とを備え、切開刃を閉じながら引き込み、生体
組織を切開するようになっている。US Pat. No. 5,431,674 has an anvil fixed to the distal end of a sheath and an incising blade that can be advanced and retracted and is rotatable. The incising blade is closed and pulled in to incise living tissue. I have.
【０００８】米国特許第５４８４４３６号明細書は、シ
ースの先端部に一対の切開刃を回動自在に設け、一対の
切開刃に凝固電流を流して生体組織を凝固させた後、切
開刃によって生体組織を切開するようになっている。In US Pat. No. 5,484,436, a pair of cutting blades are rotatably provided at the distal end of a sheath, and a coagulation current is applied to the pair of cutting blades to coagulate living tissue. The tissue is to be dissected.
【０００９】米国特許第５２６７９９８号明細書は、一
対の凝固電極と移動可能な切開電極を有し、一対の凝固
電極間に凝固電流を流して生体組織を凝固させた後、手
元操作部の操作によって切開電極を移動させるととも
に、切開電流を流して生体組織を切開するようになって
いる。US Pat. No. 5,267,998 has a pair of coagulation electrodes and a movable incision electrode. After a coagulation current is passed between the pair of coagulation electrodes to coagulate the living tissue, the operation of the hand operation unit is performed. As a result, the incision electrode is moved, and an incision current is applied to incise the living tissue.
【００１０】[0010]
【発明が解決しようとする課題】しかしながら、前述し
た米国特許第４６５５２１６号明細書は、一対の把持部
材の間に切開刃が突出しているため、正常な生体組織に
傷を付ける虞があり、細心の注意を払う必要があること
から操作性が悪いという欠点がある。However, in the above-mentioned U.S. Pat. No. 4,655,216, since the incision blade projects between the pair of gripping members, there is a fear that normal living tissue may be damaged, and However, there is a disadvantage that operability is poor because it is necessary to pay attention to the above.
【００１１】米国特許第５４４５６３８号明細書及び米
国特許第５５５８６７１号明細書は、一対の把持部材間
に進退自在な切開ナイフを備えたものであり、切開ナイ
フの切れ味が劣化すると、切開ナイフを前進させて切開
する際に把持した生体組織を押し出してしまうという不
都合があり、切開ナイフを頻繁に交換する必要がある。
また、把持部材の間に切開ナイフを進退自在に配置する
複雑な構造で、洗浄性も悪いという欠点がある。US Pat. No. 5,456,638 and US Pat. No. 5,558,671 are provided with a cutting knife which can be advanced and retracted between a pair of gripping members, and when the sharpness of the cutting knife deteriorates, the cutting knife is advanced. There is a disadvantage that the grasped living tissue is pushed out when making the incision, and the incision knife needs to be replaced frequently.
Further, it has a complicated structure in which the incision knife is disposed between the gripping members so as to be able to advance and retreat, and there is a disadvantage that cleaning performance is poor.
【００１２】米国特許第５４３１６７４号明細書、米国
特許第５４８４４３６号明細書及び米国特許第５２６７
９９８号明細書は、生体組織を把持する機能がないた
め、処置対象部位を確実に切開することができない。No. 5,431,674, US Pat. No. 5,484,436 and US Pat. No. 5,267.
The '998 specification does not have a function of grasping a living tissue, and thus cannot reliably incise a treatment target site.
【００１３】この発明は、前記事情に着目してなされた
もので、その目的とするところは、体腔内に挿入したと
き正常な生体組織に傷を付ける虞がなく、また切開性能
を維持できる内視鏡下手術器械を提供することにある。The present invention has been made in view of the above circumstances, and has as its object to eliminate the possibility of damaging normal living tissue when inserted into a body cavity and to maintain incision performance. An object of the present invention is to provide an endoscopic surgical instrument.
【００１４】[0014]
【課題を解決するための手段】この発明は、前記目的を
達成するために、組織を把持する一対の把持部材と、前
記把持部材の把持面に設けられた双極電極と、組織を切
開する切開手段とを備えた内視鏡下手術器械において、
前記切開手段は、把持する組織に接触しないよう前記把
持部材の内部に収容される第１の位置に配置され、切開
時に切開手段の少なくとも一部が第１の位置から一対の
把持部材で形成される把持面を通過するように移動自在
であることを特徴とする。To achieve the above object, the present invention provides a pair of gripping members for gripping tissue, a bipolar electrode provided on a gripping surface of the gripping member, and an incision for cutting tissue. Endoscope-operated surgical instrument comprising:
The incision means is disposed at a first position housed inside the grasping member so as not to contact a tissue to be grasped, and at least part of the incision means is formed by a pair of grasping members from the first position at the time of incision. Characterized by being movable so as to pass through a gripping surface.
【００１５】そして、生体組織の凝固止血等の処置時に
把持部材によって生体組織を把持した状態で把持部材間
に凝固電流を流して生体組織を凝固させ、次に、切開手
段を一対の把持部材で形成される把持面に移動して生体
組織を切開することができるようにしたものである。[0015] When a living tissue is grasped by a grasping member during treatment such as coagulation and hemostasis of a living tissue, a coagulation current is passed between the grasping members to coagulate the living tissue, and then the incision means is operated by a pair of grasping members. The living tissue can be dissected by moving to a gripping surface to be formed.
【００１６】[0016]
【発明の実施の形態】以下、この発明の各実施の形態を
図面に基づいて説明する。Embodiments of the present invention will be described below with reference to the drawings.
【００１７】図１〜図６は第１の実施形態を示し、図１
は内視鏡下手術器械としてのバイポーラ鉗子１を示す。
バイポーラ鉗子１には患者の体腔内に挿入される細長い
挿入部２と、この挿入部２の先端部に配置され、体腔内
で生体組織を把持、凝固するための通電可能な処置部３
と、挿入部２の基端部に連結された操作部４とが設けら
れている。1 to 6 show a first embodiment, and FIG.
Shows a bipolar forceps 1 as an endoscopic surgical instrument.
The bipolar forceps 1 has an elongated insertion section 2 inserted into a body cavity of a patient, and a treatment section 3 disposed at the distal end of the insertion section 2 and capable of energizing and coagulating a living tissue in the body cavity.
And an operation unit 4 connected to the base end of the insertion unit 2.
【００１８】挿入部２は、図４〜図６に示すように、シ
ース５と、このシース５の内部に軸方向に進退自在に挿
入されたロッド６とからなり、シース５の先端部には絶
縁材料からなる係合部材７が固定され、シース５の基端
部は操作部４を構成するグリップ８に固定されている。
ロッド６の基端部は、図１に示すように、操作部４に設
けられたロッド駆動部材９に固定されている。As shown in FIGS. 4 to 6, the insertion portion 2 includes a sheath 5 and a rod 6 inserted into the sheath 5 so as to be able to advance and retreat in the axial direction. An engaging member 7 made of an insulating material is fixed, and a base end of the sheath 5 is fixed to a grip 8 constituting the operation unit 4.
As shown in FIG. 1, the base end of the rod 6 is fixed to a rod driving member 9 provided on the operation unit 4.
【００１９】処置部３は、電極を構成する一対の把持部
材１１ａ，１１ｂと、これらの把持部材１１ａ，１１ｂ
を支持し、拡開させる方向に付勢する上下２本ずつの弾
性部材１２ａ，１２ｂとからなり、これら弾性部材１２
ａ，１２ｂの基端部がロッド６の先端部に固定されてい
る。弾性部材１２ａ，１２ｂはばね鋼等によって形成さ
れ、先端部には略くの字状に屈曲された屈曲部１３ａ，
１３ｂが形成され、表面は絶縁被膜によって被覆されて
いる。The treatment section 3 includes a pair of gripping members 11a and 11b constituting electrodes, and these gripping members 11a and 11b.
And two upper and lower elastic members 12a and 12b each of which supports and biases in the direction of expanding.
The base ends of a and 12 b are fixed to the front end of the rod 6. The elastic members 12a, 12b are formed of spring steel or the like, and have bent portions 13a, 13a,
13b is formed, and the surface is covered with an insulating film.
【００２０】図５及び図６に示すように、把持部材１１
ａ，１１ｂは閉じたときに内部に空間部１４が形成され
るように断面が略コ字状の凹溝１４ａ，１４ｂが形成さ
れ、互いに対向する端縁は閉じたときに互いに噛合する
鋸歯状部が形成され、生体組織Ａを確実に把持できるよ
うに形成されている。As shown in FIG. 5 and FIG.
A and 11b are formed with concave grooves 14a and 14b each having a substantially U-shaped cross section so that a space 14 is formed inside when closed, and the opposing edges are saw-toothed meshing with each other when closed. The part is formed so that the living tissue A can be securely grasped.
【００２１】さらに、図４〜図６に示すように、ロッド
６にはばね鋼等によって形成されたナイフロッド１５が
挿通されており、このナイフロッド１５の先端部には切
開手段としての切開ナイフ１６が設けられている。さら
に、ナイフロッド１５はロッド６の先端部においては下
側の弾性部材１２ｂ，１２ｂの間に位置し、ロッド６の
軸心より下側に位置しているが、ロッド６の先端部から
延出した部分は上側の把持部材１１ａに向かって斜めに
曲り癖が付けられ、先端の切開ナイフ１６は上側の把持
部材１１ａの凹溝１４ａの内部に収容されている。すな
わち、通常時においては、ナイフロッド１５の弾性によ
って切開ナイフ１６が生体組織Ａと接触しないように退
避している。また、切開ナイフ１６は矩形板状体で、そ
の下側に前後方向に延びる切刃１６ａを有する片刃ナイ
フであり、先端側に向かって上り勾配の斜面が形成され
ている。Further, as shown in FIGS. 4 to 6, a knife rod 15 made of spring steel or the like is inserted through the rod 6, and a cutting knife as a cutting means is inserted into the tip of the knife rod 15. 16 are provided. Further, the knife rod 15 is located between the lower elastic members 12b and 12b at the distal end of the rod 6 and is located below the axis of the rod 6, but extends from the distal end of the rod 6. The cut portion is inclined and bent toward the upper gripping member 11a, and the cutting knife 16 at the tip is housed in the concave groove 14a of the upper gripping member 11a. That is, at normal times, the cutting knife 16 is retracted so as not to contact the living tissue A by the elasticity of the knife rod 15. The incision knife 16 is a rectangular plate-shaped body, and is a single-edged knife having a cutting blade 16a extending in the front-rear direction below the plate-like body, and has a slope that is inclined upward toward the distal end.
【００２２】さらに、ロッド６の軸心より上側には軸方
向に亘って貫通孔６ａが設けられ、この貫通孔６ａには
ナイフ操作ロッド１７が進退自在に挿通されている。こ
のナイフ操作ロッド１７の先端部にはナイフロッド１５
と係合する係合溝１８ａを有した操作ヘッド１８が設け
られている。そして、ナイフ操作ロッド１７の前進によ
って操作ヘッド１８によりナイフロッド１５の弾性力に
抗して押し下げ、切開ナイフ１６を把持部材１１ａの内
部から下側に移動させ、把持部材１１ａ，１１ｂの把持
面を通過させることができるようになっている。Further, a through hole 6a is provided in the axial direction above the axis of the rod 6, and a knife operating rod 17 is inserted through the through hole 6a so as to be able to move forward and backward. A knife rod 15 is provided at the tip of the knife operation rod 17.
An operation head 18 having an engagement groove 18a that engages with the operation head 18 is provided. When the knife operation rod 17 advances, the operating head 18 pushes down the knife rod 15 against the elastic force of the knife rod 15 to move the incision knife 16 downward from the inside of the gripping member 11a, and the gripping surfaces of the gripping members 11a and 11b are moved downward. It can be passed through.
【００２３】このように構成された処置部３の把持部材
１１ａ，１１ｂのロッド６、切開ナイフ１６のナイフロ
ッド１５及びナイフ操作ロッド１７は前記挿入部３を構
成するシース５に内挿され、シース５の基端部から突出
して操作部４まで延長している。The thus configured rods 6 of the holding members 11a and 11b of the treatment section 3, the knife rod 15 of the cutting knife 16 and the knife operating rod 17 are inserted into the sheath 5 constituting the insertion section 3, and 5 protrudes from the base end and extends to the operation unit 4.
【００２４】また、図１〜図３に示すように、操作部４
のグリップ８には先端部側に延出された先端側延出部８
ａが設けられている。この先端側延出部８ａにはシース
５の基端部に連結固定される連結リング８ｂが設けられ
ている。さらに、先端側延出部８ａの後方には処置部３
の後端部と電気、機械的に接続するための処置部ユニッ
ト接続部１９が配設されている。ここで、処置部ユニッ
ト接続部１９には処置部３のロッド６の後端部を収納す
る内腔と、この内腔に収納したロッド６の後端部に接続
される接続手段とが設けられている。Further, as shown in FIGS.
The grip 8 has a distal extension 8 extending toward the distal end.
a is provided. The distal extension 8a is provided with a connection ring 8b which is connected and fixed to the base end of the sheath 5. Further, the treatment section 3 is provided behind the distal-side extension section 8a.
A treatment unit connection 19 is provided for electrical and mechanical connection with the rear end of the treatment unit. Here, the treatment section unit connection section 19 is provided with a lumen for accommodating the rear end of the rod 6 of the treatment section 3 and connection means connected to the rear end of the rod 6 accommodated in this lumen. ing.
【００２５】また、処置部ユニット接続部１９には処置
部３の把持部材１１ａ，１１ｂと電気的に接続されるガ
イドロッド２０を介して電極ピン２１が設けられ、この
電極ピン２１は高周波ケーブル２１ａを介して高周波焼
灼電源装置（図示しない）に接続されるようになってい
る。The treatment section unit connection section 19 is provided with an electrode pin 21 via a guide rod 20 which is electrically connected to the holding members 11a and 11b of the treatment section 3, and the electrode pin 21 is connected to the high-frequency cable 21a. Via a high-frequency ablation power supply device (not shown).
【００２６】また、グリップ８には処置部ユニット接続
部１９の操作用のトリガー２２が設けられている。この
トリガー２２はグリップ８の上端部に回動ピン２３を中
心に回動自在に連結されている。さらに、このトリガー
２２には回動支点の上方に長孔２４が形成されている。
この長孔２４にはロッド駆動部材９の側面に突設された
係合ピン２５が挿入されている。なお、２６は回転ノブ
であり、シース５内でロッド６を円周方向に回転させる
ことにより、把持部材１１ａ，１１ｂの向きを任意に変
更できるようになっている。The grip 8 is provided with a trigger 22 for operating the treatment unit connection 19. The trigger 22 is connected to the upper end of the grip 8 so as to be rotatable around a rotation pin 23. Further, a long hole 24 is formed in the trigger 22 above the pivot point.
An engagement pin 25 projecting from the side surface of the rod driving member 9 is inserted into the elongated hole 24. Reference numeral 26 denotes a rotation knob, and the direction of the gripping members 11a and 11b can be arbitrarily changed by rotating the rod 6 in the sheath 5 in the circumferential direction.
【００２７】また、グリップ８の内部にはトリガー２２
の下端部の手掛け部２２ａをグリップ８から離れる方向
（図１において回動ピン２３を中心に時計回り方向）に
付勢する付勢部材（図示しない）が配設されている。そ
して、トリガー２２は付勢部材のばね力によって常時グ
リップ８から最も離れた定位置（解放位置）で保持され
ている。The trigger 22 is provided inside the grip 8.
There is provided an urging member (not shown) for urging the handle portion 22a at the lower end of the gripper 8 in the direction away from the grip 8 (clockwise around the pivot pin 23 in FIG. 1). The trigger 22 is always held at a fixed position (release position) farthest from the grip 8 by the spring force of the urging member.
【００２８】さらに、グリップ８の後端上部における側
面にはナイフ操作レバー２７が設けられている。このナ
イフ操作レバー２７はグリップ８に対して回動ピン２８
を中心に回動自在に連結されている。さらに、ナイフ操
作レバー２７の回動中心より上方には長孔２９が形成さ
れ、この長孔２９には前記ナイフ操作ロッド１７の後端
側面から突設された係合ピン３０が挿入されている。Further, a knife operation lever 27 is provided on a side surface at an upper portion of a rear end of the grip 8. The knife operating lever 27 is pivotally connected to the grip 8 by a rotating pin 28.
Are connected so as to be rotatable around the center. Further, a long hole 29 is formed above the center of rotation of the knife operation lever 27, and an engagement pin 30 projecting from the rear end side surface of the knife operation rod 17 is inserted into the long hole 29. .
【００２９】ナイフ操作レバー２７には略Ｖ字状に配置
された上下のアーム部３１，３２が設けられている。そ
して、一方のアーム部３１には指掛け部３３が他方のア
ーム３２はストッパピン３４と当接してナイフ操作レバ
ー２７の回動範囲を規制する役目をしている。さらに、
回動ピン２８にはナイフ操作レバー２７を時計回り方向
に付勢する付勢部材（図示しない）が装着されている。The knife operating lever 27 is provided with upper and lower arms 31 and 32 arranged in a substantially V-shape. A finger hook 33 is in contact with one arm 31 and the other arm 32 is in contact with a stopper pin 34 to play a role in restricting the rotation range of the knife operation lever 27. further,
An urging member (not shown) for urging the knife operation lever 27 in a clockwise direction is attached to the rotating pin 28.
【００３０】ここで、トリガー２２の手掛け部２２ａを
付勢部材のばね力に抗してグリップ８側に引き込み操作
することにより、ロッド駆動部材９を介してロッド６が
シース５の軸方向前方へ移動する。ロッド６の前進に伴
って弾性部材１２ａ，１２ｂがシース５から突出し、弾
性部材１２ａ，１２ｂの弾性復元力によって拡開して把
持部材１１ａ，１１ｂが開く。また、トリガー２２が解
放されるとグリップ８内の付勢部材のばね力によって定
位置に戻り、弾性部材１２ａ，１２ｂが弾性復元力に抗
してシース５内に引き込まれ、把持部材１１ａ，１１ｂ
が閉じるようになっている。Here, by pulling the handle 22a of the trigger 22 toward the grip 8 against the spring force of the biasing member, the rod 6 is moved forward in the axial direction of the sheath 5 via the rod driving member 9. Moving. As the rod 6 advances, the elastic members 12a and 12b protrude from the sheath 5, and expand by the elastic restoring force of the elastic members 12a and 12b to open the grip members 11a and 11b. When the trigger 22 is released, the elastic member 12a, 12b returns to the home position by the spring force of the urging member in the grip 8, and the elastic members 12a, 12b are pulled into the sheath 5 against the elastic restoring force.
Is closed.
【００３１】また、ナイフ操作レバー２７の指掛け部３
３に指を掛け、付勢部材の付勢力に抗してナイフ操作レ
バー２７を反時計回り方向に回動すると、長孔２９に挿
入されている係合ピン３０を介してナイフ操作ロッド１
７が前進駆動し、ナイフ操作ロッド１７の先端部の操作
ヘッド１８によりナイフロッド１５の弾性力に抗して押
し下げ、切開ナイフ１６を把持部材１１ａの内部から下
側に移動させ、把持部材１１ａ，１１ｂの把持面を通過
させることができるようになっている。Also, the finger hook 3 of the knife operating lever 27
When the knife operation lever 27 is rotated counterclockwise against the urging force of the urging member, the knife operation rod 1 is inserted through the engagement pin 30 inserted into the elongated hole 29.
7 is driven forward and pushed down by the operation head 18 at the tip of the knife operation rod 17 against the elastic force of the knife rod 15 to move the incision knife 16 downward from the inside of the gripping member 11a. 11b can be passed through.
【００３２】また、ナイフ操作レバー２７が解放される
と付勢部材のばね力によって定位置に戻り、ナイフ操作
ロッド１７は相対的にシース６に引き込まれてナイフロ
ッド１５が解放されて弾性復元力により上方に移動して
切開ナイフ１６が上側の把持部材１１ａの内部に収容さ
れ、アーム部３２はストッパピン３４に当接すると停止
するようになっている。When the knife operating lever 27 is released, the knife operating rod 17 returns to the home position by the spring force of the urging member, and the knife operating rod 17 is relatively retracted into the sheath 6 to release the knife rod 15 and the elastic restoring force. As a result, the incision knife 16 is accommodated inside the upper gripping member 11a, and the arm 32 stops when it comes into contact with the stopper pin 34.
【００３３】次に、第１の実施形態の作用について説明
する。Next, the operation of the first embodiment will be described.
【００３４】バイポーラ鉗子１の電極ピン２１に高周波
ケーブル２１ａを接続し、バイポーラ鉗子１と高周波焼
灼電源装置とを電気的に接続する。初期状態では操作部
４のトリガー２２の手掛け部２２ａは図１（ａ）（ｂ）
に示すようにグリップ８から最も離れた定位置で保持さ
れ、処置部ユニット接続部１９は挿入部３の軸方向の移
動範囲の最後端位置で保持される。この状態では処置部
３の一対の弾性部材１２ａ，１２ｂがシース６内に没入
して把持部材１１ａ，１１ｂが閉じた状態にある。The high frequency cable 21a is connected to the electrode pin 21 of the bipolar forceps 1, and the bipolar forceps 1 and the high frequency ablation power supply device are electrically connected. In the initial state, the handle 22a of the trigger 22 of the operation unit 4 is shown in FIGS.
As shown in the figure, the treatment section unit connection section 19 is held at the fixed position furthest from the grip 8, and the treatment section unit connection section 19 is held at the rearmost position in the axial movement range of the insertion section 3. In this state, the pair of elastic members 12a and 12b of the treatment section 3 are immersed in the sheath 6 and the grip members 11a and 11b are closed.
【００３５】この状態で、バイポーラ鉗子１の挿入部２
を患者の体内に挿入し、この挿入部２の先端の処置部３
を体内の処置対象の生体組織Ａの近傍位置まで誘導す
る。そこで、トリガー２２の手掛け部２２ａを付勢部材
の付勢力に抗してグリップ８側に引き込み操作すること
により、ロッド駆動部材９を介してロッド６がシース５
の軸方向前方へ移動する。ロッド６の前進に伴って弾性
部材１２ａ，１２ｂがシース６から突出し、弾性部材１
２ａ，１２ｂの弾性復元力によって把持部材１１ａ，１
１ｂが開く（図２参照）。In this state, the insertion portion 2 of the bipolar forceps 1
Is inserted into the body of the patient, and the treatment section 3 at the tip of the insertion section 2
Is guided to a position near the living tissue A to be treated in the body. The rod 6 is pulled through the rod driving member 9 by pulling the handle 22a of the trigger 22 toward the grip 8 against the urging force of the urging member.
Move forward in the axial direction of. As the rod 6 advances, the elastic members 12a and 12b protrude from the sheath 6, and the elastic member 1
The gripping members 11a, 1
1b opens (see FIG. 2).
【００３６】続いて、拡開した把持部材１１ａ，１１ｂ
の間に生体組織Ａを挿入した後、トリガー２２を解放す
るとグリップ８内の付勢部材のばね力によって定位置に
戻り、弾性部材１２ａ，１２ｂがシース６内に引き込ま
れ、把持部材１１ａ，１１ｂが図３に示すように、閉
じ、生体組織Ａが図５に示すように、一対の把持部材１
１ａ，１１ｂ間に把持される。Subsequently, the expanded gripping members 11a, 11b
When the trigger 22 is released after the insertion of the living tissue A, the elastic member 12a, 12b is retracted into the sheath 6 by the spring force of the biasing member in the grip 8, and the grip members 11a, 11b Is closed as shown in FIG. 3, and the living tissue A is closed as shown in FIG.
It is gripped between 1a and 11b.
【００３７】このとき、把持部材１１ａ，１１ｂには閉
じたときに互いに噛合する鋸歯状部に形成され、生体組
織Ａを確実に把持できる。この状態で、高周波焼灼電源
装置から高周波ケーブル２１ａを介して電極ピン２１に
高周波電流が流れ、さらに弾性部材１２ａ，１２ｂを介
して把持部材１１ａと１１ｂとの間に凝固電流が流れ、
生体組織Ａの凝固が行われる。At this time, the gripping members 11a and 11b are formed as saw-toothed portions that mesh with each other when closed, so that the living tissue A can be reliably gripped. In this state, a high-frequency current flows from the high-frequency cautery power supply to the electrode pin 21 via the high-frequency cable 21a, and a coagulation current flows between the gripping members 11a and 11b via the elastic members 12a and 12b.
Coagulation of the living tissue A is performed.
【００３８】一定時間凝固電流を流して生体組織Ａを凝
固（図６（ｂ）の生体組織Ａのクロス線部分は、凝固電
流によって凝固された部分を示す。）させた後、ナイフ
操作レバー２７の指掛け部３３に指を掛け、付勢部材の
付勢力に抗してナイフ操作レバー２７を反時計回り方向
に回動すると、長孔２９に挿入されている係合ピン３０
を介してナイフ操作ロッド１７が前進駆動する。ナイフ
操作ロッド１７の前進によって操作ヘッド１８によりナ
イフロッド１５を弾性力に抗して押し下げ、切開ナイフ
１６を把持部材１１ａの内部から下側に移動させる。After a coagulation current is applied for a certain period of time to coagulate the living tissue A (the cross-line portion of the living tissue A in FIG. 6B indicates the portion coagulated by the coagulation current), the knife operating lever 27 is used. When the knife operation lever 27 is rotated counterclockwise against the urging force of the urging member, the engaging pin 30 inserted in the elongated hole 29 is pressed.
, The knife operation rod 17 is driven forward. The knife rod 15 is pushed down against the elastic force by the operation head 18 by the advance of the knife operation rod 17, and the cutting knife 16 is moved downward from the inside of the gripping member 11a.
【００３９】そして、図６（ａ）（ｂ）に示すように、
切開ナイフ１６が把持部材１１ａ，１１ｂの把持面を通
過すると、把持部材１１ａ，１１ｂ間に把持された生体
組織Ａの凝固された部分の内部が切開ナイフ１６の切刃
１６ａによって機械的に切開される。Then, as shown in FIGS. 6A and 6B,
When the cutting knife 16 passes through the holding surfaces of the holding members 11a and 11b, the inside of the coagulated portion of the living tissue A held between the holding members 11a and 11b is mechanically cut by the cutting blade 16a of the cutting knife 16. You.
【００４０】切開が完了した後、ナイフ操作レバー２７
を解放すると、付勢部材のばね力によって定位置に戻
り、ナイフ操作ロッド１７は相対的にシース６に引き込
まれて操作ヘッド１８が後退し、切開ナイフ１６はナイ
フロッド１５の弾性力によって上昇して上側の把持部材
１１ａの内部に収容され、アーム部３２はストッパピン
３４に当接すると停止する。After the incision is completed, the knife operating lever 27
Is released, the knife operating rod 17 is returned to the home position by the spring force of the urging member, the knife operating rod 17 is relatively retracted into the sheath 6 and the operating head 18 is retracted, and the cutting knife 16 is raised by the elastic force of the knife rod 15. The arm portion 32 is stored inside the upper gripping member 11a and stops when the arm portion 32 comes into contact with the stopper pin 34.
【００４１】また、トリガー２２を解放するとグリップ
８内の付勢部材のばね力によって定位置に戻り、弾性部
材１２ａ，１２ｂがシース６から突出して把持部材１１
ａ，１１ｂは弾性部材１２ａ，１２ｂの弾性復元力によ
って開き、把持部材１１ａ，１１ｂは生体組織Ａから解
放される。When the trigger 22 is released, it returns to the home position by the spring force of the biasing member in the grip 8, and the elastic members 12a and 12b protrude from the sheath 6 to hold the grip member 11.
The gripping members 11a and 11b are released from the living tissue A by the elastic restoring force of the elastic members 12a and 12b.
【００４２】本実施形態によれば、通常時には、切開ナ
イフ１６が把持部材１１ａの内部に収容された状態に退
避しているため、処置部３を体腔内に目的部位に誘導す
る際に、切開ナイフ１６によって正常な組織に傷を付け
る虞がなく、操作性を向上できる。また、切開ナイフ１
６の切れ味が低下しても切開時に生体組織Ａを逃がすこ
となく、確実に切開できる。According to the present embodiment, the incision knife 16 is normally retracted in a state of being housed inside the gripping member 11a, so that when the treatment section 3 is guided into the body cavity to the target site, the incision knife 16 is incised. There is no risk of damaging the normal tissue by the knife 16, and the operability can be improved. In addition, incision knife 1
Even if the sharpness of No. 6 is reduced, the incision can be reliably performed without escaping the living tissue A during the incision.
【００４３】図７〜図１１は第２の実施形態を示し、第
１の実施形態と同一構成部分は同一番号を付して説明を
省略する。図７〜図１１に示すように、シース５に進退
自在に内挿されたロッド６の先端部には弾性部材１２
ａ，１２ｂによって一対の把持部材４１ａ，４１ｂが設
けられている。把持部材４１ａ，４１ｂは閉じたときに
内部に空間部４２が形成されるように互いに対向する面
に凹溝４３ａ，４３ｂが形成され、その周縁には閉じた
ときに互いに噛合する鋸歯状部が形成され、生体組織Ａ
を確実に把持できるように形成されている。FIGS. 7 to 11 show a second embodiment, in which the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. As shown in FIG. 7 to FIG. 11, an elastic member 12
A pair of gripping members 41a and 41b are provided by a and 12b. When the gripping members 41a and 41b are closed, concave grooves 43a and 43b are formed on surfaces facing each other so that a space 42 is formed inside, and a sawtooth-shaped portion which meshes with each other when closed is formed on the periphery thereof. Formed and living tissue A
Is formed so as to be surely gripped.
【００４４】上側の把持部材４１ａの凹溝４３ａは手前
側に向かって漸次浅くなるように斜面に形成され、切開
ナイフ４４を案内する案内面４５に形成されている。切
開ナイフ４４は矩形板状体で、下部手前側に斜めに切刃
４４ａを有しており、この切開ナイフ４４は上側の把持
部材４１ａの凹溝４３ａおける最も深い先端側に位置し
ているときには生体組織Ａと接触しないように退避して
いる。The concave groove 43a of the upper gripping member 41a is formed on a slope so as to gradually become shallower toward the near side, and is formed on a guide surface 45 for guiding the cutting knife 44. The incision knife 44 is a rectangular plate-like body, and has a cutting blade 44a obliquely on the lower front side. When the incision knife 44 is located at the deepest tip side in the concave groove 43a of the upper gripping member 41a. It is retracted so as not to come into contact with the living tissue A.
【００４５】一方、ロッド６の軸心より下側に偏倚した
位置には軸方向に亘って貫通孔４６が設けられている。
この貫通孔４６にはばね鋼からなるナイフ操作ロッド４
７が進退自在に挿通されている。ナイフ操作ロッド４７
のロッド６の先端部から延出した部分は上側の把持部材
４１ａに向かって斜めに曲り癖が付けられ、先端部には
前記切開ナイフ４４が固定されている。ナイフ操作ロッ
ド４７の基端部は操作部４まで延長しており、操作部４
に設けられたナイフ操作レバー２７と連結されている。
このナイフ操作レバー２７はグリップ８に対して回動ピ
ン２８を中心に回動自在に連結され、付勢部材（図示し
ない）によって反時計回り方向に付勢され、ナイフ操作
ロッド４７を前進させる方向に付勢している。On the other hand, a through hole 46 is provided at a position deviated below the axis of the rod 6 in the axial direction.
The through-hole 46 has a knife operating rod 4 made of spring steel.
7 is inserted to be able to advance and retreat. Knife operating rod 47
The portion extending from the distal end of the rod 6 is bent obliquely toward the upper gripping member 41a, and the cutting knife 44 is fixed to the distal end. The base end of the knife operation rod 47 extends to the operation unit 4.
Is connected to a knife operation lever 27 provided at the first position.
The knife operation lever 27 is rotatably connected to the grip 8 about a rotation pin 28, is urged counterclockwise by an urging member (not shown), and moves the knife operation rod 47 forward. It is energizing.
【００４６】次に、第２の実施形態の作用について説明
する。把持部材４１ａと４１ｂとを閉じて生体組織Ａを
把持し、把持部材４１ａ，４１ｂ間に凝固電流を流して
生体組織Ａを凝固するまでは第１の実施形態と同様であ
り、図１１（ｂ）の生体組織Ａのクロス線部分は、凝固
電流によって凝固された部分を示す。生体組織Ａを凝固
させた後、ナイフ操作レバー２７の指掛け部３３に指を
掛け、付勢部材の付勢力に抗してナイフ操作レバー２７
を時計回り方向に回動すると、長孔２９に挿入されてい
る係合ピン３０を介してナイフ操作ロッド４７が後退駆
動する。ナイフ操作ロッド４７の後退によってナイフ操
作ロッド４７の先端部に設けられた切開ナイフ４４が手
前側に引かれ、把持部材４１ａの案内面４５に案内され
て凹溝４３ａの深い位置から浅い位置に移動する。Next, the operation of the second embodiment will be described. FIG. 11 (b) is the same as in the first embodiment until the living tissue A is gripped by closing the gripping members 41a and 41b, and a coagulation current flows between the gripping members 41a and 41b to solidify the living tissue A. The cross line portion of the living tissue A in ()) indicates a portion coagulated by the coagulation current. After coagulating the living tissue A, a finger is put on the finger hook 33 of the knife operating lever 27, and the knife operating lever 27 is pressed against the urging force of the urging member.
Is rotated clockwise, the knife operation rod 47 is driven to retreat through the engagement pin 30 inserted into the elongated hole 29. By retreating the knife operating rod 47, the incision knife 44 provided at the distal end of the knife operating rod 47 is pulled toward the near side, guided by the guide surface 45 of the gripping member 41a, and moved from the deep position to the shallow position of the concave groove 43a. I do.
【００４７】したがって、図１１に示すように、切開ナ
イフ４４の切刃４４ａが把持部材４１ａ，４１ｂの把持
面を通過し、把持部材４１ａ，４１ｂ間に把持された生
体組織Ａの凝固された部分の内部が切開ナイフ４４の切
刃４４ａによって機械的に切開される。Therefore, as shown in FIG. 11, the cutting blade 44a of the cutting knife 44 passes through the gripping surfaces of the gripping members 41a and 41b, and the coagulated portion of the living tissue A gripped between the gripping members 41a and 41b. Is mechanically cut by the cutting blade 44a of the cutting knife 44.
【００４８】切開が完了した後、ナイフ操作レバー２７
を解放すると、付勢部材のばね力によって定位置に戻
り、ナイフ操作ロッド４７は前進し、切開ナイフ４４は
ナイフ操作ロッド４７の弾性力によって徐々に上昇して
上側の把持部材４１ａの凹溝４３ａの内部に収容され、
アーム部３２はストッパピン３４に当接すると停止す
る。After the incision is completed, the knife operating lever 27
Is released, the knife operating rod 47 is returned to the home position by the spring force of the urging member, the knife operating rod 47 advances, and the incision knife 44 is gradually raised by the elastic force of the knife operating rod 47, and the concave groove 43a of the upper gripping member 41a. Housed inside
The arm 32 stops when it comes into contact with the stopper pin 34.
【００４９】なお、第２の実施形態においては、切開ナ
イフ４４は矩形板状体で、下部手前側に斜めに切刃４４
ａを有した形状であるが、図１２に示すように、下部手
前側に略Ｌ字状の切刃４８ａを有した切開ナイフ４８と
することにより、生体組織Ａを一層良好に切開できる。In the second embodiment, the cutting knife 44 is a rectangular plate, and the cutting knife 44 is inclined diagonally toward the lower front side.
Although the shape has a, as shown in FIG. 12, the incision knife 48 having a substantially L-shaped cutting blade 48a on the lower front side allows the living tissue A to be more incised.
【００５０】本実施形態によれば、通常時には、切開ナ
イフ４４が把持部材４１ａの内部に収容された状態に退
避しているため、処置部３を体腔内に目的部位に誘導す
る際に、切開ナイフ４４によって正常な組織に傷を付け
る虞がなく、操作性を向上できる。また、切開ナイフ１
６の切れ味が低下しても切開時に生体組織Ａを逃がすこ
となく、確実に切開できる。According to the present embodiment, the incision knife 44 is normally retracted in a state of being housed inside the gripping member 41a, so that when the treatment section 3 is guided to the target site in the body cavity, the incision knife 44 is incised. There is no risk of damaging the normal tissue by the knife 44, and the operability can be improved. In addition, incision knife 1
Even if the sharpness of No. 6 is reduced, the incision can be reliably performed without escaping the living tissue A during the incision.
【００５１】図１３〜図１７は第３の実施形態を示し、
第１の実施形態と同一構成部分は同一番号を付して説明
を省略する。本実施形態は、第１の実施形態の切開ナイ
フ１６に代ってナイフワイヤ５０を設けたものである。
ロッド６の軸心より下側に偏倚した位置には軸方向に亘
って貫通孔５１が設けられ、この貫通孔５１にはばね鋼
からなるナイフ操作ロッド５２が進退自在に挿通されて
いる。ナイフ操作ロッド５２のロッド６の先端部から延
出した部分は一体にナイフワイヤ５０が設けられてい
る。このナイフワイヤ５０は、断面が角軸状で、上側面
を鋭角に形成した切刃５０ａが設けられている。また、
ナイフ操作ロッド５２の基端部は操作部４まで延長して
おり、操作部４に設けられたナイフ操作レバー２７と連
結されている。FIGS. 13 to 17 show a third embodiment.
The same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted. In the present embodiment, a knife wire 50 is provided in place of the cutting knife 16 of the first embodiment.
A through hole 51 is provided in a position deviated below the axis of the rod 6 in the axial direction, and a knife operation rod 52 made of spring steel is inserted through the through hole 51 so as to be able to advance and retreat. A portion of the knife operation rod 52 extending from the distal end of the rod 6 is integrally provided with a knife wire 50. The knife wire 50 is provided with a cutting blade 50a having a square axis in cross section and an upper surface formed at an acute angle. Also,
The base end of the knife operation rod 52 extends to the operation section 4 and is connected to the knife operation lever 27 provided on the operation section 4.
【００５２】そして、このナイフワイヤ５０の先端部は
下側の把持部材１１ｂの内底部に溶接等によって固定さ
れており、ナイフワイヤ５０の把持部材１１ｂの内部に
位置する部分は上側の把持部材１１ａに向かって円弧状
に湾曲するように曲り癖が付けられている。The tip of the knife wire 50 is fixed to the inner bottom of the lower gripping member 11b by welding or the like, and the portion of the knife wire 50 located inside the gripping member 11b is the upper gripping member 11a. It is bent so as to be curved in an arc toward.
【００５３】次に、第３の実施形態の作用について説明
する。把持部材１１ａと１１ｂとを閉じて生体組織Ａを
把持し、把持部材１１ａ，１１ｂ間に凝固電流を流して
生体組織Ａを凝固するまでは第１の実施形態と同様であ
り、図１５（ｂ）の生体組織Ａのクロス線部分は、凝固
電流によって凝固された部分を示す。生体組織Ａを凝固
させた後、ナイフ操作レバー２７の指掛け部３３に指を
掛け、付勢部材の付勢力に抗してナイフ操作レバー２７
を半時計回り方向に回動すると、長孔２９に挿入されて
いる係合ピン３０を介してナイフ操作ロッド５２が前進
駆動する。ナイフ操作ロッド５２の前進によってナイフ
操作ロッド５２の先端部に一体に設けられたナイフワイ
ヤ５０が前方に押され、ナイフワイヤ５０の先端部が把
持部材１１ｂに固定されていることと、円弧状に湾曲す
るように曲り癖が付けられていることから、把持部材１
１ａに向かって円弧状に湾曲する。Next, the operation of the third embodiment will be described. FIG. 15 (b) is the same as that of the first embodiment until the living tissue A is gripped by closing the gripping members 11a and 11b and coagulating the living tissue A by flowing a coagulation current between the gripping members 11a and 11b. The cross line portion of the living tissue A in ()) indicates a portion coagulated by the coagulation current. After coagulating the living tissue A, a finger is put on the finger hook 33 of the knife operating lever 27, and the knife operating lever 27 is pressed against the urging force of the urging member.
Is rotated in the counterclockwise direction, the knife operation rod 52 is driven forward through the engagement pin 30 inserted in the elongated hole 29. The knife wire 50 provided integrally with the distal end of the knife operating rod 52 is pushed forward by the advance of the knife operating rod 52, and the distal end of the knife wire 50 is fixed to the gripping member 11b. The holding member 1 has a bending habit so as to be curved.
It curves in an arc toward 1a.
【００５４】したがって、図１５に示すように、ナイフ
ワイヤ５０の切刃５０ａが把持部材１１ａ，１１ｂの把
持面を通過し、把持部材１１ａ，１１ｂ間に把持された
生体組織Ａの凝固された部分の内部がナイフワイヤ５０
の切刃５０ａによって機械的に切開される。Therefore, as shown in FIG. 15, the cutting edge 50a of the knife wire 50 passes through the holding surfaces of the holding members 11a and 11b, and the coagulated portion of the living tissue A held between the holding members 11a and 11b. Inside is a knife wire 50
Is mechanically cut by the cutting blade 50a.
【００５５】切開が完了した後、ナイフ操作レバー２７
を解放すると、付勢部材のばね力によって定位置に戻
り、ナイフ操作ロッド５２は後退し、ナイフワイヤ５０
は弾性復元力によって略真っ直ぐに復元して下側の把持
部材１１ｂの凹溝の内部に収容され、アーム部３２はス
トッパピン３４に当接すると停止する。After the incision is completed, the knife operating lever 27
Is released, the knife operating rod 52 returns to the home position by the spring force of the urging member, and the knife wire 50 is retracted.
Is restored substantially straight by the elastic restoring force, is accommodated in the concave groove of the lower gripping member 11b, and stops when the arm portion 32 comes into contact with the stopper pin.
【００５６】本実施形態によれば、通常時には、ナイフ
ワイヤ５０が把持部材１１ｂの内部に収容された状態に
退避しているため、処置部３を体腔内に目的部位に誘導
する際に、ナイフワイヤ５０によって正常な組織に傷を
付ける虞がなく、操作性を向上できる。また、切開ナイ
フ１６の切れ味が低下しても切開時に生体組織Ａを逃が
すことなく、確実に切開できる。According to the present embodiment, the knife wire 50 is normally retracted in a state of being housed inside the gripping member 11b. Therefore, when the treatment section 3 is guided to the target site in the body cavity, the knife wire 50 is retracted. There is no risk of damaging normal tissue by the wire 50, and operability can be improved. In addition, even if the sharpness of the cutting knife 16 is reduced, the incision can be reliably performed without escaping the living tissue A during the incision.
【００５７】図１８〜図２３は第４の実施形態を示し、
第１の実施形態と同一構成部分は同一番号を付して説明
を省略する。図２１〜図２３に示すように、挿入部２
は、ロッド５５と、このロッド５５に軸方向に進退自在
に外嵌されれたシース５６とからなり、シース５６の先
端部には絶縁材料からなる係合部材５７が固定され、ロ
ッド５５の基端部は操作部４を構成するグリップ８に固
定されている。シース５６の基端部は操作部４に設けら
れたシース駆動部材５９に固定されている。FIGS. 18 to 23 show a fourth embodiment.
The same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted. As shown in FIG. 21 to FIG.
Is composed of a rod 55 and a sheath 56 which is fitted to the rod 55 so as to be able to advance and retreat in the axial direction. An engaging member 57 made of an insulating material is fixed to the distal end of the sheath 56. The end is fixed to a grip 8 constituting the operation unit 4. The proximal end of the sheath 56 is fixed to a sheath driving member 59 provided in the operation unit 4.
【００５８】処置部３は、電極を構成する一対の把持部
材６１ａ，６１ｂと、これらの把持部材６１ａ，６１ｂ
を支持し、拡開させる方向に付勢する上下２本ずつの弾
性部材６２ａ，６２ｂとからなり、これら弾性部材６２
ａ，６２ｂの基端部がロッド５５の先端部に固定されて
いる。弾性部材６２ａ，６２ｂはばね鋼等によって形成
され、先端部には略くの字状に屈曲された屈曲部６３
ａ，６３ｂが形成され、表面は絶縁被膜によって被覆さ
れている。The treatment section 3 includes a pair of gripping members 61a, 61b constituting electrodes, and these gripping members 61a, 61b.
And upper and lower two elastic members 62a and 62b which urge in the direction of expanding.
The base ends of a and 62b are fixed to the front end of the rod 55. The elastic members 62a and 62b are formed of spring steel or the like, and have bent portions 63 bent in a substantially U-shape at the distal ends.
a, 63b are formed, and the surface is covered with an insulating film.
【００５９】図２０に示すように、下側の把持部材６１
ｂの把持面における幅方向の中間部には鋭利な切開刃６
４が前後方向に亘って設けられ、この切開刃６４の両側
は平坦面に形成されている。下側の把持部材６１ｂの把
持面にはシリコンゴム等の複数個の弾性体６５が設けら
れ、この弾性体６５の高さ寸法は、切開刃６４の高さ寸
法よりも大きく、通常時においては、切開刃６４が弾性
体６５の間の内部にあり、組織に傷を付けないようにな
っている。As shown in FIG. 20, the lower gripping member 61
A sharp incision blade 6 is provided at the middle part in the width direction on the gripping surface of b.
4 are provided in the front-rear direction, and both sides of the cutting blade 64 are formed as flat surfaces. A plurality of elastic bodies 65 such as silicone rubber are provided on the gripping surface of the lower gripping member 61b, and the height of the elastic body 65 is larger than the height of the cutting blade 64. The cutting blade 64 is located between the elastic members 65 so as not to damage the tissue.
【００６０】次に、第４の実施形態の作用について説明
する。Next, the operation of the fourth embodiment will be described.
【００６１】初期状態では操作部４のトリガー２２の手
掛け部２２ａは図２１に示すようにグリップ８から最も
離れた定位置で保持され、この状態ではシース５６が後
退位置にあることから一対の弾性部材６２ａ，６２ｂが
弾性復元力で拡開し、図１８に示すように、一対の把持
部材６１ａ，６１ｂが開いた状態にある。In the initial state, the handle portion 22a of the trigger 22 of the operation section 4 is held at a fixed position farthest from the grip 8 as shown in FIG. 21. In this state, since the sheath 56 is at the retracted position, a pair of elastic members is provided. The members 62a and 62b are expanded by the elastic restoring force, and as shown in FIG. 18, the pair of gripping members 61a and 61b are in an open state.
【００６２】この状態で、挿入部２の先端の処置部３を
体内の処置対象の生体組織Ａの近傍位置まで誘導する。
続いて、拡開した把持部材６１ａ，６１ｂの間に生体組
織Ａを挿入する。そこで、トリガー２２の手掛け部２２
ａを付勢部材の付勢力に抗してグリップ８側に引き込み
操作することにより、シース駆動部材５９を介してシー
ス５６の軸方向前方へ移動する。In this state, the treatment section 3 at the distal end of the insertion section 2 is guided to a position near the living tissue A to be treated in the body.
Subsequently, the living tissue A is inserted between the expanded holding members 61a and 61b. Therefore, the handle 22 of the trigger 22
By pulling a toward the grip 8 against the urging force of the urging member, the a moves forward in the axial direction of the sheath 56 via the sheath driving member 59.
【００６３】シース５６の前進に伴って弾性部材６２
ａ，６２ｂがシース５６内に相対的に引き込まれ、弾性
部材６２ａ，６２ｂの弾性復元力に抗して把持部材６１
ａ，６１ｂが閉じ、生体組織Ａが図１９に示すように、
一対の把持部材６１ａ，６１ｂ間に把持される。この状
態で、高周波焼灼電源装置から高周波ケーブル２１ａを
介して電極ピン２１に高周波電流が流れ、さらに弾性部
材６２ａ，６２ｂを介して把持部材６１ａと６１ｂとの
間に凝固電流が流れ、生体組織Ａの凝固が行われる。As the sheath 56 advances, the elastic member 62
a and 62b are relatively drawn into the sheath 56, and the grip members 61 are opposed to the elastic restoring force of the elastic members 62a and 62b.
a, 61b are closed, and the living tissue A is as shown in FIG.
It is gripped between the pair of gripping members 61a, 61b. In this state, a high-frequency current flows from the high-frequency ablation power supply device to the electrode pin 21 via the high-frequency cable 21a, and a coagulation current flows between the gripping members 61a and 61b via the elastic members 62a and 62b. Coagulation is performed.
【００６４】一定時間凝固電流を流して生体組織Ａを凝
固させた後、図２３に示すように、トリガー２２の手掛
け部２２ａを付勢部材の付勢力に抗してさらにグリップ
８側に引き込み操作すること、つまりトリガー２２をさ
らに強く引くと、シース駆動部材５９を介してシース５
６がさらに軸方向前方へ移動する。After the coagulation current is passed for a certain period of time to coagulate the living tissue A, as shown in FIG. 23, the handle 22a of the trigger 22 is further pulled toward the grip 8 against the urging force of the urging member. In other words, when the trigger 22 is pulled more strongly, the sheath 5
6 moves further axially forward.
【００６５】シース５６の前進に伴って弾性部材６２
ａ，６２ｂがシース５６内に相対的にさらに深く引き込
まれ、把持部材６１ａ，６１ｂが強く閉じられるため、
弾性体６５が圧縮され、相対的に切開刃６４が突出す
る。したがって、切開刃６４が把持部材６１ａ，６１ｂ
の把持面を通過して把持部材６１ａ，６１ｂ間に把持さ
れた生体組織Ａは切開刃６４によって機械的に切開され
る。As the sheath 56 advances, the elastic member 62
a and 62b are drawn relatively deeper into the sheath 56, and the gripping members 61a and 61b are strongly closed.
The elastic body 65 is compressed, and the cutting blade 64 protrudes relatively. Therefore, the incision blade 64 is used for the holding members 61a, 61b.
The living tissue A grasped between the grasping members 61a and 61b after passing through the grasping surface is mechanically dissected by the dissecting blade 64.
【００６６】切開が完了した後、トリガー２２を解放す
ると、付勢部材のばね力によって定位置に戻り、シース
５６は後退し、弾性部材６２ａ，６２ｂの弾性復元力に
よって開き、把持部材６１ａ，６１ｂは生体組織Ａから
解放される。After the incision is completed, when the trigger 22 is released, the sheath returns to the home position by the spring force of the urging member, and the sheath 56 retreats and opens by the elastic restoring force of the elastic members 62a and 62b, and the grip members 61a and 61b. Is released from the living tissue A.
【００６７】本実施形態においては、グリップ８を握っ
てトリガー２２の手掛け部２２ａを引き込む一連の動作
によって生体組織Ａを把持して凝固させ、その凝固部分
を切開することができ、操作性を向上させることができ
る。また、切開ナイフ１６の切れ味が低下しても切開時
に生体組織Ａを逃がすことなく、確実に切開できる。な
お、本実施形態においては、一対の把持部材６１ａ，６
１ｂのうち、下側の把持部材６１ｂのみに切開刃６４及
び弾性体６５を設けたが、図２４に示すように、一対の
把持部材６１ａ，６１ｂの両方に切開刃６４及び弾性体
６５を互いに対向して設けてもよく、図２５に示すよう
に、下側の把持部材６１ｂもしくは一対の把持部材６１
ａ，６１ｂの両方にばね６６を介してブロック６７を取
り付け、通常時において、ブロック６７の高さが切開刃
６４より高くなるようにしてもよい。In the present embodiment, the living tissue A is grasped and coagulated by a series of operations of grasping the grip 8 and pulling the handle 22a of the trigger 22, and the coagulated portion can be cut, thereby improving operability. Can be done. In addition, even if the sharpness of the cutting knife 16 is reduced, the incision can be reliably performed without escaping the living tissue A during the incision. In the present embodiment, a pair of gripping members 61a, 6
1b, the cutting blade 64 and the elastic body 65 are provided only on the lower gripping member 61b, but as shown in FIG. 24, the cutting blade 64 and the elastic body 65 are attached to both the pair of gripping members 61a, 61b. The lower gripping member 61b or a pair of gripping members 61 may be provided as shown in FIG.
A block 67 may be attached to both a and 61b via a spring 66 so that the height of the block 67 is higher than the cutting blade 64 in a normal state.
【００６８】本実施形態によれば、通常時には、切開刃
６４が弾性体６５の間に没入された状態に退避している
ため、処置部３を体腔内に目的部位に誘導する際に、切
開刃６４によって正常な組織に傷を付ける虞がなく、操
作性を向上できる。According to the present embodiment, the incision blade 64 is normally retracted in a state of being immersed between the elastic bodies 65, so that when the treatment section 3 is guided to a target site in the body cavity, the incision blade 64 is incised. There is no risk of damaging normal tissue by the blade 64, and operability can be improved.
【００６９】また、前述した第１〜第４の実施形態にお
いては、切開刃及びナイフワイヤにおける切開手段は、
機械的な切開について説明したが、切開時に切開刃及び
ナイフワイヤに切開電流を流して機械的及び電気的に切
開するようにしてもよい。In the first to fourth embodiments described above, the incision means in the incision blade and the knife wire is
Although the mechanical incision has been described, the incision may be made mechanically and electrically by applying an incision current to the incision blade and the knife wire at the time of incision.
【００７０】図２６〜図３１は内視鏡下手術器械の第１
の開示例を示し、図３１は全体構成図である。手術器械
７０は挿入部７１と、この挿入部７１の先端部に設けら
れた処置部７２と、挿入部７１の基端部に設けられた操
作部７３とから構成され、手術器械７０は高周波焼灼電
源装置７４に接続されている。FIGS. 26 to 31 show a first example of the endoscopic surgical instrument.
FIG. 31 is an overall configuration diagram. The surgical instrument 70 includes an insertion section 71, a treatment section 72 provided at the distal end of the insertion section 71, and an operation section 73 provided at the base end of the insertion section 71. It is connected to a power supply 74.
【００７１】図２６〜図３０に示すように、挿入部７１
は内シース７５と、この内シース７５に外嵌され軸方向
に進退自在な外シース７６とから二重管構造に構成され
ている。内シース７５の先端部は外シース７６の先端部
より突出しており、この突出部には固定ジョー７７が設
けられている。固定ジョー７７の上面には鋸歯状の凹凸
面が形成されていると共に、幅方向の中間部には前後方
向に亘って案内溝７７ａが設けられている。さらに、固
定ジョー７７の両側面には前後方向に長いスライド溝７
８が設けられ、このスライド溝７８には外シース７６の
先端部に横方向に貫通して設けられた枢支ピン７９が挿
入されている。したがって、外シース７６はスライド溝
７８の長さの範囲内で進退自在である。As shown in FIGS. 26 to 30, the insertion portion 71
Is formed in a double-pipe structure by an inner sheath 75 and an outer sheath 76 which is fitted on the inner sheath 75 and which can move forward and backward in the axial direction. The distal end portion of the inner sheath 75 protrudes from the distal end portion of the outer sheath 76, and a fixing jaw 77 is provided at this protruding portion. The upper surface of the fixed jaw 77 is formed with a saw-toothed uneven surface, and a guide groove 77a is provided in the middle part in the width direction in the front-rear direction. Further, slide grooves 7 which are long in the front-rear direction
A pivot pin 79 is inserted into the slide groove 78 so as to penetrate the distal end of the outer sheath 76 in the lateral direction. Therefore, the outer sheath 76 can move forward and backward within the length of the slide groove 78.
【００７２】さらに、枢支ピン７９の中間部には可動ジ
ョー８０が回動自在に枢支されている。この可動ジョー
８０は固定ジョー７７の案内溝７７ａに対向し、案内溝
７７ａの溝幅より狭幅に形成されている。また、可動ジ
ョー８０の基端部で、枢支ピン７９より下側に位置する
部分には連結ピン８１が設けられ、この連結ピン８１に
はジョー操作ロッド８２の先端部が回動自在に連結され
ている。ジョー操作ロッド８２は内シース７５の内部を
貫通して前記操作部７３まで延長しており、内シース７
５及び外シース７６も操作部７３まで延長している。Further, a movable jaw 80 is rotatably supported at an intermediate portion of the pivot pin 79. The movable jaw 80 faces the guide groove 77a of the fixed jaw 77 and is formed to have a width smaller than the width of the guide groove 77a. A connecting pin 81 is provided at a portion of the base end of the movable jaw 80 below the pivot pin 79, and a distal end of a jaw operating rod 82 is rotatably connected to the connecting pin 81. Have been. The jaw operation rod 82 extends through the inside of the inner sheath 75 and extends to the operation section 73.
5 and the outer sheath 76 also extend to the operation section 73.
【００７３】操作部７３は固定ハンドル８３と、この固
定ハンドル８３に枢支軸８４によって回動自在に枢支さ
れた可動ハンドル８５及び可動ハンドル８５を反時計回
り方向に付勢する付勢部材（図示しない）とから構成さ
れている。固定ハンドル８３には内シース７５の基端部
が連結され、外シース７６の基端部は固定ハンドル８３
の近傍まで延長しており、この固定ハンドル８３と外シ
ース７６の基端部との間には内シース７５に対して嵌合
するコイルばね８６が設けられている。そして、コイル
ばね８６の復元力によって外シース７６を前進する方向
に付勢している。また、可動ハンドル８５にはジョー操
作ロッド８２の基端部が連結されている。The operating portion 73 includes a fixed handle 83, a movable handle 85 pivotally supported by the fixed handle 83 by a pivot 84, and an urging member (urging member) for urging the movable handle 85 counterclockwise. (Not shown). The proximal end of the inner sheath 75 is connected to the fixed handle 83, and the proximal end of the outer sheath 76 is connected to the fixed handle 83.
Is provided between the fixed handle 83 and the proximal end of the outer sheath 76, and a coil spring 86 fitted to the inner sheath 75 is provided. The outer sheath 76 is urged in the forward direction by the restoring force of the coil spring 86. The movable handle 85 is connected to the base end of the jaw operation rod 82.
【００７４】さらに、固定ハンドル８３の上部には凝固
電流と切開電流とを切換える電流切換えスイッチ８７が
取り付けられている。この電流切換えスイッチ８７と対
向する外シース７６の基端部にはスイッチ操作レバー８
８が取り付けられている。電流切換えスイッチ８７はケ
ーブル８９を介して前記高周波焼灼電源装置７４に接続
されている。Further, a current switch 87 for switching between coagulation current and incision current is mounted on the upper portion of the fixed handle 83. A switch operating lever 8 is provided at the base end of the outer sheath 76 facing the current switch 87.
8 is attached. The current switch 87 is connected to the high-frequency ablation power supply 74 via a cable 89.
【００７５】次に、前述のように構成された手術器械７
０の作用について説明する。Next, the surgical instrument 7 configured as described above is used.
The operation of 0 will be described.
【００７６】まず、体腔内に挿入部７１を挿入して処置
部７２を処置対象部位に誘導する。通常時においては、
可動ハンドル８５は付勢部材によって反時計回りに方向
に付勢されているため、可動ハンドル８５によってジョ
ー操作ロッド８２は前進状態にあり、可動ジョー８０は
枢支ピン７９を支点として時計回り方向に回動して固定
ジョー７７に対して可動ジョー８０が開いた状態にあ
る。First, the insertion section 71 is inserted into the body cavity to guide the treatment section 72 to the treatment target site. At normal times,
Since the movable handle 85 is urged in the counterclockwise direction by the urging member, the movable handle 85 moves the jaw operation rod 82 forward, and the movable jaw 80 moves clockwise about the pivot pin 79 as a fulcrum. The movable jaw 80 is opened with respect to the fixed jaw 77 by rotating.
【００７７】そこで、図２７に示すように、固定ジョー
７７と可動ジョー８０との間に生体組織Ａに入れ、可動
ハンドル８５の指掛け部に指を掛けて固定ハンドル８３
に接近する時計回り方向に回動すると、ジョー操作ロッ
ド８２は後退する。ジョー操作ロッド８２が手元側に引
かれると、図２８に示すように、連結ピン８１を介して
連結されている可動ジョー８０は枢支ピン７９を支点と
して反時計回り方向に回動し、固定ジョー７７に対して
可動ジョー８０が閉じて生体組織Ａを把持する。Therefore, as shown in FIG. 27, the living tissue A is inserted between the fixed jaw 77 and the movable jaw 80,
, The jaw operation rod 82 is retracted. When the jaw operation rod 82 is pulled toward the hand, as shown in FIG. 28, the movable jaw 80 connected via the connection pin 81 rotates counterclockwise around the pivot pin 79 as a fulcrum and is fixed. The movable jaw 80 closes with respect to the jaw 77 to grip the living tissue A.
【００７８】そこで、高周波焼灼電源装置７４から凝固
電流を流すと、凝固電流はケーブル８９、電流切換えス
イッチ８７を介して固定ジョー７７と可動ジョー８０と
の間に凝固電流が流れ、生体組織Ａの凝固が行われる。Then, when a coagulation current flows from the high-frequency ablation power supply 74, the coagulation current flows between the fixed jaw 77 and the movable jaw 80 via the cable 89 and the current changeover switch 87, and Coagulation takes place.
【００７９】一定時間凝固電流を流して生体組織Ａを凝
固させた後、可動ハンドル８５をさらに固定ハンドル８
３に接近する方向に回動させると、ジョー操作ロッド８
２はさらに後退する。ジョー操作ロッド８２がさらに手
元側に引かれると、連結ピン８１を介して連結されてい
る可動ジョー８０は手元側に引かれるため、枢支ピン７
９を介して連結されている外シース７６もコイルばね８
６の復元力に抗して後退する。このとき、枢支ピン７９
はスライド溝７８に支持されているため、枢支ピン７９
はスライド溝７８内をスライドして後退し、可動ジョー
８０が固定ジョー７７の案内溝７７ａに沿って移動す
る。すなわち、可動ジョー８０が凝固された生体組織Ａ
を剪断力によって切開する動作に移り、このとき外シー
ス７６の後退によってスイッチ操作レバー８８が電流切
換えスイッチ８７を押圧して電流を切換えるため、高周
波焼灼電源装置７４から固定ジョー７７と可動ジョー８
０との間に切開電流が流れる。したがって、可動ジョー
８０の移動による機械的な切開と切開電流との電気的切
開が同時に行える。After the living tissue A is coagulated by flowing a coagulation current for a predetermined time, the movable handle 85 is further fixed to the fixed handle 8.
3, the jaw operation rod 8
2 retreats further. When the jaw operation rod 82 is further pulled to the proximal side, the movable jaw 80 connected via the connecting pin 81 is pulled to the proximal side.
The outer sheath 76 connected via the coil spring 8
6 retreats against the restoring force. At this time, the pivot pin 79
Is supported by the slide groove 78, so that the pivot pin 79
Slides back in the slide groove 78, and the movable jaw 80 moves along the guide groove 77a of the fixed jaw 77. That is, the living tissue A in which the movable jaw 80 is coagulated
Is moved by the shearing force. At this time, the switch operation lever 88 presses the current changeover switch 87 to switch the current by the retreat of the outer sheath 76, so that the fixed jaw 77 and the movable jaw 8 are supplied from the high frequency ablation power supply 74.
An incision current flows between zero. Therefore, the mechanical incision by the movement of the movable jaw 80 and the electrical incision of the incision current can be performed simultaneously.
【００８０】切開が完了した後、可動ハンドル８５を解
放すると、付勢部材のばね力によって定位置に戻り、外
シース７６は前進すると共に、ジョー操作ロッド８２が
前進して可動ジョー８０は前進すると共に固定ジョー７
７から離れる方向に開き、生体組織Ａから解放される。When the movable handle 85 is released after the incision is completed, the movable sheath 85 returns to the home position by the spring force of the urging member, the outer sheath 76 advances, the jaw operation rod 82 advances, and the movable jaw 80 advances. With fixed jaw 7
7 and is released from the living tissue A.
【００８１】本実施形態においては、可動ハンドル８５
を固定ハンドル８３側に接近方向に回動する一連の動作
によって生体組織Ａを把持して凝固させ、その凝固部分
を切開することができ、操作性を向上させることができ
る。In this embodiment, the movable handle 85
The living tissue A can be grasped and coagulated by a series of operations of rotating in the approaching direction toward the fixed handle 83 side, and the coagulated portion can be incised to improve operability.
【００８２】図３２は手術器械の第２の開示例を示し、
第１の開示例と同一構成部分は同一番号を付して説明を
省略する。本開示例は、第１の開示例の操作部７３にロ
ック機構を設けたものである。外シース７６の基端部に
は手元側に延出する延出レバー９０が設けられ、この延
出レバー９０の先端部には掛止部９１が設けられてい
る。固定ハンドル８３にはトリガー９２によって回動自
在な掛止爪９３が設けられ、掛止爪９３は掛止部９１に
掛止されている。したがって、固定ハンドル８３に対し
て外シース７６が前後方向に移動不能にロックされ、可
動ジョー８０が不用意に前後方向に移動しないようにな
っている。FIG. 32 shows a second disclosed example of the surgical instrument,
The same components as those of the first disclosure are denoted by the same reference numerals, and description thereof will be omitted. In the present disclosure, a lock mechanism is provided in the operation unit 73 of the first disclosure. An extension lever 90 is provided at the base end of the outer sheath 76 and extends toward the hand. A hook 91 is provided at the tip of the extension lever 90. The fixed handle 83 is provided with a locking claw 93 that is rotatable by a trigger 92, and the locking claw 93 is locked by a locking portion 91. Therefore, the outer sheath 76 is locked immovably in the front-rear direction with respect to the fixed handle 83, so that the movable jaw 80 is not accidentally moved in the front-rear direction.
【００８３】このように構成することにより、生体組織
Ａを把持して凝固する際に、可動ハンドル８５を過剰に
操作しても外シース７６が後退することはなく、可動ジ
ョー８０による不用意な切開動作を防止でき、切開時に
はトリガー９２を操作して掛止爪９３を掛止部９１から
外してロック解除してから操作すればよい。With this configuration, when the living tissue A is grasped and coagulated, the outer sheath 76 does not retreat even if the movable handle 85 is excessively operated, and the movable jaw 80 is inadvertent. The incision operation can be prevented, and at the time of incision, the trigger 92 should be operated to release the locking claw 93 from the locking portion 91 and release the lock before operation.
【００８４】図３３は手術器械の第３の開示例を示し、
第１の開示例と同一構成部分は同一番号を付して説明を
省略する。本開示例は、ジョー操作ロッド８２を可動ハ
ンドル８５によって駆動し、外シース７６は固定ハンド
ル８３に設けたシーススライドアクチュエータ９４によ
って駆動するようにしたものである。FIG. 33 shows a third disclosed example of the surgical instrument.
The same components as those of the first disclosure are denoted by the same reference numerals, and description thereof will be omitted. In the present disclosure, the jaw operation rod 82 is driven by the movable handle 85, and the outer sheath 76 is driven by the sheath slide actuator 94 provided on the fixed handle 83.
【００８５】高周波焼灼電源装置７４にはインピーダン
ス検知器９５が設けられ、このインピーダンス検知器９
５はシーススライドアクチュエータ９４を駆動するアク
チュエータ駆動装置９６に接続されている。高周波焼灼
電源装置７４から凝固電流を流し、固定ジョー７７と可
動ジョー８０との間に凝固電流を流して生体組織Ａの凝
固を行った後、生体組織Ａのインピーダンスをインピー
ダンス検知器９５によって検知して凝固が完全に行われ
たか否かを判断する。The high-frequency ablation power supply 74 is provided with an impedance detector 95.
5 is connected to an actuator driving device 96 for driving a sheath slide actuator 94. After a coagulation current is supplied from the high frequency ablation power supply 74 and a coagulation current is supplied between the fixed jaw 77 and the movable jaw 80 to coagulate the living tissue A, the impedance of the living tissue A is detected by the impedance detector 95. To determine if coagulation has been completed.
【００８６】そして、生体組織Ａのインピーダンスによ
って凝固が完全におこなわたことを判断したとき、イン
ピーダンス検知器９５はアクチュエータ駆動装置９６に
駆動信号を出力し、アクチュエータ駆動装置９６はシー
ススライドアクチュエータ９４を駆動して外シース７６
を後退移動させ、可動ジョー８０を後方にスライドさせ
て生体組織Ａの切開を行う。このように構成することに
より、生体組織Ａを把持して凝固する際に、可動ハンド
ル８５を過剰に操作しても外シース７６が後退すること
はなく、可動ジョー８０による不用意な切開動作を防止
できる。When it is determined from the impedance of the living tissue A that coagulation has been completed, the impedance detector 95 outputs a driving signal to the actuator driving device 96, and the actuator driving device 96 drives the sheath slide actuator 94. Outer sheath 76
Is moved backward, and the movable jaw 80 is slid backward to make an incision in the living tissue A. With this configuration, when the living tissue A is grasped and coagulated, the outer sheath 76 does not retreat even if the movable handle 85 is excessively operated, and the careless incision operation by the movable jaw 80 can be performed. Can be prevented.
【００８７】図３４及び図３５は第４の開示例を示し、
第１の開示例と同一構成部分は同一番号を付して説明を
省略する。本開示例は、枢支ピン７９及びこの枢支ピン
７９に枢支された可動ジョー８０に絶縁層７９Ａ，８０
Ａを設け、固定ジョー７７と可動ジョー８０とを電気的
絶縁状態にしてバイポーラ化したものである。FIGS. 34 and 35 show a fourth disclosure example.
The same components as those of the first disclosure are denoted by the same reference numerals, and description thereof will be omitted. In the present disclosure, the insulating layers 79A and 80A are attached to the pivot pin 79 and the movable jaw 80 pivotally supported by the pivot pin 79.
A is provided, and the fixed jaw 77 and the movable jaw 80 are electrically insulated to be bipolar.
【００８８】図３６及び図３７は第５の開示例を示す。
本開示例は、挿入部としての軸方向に進退自在なスライ
ドパイプ１００の先端部に軸方向に進退自在な第１の可
動ジョー１０１とアーム１０２に固定された第２の可動
ジョー１０３とから構成されている。アーム１０２は弾
性部材によって形成され、拡開方向に曲り癖が付けられ
ており、スライドパイプ１００が後退することにより、
第１の可動ジョー１０１に対して第２の可動ジョー１０
３が開き、スライドパイプ１００が前進することによ
り、第１の可動ジョー１０１に対して第２の可動ジョー
１０３が閉じて生体組織Ａを把持できるようになってい
る。FIGS. 36 and 37 show a fifth disclosure example.
The present disclosure example includes a first movable jaw 101 axially movable back and forth at a distal end portion of a slide pipe 100 axially movable as an insertion portion, and a second movable jaw 103 fixed to an arm 102. Have been. The arm 102 is formed of an elastic member, has a bending tendency in the expanding direction, and the slide pipe 100 retreats,
The first movable jaw 101 and the second movable jaw 10
When the slide 3 is opened and the slide pipe 100 moves forward, the second movable jaw 103 closes with respect to the first movable jaw 101 so that the living tissue A can be grasped.
【００８９】そして、高周波焼灼電源装置から第１の可
動ジョー１０１と第２の可動ジョー１０３との間に凝固
電流を流して生体組織Ａを凝固させた後、第１の可動ジ
ョー１０１と第２の可動ジョー１０３との間に切開電流
を流すとともに、第１の可動ジョー１０１を後退させる
と、第１の可動ジョー１０１の移動による機械的な切開
と切開電流との電気的切開が同時に行える。Then, after a coagulation current is passed between the first movable jaw 101 and the second movable jaw 103 from the high-frequency cautery power supply to coagulate the living tissue A, the first movable jaw 101 and the second movable jaw 101 are coagulated. When a cutting current is caused to flow between the movable jaw 103 and the first movable jaw 101, and the first movable jaw 101 is retracted, mechanical dissection by the movement of the first movable jaw 101 and electric dissection of the dissection current can be performed simultaneously.
【００９０】切開が完了した後、スライドパイプ１００
を後退させると、アーム１０２の弾性力によって拡開し
て第２の可動ジョー１０３は第１の可動ジョー１０１か
ら離れる方向に開き、生体組織Ａから解放される。After the incision is completed, slide pipe 100
Is retracted, the second movable jaw 103 expands due to the elastic force of the arm 102, opens in a direction away from the first movable jaw 101, and is released from the living tissue A.
【００９１】前記実施の形態によれば、次のような構成
が得られる。According to the above embodiment, the following configuration is obtained.
【００９２】（付記１）組織を把持する一対の把持部材
と、前記把持部材の把持面に設けられた双極電極と、組
織を切開する切開手段とを備えた内視鏡下手術器械にお
いて、前記切開手段は、把持する組織に接触しないよう
前記把持部材の内部に収容される第１の位置に配置さ
れ、切開時に切開手段の少なくとも一部が第１の位置か
ら一対の把持部材で形成される把持面を通過するように
移動自在であることを特徴とする内視鏡下手術器械。(Supplementary Note 1) An endoscopic surgical instrument comprising a pair of gripping members for gripping tissue, a bipolar electrode provided on a gripping surface of the gripping member, and a cutting means for cutting tissue. The incision means is disposed at a first position accommodated inside the gripping member so as not to contact the tissue to be gripped, and at the time of incision, at least a part of the incision means is formed by a pair of gripping members from the first position. An endoscopic surgical instrument which is movable so as to pass through a gripping surface.
【００９３】（付記２）切開手段は、収納される把持部
材の開閉動作に応じて移動可能なような弾性部材で支持
されていることを特徴とする付記１記載の内視鏡下手術
器械。(Supplementary Note 2) The endoscopic surgical instrument according to Supplementary Note 1, wherein the incision means is supported by an elastic member that is movable in accordance with the opening and closing operation of the stored gripping member.
【００９４】（付記３）切開手段は、切開操作部材を有
し、この切開操作部材は、切開手段を付勢する弾性部材
に係合しない第１の位置と弾性部材に係合してその付勢
力に抗して切開手段を把持部材から突出させる第２の位
置に移動可能であることを特徴とする付記１または２記
載の内視鏡下手術器械。(Supplementary Note 3) The incision means has an incision operating member, and the incision operation member engages with the first position not engaged with the elastic member biasing the incision means and the elastic member. 3. The endoscopic surgical instrument according to claim 1, wherein the incision means is movable to a second position where the incision means projects from the gripping member against the force.
【００９５】（付記４）切開手段は、鋭利な切刃を有す
る切開刃であることを特徴とする付記１または２記載の
内視鏡手術器械。(Supplementary Note 4) The endoscopic surgical instrument according to Supplementary note 1 or 2, wherein the cutting means is a cutting blade having a sharp cutting blade.
【００９６】（付記５）切開手段は、把持部材の内部に
収納される第１の位置と挿入部内まで後退する第２の位
置との間を移動可能であることを特徴とする付記１また
は２記載の内視鏡手術器械。(Supplementary note 5) Supplementary note 1 or 2, characterized in that the cutting means is movable between a first position housed inside the gripping member and a second position retracted into the insertion portion. An endoscopic surgical instrument as described.
【００９７】（付記６）切開手段は、Ｌ字状の切刃を有
する切開刃であることを特徴とする付記５記載の内視鏡
手術器械。(Supplementary note 6) The endoscopic surgical instrument according to supplementary note 5, wherein the cutting means is a cutting blade having an L-shaped cutting blade.
【００９８】（付記７）切開手段は、先端が一方の把持
部材に固定され、後端が把持部材に対して移動可能な弾
性を有するナイフワイヤで、このナイフワイヤは、前進
動作に伴って湾曲して把持部材の把持面を通過すること
を特徴とする付記１記載の内視鏡手術器械。(Supplementary Note 7) The cutting means is a knife wire having a distal end fixed to one of the gripping members and a rear end having elasticity movable with respect to the gripping member. 2. The endoscopic surgical instrument according to claim 1, wherein the instrument passes through a gripping surface of the gripping member.
【００９９】（付記８）ナイフワイヤは、湾曲方向に鋭
利な切刃を有していることを特徴とする付記７記載の内
視鏡手術器械。(Supplementary note 8) The endoscopic surgical instrument according to supplementary note 7, wherein the knife wire has a sharp cutting edge in a bending direction.
【０１００】（付記９）組織の凝固後に凝固部位を切開
するための機能を有した高周波処置具において、通常の
把持操作では組織に切開を行わないよう、組織把持部に
組織の切開を制御する弾性部材を有していることを特徴
とする高周波処置具。(Supplementary Note 9) In a high-frequency treatment instrument having a function of incising a coagulation site after coagulation of tissue, incision of the tissue is controlled by a tissue grasping portion so that the tissue is not incised by a normal grasping operation. A high-frequency treatment instrument having an elastic member.
【０１０１】（付記１０）凝固操作と切開操作が一連の
動作で行えることを特徴とする付記９記載の高周波処置
具。(Supplementary note 10) The high-frequency treatment instrument according to supplementary note 9, wherein the coagulation operation and the incision operation can be performed by a series of operations.
【０１０２】（付記１１）操作部の操作により凝固操作
と切開操作が一連の動作で行えることを特徴とする付記
１０記載の高周波処置具。(Supplementary note 11) The high-frequency treatment instrument according to supplementary note 10, wherein the coagulation operation and the incision operation can be performed by a series of operations by operating the operation unit.
【０１０３】（付記１２）弾性部材は、シリコンゴムで
あることを特徴とする付記９記載の高周波処置具。(Supplementary note 12) The high-frequency treatment instrument according to supplementary note 9, wherein the elastic member is silicon rubber.
【０１０４】（付記１３）シリコンゴムはばねによって
支持されていることを特徴とする付記１２記載の高周波
処置具。(Supplementary note 13) The high-frequency treatment instrument according to supplementary note 12, wherein the silicone rubber is supported by a spring.
【０１０５】（付記１４）組織切開部は、組織把持面の
一部に設けられ鋭利な切刃を有していることを特徴とす
る付記９記載の高周波処置具。(Supplementary note 14) The high-frequency treatment instrument according to supplementary note 9, wherein the tissue incision portion is provided on a part of the tissue gripping surface and has a sharp cutting blade.
【０１０６】（付記１５）組織切開部は、その両側に組
織把持面を持っていることを特徴とする付記１４記載の
高周波処置具。(Supplementary note 15) The high-frequency treatment instrument according to supplementary note 14, wherein the tissue incision portion has tissue grasping surfaces on both sides thereof.
【０１０７】（付記１６）相対的に開閉する一対のジョ
ーを挿入部の先端に有し、組織を凝固する内視鏡下手術
器械において、一方のジョーが他方のジョーに対して開
閉するとともに近位側に挿入部と略平行にスライドし、
一対のジョーの組織接触面には凝固面が形成され、凝固
面に高周波電流を通電して組織の切開を行う内視鏡下手
術器械。(Supplementary Note 16) In an endoscopic surgical instrument that has a pair of jaws that relatively open and close at the distal end of an insertion portion and coagulates tissue, one jaw opens and closes with respect to the other jaw and closes. Slide in parallel with the insertion section
An endoscopic surgical instrument in which a coagulated surface is formed on a tissue contacting surface of a pair of jaws, and a high-frequency current is applied to the coagulated surface to cut the tissue.
【０１０８】（付記１７）一対のジョーは、第１のジョ
ーと第２のジョーとからなり、第１のジョーは第２のジ
ョーに対して回動自在に支点ピンで支持され、さらに支
点ピンは第２のジョーに挿入部と略平行に設けられたス
ライド溝内をスライド可能であり、さらに支点ピンは第
２のジョーに対してスライド可能に設けられたシースに
接続され、シースにはスライド防止手段が設けられた付
記１６記載の内視鏡下手術器械。(Supplementary Note 17) The pair of jaws includes a first jaw and a second jaw, and the first jaw is rotatably supported by a fulcrum pin with respect to the second jaw. Is slidable in a slide groove provided substantially parallel to the insertion portion in the second jaw, and the fulcrum pin is connected to a sheath provided slidably with respect to the second jaw. 17. The endoscopic surgical instrument according to claim 16, further comprising a prevention means.
【０１０９】（付記１８）第１のジョーは弾性変形可能
なアームで支持され、アームにシースがスライドして係
合することで開閉するとともに、第２のジョーは第１の
ジョー及びシースに対してスライドし、シースにはスラ
イド防止手段が設けられた付記１６記載の内視鏡下手術
器械。(Supplementary Note 18) The first jaw is supported by an elastically deformable arm, and the sheath is slid and engaged with the arm to open and close, and the second jaw is moved relative to the first jaw and the sheath. 17. The endoscopic surgical instrument according to claim 16, wherein the surgical instrument is slid and the sheath is provided with a slide preventing means.
【０１１０】（付記１９）スライド防止手段は、シース
を遠位方向に付勢するコイルばねからなる付記１７また
は１８記載の内視鏡下手術器械。(Supplementary note 19) The endoscopic surgical instrument according to supplementary note 17 or 18, wherein the slide preventing means comprises a coil spring for biasing the sheath in a distal direction.
【０１１１】（付記２０）スライド防止手段は、さらに
シースに接続された掛止部及びこの掛止部に係脱に係合
する掛止爪を有している付記１９記載の内視鏡下手術器
械。(Supplementary note 20) The endoscopic surgery according to supplementary note 19, wherein the slide prevention means further has a hook connected to the sheath and a hook claw that engages with and disengages from the hook. instrument.
【０１１２】（付記２１）付記１６乃至１８記載の内視
鏡下手術器械は、シーススライドアクチュエータからな
るスライド防止手段と、生体組織のインピーダンスを検
知するインピーダンス検知器と、アクチェエータ駆動装
置とを有し、凝固された組織のインピ一ダンスが所定の
値を超えたときにアクチェエータ駆動装置がシーススラ
イドアクチュエータを作動させ、ジョーをスライドさせ
ることを特徴とする内視鏡下手術器械。(Supplementary Note 21) The endoscopic surgical instrument according to Supplementary Notes 16 to 18 has a slide prevention means including a sheath slide actuator, an impedance detector for detecting impedance of a living tissue, and an actuator driving device. An endoscopic surgical instrument characterized in that an actuator driving device activates a sheath slide actuator to slide a jaw when the impedance of coagulated tissue exceeds a predetermined value.
【０１１３】（付記２２）付記１６〜２１のいずれかに
記載の内視鏡下手術器械は、一方のジョーを他方のジョ
ーから絶縁する手段を含み、各々のジョーには異なる極
の高周波電流を通電可能な内視鏡下手術器械。(Supplementary Note 22) The endoscopic surgical instrument according to any one of Supplementary Notes 16 to 21 includes means for insulating one jaw from the other jaw, and each jaw receives a high-frequency current of a different pole. Endoscopic surgical instruments that can be energized.
【０１１４】（付記２３）付記１６〜２１のいずれかに
記載の内視鏡下手術器械は、ジョーが閉じて組織凝固時
には凝固電流を、ジョーのスライド時に切開電流を通電
することにより連続的に組織の凝固・切開が可能な内視
鏡下手術器械。(Supplementary Note 23) In the endoscopic surgical instrument according to any one of Supplementary Notes 16 to 21, the coagulation current is continuously supplied when the jaws are closed and the tissue is coagulated, and the incision current is supplied when the jaws are slid. Endoscopic surgical instruments that can coagulate and dissect tissues.
【０１１５】（付記２４）付記２３において、ジョーの
スライド開始に応じて電流を凝固電流から切開電流に変
化させる手段を持つ内視鏡下手術器械。(Supplementary note 24) The endoscopic surgical instrument according to supplementary note 23, further comprising means for changing a current from a coagulation current to an incision current in response to the start of sliding of the jaw.
【０１１６】[0116]
【発明の効果】以上説明したように、この発明によれ
ば、切開手段を、把持する組織に接触しないよう把持部
材の内部に収容し、切開時に切開手段の少なくとも一部
が一対の把持部材で形成される把持面を通過するように
移動自在にしたから、体腔内に挿入したとき、切開手段
が正常な組織に接触して傷を付ける虞がなく、操作性の
向上を図ることができる。また、切開手段の切れ味が低
下しても切開時に生体組織を逃がすことなく、確実に切
開できるという効果がある。As described above, according to the present invention, the incision means is housed inside the grasping member so as not to contact the tissue to be grasped, and at least a part of the incision means is formed by a pair of grasping members at the time of incision. Since it is free to move so as to pass through the formed gripping surface, there is no possibility that the incision means will contact and damage normal tissue when inserted into a body cavity, and operability can be improved. Moreover, even if the sharpness of the incision means is reduced, there is an effect that the incision can be reliably performed without escaping the living tissue at the time of incision.
【図１】この発明の第１の実施形態を示し、（ａ）は内
視鏡下手術器械の全体の平面図、（ｂ）は同側面図、
（ｃ）は把持部材が開いた状態の側面図。1A and 1B show a first embodiment of the present invention, wherein FIG. 1A is a plan view of an entire endoscopic surgical instrument, FIG.
(C) is a side view in the state where the holding member was opened.
【図２】同実施形態の内視鏡下手術器械の動作説明図。FIG. 2 is an explanatory view of the operation of the endoscopic surgical instrument of the embodiment.
【図３】同実施形態の内視鏡下手術器械の動作説明図。FIG. 3 is an explanatory view of the operation of the endoscopic surgical instrument of the embodiment.
【図４】同実施形態を示し、把持部材が開いた状態の縦
断側面図。FIG. 4 is a longitudinal sectional side view showing the same embodiment, with a gripping member opened.
【図５】同実施形態を示し、（ａ）は把持部材が閉じて
生体組織を凝固している状態の縦断側面図、（ｂ）はＡ
−Ａ線に沿う断面図。5A and 5B show the same embodiment, wherein FIG. 5A is a longitudinal side view showing a state in which a grasping member is closed to coagulate a living tissue, and FIG.
Sectional drawing which follows the -A line.
【図６】同実施形態を示し、（ａ）は生体組織の切開状
態の縦断側面図、（ｂ）はＢ−Ｂ線に沿う断面図。6A and 6B show the same embodiment, in which FIG. 6A is a longitudinal sectional side view of an incised state of a living tissue, and FIG. 6B is a cross-sectional view along line BB.
【図７】この発明の第２の実施形態を示す内視鏡下手術
器械の動作説明図。FIG. 7 is an explanatory view of the operation of the endoscopic surgical instrument according to the second embodiment of the present invention.
【図８】同実施形態の内視鏡下手術器械の動作説明図。FIG. 8 is an operation explanatory view of the endoscopic surgical instrument of the embodiment.
【図９】同実施形態を示し、把持部材が開いた状態の縦
断側面図。FIG. 9 shows the same embodiment, and is a longitudinal side view in a state where a gripping member is opened.
【図１０】同実施形態を示し、把持部材が閉じて生体組
織を凝固している状態の縦断側面図。FIG. 10 is a longitudinal sectional side view showing the same embodiment, in a state where the grasping member is closed and the living tissue is coagulated.
【図１１】同実施形態を示し、（ａ）は生体組織の切開
状態の縦断側面図、（ｂ）はＣ−Ｃ線に沿う断面図。11A and 11B show the same embodiment, in which FIG. 11A is a longitudinal side view of an incised state of a living tissue, and FIG. 11B is a cross-sectional view taken along line CC.
【図１２】同実施形態の切削刃の変形例を示す側面図。FIG. 12 is a side view showing a modification of the cutting blade of the embodiment.
【図１３】この発明の第３の実施形態を示し、把持部材
が開いた状態の縦断側面図。FIG. 13 shows a third embodiment of the present invention, and is a longitudinal sectional side view in a state where a gripping member is opened.
【図１４】同実施形態を示し、把持部材が閉じて生体組
織を凝固している状態の縦断側面図。FIG. 14 is a longitudinal sectional side view showing the same embodiment, in a state where the grasping member is closed and the living tissue is coagulated.
【図１５】同実施形態を示し、（ａ）は生体組織の切開
状態の縦断側面図、（ｂ）はＤ−Ｄ線に沿う断面図。15A and 15B show the same embodiment, wherein FIG. 15A is a longitudinal side view of an incised state of a living tissue, and FIG. 15B is a cross-sectional view taken along line DD.
【図１６】同実施形態の内視鏡下手術器械の動作説明
図。FIG. 16 is an explanatory view of the operation of the endoscopic surgical instrument of the embodiment.
【図１７】同実施形態の内視鏡下手術器械の動作説明
図。FIG. 17 is an explanatory view of the operation of the endoscopic surgical instrument of the embodiment.
【図１８】この発明の第４の実施形態を示し、把持部材
が開いた状態の図２０（ｂ）のＨ−Ｈ線に沿う縦断側面
図。FIG. 18 shows the fourth embodiment of the present invention and is a longitudinal sectional side view along the line HH in FIG. 20 (b) with the gripping member opened.
【図１９】同実施形態を示し、（ａ）把持部材が閉じて
生体組織を凝固している状態の図２０（ｂ）のＨ−Ｈ線
に沿う縦断側面図、（ｂ）はＥ−Ｅ線に沿う断面図。FIGS. 19A and 19B show the same embodiment, and FIG. 20A is a longitudinal sectional view taken along line HH of FIG. 20B in a state where the grasping member is closed and the living tissue is coagulated, and FIG. Sectional view along the line.
【図２０】同実施形態を示し、（ａ）は生体組織の切開
状態の縦断側面図、（ｂ）はＦ−Ｆ線に沿う断面図。FIG. 20 shows the same embodiment, (a) is a longitudinal sectional side view of an incised state of a living tissue, and (b) is a cross-sectional view taken along line FF.
【図２１】同実施形態の内視鏡下手術器械の動作説明
図。FIG. 21 is an explanatory view of the operation of the endoscopic surgical instrument of the embodiment.
【図２２】同実施形態の内視鏡下手術器械の動作説明
図。FIG. 22 is an explanatory view of the operation of the endoscopic surgical instrument of the embodiment.
【図２３】同実施形態の内視鏡下手術器械の動作説明
図。FIG. 23 is an explanatory view of the operation of the endoscopic surgical instrument of the embodiment.
【図２４】同実施形態の変形例を示す把持部材の断面
図。FIG. 24 is a sectional view of a gripping member showing a modification of the embodiment.
【図２５】同実施形態の変形例を示す把持部材の断面
図。FIG. 25 is a sectional view of a gripping member showing a modification of the embodiment.
【図２６】内視鏡下手術器械の第１の開示例を示す処置
部の平面図。FIG. 26 is a plan view of a treatment section showing a first disclosed example of the endoscopic surgical instrument.
【図２７】同開示例の処置部の側面図。FIG. 27 is a side view of the treatment section of the disclosure example.
【図２８】同開示例の把持部材で生体組織を把持して凝
固している状態の側面図。FIG. 28 is a side view of a state where the living tissue is grasped and coagulated by the grasping member of the example of the disclosure.
【図２９】同開示例の把持部材で生体組織を切開してい
る状態の側面図。FIG. 29 is a side view of a state where the living tissue is incised by the gripping member according to the embodiment of the disclosure;
【図３０】同開示例の切開時の横断正面図。FIG. 30 is a cross-sectional front view of the disclosed example at the time of incision.
【図３１】同開示例の内視鏡下手術器械の全体構成を示
す側面図。FIG. 31 is a side view showing the overall configuration of the endoscopic surgical instrument according to the embodiment of the present disclosure;
【図３２】内視鏡下手術器械の第２の開示例を示す操作
部側の側面図。FIG. 32 is a side view of the operation unit side showing a second disclosed example of the endoscopic surgical instrument.
【図３３】内視鏡下手術器械の第３の開示例を示す操作
部側の側面図。FIG. 33 is a side view of the operation unit side showing a third disclosed example of the endoscopic surgical instrument.
【図３４】内視鏡下手術器械の第４の開示例を示す処置
部の縦断平面図。FIG. 34 is a longitudinal plan view of a treatment unit showing a fourth disclosed example of the endoscopic surgical instrument.
【図３５】同開示例を示す処置部の横断正面図。FIG. 35 is a cross-sectional front view of a treatment section showing the example of the disclosure.
【図３６】内視鏡下手術器械の第５の開示例を示す処置
部の側面図。FIG. 36 is a side view of a treatment section showing a fifth disclosed example of the endoscopic surgical instrument.
【図３７】同開示例を示し、生体組織を切開している状
態を示す側面図。FIG. 37 is a side view showing the example of the disclosure and showing a state in which a living tissue is incised.
２…挿入部 ３…処置部 ４…操作部 １１ａ，１１ｂ…把持部材 １６…切開刃 2. Insertion part 3. Treatment part 4. Operation part 11a, 11b. Gripping member 16. Cutting blade.
───────────────────────────────────────────────────── フロントページの続き (72)発明者 関野 直己 東京都渋谷区幡ヶ谷２丁目43番２号 オリ ンパス光学工業株式会社内 ────────────────────────────────────────────────── ─── Continuing on the front page (72) Inventor Naoki Sekino 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd.
Claims (1)
把持部材の把持面に設けられた双極電極と、組織を切開
する切開手段とを備えた内視鏡下手術器械において、 前記切開手段は、把持する組織に接触しないよう前記把
持部材の内部に収容される第１の位置に配置され、切開
時に切開手段の少なくとも一部が第１の位置から一対の
把持部材で形成される把持面を通過するように移動自在
であることを特徴とする内視鏡下手術器械。1. An endoscopic surgical instrument comprising: a pair of gripping members for gripping tissue; a bipolar electrode provided on a gripping surface of the gripping member; and a cutting means for cutting tissue. Is disposed at a first position accommodated inside the gripping member so as not to contact a tissue to be gripped, and a gripping surface formed by a pair of gripping members at least a part of the incision means from the first position at the time of incision An endoscopic surgical instrument, which is movable so as to pass through.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP21198697A JP3986127B2 (en) | 1997-08-06 | 1997-08-06 | Endoscopic surgical instrument |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP21198697A JP3986127B2 (en) | 1997-08-06 | 1997-08-06 | Endoscopic surgical instrument |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH1147150A true JPH1147150A (en) | 1999-02-23 |
| JP3986127B2 JP3986127B2 (en) | 2007-10-03 |
Family
ID=16615006
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP21198697A Expired - Fee Related JP3986127B2 (en) | 1997-08-06 | 1997-08-06 | Endoscopic surgical instrument |
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| Country | Link |
|---|---|
| JP (1) | JP3986127B2 (en) |
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-
1997
- 1997-08-06 JP JP21198697A patent/JP3986127B2/en not_active Expired - Fee Related
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| US11471211B2 (en) | 2018-10-12 | 2022-10-18 | Covidien Lp | Electrosurgical forceps |
| US11350982B2 (en) | 2018-12-05 | 2022-06-07 | Covidien Lp | Electrosurgical forceps |
| US11523861B2 (en) | 2019-03-22 | 2022-12-13 | Covidien Lp | Methods for manufacturing a jaw assembly for an electrosurgical forceps |
| JP2020178848A (en) * | 2019-04-24 | 2020-11-05 | 拓朗 田▲崎▼ | Medical forceps |
| US11607267B2 (en) | 2019-06-10 | 2023-03-21 | Covidien Lp | Electrosurgical forceps |
| US11628008B2 (en) | 2020-03-16 | 2023-04-18 | Covidien Lp | Forceps with linear trigger kickout mechanism |
| US11944369B2 (en) | 2020-03-16 | 2024-04-02 | Covidien Lp | Forceps with linear trigger kickout mechanism |
| US11844562B2 (en) | 2020-03-23 | 2023-12-19 | Covidien Lp | Electrosurgical forceps for grasping, treating, and/or dividing tissue |
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| JP3986127B2 (en) | 2007-10-03 |
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