WO2015022842A1 - High-frequency treatment instrument - Google Patents

High-frequency treatment instrument Download PDF

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Publication number
WO2015022842A1
WO2015022842A1 PCT/JP2014/069283 JP2014069283W WO2015022842A1 WO 2015022842 A1 WO2015022842 A1 WO 2015022842A1 JP 2014069283 W JP2014069283 W JP 2014069283W WO 2015022842 A1 WO2015022842 A1 WO 2015022842A1
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Prior art keywords
treatment
stainless steel
frequency
tissue
forceps
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PCT/JP2014/069283
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French (fr)
Japanese (ja)
Inventor
渉 大塚
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住友ベークライト株式会社
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Publication of WO2015022842A1 publication Critical patent/WO2015022842A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • A61B2018/141—Snare
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1417—Ball
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1422—Hook
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/144—Wire

Definitions

  • the present invention relates to a high-frequency treatment instrument.
  • This application claims priority based on Japanese Patent Application No. 2013-169025 for which it applied to Japan on August 16, 2013, and uses the content here.
  • a high-frequency treatment instrument includes a sheath portion (insertion portion) that is inserted into a body cavity, an operation wire that is inserted into the sheath portion so as to freely advance and retract, and a living tissue that is disposed at the distal end portion of the operation wire by applying a high-frequency current.
  • the treatment section includes a treatment section, a high-frequency application section that abuts on the operation wire and applies a high-frequency current, and an operation section that is attached to the proximal end portion of the sheath section and operates the treatment section via the operation wire.
  • the high-frequency treatment instrument connects a high-frequency power supply connection cord connected to a high-frequency power supply device to a high-frequency terminal of the operation unit, and causes a high-frequency current to flow from the high-frequency power supply device to the operation wire and the treatment portion attached to the distal end portion of the operation wire This makes it possible to perform treatments such as separation and hemostasis of living tissue.
  • Patent Document 1 is known as a high-frequency treatment instrument having a grasping forceps function in a treatment portion.
  • a pair of forceps pieces provided at the distal end of a treatment section is opened and closed by remote control, and has a grasping forceps function for collecting a body tissue, extracting a living tissue, and performing other treatments.
  • a high frequency treatment device is disclosed.
  • the high-frequency treatment tool includes a pair of forceps pieces configured as a high-frequency electrode, and a treatment in which a high-frequency current is passed through the grasping forceps to cauterize the body tissue, that is, a treatment such as incision of a living tissue, Treatments such as coagulation and hemostasis are possible.
  • the present invention has been made in view of the above circumstances, and an object of the present invention is to provide a high-frequency treatment instrument in which tissue is difficult to adhere during tissue cauterization treatment.
  • the present invention employs the following configuration. That is, the present invention includes an insertion portion that is inserted into a body cavity; An operation wire inserted through the insertion portion so as to freely advance and retract; A treatment section disposed at the distal end of the operation wire and treating a living tissue by application of a high-frequency current; An operation unit attached to a proximal end portion of the insertion unit and operating the treatment unit,
  • the high-frequency treatment instrument is characterized in that a material having a thermal conductivity at 100 ° C. of 18 W / m ⁇ K or more and 30 W / m ⁇ K or less is used for at least an electrode portion in contact with a body tissue of the treatment section.
  • the treatment portion is a grasping forceps portion having a pair of forceps pieces that can be opened and closed with each other, and inner surfaces of the pair of forceps pieces facing each other serve as the electrode portions.
  • the material of the said treatment part is stainless steel.
  • the said stainless steel is chromium type stainless steel.
  • the stainless steel is preferably martensitic stainless steel.
  • the stainless steel is preferably ferritic stainless steel.
  • the stainless steel is preferably a duplex stainless steel.
  • a material having a thermal conductivity of 18 W / m ⁇ K or more and 30 W / m ⁇ K or less at 100 ° C. is used for at least an electrode portion of the treatment portion that is in contact with the body tissue.
  • FIG. 1 is a diagram illustrating an example of a high-frequency treatment instrument 1 according to a first embodiment to which the present invention is applied.
  • a high-frequency treatment instrument 1 includes a sheath part (insertion part) 2 inserted into a body cavity, a conductive operation wire (not shown) inserted through the sheath part 2 so as to freely advance and retract, and an operation
  • the treatment unit 3 is disposed at the distal end of the wire and treats a living tissue by applying a high-frequency current, and the operation unit 4 is attached to the sheath unit 2 and operates the treatment unit 3.
  • the high-frequency treatment instrument 1 is used by passing the treatment portion 3 and the sheath portion 2 through which the operation wire is inserted to a forceps port of an endoscope (not shown).
  • the sheath part 2 connects the operation part 4 and the treatment part 3 to enable the treatment part 3 to access the lesion site.
  • the sheath part 2 should just have flexibility,
  • the material is not specifically limited.
  • a conductive material such as stainless steel, a fluorine resin, a polyolefin resin such as a polyethylene resin or a polypropylene resin, a polyamide resin, a polyimide resin, a polyurethane resin, Examples include polycarbonate resins.
  • a fluorine-based resin as the material of the sheath portion 2 because it is excellent in slidability with the forceps hole of the endoscope through which the sheath portion 2 is inserted.
  • a conductive material it is preferable to coat the inner surface of the sheath portion 2 having conductivity with a thin film of an insulating material.
  • the dimensions of the sheath part 2 vary depending on the endoscope to be used, but for example, the length is preferably in the range of 1500 to 2500 mm and the outer diameter is in the range of 1.5 to 3 mm. If the length is within the above range, the high-frequency treatment instrument 1 can be used by being inserted into the forceps opening of the endoscope. Moreover, if an outer diameter is below the said upper limit, the penetration property to the forceps hole of an endoscope will become more favorable.
  • the treatment part 3 is provided at the distal end of the sheath part 2 and has a function of treating a living tissue such as an affected part by application of a high-frequency current.
  • the treatment section 3 is driven by the advancement and retraction of an operation wire (not shown) passed through the sheath section 2.
  • an operation wire (not shown) passed through the sheath section 2.
  • a power supply terminal 12 to which a high-frequency current cord (not shown) is attached is protruded in the operation section 4 in a direction perpendicular to the axial direction of the high-frequency treatment instrument 1. (See FIG. 3).
  • the biological tissue to be treated is not limited to an affected part having a lesion or trauma, but may be a normal biological tissue that can be included as a target for pathological examination or the like.
  • the treatment part 3 in the high-frequency treatment instrument 1 of the present embodiment constitutes a grasping forceps part having a pair of forceps pieces 5 and 5 that can be opened and closed with respect to each other, as shown in FIG. More specifically, the treatment portion 3 has serrated irregularities in which convex portions and concave portions are alternately arranged on the inner surfaces (that is, opposite surfaces) of the pair of upper and lower forceps pieces 5 and 5. Yes.
  • the treatment section 3 is provided so that the inner surfaces 5a and 5a facing each other in a pair of forceps pieces 5 and 5 are at least partially in contact with each other. As a result, the treatment section 3 functions as a grasping forceps called an inguinal forceps that grips the body tissue between the forceps pieces 5 and 5.
  • the forceps pieces 5 and 5 are connected to a link mechanism 6, and the link mechanism 6 performs an opening / closing operation.
  • the link mechanism 6 is connected to an operating member (not shown) that operates in the axial direction of the high-frequency treatment instrument 1, and is further connected to a conductive operation wire (not shown) through this operating member. Thereby, the operation wire and the operating member are moved in the axial direction by the operation of the operation unit 4, the link mechanism 6 is operated, and the forceps pieces 5 and 5 constituting the treatment unit 3 are opened and closed.
  • the forceps pieces 5 and 5 are connected to the operation wire via the link mechanism 6 and the operation member, and each of these members is formed of a conductive member. Therefore, these members constitute a power feeding path from the power terminal 12 provided in the operation unit 4 to the forceps pieces 5 and 5.
  • the inner surfaces 5a and 5a of the forceps pieces 5 and 5 are exposed, but portions other than the inner surfaces 5a and 5a are covered with insulation. Thereby, the mutually opposing inner surfaces 5a, 5a of the pair of forceps pieces 5, 5 serve as electrode portions, and a high-frequency current can flow.
  • the high-frequency treatment instrument 1 of the present embodiment uses a material having a thermal conductivity of 18 W / m ⁇ K or more and 30 W / m ⁇ K or less for the forceps pieces 5 and 5 constituting the treatment section 3. It is a feature.
  • the thermal conductivity means the thermal conductivity at 100 ° C., and can be measured by, for example, a temperature gradient method, a laser flash method, or a hot wire method.
  • the lower limit value of the thermal conductivity is preferably 18 W / m ⁇ K or more, more preferably 20 W / m ⁇ K or more, and further preferably 22 W / m ⁇ K or more.
  • the upper limit value of the thermal conductivity is preferably 30 W / m ⁇ K or less, more preferably 28 W / m ⁇ K or less, and further preferably 27 W / m ⁇ K or less.
  • the thermal conductivity of the material of the electrode portion of the treatment portion 3 is 18 to 30 W / m ⁇ K, preferably 18 to 28 W / m ⁇ K, more preferably 20 to 28 W / m ⁇ K. 20 to 27 W / m ⁇ K is more preferable, and 22 to 27 W / m ⁇ K is particularly preferable.
  • the upper limit exceeds 30 W / m ⁇ K excessive heat is applied to the cautery treatment part, and the visibility is hindered by water vapor generated during treatment of the body tissue, and work efficiency decreases until the water vapor clears. Therefore, the treatment may take time, which is not preferable.
  • the thermal conductivity of the material used for the forceps pieces 5 and 5 is within the above range, the tissue does not adhere to the forceps pieces 5 and 5 when the internal tissue is cauterized. This is preferable because there is no fear of lowering.
  • the material used for the forceps pieces 5 and 5 is not particularly limited as long as the thermal conductivity is within the above range.
  • Specific examples of such materials include stainless steel, titanium, monel metal, constantan, and the like.
  • stainless steel is preferable in terms of price, workability, biocompatibility, and conductivity.
  • stainless steel is austenitic stainless steel (chromium nickel), martensitic stainless steel (chromium), ferrite stainless steel (chromium), duplex stainless steel (chromium nickel), precipitation hardening stainless steel according to JIS standards. Five systems (chromium nickel system) are defined.
  • stainless steel used for the forceps pieces 5 and 5 for example, SUS403 (JIS standard steel type symbol, the same shall apply hereinafter), SUS410, SUS410S, SUS420J1, SUS420J2, SUS440A, SUS440C, or other martensitic stainless steel (chromium); SUS405, SUS410L, SUS429, SUS430, SUS430LX, SUS430J1L, SUS434, SUS436L, SUS436J1L, SUS445J1, SUS445J2, SUS444, SUS447J1, SUSXM27, etc. ) Based stainless steel (chromium nickel based) is preferred.
  • SUS440C and SUS444 are particularly preferable.
  • SUS440C is used as the material for the forceps pieces 5 and 5
  • the tissue is difficult to adhere to the electrode part during cauterization, and the forceps piece as the electrode part is easily peeled off from the tissue. Because of this material, the property of excellent durability can be obtained.
  • SUS444 is used, it is excellent in corrosion resistance.
  • Table 1 shows the thermal conductivity of typical stainless steel. Of the stainless steels shown in Table 1, stainless steel having a thermal conductivity of 18 to 30 W / m ⁇ K can be preferably used.
  • this embodiment demonstrated the case where the material of required heat conductivity was applied to the forceps pieces 5 and 5 which comprise the treatment part 3 whole, it is not limited to this. Specifically, a material having a required thermal conductivity may be applied only to the electrode portion (that is, the inner surfaces 5a and 5a of the forceps pieces 5 and 5 facing each other) of the treatment portion 3 that are in contact with the body tissue.
  • the operation wire (not shown) is a metal wire inserted into the lumen of the sheath portion 2.
  • the distal end of the operation wire is connected to the treatment unit 3.
  • the proximal end of the operation wire is connected to the operation unit 4. Accordingly, the treatment section 3 can be driven and operated via the operation wire by operating the operation section 4.
  • a torque wire or a torque rope made of a conductive material such as stainless steel and having a high torque performance as the operation wire.
  • the rotation to the treatment section 3 can be transmitted without loss by using an operation wire having high torque performance.
  • the operation unit 4 includes a rotation operation unit 9 that rotates integrally with the treatment unit 3 via a high-frequency application unit 8 and an operation wire (not shown) inserted into the main body 7. And a slider portion 10 that is slidably supported in the axial direction of the rotation operation portion 9 and assists the operation of the treatment portion 3, and a handle portion 11 that assists the operation of the slider portion 10. .
  • the high frequency application section 8 is provided with an electrode terminal 12 connected to a high frequency current cord (not shown).
  • the high frequency application unit 8 is rotatable independently of the rotation operation unit 9.
  • the shape of the slider portion 10 is not particularly limited, but it is preferable that the slider can be engaged with the middle finger and the index finger of the operator's hand.
  • the shape of the handle portion 11 is not particularly limited, but is preferably a ring shape so that the operator's thumb can be inserted.
  • the slider portion 10 and the treatment portion 3 are connected to an operation wire that is inserted into the main body 7. Accordingly, the treatment unit 3 can be operated by sliding the slider unit 10 in the axial direction with respect to the main body 7. In addition, the treatment unit 3 can be rotated by rotating the rotation operation unit 9.
  • the high-frequency treatment tool 1 of the present embodiment has a function of grasping a body tissue as grasping forceps.
  • the high-frequency treatment instrument 1 is used without being connected to a high-frequency power source.
  • the treatment portion 3 provided at the distal end of the sheath portion 2 is inserted into the body, and is faced to an organ or tissue to be grasped, and the slider portion 10 is moved along the axial direction of the main body 7.
  • the forceps pieces 5 and 5 are opened and closed.
  • the conventional high-frequency treatment instrument has a problem that the forceps piece is difficult to be peeled off from the tissue because the tissue adheres to the forceps piece serving as the electrode portion when performing a treatment for cauterizing the body tissue.
  • the electrode part is to be peeled from the tissue, the attached tissue follows the movement of the electrode part, and the workability may be reduced.
  • the ring-shaped operation wires 25a to 25c constituting the treatment portion 23 (23A to 23C) of the present embodiment, or at least the portion in contact with the tissue in the body, are required as described in the first embodiment.
  • a material with thermal conductivity is applied. Thereby, the effect similar to 1st Embodiment is acquired.
  • the shapes and sizes of the ring-shaped operation wires 25a to 25c constituting the treatment portion 23 (23A to 23C) of the present embodiment shown in FIGS. 4A to 4C are merely examples, and are limited to this. It is not a thing.
  • FIGS. 5A to 5C show enlarged views of the treatment portion constituting the high-frequency treatment device of the third embodiment.
  • the treatment portions 33 (33A to 33C) of the present embodiment are treatment portions having different shapes at the distal end portions 35a to 35c.
  • the knife-type treatment portion 33A having the bent distal end portion 35a shown in FIG. 5A has a treatment portion while applying a high-frequency current to the living tissue while the bent distal end portion 35a is hooked on the living tissue.
  • the biological tissue is incised by pulling 33A proximally.
  • the treatment portion 33B having a needle-shaped tip portion 35b shown in FIG. 5B the tip portion 35b is pressed against the living tissue, and an incision is made while applying high-frequency current to the living tissue.
  • the treatment portion 33C has a needle-like portion and a substantially hemispherical portion with an enlarged diameter provided at the forefront of the needle-like portion, the treatment portion 33C is replaced with a living tissue.
  • the treatment portion 33C is pulled toward the proximal end while applying a high-frequency current to the living tissue, and the living tissue is incised.
  • the required thermal conductivity described in the first embodiment is applied to the entirety of the distal end portions 35a to 35c constituting the treatment portion 33 (33A to 33C) of this embodiment, or at least the portion in contact with the body tissue. Material has been applied. Thereby, the same effect as the first and second embodiments can be obtained.
  • the shapes and sizes of the distal end portions 35a to 35c constituting the treatment portion 33 (33A to 33C) of the present embodiment shown in FIGS. 5A to 5C are merely examples, and the present invention is not limited thereto. .
  • a high frequency current is applied in the state which hold
  • the material having the required thermal conductivity described in the first embodiment is applied to the tip forceps pieces 45 and 45 constituting the treatment portion 43 of the present embodiment. Thereby, the same effects as those of the first to third embodiments can be obtained.
  • this embodiment demonstrated the case where the material of required heat conductivity was applied to the front-end
  • the tissue adhesion was evaluated using the produced mouth-holding forceps.
  • the operating procedure, the conditions of the high frequency power supply, the ablation object, and the judgment criteria are as shown below.
  • [Operating procedure] (1) Place an ablation object (pig esophageal mucosa) on the counter electrode. (2) The ablation object is sandwiched between the electrode parts, and ablation is performed for 10 seconds while the electrode part is drawn in the opposite direction with respect to the ablation object. (3) The state of the electrode part after cauterization is observed. (4) The above operations 2 and 3 are repeated by changing the location of the ablation object. (5) From the result of (3), “ ⁇ ”, “ ⁇ ”, and “ ⁇ ” are determined according to the following criteria.
  • High frequency power supply VIO300D (manufactured by Elbe)
  • Output Soft coag E5 50W
  • test Example 1 and Test Example 2 forceps pieces were made of a material having a thermal conductivity of 16.3 (W / m ⁇ K) at 100 ° C.
  • a forceps piece was made of a material having a thermal conductivity of 50 (W / m ⁇ K) at 100 ° C.
  • water vapor was generated during the cauterization treatment of the living tissue, obstructing the view of the operator, and the work efficiency was lowered, so the test was stopped.
  • Test Example 3 Test Example 4 and Test Example 5
  • the forceps pieces are made of materials having thermal conductivities at 100 ° C. of 24.3, 25.9 and 27.2 (W / m ⁇ K), respectively. It was produced.
  • the grasping forceps of Test Example 3, Test Example 4, and Test Example 5 it was confirmed that when the living tissue was cauterized, the tissue did not adhere to the forceps piece as the electrode portion.
  • the grasping forceps of Test Example 3 and Test Example 4 it was observed that the tissue was not attached at all visually.

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Abstract

This high-frequency treatment instrument is provided with: an insertion section which is to be inserted into a body cavity; an operation wire which is inserted through the insertion section so as to be capable of being advanced and retracted; a treatment section which is disposed at the distal end of the operation wire and which treats living organism tissue by applying high-frequency electric current to the living organism tissue; and an operation section which is attached to the proximal end of the insertion section and which operates the treatment section. A material having thermal conductivity in the range of 18 W/m·K to 30 W/m·K, inclusive, at 100ºC is used for the electrode portion of the treatment section, the electrode portion coming into contact with at least body tissue.

Description

高周波処置具High frequency treatment tool
　本発明は、高周波処置具に関するものである。
　本願は、２０１３年８月１６日に、日本に出願された特願２０１３－１６９０２５号に基づき優先権を主張し、その内容をここに援用する。 The present invention relates to a high-frequency treatment instrument.
This application claims priority based on Japanese Patent Application No. 2013-169025 for which it applied to Japan on August 16, 2013, and uses the content here.
　医療用高周波処置具は、体内の病変部位における高周波電流を利用した処置に用いられている。一般的に高周波処置具は、体腔内に挿入されるシース部（挿入部）と、シース部内に進退自在に挿通された操作ワイヤと、操作ワイヤ先端部に配置され高周波電流の印加により生体組織を処置する処置部と、操作ワイヤに当接して高周波電流を印加する高周波印加部と、シース部の基端部に付設され操作ワイヤを介して処置部を操作する操作部で構成されている。 Medical high-frequency treatment tools are used for treatments that utilize high-frequency currents in lesions in the body. In general, a high-frequency treatment instrument includes a sheath portion (insertion portion) that is inserted into a body cavity, an operation wire that is inserted into the sheath portion so as to freely advance and retract, and a living tissue that is disposed at the distal end portion of the operation wire by applying a high-frequency current. The treatment section includes a treatment section, a high-frequency application section that abuts on the operation wire and applies a high-frequency current, and an operation section that is attached to the proximal end portion of the sheath section and operates the treatment section via the operation wire.
　高周波処置具は、高周波電源装置に接続された高周波電源接続コードを操作部の高周波端子に接続して、高周波電源装置から操作ワイヤ及び操作ワイヤの先端部に付設された処置部に高周波電流を流すことによって生体組織の切離・止血等の処置が可能となる。 The high-frequency treatment instrument connects a high-frequency power supply connection cord connected to a high-frequency power supply device to a high-frequency terminal of the operation unit, and causes a high-frequency current to flow from the high-frequency power supply device to the operation wire and the treatment portion attached to the distal end portion of the operation wire This makes it possible to perform treatments such as separation and hemostasis of living tissue.
　処置部に把持鉗子機能を有する高周波処置具としては、例えば、特許文献１が知られている。この特許文献１には、処置部の先端に設けられた一対の鉗子片の開閉操作が遠隔操作によって行われ、体内組織の採取，生体組織の摘出その他の処置を行うための把持鉗子機能を有する高周波処置具が開示されている。さらに、上記高周波処置具は、一対の鉗子片が高周波電極として構成されており、把持鉗子に高周波電流を流して体内組織を焼灼する処置、すなわち生体組織を切開する等の処置や、体内組織を凝固させて止血する等の処置が可能とされている。 For example, Patent Document 1 is known as a high-frequency treatment instrument having a grasping forceps function in a treatment portion. In this patent document 1, a pair of forceps pieces provided at the distal end of a treatment section is opened and closed by remote control, and has a grasping forceps function for collecting a body tissue, extracting a living tissue, and performing other treatments. A high frequency treatment device is disclosed. Further, the high-frequency treatment tool includes a pair of forceps pieces configured as a high-frequency electrode, and a treatment in which a high-frequency current is passed through the grasping forceps to cauterize the body tissue, that is, a treatment such as incision of a living tissue, Treatments such as coagulation and hemostasis are possible.
特開２００９－００６１２８号公報JP 2009-006128 A
　しかしながら、特許文献１に記載されているような従来の高周波処置具では、体内組織を焼灼する処置をする際に電極部（把持鉗子においては、例えば鉗子片）に組織が付着してしまい、組織から電極部が剥がれにくいという課題があった。このため、組織焼灼処置後に組織から電極部を剥がそうとしたときに、付着した組織が電極部の動きに追従してしまい、作業性が低下するおそれがあった。 However, in the conventional high-frequency treatment tool as described in Patent Document 1, tissue adheres to the electrode part (for example, a forceps piece in the grasping forceps) when performing a cauterization of the body tissue, and the tissue There was a problem that the electrode part was not easily peeled off. For this reason, when it was going to peel an electrode part from a structure | tissue after a tissue cauterization treatment, the attached structure | tissue followed the movement of an electrode part and there existed a possibility that workability | operativity might fall.
　本発明は、上記事情に鑑みてなされたものであって、組織焼灼処置の際に組織が付着しにくい高周波処置具を提供することを課題とする。 The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a high-frequency treatment instrument in which tissue is difficult to adhere during tissue cauterization treatment.
　上記の課題を達成するために、本発明は以下の構成を採用した。
　すなわち、本発明は、体腔内に挿入される挿入部と、
　前記挿入部に進退自在に挿通された操作ワイヤと、
　前記操作ワイヤの先端部に配置され、高周波電流の印加によって生体組織を処置する処置部と、
　前記挿入部の基端部に付設され、前記処置部を操作する操作部と、を備える高周波処置具であって、
　前記処置部の、少なくとも体内組織と接する電極部分に、１００℃における熱伝導率が１８Ｗ／ｍ・Ｋ以上、３０Ｗ／ｍ・Ｋ以下の材料を用いることを特徴とする高周波処置具である。 In order to achieve the above object, the present invention employs the following configuration.
That is, the present invention includes an insertion portion that is inserted into a body cavity;
An operation wire inserted through the insertion portion so as to freely advance and retract;
A treatment section disposed at the distal end of the operation wire and treating a living tissue by application of a high-frequency current;
An operation unit attached to a proximal end portion of the insertion unit and operating the treatment unit,
The high-frequency treatment instrument is characterized in that a material having a thermal conductivity at 100 ° C. of 18 W / m · K or more and 30 W / m · K or less is used for at least an electrode portion in contact with a body tissue of the treatment section.
　また、前記処置部が、相互に開閉可能な一対の鉗子片を有する把持鉗子部であり、前記一対の鉗子片の互いに対向する内面が、前記電極部分となることが好ましい。
　また、前記処置部の材料が、ステンレス鋼であることが好ましい。
　また、前記ステンレス鋼が、クロム系ステンレスであることが好ましい。
　また、前記ステンレス鋼が、マルテンサイト系ステンレスであることが好ましい。
　また、前記ステンレス鋼が、フェライト系ステンレスであることが好ましい。
　また、前記ステンレス鋼が、二相系ステンレスであることが好ましい。 Moreover, it is preferable that the treatment portion is a grasping forceps portion having a pair of forceps pieces that can be opened and closed with each other, and inner surfaces of the pair of forceps pieces facing each other serve as the electrode portions.
Moreover, it is preferable that the material of the said treatment part is stainless steel.
Moreover, it is preferable that the said stainless steel is chromium type stainless steel.
The stainless steel is preferably martensitic stainless steel.
The stainless steel is preferably ferritic stainless steel.
The stainless steel is preferably a duplex stainless steel.
　本発明の高周波処置具によれば、処置部の少なくとも体内組織と接する電極部分に１００℃における熱伝導率が１８Ｗ／ｍ・Ｋ以上、３０Ｗ／ｍ・Ｋ以下の材料を用いるため、組織焼灼処置の際に組織が付着しにくい高周波処置具を提供することができる。したがって、本発明の高周波処置具によれば、作業性が向上し、被験者への負担を軽減することができる。 According to the high-frequency treatment tool of the present invention, a material having a thermal conductivity of 18 W / m · K or more and 30 W / m · K or less at 100 ° C. is used for at least an electrode portion of the treatment portion that is in contact with the body tissue. In this case, it is possible to provide a high-frequency treatment instrument in which tissue is difficult to adhere. Therefore, according to the high-frequency treatment tool of the present invention, workability is improved and the burden on the subject can be reduced.
本発明を適用した第１の実施形態である高周波処置具の構成を説明するための図である。It is a figure for demonstrating the structure of the high frequency treatment tool which is 1st Embodiment to which this invention is applied. 本発明を適用した第１の実施形態である高周波処置具を構成する処置部の拡大図である。It is an enlarged view of the treatment part which comprises the high frequency treatment tool which is 1st Embodiment to which this invention is applied. 本発明を適用した第１の実施形態である高周波処置具を構成する操作部の拡大図である。It is an enlarged view of the operation part which comprises the high frequency treatment tool which is 1st Embodiment to which this invention is applied. 本発明を適用した第２の実施形態である高周波処置具を構成する処置部の拡大図である。It is an enlarged view of the treatment part which comprises the high frequency treatment tool which is 2nd Embodiment to which this invention is applied. 本発明を適用した第２の実施形態である高周波処置具を構成する処置部の拡大図である。It is an enlarged view of the treatment part which comprises the high frequency treatment tool which is 2nd Embodiment to which this invention is applied. 本発明を適用した第２の実施形態である高周波処置具を構成する処置部の拡大図である。It is an enlarged view of the treatment part which comprises the high frequency treatment tool which is 2nd Embodiment to which this invention is applied. 本発明を適用した第３の実施形態である高周波処置具を構成する処置部の拡大図である。It is an enlarged view of the treatment part which comprises the high frequency treatment tool which is 3rd Embodiment to which this invention is applied. 本発明を適用した第３の実施形態である高周波処置具を構成する処置部の拡大図である。It is an enlarged view of the treatment part which comprises the high frequency treatment tool which is 3rd Embodiment to which this invention is applied. 本発明を適用した第３の実施形態である高周波処置具を構成する処置部の拡大図である。It is an enlarged view of the treatment part which comprises the high frequency treatment tool which is 3rd Embodiment to which this invention is applied. 本発明を適用した第４の実施形態である高周波処置具を構成する処置部の拡大図である。It is an enlarged view of the treatment part which comprises the high frequency treatment tool which is 4th Embodiment to which this invention is applied.
　以下、本発明を適用した一実施形態である高周波処置具について、図面を用いて詳細に説明する。
　なお、以下の説明で用いる図面は、特徴をわかりやすくするために、便宜上特徴となる部分を拡大して示している場合があり、各構成要素の寸法比率などが実際と同じであるとは限らない。 Hereinafter, a high-frequency treatment instrument that is an embodiment to which the present invention is applied will be described in detail with reference to the drawings.
In addition, in the drawings used in the following description, in order to make the features easy to understand, there are cases where the portions that become the features are enlarged for the sake of convenience, and the dimensional ratios of the respective components are not always the same as the actual ones. Absent.
＜第１の実施形態＞
　先ず、本発明を適用した第１の実施形態である高周波処置具の構成について説明する。
　図１は、本発明を適用した第１実施形態である高周波処置具１の一例を示す図である。図１に示すように、高周波処置具１は、体腔内に挿入されるシース部（挿入部）２と、シース部２に進退自在に挿通された導電性の操作ワイヤ（図示略）と、操作ワイヤの先端部に配置され、高周波電流の印加によって生体組織を処置する処置部３と、シース部２に付設されて処置部３を操作する操作部４とを備えて、概略構成されている。この高周波処置具１は、処置部３及び操作ワイヤが挿通されたシース部２を、内視鏡（図示略）の鉗子口に送通して用いられる。 <First Embodiment>
First, the structure of the high frequency treatment tool which is 1st Embodiment to which this invention is applied is demonstrated.
FIG. 1 is a diagram illustrating an example of a high-frequency treatment instrument 1 according to a first embodiment to which the present invention is applied. As shown in FIG. 1, a high-frequency treatment instrument 1 includes a sheath part (insertion part) 2 inserted into a body cavity, a conductive operation wire (not shown) inserted through the sheath part 2 so as to freely advance and retract, and an operation The treatment unit 3 is disposed at the distal end of the wire and treats a living tissue by applying a high-frequency current, and the operation unit 4 is attached to the sheath unit 2 and operates the treatment unit 3. The high-frequency treatment instrument 1 is used by passing the treatment portion 3 and the sheath portion 2 through which the operation wire is inserted to a forceps port of an endoscope (not shown).
　シース部２は、操作部４と処置部３とを接続して、処置部３が病変部位へアクセスすることを可能としている。シース部２は、可撓性を有していればよく、その材料は特に限定されるものではない。シース部２の材料として具体的には、例えば、ステンレス鋼のような導電性材料、フッ素系樹脂、ポリエチレン樹脂やポリプロピレン樹脂のようなポリオレフィン系樹脂、ポリアミド系樹脂、ポリイミド系樹脂、ポリウレタン系樹脂、ポリカーボネート系樹脂等が挙げられる。これらの中でも、シース部２の材料としてフッ素系樹脂を用いる場合、シース部２が挿通される内視鏡の鉗子孔との摺動性に優れるために好ましい。一方、導電性材料を用いる場合には、シース部２の導電性を有する内表面には絶縁性材料を薄膜コーティングすることが好ましい。 The sheath part 2 connects the operation part 4 and the treatment part 3 to enable the treatment part 3 to access the lesion site. The sheath part 2 should just have flexibility, The material is not specifically limited. Specifically, as the material of the sheath part 2, for example, a conductive material such as stainless steel, a fluorine resin, a polyolefin resin such as a polyethylene resin or a polypropylene resin, a polyamide resin, a polyimide resin, a polyurethane resin, Examples include polycarbonate resins. Among these, it is preferable to use a fluorine-based resin as the material of the sheath portion 2 because it is excellent in slidability with the forceps hole of the endoscope through which the sheath portion 2 is inserted. On the other hand, when a conductive material is used, it is preferable to coat the inner surface of the sheath portion 2 having conductivity with a thin film of an insulating material.
　シース部２の寸法は、使用する内視鏡により異なるが、例えば、長さが１５００～２５００ｍｍ、外径が１．５～３ｍｍの範囲にあることが好ましい。長さが上記範囲内にあれば、高周波処置具１を内視鏡の鉗子口に挿通して使用することができる。また、外径が上記上限以下であれば、内視鏡の鉗子孔への挿通性がより良好となる。 The dimensions of the sheath part 2 vary depending on the endoscope to be used, but for example, the length is preferably in the range of 1500 to 2500 mm and the outer diameter is in the range of 1.5 to 3 mm. If the length is within the above range, the high-frequency treatment instrument 1 can be used by being inserted into the forceps opening of the endoscope. Moreover, if an outer diameter is below the said upper limit, the penetration property to the forceps hole of an endoscope will become more favorable.
　処置部３は、シース部２の先端に設けられており、高周波電流の印加により例えば患部等の生体組織を処置する機能を有している。また、処置部３は、シース部２内に送通された操作ワイヤ（図示略）の進退により駆動する。なお、処置部３に高周波電流を印加するために、操作部４には高周波電流コード（図示略）が装着される電源端子１２が高周波処置具１の軸方向に対して垂直方向に突出するようにして設けられている（図３を参照）。また、処置の対象とされる生体組織は、病変や外傷を有する患部に限らず、病理検査などの対象として含まれ得る正常な生体組織であっても良い。 The treatment part 3 is provided at the distal end of the sheath part 2 and has a function of treating a living tissue such as an affected part by application of a high-frequency current. The treatment section 3 is driven by the advancement and retraction of an operation wire (not shown) passed through the sheath section 2. In order to apply a high-frequency current to the treatment section 3, a power supply terminal 12 to which a high-frequency current cord (not shown) is attached is protruded in the operation section 4 in a direction perpendicular to the axial direction of the high-frequency treatment instrument 1. (See FIG. 3). The biological tissue to be treated is not limited to an affected part having a lesion or trauma, but may be a normal biological tissue that can be included as a target for pathological examination or the like.
　本実施形態の高周波処置具１における処置部３は、図２に示すように、相互に開閉可能な一対の鉗子片５，５を有する把持鉗子部を構成している。より具体的には、処置部３は、上下一対の鉗子片５，５の内面（すなわち、相対向する面）に、凸部と凹部とを交互に配設した鋸歯状の凹凸が形成されている。また、処置部３は、一対の鉗子片５，５が閉状態において互いに対向する内面５ａ，５ａが少なくとも部分的に当接するように設けられている。これにより、処置部３は、鉗子片５，５間に体内組織を挟み込むようにして把持する、鰐口型鉗子と呼ばれる把持鉗子として機能する。 The treatment part 3 in the high-frequency treatment instrument 1 of the present embodiment constitutes a grasping forceps part having a pair of forceps pieces 5 and 5 that can be opened and closed with respect to each other, as shown in FIG. More specifically, the treatment portion 3 has serrated irregularities in which convex portions and concave portions are alternately arranged on the inner surfaces (that is, opposite surfaces) of the pair of upper and lower forceps pieces 5 and 5. Yes. The treatment section 3 is provided so that the inner surfaces 5a and 5a facing each other in a pair of forceps pieces 5 and 5 are at least partially in contact with each other. As a result, the treatment section 3 functions as a grasping forceps called an inguinal forceps that grips the body tissue between the forceps pieces 5 and 5.
　鉗子片５，５は、リンク機構６に連結されており、このリンク機構６により開閉動作が行われる。リンク機構６は、高周波処置具１の軸線方向に作動する図示略の作動部材に連結されており、この作動部材を介してさらに導電性の操作ワイヤ（図示略）と接続されている。これにより、操作部４の操作によって、操作ワイヤ及び作動部材が軸線方向に移動して、リンク機構６が作動し、処置部３を構成する鉗子片５，５が開閉動作することになる。 The forceps pieces 5 and 5 are connected to a link mechanism 6, and the link mechanism 6 performs an opening / closing operation. The link mechanism 6 is connected to an operating member (not shown) that operates in the axial direction of the high-frequency treatment instrument 1, and is further connected to a conductive operation wire (not shown) through this operating member. Thereby, the operation wire and the operating member are moved in the axial direction by the operation of the operation unit 4, the link mechanism 6 is operated, and the forceps pieces 5 and 5 constituting the treatment unit 3 are opened and closed.
　さらに、鉗子片５，５は、リンク機構６及び作動部材を介して操作ワイヤと連結されるとともに、これらの各部材が導電性を有する部材で形成されている。したがって、これらの部材が、操作部４に設けられた電源端子１２から鉗子片５，５に至る給電路を構成する。一方、鉗子片５，５の内面５ａ，５ａは露出しているが、この内面５ａ，５ａ以外の部分は絶縁被覆されている。これにより、一対の鉗子片５，５の互いに対向する内面５ａ，５ａが電極部分となり、高周波電流を流すことが可能とされている。 Furthermore, the forceps pieces 5 and 5 are connected to the operation wire via the link mechanism 6 and the operation member, and each of these members is formed of a conductive member. Therefore, these members constitute a power feeding path from the power terminal 12 provided in the operation unit 4 to the forceps pieces 5 and 5. On the other hand, the inner surfaces 5a and 5a of the forceps pieces 5 and 5 are exposed, but portions other than the inner surfaces 5a and 5a are covered with insulation. Thereby, the mutually opposing inner surfaces 5a, 5a of the pair of forceps pieces 5, 5 serve as electrode portions, and a high-frequency current can flow.
　ここで、本実施形態の高周波処置具１は、処置部３を構成する鉗子片５，５に、熱伝導率が、１８Ｗ／ｍ・Ｋ以上、３０Ｗ／ｍ・Ｋ以下の材料を用いることを特徴としている。なお、熱伝導率とは、１００℃における熱伝導率をいい、例えば、温度傾斜法、レーザーフラッシュ法、熱線法によって測定することができる。また、熱伝導率の下限値としては、１８Ｗ／ｍ・Ｋ以上であることが好ましく、２０Ｗ／ｍ・Ｋ以上であることがより好ましく、２２Ｗ／ｍ・Ｋ以上であることがさらに好ましい。一方、熱伝導率の上限値としては、３０Ｗ／ｍ・Ｋ以下であることが好ましく、２８Ｗ／ｍ・Ｋ以下であることがより好ましく、２７Ｗ／ｍ・Ｋ以下であることがさらに好ましい。換言すると、本願において処置部３の電極部分の材料の熱伝導率は、１８～３０Ｗ／ｍ・Ｋであって、１８～２８Ｗ／ｍ・Ｋが好ましく、２０～２８Ｗ／ｍ・Ｋがより好ましく、２０～２７Ｗ／ｍ・Ｋがさらに好ましく、２２～２７Ｗ／ｍ・Ｋが特に好ましい。 Here, the high-frequency treatment instrument 1 of the present embodiment uses a material having a thermal conductivity of 18 W / m · K or more and 30 W / m · K or less for the forceps pieces 5 and 5 constituting the treatment section 3. It is a feature. The thermal conductivity means the thermal conductivity at 100 ° C., and can be measured by, for example, a temperature gradient method, a laser flash method, or a hot wire method. Further, the lower limit value of the thermal conductivity is preferably 18 W / m · K or more, more preferably 20 W / m · K or more, and further preferably 22 W / m · K or more. On the other hand, the upper limit value of the thermal conductivity is preferably 30 W / m · K or less, more preferably 28 W / m · K or less, and further preferably 27 W / m · K or less. In other words, in this application, the thermal conductivity of the material of the electrode portion of the treatment portion 3 is 18 to 30 W / m · K, preferably 18 to 28 W / m · K, more preferably 20 to 28 W / m · K. 20 to 27 W / m · K is more preferable, and 22 to 27 W / m · K is particularly preferable.
　鉗子片５，５に用いる材料の熱伝導率の下限値が１８Ｗ／ｍ・Ｋ未満であると、体内組織の焼灼処置をする際に電極部分に組織が付着してしまい、組織から電極部分である鉗子片５，５が剥がれにくくなり、作業性が低下するおそれがあるため、好ましくない。一方、上限値が３０Ｗ／ｍ・Ｋを超えると、焼灼処置部分に想定以上の過度の熱がかかり、体内組織の処置時に発生する水蒸気のため視界が妨げられ、水蒸気が晴れるまで作業効率が低下して処置に時間がかかるおそれがあるため、好ましくない。これに対して、鉗子片５，５に用いる材料の熱伝導率が上記範囲内であると、体内組織を焼灼処置する際に組織が鉗子片５，５に付着することがなく、作業性が低下するおそれがないために好ましい。 When the lower limit value of the thermal conductivity of the material used for the forceps pieces 5 and 5 is less than 18 W / m · K, the tissue adheres to the electrode portion when the internal tissue is cauterized. It is not preferable because the forceps pieces 5 and 5 are difficult to peel off and workability may be reduced. On the other hand, if the upper limit exceeds 30 W / m · K, excessive heat is applied to the cautery treatment part, and the visibility is hindered by water vapor generated during treatment of the body tissue, and work efficiency decreases until the water vapor clears. Therefore, the treatment may take time, which is not preferable. On the other hand, when the thermal conductivity of the material used for the forceps pieces 5 and 5 is within the above range, the tissue does not adhere to the forceps pieces 5 and 5 when the internal tissue is cauterized. This is preferable because there is no fear of lowering.
　鉗子片５，５に用いる材料としては、その熱伝導率が上記範囲内であれば特に限定されるものではない。このような材料としては、具体的には、例えば、ステンレス鋼、チタン、モネルメタル、コンスタンタン等が挙げられるが、中でもステンレス鋼が、値段、加工性、生体適合性、導電性の点で好ましい。 The material used for the forceps pieces 5 and 5 is not particularly limited as long as the thermal conductivity is within the above range. Specific examples of such materials include stainless steel, titanium, monel metal, constantan, and the like. Among these materials, stainless steel is preferable in terms of price, workability, biocompatibility, and conductivity.
　一般に、ステンレス鋼は、ＪＩＳ規格によって、オーステナイト系ステンレス（クロムニッケル系）、マルテンサイト系ステンレス（クロム系）、フェライト系ステンレス（クロム系）、二相系ステンレス（クロムニッケル系）、析出硬化系ステンレス（クロムニッケル系）の５系統が規定されている。ここで、鉗子片５，５に用いるステンレス鋼としては、例えば、ＳＵＳ４０３（ＪＩＳ規格鋼種記号、以下同じ）、ＳＵＳ４１０、ＳＵＳ４１０Ｓ、ＳＵＳ４２０Ｊ１、ＳＵＳ４２０Ｊ２、ＳＵＳ４４０Ａ、ＳＵＳ４４０Ｃ等のマルテンサイト系ステンレス（クロム系）；ＳＵＳ４０５、ＳＵＳ４１０Ｌ、ＳＵＳ４２９、ＳＵＳ４３０、ＳＵＳ４３０ＬＸ、ＳＵＳ４３０Ｊ１Ｌ、ＳＵＳ４３４、ＳＵＳ４３６Ｌ、ＳＵＳ４３６Ｊ１Ｌ、ＳＵＳ４４５Ｊ１、ＳＵＳ４４５Ｊ２、ＳＵＳ４４４、ＳＵＳ４４７Ｊ１、ＳＵＳＸＭ２７等のフェライト系ステンレス（クロム系）；ＳＵＳ３２９Ｊ１、ＳＵＳ３２９Ｊ３Ｌ、ＳＵＳ３２９Ｊ４Ｌ等の二相（オーステナイト・フェライト）系ステンレス（クロムニッケル系）であることが好ましい。 Generally, stainless steel is austenitic stainless steel (chromium nickel), martensitic stainless steel (chromium), ferrite stainless steel (chromium), duplex stainless steel (chromium nickel), precipitation hardening stainless steel according to JIS standards. Five systems (chromium nickel system) are defined. Here, as the stainless steel used for the forceps pieces 5 and 5, for example, SUS403 (JIS standard steel type symbol, the same shall apply hereinafter), SUS410, SUS410S, SUS420J1, SUS420J2, SUS440A, SUS440C, or other martensitic stainless steel (chromium); SUS405, SUS410L, SUS429, SUS430, SUS430LX, SUS430J1L, SUS434, SUS436L, SUS436J1L, SUS445J1, SUS445J2, SUS444, SUS447J1, SUSXM27, etc. ) Based stainless steel (chromium nickel based) is preferred.
　これらの中でも、特に、ＳＵＳ４４０Ｃ、ＳＵＳ４４４が好ましい。鉗子片５，５の材料としてＳＵＳ４４０Ｃを用いた場合、焼灼処置をする際に電極部分に組織が付着しにくく、組織から電極部分である鉗子片が剥がれやすくなることに加え、高強度、高硬度の材料であることから耐久性に優れるという性質が得られる。また、ＳＵＳ４４４を用いた場合、耐食性に優れる。
　なお、表１に代表的なステンレス鋼の熱伝導率を示す。表１に示すステンレス鋼のうち、熱伝導率が１８～３０Ｗ／ｍ・Ｋであるステンレス鋼を好ましく用いることができる。 Among these, SUS440C and SUS444 are particularly preferable. When SUS440C is used as the material for the forceps pieces 5 and 5, the tissue is difficult to adhere to the electrode part during cauterization, and the forceps piece as the electrode part is easily peeled off from the tissue. Because of this material, the property of excellent durability can be obtained. Moreover, when SUS444 is used, it is excellent in corrosion resistance.
Table 1 shows the thermal conductivity of typical stainless steel. Of the stainless steels shown in Table 1, stainless steel having a thermal conductivity of 18 to 30 W / m · K can be preferably used.
Figure JPOXMLDOC01-appb-T000001
Figure JPOXMLDOC01-appb-T000001
　なお、本実施形態では、処置部３を構成する鉗子片５，５全体に所要の熱伝導率の材料を適用する場合について説明したが、これに限定されるものではない。具体的には、処置部３の、体内組織と接する電極部分（すなわち、鉗子片５，５の互いに対向する内面５ａ，５ａ）のみに所要の熱伝導率の材料を適用する構成としてもよい。 In addition, although this embodiment demonstrated the case where the material of required heat conductivity was applied to the forceps pieces 5 and 5 which comprise the treatment part 3 whole, it is not limited to this. Specifically, a material having a required thermal conductivity may be applied only to the electrode portion (that is, the inner surfaces 5a and 5a of the forceps pieces 5 and 5 facing each other) of the treatment portion 3 that are in contact with the body tissue.
　操作ワイヤ（図示略）は、シース部２の管腔に挿通される金属製のワイヤである。操作ワイヤの先端は、処置部３と接続されている。また、操作ワイヤの基端は、操作部４と接続されている。これにより、操作部４を操作することで操作ワイヤを介して処置部３を駆動操作することができる。 The operation wire (not shown) is a metal wire inserted into the lumen of the sheath portion 2. The distal end of the operation wire is connected to the treatment unit 3. The proximal end of the operation wire is connected to the operation unit 4. Accordingly, the treatment section 3 can be driven and operated via the operation wire by operating the operation section 4.
　また、操作ワイヤは、ステンレス鋼のような導電性材料で作製され、高いトルク性能をもつトルクワイヤもしくはトルクロープを使用することが望ましい。処置部３がシース部２に対して回転可能な場合、高いトルク性能をもつ操作ワイヤを使用することにより、処置部３への回転をロスなく伝達することが可能となる。また、操作ワイヤの表面にフッ素樹脂等をコーティングしてもよい。これにより、シース部２の内部と操作ワイヤとの滑り性が良好となり、操作ワイヤの操作性を向上させることができる。 Also, it is desirable to use a torque wire or a torque rope made of a conductive material such as stainless steel and having a high torque performance as the operation wire. When the treatment section 3 is rotatable with respect to the sheath section 2, the rotation to the treatment section 3 can be transmitted without loss by using an operation wire having high torque performance. Moreover, you may coat a fluororesin etc. on the surface of an operation wire. Thereby, the slidability between the inside of the sheath portion 2 and the operation wire is improved, and the operability of the operation wire can be improved.
　操作部４は、図３に示すように、本体７に、高周波印加部８と、本体７内に挿通される図示略の操作ワイヤを介して処置部３と一体的に回転する回転操作部９と、回転操作部９の軸線方向にスライド自在に支持されて処置部３の操作を補助するスライダー部１０と、スライダー部１０の動作を補助する把手部１１と、を備えて概略構成されている。 As shown in FIG. 3, the operation unit 4 includes a rotation operation unit 9 that rotates integrally with the treatment unit 3 via a high-frequency application unit 8 and an operation wire (not shown) inserted into the main body 7. And a slider portion 10 that is slidably supported in the axial direction of the rotation operation portion 9 and assists the operation of the treatment portion 3, and a handle portion 11 that assists the operation of the slider portion 10. .
　高周波印加部８には、図示略の高周波電流コードと接続する電極端子１２が設けられている。また、この高周波印加部８は、回転操作部９と独立して回転可能とされている。 The high frequency application section 8 is provided with an electrode terminal 12 connected to a high frequency current cord (not shown). The high frequency application unit 8 is rotatable independently of the rotation operation unit 9.
　スライダー部１０の形状は、特に限定されるものではないが、操作者の手の中指と人指し指とを係合させることができる形状であることが好ましい。また、把手部１１の形状は、特に限定されるものではないが、操作者の親指が挿入できるようにリング状の形状であることが好ましい。 The shape of the slider portion 10 is not particularly limited, but it is preferable that the slider can be engaged with the middle finger and the index finger of the operator's hand. The shape of the handle portion 11 is not particularly limited, but is preferably a ring shape so that the operator's thumb can be inserted.
　スライダー部１０と処置部３とは、本体７内に挿通される操作ワイヤと連結されている。これにより、スライダー部１０を本体７に対して軸方向にスライドさせることによって、処置部３の操作が可能とされている。また、回転操作部９を回転させることによって、処置部３の回転が可能とされている。 The slider portion 10 and the treatment portion 3 are connected to an operation wire that is inserted into the main body 7. Accordingly, the treatment unit 3 can be operated by sliding the slider unit 10 in the axial direction with respect to the main body 7. In addition, the treatment unit 3 can be rotated by rotating the rotation operation unit 9.
　次に、上述した高周波処置具１の使用方法について説明する。
　本実施形態の高周波処置具１は、把持鉗子として体内組織を把持する機能を有する。この場合、高周波処置具１は、高周波電源と接続しないで用いる。具体的には、シース部２の先端に設けられた処置部３を体内に挿入し、把持しようとする臓器あるいは組織と対面させて、スライダー部１０を本体７の軸線方向に沿って移動させることにより鉗子片５，５の開閉操作を行う。 Next, the usage method of the high frequency treatment tool 1 mentioned above is demonstrated.
The high-frequency treatment tool 1 of the present embodiment has a function of grasping a body tissue as grasping forceps. In this case, the high-frequency treatment instrument 1 is used without being connected to a high-frequency power source. Specifically, the treatment portion 3 provided at the distal end of the sheath portion 2 is inserted into the body, and is faced to an organ or tissue to be grasped, and the slider portion 10 is moved along the axial direction of the main body 7. Thus, the forceps pieces 5 and 5 are opened and closed.
　また、本実施形態の高周波処置具１は、図示略の高周波電流コードを電極端子１２に接続して、鉗子片５，５に高周波電流を流すことにより、焼灼による止血や病変部の切除等といった処置を行う機能を有する。具体的には、先ず、内視鏡観察により出血部や病変部が発見されたときに、処置具挿通チャンネル等を介して処置部３を焼灼あるいは切除すべき部位近傍に導入する。次に、処置部３の鉗子片５，５を開いて、焼灼あるいは切除すべき部位を狙撃部として取り込むようにする。この際、シース部２や操作部４を操作して狙撃部を挟み易い方向に処置部３を回転させる。 In addition, the high-frequency treatment instrument 1 according to the present embodiment connects a high-frequency current cord (not shown) to the electrode terminal 12 and causes a high-frequency current to flow through the forceps pieces 5 and 5, thereby causing hemostasis by cauterization, excision of a lesioned part, and the like. Has the function of performing treatment. Specifically, first, when a bleeding part or a lesioned part is found by endoscopic observation, the treatment part 3 is introduced in the vicinity of a site to be cauterized or excised via a treatment instrument insertion channel or the like. Next, the forceps pieces 5 and 5 of the treatment section 3 are opened so that a site to be cauterized or excised is taken as a sniper section. At this time, the treatment section 3 is rotated in a direction in which the sheath section 2 and the operation section 4 are operated to easily sandwich the sniper section.
　次に、鉗子片５，５を閉じることによって、この狙撃した部位を挟持する。狙撃部でない部位を挟み込んでしまった場合には、高周波電流を流す前であるため、適宜正確な狙撃部を挟み直すことが可能である。狙撃部を正確に挟持した後、処置部３を内視鏡側に引き込むように操作し、この状態で高周波電流を鉗子片５，５に向けて流すことにより、焼灼して凝固させることによる止血や病変した体内組織の切除といった処置を行うことができる。 Next, by closing the forceps pieces 5 and 5, the sniped part is clamped. When a portion that is not a sniper is sandwiched, it is before flowing a high-frequency current, so that an accurate sniper can be sandwiched as appropriate. After pinching the sniper part accurately, the treatment part 3 is operated so as to be pulled into the endoscope, and in this state, a high-frequency current is directed toward the forceps pieces 5 and 5 to cause hemostasis by cauterizing and coagulating. Or excision of the affected body tissue can be performed.
　ところで、従来の高周波処置具では、体内組織を焼灼する処置をする際に、電極部分となる鉗子片に組織が付着してしまうため、組織から鉗子片が剥がれにくいという問題があった。このとき、組織から電極部を剥がそうとすると、付着した組織が電極部の動きに追従してしまい、作業性が低下するおそれがあった。 By the way, the conventional high-frequency treatment instrument has a problem that the forceps piece is difficult to be peeled off from the tissue because the tissue adheres to the forceps piece serving as the electrode portion when performing a treatment for cauterizing the body tissue. At this time, if the electrode part is to be peeled from the tissue, the attached tissue follows the movement of the electrode part, and the workability may be reduced.
　これに対して、本実施形態の高周波処置具１によれば、処置部３の少なくとも体内組織と接する電極部分である鉗子片５，５に、１００℃における熱伝導率が１８Ｗ／ｍ・Ｋ以上、３０Ｗ／ｍ・Ｋ以下の材料を用いている。これにより、焼灼処置の際に組織が鉗子片５，５に付着しにくくなり、作業性が低下するおそれがない高周波処置具１を提供することができる。したがって、本実施形態の高周波処置具１によれば、被験者への負担を軽減することができる。 On the other hand, according to the high-frequency treatment tool 1 of the present embodiment, the thermal conductivity at 100 ° C. is 18 W / m · K or more in the forceps pieces 5 and 5 which are electrode portions in contact with at least the body tissue of the treatment portion 3. 30 W / m · K or less is used. Accordingly, it is possible to provide the high-frequency treatment instrument 1 that makes it difficult for the tissue to adhere to the forceps pieces 5 and 5 during the cauterization treatment and does not cause a decrease in workability. Therefore, according to the high frequency treatment tool 1 of the present embodiment, the burden on the subject can be reduced.
＜第２の実施形態＞
　次に、本発明を適用した第２の実施形態について説明する。本実施形態では、第１の実施形態の高周波処置具１とは処置部の構成のみが異なっており、その他の構成部分については、第１の実施形態と共通となっている。したがって、第１の実施形態と同一の構成部分については同じ符号を付すると共に説明を省略する。 <Second Embodiment>
Next, a second embodiment to which the present invention is applied will be described. In the present embodiment, only the configuration of the treatment unit is different from the high-frequency treatment instrument 1 of the first embodiment, and the other components are common to the first embodiment. Therefore, the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted.
　図４Ａ～４Ｃは、第２実施形態の高周波処置具を構成する処置部の拡大図を示している。図４Ａ～４Ｃに示すように、本実施形態の処置部２３（２３Ａ～２３Ｃ）は、リング状の操作ワイヤ２５ａ～２５ｃをそれぞれ備えるスネア型の処置部である。このスネア型の処置部２３（２３Ａ～２３Ｃ）は、操作ワイヤ２５ａ～２５ｃの進退によりスネア径が拡大または縮小し、生体組織に高周波電流を印加しつつこれを緊縛し、当該生体組織を切開する。 FIGS. 4A to 4C show enlarged views of the treatment portion constituting the high-frequency treatment instrument of the second embodiment. As shown in FIGS. 4A to 4C, the treatment portion 23 (23A to 23C) of the present embodiment is a snare-type treatment portion provided with ring-shaped operation wires 25a to 25c, respectively. The snare type treatment unit 23 (23A to 23C) expands or contracts the snare diameter by the advancement and retraction of the operation wires 25a to 25c, and binds the biological tissue while applying a high-frequency current to incise the biological tissue. .
　ここで、本実施形態の処置部２３（２３Ａ～２３Ｃ）を構成するリング状の操作ワイヤ２５ａ～２５ｃの全体、もしくは、少なくとも体内組織と接する部分に、上述した第１実施形態で説明した所要の熱伝導率の材料が適用されている。これにより、第１実施形態と同様の効果が得られる。 Here, the ring-shaped operation wires 25a to 25c constituting the treatment portion 23 (23A to 23C) of the present embodiment, or at least the portion in contact with the tissue in the body, are required as described in the first embodiment. A material with thermal conductivity is applied. Thereby, the effect similar to 1st Embodiment is acquired.
　なお、図４Ａ～４Ｃ中に示した、本実施形態の処置部２３（２３Ａ～２３Ｃ）を構成するリング状の操作ワイヤ２５ａ～２５ｃの形状や大きさは一例であって、これに限定されるものではない。 The shapes and sizes of the ring-shaped operation wires 25a to 25c constituting the treatment portion 23 (23A to 23C) of the present embodiment shown in FIGS. 4A to 4C are merely examples, and are limited to this. It is not a thing.
＜第３の実施形態＞
　次に、本発明を適用した第３の実施形態について説明する。本実施形態では、第１及び第２の実施形態の高周波処置具とは処置部の構成のみが異なっており、その他の構成部分については、第１の実施形態と共通となっている。したがって、第１の実施形態と同一の構成部分については同じ符号を付すると共に説明を省略する。 <Third Embodiment>
Next, a third embodiment to which the present invention is applied will be described. In the present embodiment, only the configuration of the treatment portion is different from the high-frequency treatment tools of the first and second embodiments, and the other components are common to the first embodiment. Therefore, the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted.
　図５Ａ～５Ｃは、第３実施形態の高周波処置具を構成する処置部の拡大図を示している。図５Ａ～５Ｃに示すように、本実施形態の処置部３３（３３Ａ～３３Ｃ）は、それぞれ先端部３５ａ～３５ｃが異なる形状の処置部である。 FIGS. 5A to 5C show enlarged views of the treatment portion constituting the high-frequency treatment device of the third embodiment. As shown in FIGS. 5A to 5C, the treatment portions 33 (33A to 33C) of the present embodiment are treatment portions having different shapes at the distal end portions 35a to 35c.
　具体的には、図５Ａに示した、先端部３５ａが屈曲したナイフ型の処置部３３Ａは、屈曲した先端部３５ａを生体組織に引っ掛けた状態で、生体組織に高周波電流を印加しつつ処置部３３Ａを基端側に牽引して、当該生体組織を切開する。また、図５Ｂに示した、先端部３５ｂが針状型の処置部３３Ｂでは、先端部３５ｂを生体組織に押し当て、生体組織に高周波電流を印加しつつこれを切開する。さらに、図５Ｃに示した、先端部３５ｃが、針状部と、この針状部の最先端に設けられた拡径した略半球状部とを有する処置部３３Ｃでは、処置部３３Ｃを生体組織に押し当てた状態で、あるいは先端部３５ｃを生体組織に引っ掛けた状態で、生体組織に高周波電流を印加しつつ処置部３３Ｃを基端側に牽引して、当該生体組織を切開する。 Specifically, the knife-type treatment portion 33A having the bent distal end portion 35a shown in FIG. 5A has a treatment portion while applying a high-frequency current to the living tissue while the bent distal end portion 35a is hooked on the living tissue. The biological tissue is incised by pulling 33A proximally. Further, in the treatment portion 33B having a needle-shaped tip portion 35b shown in FIG. 5B, the tip portion 35b is pressed against the living tissue, and an incision is made while applying high-frequency current to the living tissue. Furthermore, in the treatment portion 33C in which the distal end portion 35c shown in FIG. 5C has a needle-like portion and a substantially hemispherical portion with an enlarged diameter provided at the forefront of the needle-like portion, the treatment portion 33C is replaced with a living tissue. In a state of pressing against the living tissue or in a state where the distal end portion 35c is hooked on the living tissue, the treatment portion 33C is pulled toward the proximal end while applying a high-frequency current to the living tissue, and the living tissue is incised.
　ここで、本実施形態の処置部３３（３３Ａ～３３Ｃ）を構成する先端部３５ａ～３５ｃの全体、もしくは、少なくとも体内組織と接する部分に、上述した第１実施形態で説明した所要の熱伝導率の材料が適用されている。これにより、第１及び第２の実施形態と同様の効果が得られる。 Here, the required thermal conductivity described in the first embodiment is applied to the entirety of the distal end portions 35a to 35c constituting the treatment portion 33 (33A to 33C) of this embodiment, or at least the portion in contact with the body tissue. Material has been applied. Thereby, the same effect as the first and second embodiments can be obtained.
　なお、図５Ａ～５Ｃ中に示した、本実施形態の処置部３３（３３Ａ～３３Ｃ）を構成する先端部３５ａ～３５ｃの形状や大きさは一例であって、これに限定されるものではない。 The shapes and sizes of the distal end portions 35a to 35c constituting the treatment portion 33 (33A to 33C) of the present embodiment shown in FIGS. 5A to 5C are merely examples, and the present invention is not limited thereto. .
＜第４の実施形態＞
　次に、本発明を適用した第４の実施形態について説明する。本実施形態では、第１～第３の実施形態の高周波処置具とは処置部の構成のみが異なっており、その他の構成部分については、第１の実施形態と共通となっている。したがって、第１の実施形態と同一の構成部分については同じ符号を付すると共に説明を省略する。 <Fourth Embodiment>
Next, a fourth embodiment to which the present invention is applied will be described. In the present embodiment, only the configuration of the treatment portion is different from the high-frequency treatment tools of the first to third embodiments, and the other components are common to the first embodiment. Therefore, the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted.
　図６は、第４実施形態の高周波処置具を構成する処置部の拡大図を示している。図６に示すように、本実施形態の処置部４３は、相互に開閉可能な一対の先端部鉗子片４５，４５を有しており、この先端部鉗子片４５，４５が交差した、ハサミ型形状の処置部である。また、先端部鉗子片４５，４５は、第１実施形態の処置部３を構成する鉗子片５，５と同様に、開閉動作が可能となっている。さらに、鉗子片４５，４５の内面４５ａ，４５ａは露出しているが、この内面４５ａ，４５ａ以外の部分は絶縁被覆されている。これにより、一対の鉗子片４５，４５の互いに対向する内面４５ａ，４５ａが電極部分となり、高周波電流を流すことが可能とされている。 FIG. 6 shows an enlarged view of a treatment portion constituting the high frequency treatment device of the fourth embodiment. As shown in FIG. 6, the treatment portion 43 of this embodiment has a pair of tip forceps pieces 45, 45 that can be opened and closed with each other, and the tip forceps pieces 45, 45 intersect each other. It is a treatment part of shape. The distal forceps pieces 45 and 45 can be opened and closed in the same manner as the forceps pieces 5 and 5 constituting the treatment section 3 of the first embodiment. Furthermore, although the inner surfaces 45a and 45a of the forceps pieces 45 and 45 are exposed, portions other than the inner surfaces 45a and 45a are covered with insulation. Thereby, the mutually opposing inner surfaces 45a, 45a of the pair of forceps pieces 45, 45 serve as electrode portions, and a high-frequency current can flow.
　そして、本実施形態の処置部４３では、先端部鉗子片４５，４５によって生体組織を把持した状態で高周波電流を印加させて、当該生体組織を切開する。 And in the treatment part 43 of this embodiment, a high frequency current is applied in the state which hold | gripped the biological tissue with the front-end | tip forceps pieces 45 and 45, and the said biological tissue is incised.
　ここで、本実施形態の処置部４３を構成する先端部鉗子片４５，４５に、上述した第１実施形態で説明した所要の熱伝導率の材料が適用されている。これにより、第１～第３の実施形態と同様の効果が得られる。 Here, the material having the required thermal conductivity described in the first embodiment is applied to the tip forceps pieces 45 and 45 constituting the treatment portion 43 of the present embodiment. Thereby, the same effects as those of the first to third embodiments can be obtained.
　なお、本実施形態では、処置部４３を構成する先端部鉗子片４５，４５全体に所要の熱伝導率の材料を適用する場合について説明したが、これに限定されるものではない。具体的には、処置部４３の、体内組織と接する電極部分（すなわち、鉗子片４５，４５の互いに対向する内面４５ａ，４５ａ）のみに所要の熱伝導率の材料を適用する構成としてもよい。 In addition, although this embodiment demonstrated the case where the material of required heat conductivity was applied to the front-end | tip part forceps pieces 45 and 45 which comprise the treatment part 43, it is not limited to this. Specifically, a configuration may be adopted in which a material having a required thermal conductivity is applied only to the electrode portion (that is, the inner surfaces 45a and 45a of the forceps pieces 45 and 45 facing each other) of the treatment portion 43 that are in contact with the body tissue.
　なお、本発明の技術範囲は上述した第１～第４の実施形態に限定されるものではなく、本発明の趣旨を逸脱しない範囲において種々の変更を加えることが可能である。 The technical scope of the present invention is not limited to the first to fourth embodiments described above, and various modifications can be made without departing from the spirit of the present invention.
　以下、実施例を示す。
（検証試験１）
　下記の表２中に示すように、異なる６種類の材料を用いて、図２に示すように鰐口型把持鉗子の鉗子片を作製した（試験例１～６）。 Examples are shown below.
(Verification test 1)
As shown in Table 2 below, six different types of materials were used to produce forceps pieces of the incision type grasping forceps as shown in FIG. 2 (Test Examples 1 to 6).
　次に、作製した鰐口型把持鉗子を用いて、組織付着性の評価を行った。具体的には、操作手順、高周波電源の条件、焼灼対象、判断基準について、下記に示す通りである。
［操作手順］
（１）対極板上に焼灼対象（ブタの食道粘膜）を配置する。
（２）焼灼対象を電極部で挟持し、電極部を焼灼対象に対して逆方向に引き込みながら１０秒間焼灼を行う。
（３）焼灼後の電極部の様子を観察する。
（４）焼灼対象の箇所を変えて、上記２，３の操作を繰り返し行う。
（５）（３）の結果から下記の判断基準に従い「◎」、「○」、「×」判定を行う。 Next, the tissue adhesion was evaluated using the produced mouth-holding forceps. Specifically, the operating procedure, the conditions of the high frequency power supply, the ablation object, and the judgment criteria are as shown below.
[Operating procedure]
(1) Place an ablation object (pig esophageal mucosa) on the counter electrode.
(2) The ablation object is sandwiched between the electrode parts, and ablation is performed for 10 seconds while the electrode part is drawn in the opposite direction with respect to the ablation object.
(3) The state of the electrode part after cauterization is observed.
(4) The above operations 2 and 3 are repeated by changing the location of the ablation object.
(5) From the result of (3), “◎”, “◯”, and “×” are determined according to the following criteria.
［高周波電源の出力等の条件］
　高周波電源装置：ＶＩＯ３００Ｄ（エルベ社製）
　出力：Ｓｏｆｔ　ｃｏａｇ　Ｅ５　５０Ｗ [Conditions of high frequency power supply output]
High frequency power supply: VIO300D (manufactured by Elbe)
Output: Soft coag E5 50W
［焼灼の対象物］
　ブタの食道粘膜 [Object of shochu]
Porcine esophageal mucosa
［判断基準］
　上記操作手順（３）の結果についての、「◎」と「○」と「×」の判断基準は、下記の通り。
「◎」：上記条件下で、焼灼後の電極部において、目視で組織が全く付着していない、あるいは付着しても組織から電極部が剥がれやすい。
「○」：上記条件下で、焼灼後の電極部において、目視で組織が付着していない、あるいは付着しても組織から電極部が剥がれやすい。
「×」：上記条件下で、焼灼後に電極部分に組織が付着してしまい、組織から電極部が剥がれにくく、付着した組織が電極部の動きに追従する。
　なお、評価結果を、表２に示す。 [Judgment criteria]
The criteria for “◎”, “○”, and “×” for the result of the operation procedure (3) are as follows.
“◎”: Under the above conditions, in the electrode part after cauterization, the tissue is not visually attached at all, or even if it is attached, the electrode part is easily peeled off from the tissue.
“◯”: Under the above conditions, in the electrode part after cauterization, the tissue is not visually attached, or even if it is attached, the electrode part is easily peeled off from the tissue.
“X”: Under the above conditions, the tissue adheres to the electrode part after cauterization, and the electrode part hardly peels off from the tissue, and the attached tissue follows the movement of the electrode part.
The evaluation results are shown in Table 2.
Figure JPOXMLDOC01-appb-T000002
Figure JPOXMLDOC01-appb-T000002
　表２に示すように、試験例１及び試験例２は、１００℃における熱伝導率がいずれも１６．３（Ｗ／ｍ・Ｋ）の材料で鉗子片を作製したものである。この試験例１及び試験例２の把持鉗子では、生体組織の焼灼処置をした際に、電極部分である鉗子片に組織が付着してしまうことが確認された。
　また、試験例６は、１００℃における熱伝導率が５０（Ｗ／ｍ・Ｋ）の材料で鉗子片を作製したものである。この試験例６の把持鉗子では、生体組織の焼灼処置をした際に水蒸気が発生して処置者の視界が妨げられ、作業効率が低下したため試験を中止した。 As shown in Table 2, in Test Example 1 and Test Example 2, forceps pieces were made of a material having a thermal conductivity of 16.3 (W / m · K) at 100 ° C. In the grasping forceps of Test Example 1 and Test Example 2, it was confirmed that when the living tissue was cauterized, the tissue adhered to the forceps piece as the electrode portion.
In Test Example 6, a forceps piece was made of a material having a thermal conductivity of 50 (W / m · K) at 100 ° C. In the grasping forceps of Test Example 6, water vapor was generated during the cauterization treatment of the living tissue, obstructing the view of the operator, and the work efficiency was lowered, so the test was stopped.
　これに対して、試験例３、試験例４及び試験例５は、１００℃における熱伝導率がそれぞれ２４．３、２５．９、２７．２（Ｗ／ｍ・Ｋ）の材料で鉗子片を作製したものである。この試験例３、試験例４及び試験例５の把持鉗子では、生体組織の焼灼処置をした際に、電極部分である鉗子片に組織が付着しないことが確認された。特に試験例３及び試験例４の把持鉗子では、目視において組織が全く付着していないように見受けられた。 On the other hand, in Test Example 3, Test Example 4 and Test Example 5, the forceps pieces are made of materials having thermal conductivities at 100 ° C. of 24.3, 25.9 and 27.2 (W / m · K), respectively. It was produced. In the grasping forceps of Test Example 3, Test Example 4, and Test Example 5, it was confirmed that when the living tissue was cauterized, the tissue did not adhere to the forceps piece as the electrode portion. In particular, in the grasping forceps of Test Example 3 and Test Example 4, it was observed that the tissue was not attached at all visually.
　１　高周波処置具
　２　シース部（挿入部）
　３，２３，３３，４３　処置部
　４　操作部
　５　鉗子片
　５ａ　内面 1 High-frequency treatment instrument 2 Sheath part (insertion part)
3, 23, 33, 43 Treatment section 4 Operation section 5 Forceps piece 5a Inner surface

Claims (7)

  1. 　体腔内に挿入される挿入部と、
    　前記挿入部に進退自在に挿通された操作ワイヤと、
    　前記操作ワイヤの先端部に配置され、高周波電流の印加によって生体組織を処置する処置部と、
    　前記挿入部の基端部に付設され、前記処置部を操作する操作部と、を備える高周波処置具であって、
    　前記処置部の、少なくとも体内組織と接する電極部分に、１００℃における熱伝導率が１８Ｗ／ｍ・Ｋ以上、３０Ｗ／ｍ・Ｋ以下の材料を用いることを特徴とする高周波処置具。     An insertion part to be inserted into the body cavity;
    An operation wire inserted through the insertion portion so as to freely advance and retract;
    A treatment section disposed at the distal end of the operation wire and treating a living tissue by application of a high-frequency current;
    An operation unit attached to a proximal end portion of the insertion unit and operating the treatment unit,
    A high-frequency treatment instrument characterized by using a material having a thermal conductivity at 100 ° C. of 18 W / m · K or more and 30 W / m · K or less for at least an electrode part of the treatment part that is in contact with a body tissue.
  2. 　前記処置部が、相互に開閉可能な一対の鉗子片を有する把持鉗子部であり、
    　前記一対の鉗子片の互いに対向する内面が、前記電極部分となることを特徴とする請求項１に記載の高周波処置具。     The treatment portion is a grasping forceps portion having a pair of forceps pieces that can be opened and closed with respect to each other,
    The high-frequency treatment instrument according to claim 1, wherein inner surfaces of the pair of forceps pieces facing each other serve as the electrode portions.
  3. 　前記処置部の材料が、ステンレス鋼であることを特徴とする請求項１又は２に記載の高周波処置具。 The high-frequency treatment tool according to claim 1 or 2, wherein the material of the treatment portion is stainless steel.
  4. 　前記ステンレス鋼が、クロム系ステンレスであることを特徴とする請求項３に記載の高周波処置具。 The high-frequency treatment instrument according to claim 3, wherein the stainless steel is chromium-based stainless steel.
  5. 　前記ステンレス鋼が、マルテンサイト系ステンレスであることを特徴とする請求項３に記載の高周波処置具。 The high-frequency treatment instrument according to claim 3, wherein the stainless steel is martensitic stainless steel.
  6. 　前記ステンレス鋼が、フェライト系ステンレスであることを特徴とする請求項３に記載の高周波処置具。 The high-frequency treatment instrument according to claim 3, wherein the stainless steel is ferritic stainless steel.
  7. 　前記ステンレス鋼が、二相系ステンレスであることを特徴とする請求項３に記載の高周波処置具。 The high-frequency treatment instrument according to claim 3, wherein the stainless steel is a duplex stainless steel.
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