1. Technical Field
The disclosure relates to a medical treatment device.
2. Related Art
In recent years, medical treatment devices have been known that apply energy to body tissue to perform treatment on the body tissue (for example, see JP 2003-325537 A).
A medical treatment device disclosed in JP 2003-325537 A includes a pair of treatment tool pieces which is rotatably connected to each other by a pivot shaft. Here, distal ends of the pair of treatment tool pieces are opened and closed when the pair of treatment tool pieces is rotated about the pivot shaft and a body tissue can be grasped by the distal ends. Further, a plurality of heating elements is embedded in the distal end of one treatment tool piece of the pair of treatment tool pieces. Then, in the medical treatment device, the body tissue is grasped by the distal ends of the pair of treatment tool pieces and power is supplied to the plurality of heating elements to apply heat energy to the body tissue in order to treat the body tissue.
Here, in the medical treatment device disclosed in JP 2003-325537 A, a flexible substrate is disposed inside one treatment tool piece and power supplied from the outside is transmitted to the plurality of heating elements by the flexible substrate. That is, in the medical treatment device disclosed in JP 2003-325537 A, since the flexible substrate is used as a wiring that transmits power from the outside to the plurality of heating elements instead of a lead wire, a small-sized medical treatment device can be achieved.
In some embodiments, a medical treatment device includes a pair of holding members configured to open and close about a first rotation axis in accordance with an operation of an operating unit, and a shaft having one end connected to the operating unit and having the other end to axially support the pair of holding members through the first rotation axis so as to allow the pair of holding members to open and close. At least one of the pair of holding members includes an energy application portion configured to contact a body tissue to apply energy to the body tissue with the body tissue grasped by the pair of holding members. The energy application portion is connected to a flexible substrate configured to be electrically connected to a lead wire provided inside the shaft extending from the other end of the shaft toward the one end of the shaft to supply energy to the energy application portion. The flexible substrate is connected to the lead wire at a location closer to the one end of the shaft than the first rotation axis.
The above and other features, advantages and technical and industrial significance of this invention will be better understood by reading the following detailed description of presently preferred embodiments of the invention, when considered in connection with the accompanying drawings.
Exemplary embodiments of the invention will be described below with reference to the drawings. The embodiments to be described below do not limit the invention. The same reference signs are used to designate the same elements throughout the drawings.
Schematic Configuration of Medical Treatment System
The medical treatment system 1 is used to perform a treatment (for example, a blood vessel sealing or dissecting) on a body tissue by applying energy to a body tissue which is a treatment object. As illustrated in
Configuration of Medical Treatment Device
The medical treatment device 2 is, for example, a linear type surgical treatment tool which is used to perform a treatment for a body tissue through an abdominal wall. As illustrated in
The operation handle 5 is a portion which is gripped by an operator. Then, as illustrated in
Configuration of Shaft
As illustrated in
The sheath 63 is not illustrated in
The main shaft body 61 has a substantially cylindrical shape, one end thereof is connected to the operation handle 5, and the other end thereof axially supports the first and second holding members 10 and 20 (
As illustrated in
As illustrated in
Further, although not illustrated in the drawings, the case 611 is provided with a wiring hole which extends along the center axis Ax of the main shaft body 61 in addition to the guide hole 6111. Then, an electric cable C (
Further, as illustrated in
The base portion 612 has a substantially elongated flat plate shape. Then, the base portion 612 is integrally formed with the lower side of the other end of the main shaft body 61 in
As illustrated in
The pair of axial supporters 613 has a substantially elongated flat plate shape each other. Then, the pair of axial supporters 613 is integrally formed with an upper surface (in
The pair of axial supporters 613 has the same shape. For this reason, hereinafter, a shape of the upper axial supporter 613 in
As illustrated in
The first bearing hole 6131 is a hole into which the first rotation axis RA1 (
As illustrated in
The rod 62 is disposed inside the case 611 and moves forward and backward along the center axis Ax in response to the operation of the operation knob 51 from the operator. That is, the rod 62 constitutes a part of an opening and closing mechanism for opening and closing the first and second holding members 10 and 20. As illustrated in
The pair of plate bodies 621 has an elongated flat plate shape and is disposed inside the case 611 to face each other (to face each other in the vertical direction in
The shaft portion 622 has a columnar shape and is inserted into each insertion hole 6211 of each of the pair of plate bodies 621. Then, both ends of the shaft portion 622 protrude outward from the pair of plate bodies 621 in a state where the shaft portion 622 is inserted into each insertion hole 6211 as illustrated in
Configuration of Grasping Portion
The grasping portion 7 is a portion which grasps a body tissue and performs a treatment (for example, a blood vessel sealing or disserting) on the body tissue. As illustrated in
The first holding member 10 is disposed with the second holding member 20 in
The first jaw 11 is a portion which is axially supported by the pair of axial supporters 613 through the first rotation axis RA1 to be rotatable. As illustrated in
As illustrated in
The pair of connection portions 112 is a portion which connects the first jaw 11 to the main shaft body 61. Each of the pair of connection portions 112 has a substantially elongated flat plate shape. Then, the pair of connection portions 112 is integrally formed with one end side (in
The pair of connection portions 112 has the same shape. For this reason, hereinafter, a shape of the upper connection portion 112 in
As illustrated in
The second bearing hole 1121 is a hole into which the first rotation axis RA1 (
As illustrated in
Specifically, the second track hole 1122 has a shape which is inclined upward in
The heat transfer plate 12 is formed by, for example, a thin copper plate and is attached to the first jaw 11 such that a treatment surface 121 (
The flexible substrate 13 serves as a sheet heater which generates heat from a part thereof and heats the heat transfer plate 12 by the heat. As illustrated in
The substrate 131 is an elongated sheet which is formed of an insulation material such as polyimide. A width dimension of the substrate 131 (in
The heating pattern 132 is obtained by processing a metal film formed on one surface of the substrate 131 by adhering or depositing and is used to heat the heat transfer plate 12. As illustrated in
Here, a material of the heating pattern 132 is stainless steel or platinum.
The pair of lead connection portions 1321 extends from one end side (in
One end of the electric resistance pattern 1322 is connected to one lead connection portion 1321, a U-shape is formed from the one end to follow an outer edge shape of the substrate 131, and the other end thereof is connected to the other lead connection portion 1321. Then, the electric resistance pattern 1322 generates heat when a voltage is applied (supplied) to the pair of lead connection portions 1321 through two lead wires C1 under the control of the control device 3.
Then, as illustrated in
Similar to the substrate 131, the insulation sheet 133 is an elongated sheet which is formed of an insulation material such as polyimide. Then, as illustrated in
The first fixed plate 14 is a member that fixes a unit, fixing the heat transfer plate 12 to the flexible substrate 13, to one plate surface (in
As illustrated in
The second jaw 21 has the substantially same shape as that of the main jaw 111. Then, in the first embodiment, as illustrated in
The grasping plate 22 is a member that is formed by, for example, a thin copper plate and grasps a body tissue between the grasping plate and the heat transfer plate 12.
The second fixed plate 23 is a member that fixes the grasping plate 22 to one plate surface (in
Operation of Opening and Closing First and Second Holding Members
Next, an operation of opening and closing the first and second holding members 10 and 20 will be described.
When the operation knob 51 is operated by the operator from a state illustrated in
Here, each of the first track holes 6132 provided in the main shaft body 61 extends along the center axis Ax as described above. Meanwhile, as described above, each of the second track holes 1122 provided in the second jaw 21 is formed so that a height position gradually increases with respect to each of the first track holes 6132 as it goes to a left side in
For this reason, in a case where the shaft portion 622 moves inside each of the first track holes 6132 and each of the second track holes 1122 from a left side toward a right side in
When the operation of the operation knob 51 from the operator is canceled from a state illustrated in
Connection Position between Flexible Substrate and Lead Wire
Next, a connection position P1 between the flexible substrate 13 and the lead wire Cl will be described with reference to
As illustrated in
More specifically, as illustrated in
Configuration of Control Device and Foot Switch
The foot switch 4 is operated by a foot from the operator. Then, the medical treatment device 2 (the electric resistance pattern 1322) is turned on and off by the control device 3 in response to the operation of the foot switch 4.
Means for switching an on/off state is not limited to the foot switch 4 and may be a switch which is operated by a hand.
The control device 3 includes a CPU (Central Processing Unit) and the like to control an operation of the medical treatment device 2 in accordance with a predetermined control program. More specifically, the control device 3 applies a voltage to the electric resistance pattern 1322 through the electric cable C in response to an operation (a power on/off operation) of the foot switch 4 from the operator, thereby to heat the heat transfer plate 12.
Operation of Medical Treatment System
Next, an operation (an operation method) of the medical treatment system 1 will be described.
The operator grips the medical treatment device 2 and inserts a distal end part (a part of the grasping portion 7 and the shaft 6) of the medical treatment device 2 into, for example, an abdominal cavity through an abdominal wall. Then, the operator operates the operation knob 51 to rotate the first holding member 10 such that a body tissue of a treatment object is pinched by the first and second holding members 10 and 20.
Next, the operator operates the foot switch 4 to select a power on state in which power is supplied from the control device 3 to the medical treatment device 2. When the power is on, the control device 3 applies a voltage to the electric resistance pattern 1322 through the electric cable C to heat the heat transfer plate 12. Then, a body tissue which contacts the heat transfer plate 12 is treated by the heat of the heat transfer plate 12 (for example, a blood vessel is sealed or disserting of a blood vessel is performed).
In the medical treatment device 2 according to the first embodiment described above, wiring inside the medical treatment device 2 is formed by a combination of the flexible substrate 13 and the lead wire C1. For this reason, a manufacturing cost of the medical treatment device 2 can be decreased compared to a configuration in which all the wirings inside the device 2 are formed by the flexible substrate.
In the medical treatment device 2 according to the first embodiment, the connection position P1 between the flexible substrate 13 and the lead wire C1 is closer to one end of the main shaft body 61 than a position of the shaft portion 622 (closer to one end of the main shaft body 61 than the first rotation axis RA1) when the first and second holding members 10 and 20 are closed. In other words, the connection position P1 is closer to one end of the main shaft body 61 than the first rotation axis RA1 so as to avoid an area which may contact the opening and closing mechanism (the shaft portion 622) when the first and second holding members 10 and 20 are opened and closed (the area between the position of the shaft portion 622 when the first and second holding members 10 and 20 are opened and the position of the shaft portion 622 when the first and second holding members 10 and 20 are closed). For this reason, it is possible to prevent interference between the connection position P1 and the first rotation axis RA1 or the shaft portion 622 when the first and second holding members 10 and 20 are opened and closed. Thus, since a load applied to the connection position 21 is reduced, disconnection can be inhibited.
From the description above, according to the medical treatment device 2 of the first embodiment, disconnection can be inhibited while an increase in manufacturing cost is prevented.
The flexible substrate 13 according to the first embodiment has a substantially flat plate shape, but the invention is not limited thereto. The flexible substrate 13A including an elastic portion 134A according to Modified Example 1-1 may be employed.
The flexible substrate 13A has the same configuration as that of the flexible substrate 13 described in the first embodiment except for the elastic portion 134A.
The elastic portion 134A is a part of the flexible substrate 13A (the part where the insulation sheet 133 is provided) and has a flexure shape. The flexible substrate 13A is extensible by the shape.
Specifically, as illustrated in
Although not illustrated in detail in the drawings, the elastic portion 134A is disposed between the first rotation axis RA1 and the connection position (for example, the connection position P1 illustrated in
When the elastic portion 134A is provided in the flexible substrate 13A as in Modified Example 1-1, the elastic portion 134A can absorb a tension applied to the flexible substrate 13A when the first and second holding members 10 and 20 are opened and closed. Thus, it is possible to further reduce a load applied to the connection position between the flexible substrate 13A and the lead wire C1.
The flexible substrate 13 according to the first embodiment has a substantially flat plate shape, but the invention is not limited thereto. The flexible substrate 13B including an elastic portion 134B according to Modified Example 1-2 may be employed.
The flexible substrate 13A has the same configuration as that of the flexible substrate 13 described in the first embodiment except for the elastic portion 134B.
The elastic portion 134B is a part of the flexible substrate 13B (the part where the insulation sheet 133 is provided) and has a flexure shape. The flexible substrate 13B is extensible by the shape.
Specifically, as illustrated in
Then, although not illustrated in detail in drawings, the elastic portion 134B is disposed between the first rotation axis RA1 and the connection position (for example, the connection position 21 illustrated in
When the elastic portion 134B is provided in the flexible substrate 13B as in Modified Example 1-2, the same effect as that of Modified Example 1-1 can be obtained.
In the first embodiment, a portion of the flexible substrate 13 which is closer to one end of the main shaft body 61 than the first rotation axis RA1 (for example, a portion of the connection position P1 between the flexible substrate 13 and the lead wire C1) may be fixed to the shaft 6. The same also applies to Modified Examples 1-1 and 1-2.
As in Modified Example 1-3, if the portion of the flexible substrate 13 which is closer to the one end of the main shaft body 61 than the first rotation axis RA1 is fixed to the shaft 6, it is possible to further reduce the load applied to the connection position P1.
Next, a second embodiment of the invention will be described.
In the description below, the same reference signs will be used to designate the same elements as those of the first embodiment, and a detailed explanation thereof will be omitted or simplified.
A medical treatment device according to the second embodiment is different from the medical treatment device 2 described in the first embodiment in that the configuration of the main shaft body 61 is different. For this reason, hereinafter, a configuration of the shaft body according to the second embodiment will be described.
Configuration of Shaft Body
For the purpose of illustration, a configuration of the other end of the main shaft body 61C (including the first and second holding members 10 and 20) is simply illustrated in
Similar to the first embodiment, one end (in
As illustrated in
The first shaft 614 is a portion which has the above-described end and is connected to the operation handle 5.
The first shaft 614 has a pair of rotation receiving portions 6141 connected to the second shaft 615, at a distal end (at a left end in
Each of the pair of rotation receiving portions 6141 has a substantially flat plate shape. The pair of rotation receiving portions 6141 is integrally formed with a distal end of the first shaft 614 to face each other while plate faces are directed upward and downward in
Each of the pair of rotation receiving portions 6141 has a third bearing hole 6142 which penetrates each rotation receiving portion and into which the second rotation axis RA2 is inserted.
The second shaft 615 is a portion which includes the above-described other end and axially supports the first and second holding members by the other end so that the first and second holding members can be opened and closed about the first rotation axis RA1. Then, the second shaft 615 is formed in a substantially cylindrical shape having an outer diameter dimension which is slightly smaller than a separated dimension of the pair of rotation receiving portions 6141.
The second shaft 615 has, at a proximal end thereof (on the right end side in
Here, as illustrated in
Although not illustrated in detail in drawings, the inside of the first shaft 614 is provided with an opening and closing mechanism which opens and closes the first and second holding members 10 and 20 or a rotating mechanism which rotates the second shaft 615 about the second rotation axis RA2 in response to the operation of the operation handle 5 from the operator.
Connection Position between Flexible Substrate and Lead Wire
Next, a connection position P2 between the flexible substrate 13 and the lead wire Cl of the second embodiment will be described with reference to
In the second embodiment, as illustrated in
According to the above-described embodiments, the following effects can be obtained in addition to the same effect as that of the first embodiment.
In the second embodiment, the connection position P2 between the flexible substrate 13 and the lead wire C1 is closer to the one end of the main shaft body 61C than the second rotation axis RA2. For this reason, even when the main shaft body 61C has a structure in which the second shaft 615 is rotatable with respect to the first shaft 614, it is possible to prevent an interference between the connection position P2 and the first rotation axis RA1 or the second rotation axis RA2 when the first and second holding members 10 and 20 are opened and closed or the second shaft 615 rotates with respect to the first shaft 614. Thus, since a load applied to the connection position P2 is reduced, disconnection can be inhibited.
In the second embodiment, the flexible substrate 13A (
When the elastic portion 134A is provided in the flexible substrate 13A as in Modified Example 2-1, it is possible to absorb a tension applied to the flexible substrate 13A by the elastic portion 134A when the first and second holding members 10 and 20 are opened and closed or the second shaft 615 rotates with respect to the first shaft 614. Thus, it is possible to further reduce a load applied to the connection position P2 between the flexible substrate 13A and the lead wire C1.
In the second embodiment, the flexible substrate 13B (
When the elastic portion 134B is provided in the flexible substrate 13B as in Modified Example 2-2, the same effect as that of Modified Example 2-1 can be obtained.
In the second embodiment, a portion of the flexible substrate 13 which is closer to one end of the main shaft body 61C (for example, a portion of the connection position P2) than the second rotation axis RA2 may be fixed to the main shaft body 61C (the first shaft 614). The same also applies to Modified Examples 2-1 and 2-2.
As in Modified Example 2-3, if the portion of the flexible substrate 13 which is closer to the one end of the main shaft body 61C than the second rotation axis RA2 is fixed to the main shaft body 61C, it is possible to further reduce a load applied to the connection position P2.
Although the embodiments of the invention have been described so far, the invention is not limited to the first embodiment and the second embodiment or Modified Examples 1-1 to 1-3 and 2-1 to 2-3.
In the first embodiment and the second embodiment or Modified Examples 1-1 to 1-3 and 2-1 to 2-3, a configuration (the heat transfer plate 12 and the flexible substrate 13, 13A, 13B) of applying energy (heat energy) to a body tissue only from the first holding member 10 has been employed, but the invention is not limited thereto. For example, energy may be applied to a body tissue only from the second holding member 20 or energy may be applied to a body tissue from both the first and second holding members 10 and 20.
In the first embodiment and the second embodiment or Modified Examples 1-1 to 1-3 and 2-1 to 2-3, the first and second holding members 10 and 20 are opened and closed in such a manner that the second holding member 20 is fixed and the first holding member 10 is rotated, but the invention is not limited thereto. For example, the first and second holding members 10 and 20 may be opened and closed in such a manner that the first holding member 10 is fixed and the second holding member 20 is rotated or the first and second holding members 10 and 20 may be opened and closed in such a manner that both the first and second holding members 10 and 20 are rotated.
Further, an opening and closing mechanism of opening and closing the first and second holding members 10 and 20 or a rotating mechanism of rotating the second shaft 615 with respect to the first shaft 614 is not limited to the opening and closing mechanism or the rotating mechanism described in the first embodiment and the second embodiment or Modified Examples 1-1 to 1-3 and 2-1 to 2-3 and the other mechanisms may be employed.
In the first embodiment and the second embodiment or Modified Examples 1-1 to 1-3 and 2-1 to 2-3, heat energy is employed as energy applied to a body tissue, but high-frequency energy or ultrasonic energy may be employed. Further, a combination of two or more different energies among the heat energy, the high-frequency energy, and the ultrasonic energy may be sequentially applied to a body tissue.
According to the medical treatment device of some embodiments, it is possible to prevent an increase in manufacturing cost as well as to suppress disconnection.
Additional advantages and modifications will readily occur to those skilled in the art. Therefore, the invention in its broader aspects is not limited to the specific details and representative embodiments shown and described herein. Accordingly, various modifications may be made without departing from the spirit or scope of the general inventive concept as defined by the appended claims and their equivalents.
This application is a continuation of PCT international application Ser. No. PCT/JP2014/078077, filed on Oct. 22, 2014 which designates the United States, incorporated herein by reference.
Number | Date | Country | |
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Parent | PCT/JP2014/078077 | Oct 2014 | US |
Child | 15492668 | US |