Patent Application
20090048589
1. Field of the Invention
The present invention relates to a treatment device, and a treatment method for a living tissue.
2. Description of the Related Art
It is increasingly apparent in general that, in the case of jointing living tissues to each other, the regeneration and/or restoration of the living tissues progress earlier in the vicinity of a part where the jointed living tissues are in contact with each other.
According to a first aspect of the present invention, there is provided a treatment device to treat a living tissue, the treatment device including:
a sealing member which joints desired regions of at least two living tissues to each other in a sealed state; and
a maintaining member which maintains contact between the tissues located in the vicinity of parts jointed by the sealing member.
According to a second aspect of the present invention, there is provided a treatment device to treat a living tissue, the treatment device including:
a pair of holding members respectively having holding surfaces to hold at least two living tissues;
a handle operated to move at least one of the pair of holding members relative to the other; and
an applying portion which is disposed in at least one of the holding members and which seals the at least two living tissues and which maintains contact between the living tissues located in the vicinity of the sealed parts.
According to a third aspect of the present invention, there is provided a method of treating a living tissue, the method including:
sealing desired parts of at least two living tissues; and
drawing the at least two living tissues close to each other in the vicinity of a position where the desired parts of the at least two living tissues are sealed in order to maintain contact between the living tissues.
Additional objects and advantages of the invention will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The objects and advantages of the invention may be realized and obtained by means of the instrumentalities and combinations particularly pointed out hereinafter.
The accompanying drawings, which are incorporated in and constitute a part of the specification, illustrate embodiments of the invention, and together with the general description given above and the detailed description of the embodiments given below, serve to explain the principles of the invention.
The best mode for carrying out the present invention will now be explained hereinafter with reference to the accompanying drawings.
A first embodiment will be explained with reference to
As shown in
The electro-surgical device 12 includes a handle 22, a shaft 24 and an openable/closable holding section 26. The handle 22 is connected with the energy source 14 via a cable 28. The energy source 14 is connected to a foot switch and a hand switch (not shown). Therefore, these foot and hand switches are operated by an operator to switch on or off the supply of energy from the energy source 14 to the electro-surgical device 12.
The handle 22 is substantially formed into an L-shape. The shaft 24 is disposed on one end of the handle 22. The cable 28 is extended from a proximal side of the handle 22 disposed coaxially with the shaft 24.
On the other hand, the other end of the handle 22 is a grip held by the operator. The handle 22 includes a holding section opening/closing knob 32 arranged on the other end of the handle 22. The holding section opening/closing knob 32 is connected to a proximal end of a sheath 44 (see
As shown in
Outside the cylindrical member 42, a concave portion 46 is formed along the axial direction of the cylindrical member 42. The concave portion 46 is provided with a first conducting line 92a connected to a first high-frequency electrode (applying portion) 56 described later. A second conducting line 92b connected to a second high-frequency electrode (applying portion) 58 described later is passed through the cylindrical member 42.
It is to be noted that the first high-frequency electrode 56 is electrically connected with a first electrode connector 88a. The first electrode connector 88a is connected with the cable 28 extended from the handle 22 via a first energization line 92a. The second high-frequency electrode 58 is electrically connected with a second electrode connector 88b. The second electrode connector 88b is connected with the cable 28 extended from the handle 22 via a second energization line 92b.
A driving rod 82 is movably disposed along an axial direction of the cylindrical member 42 in the cylindrical member of the shaft 24. A distal end of the driving rod 82 is provided with a thin-plate-like cutter 84 (an auxiliary curative device). Therefore, when the cutter driving knob 34 is operated, the cutter 84 moves via the driving rod 82.
A distal end of the cutter 84 is provided with a blade 84a, and the distal end of the driving rod 82 is fixed to a proximal end of the cutter 84. A longitudinal groove 84b is formed between the distal end and the proximal end of the cutter 84. In the longitudinal groove 84b, the movement regulation pin 86 extending in a direction crossing the axial direction of the shaft 24 at right angles is fixed to the cylindrical member 42 of the shaft 24. Therefore, the longitudinal groove 84b of the cutter 84 moves along the movement regulation pin 86. In this case, the cutter 84 linearly moves. At this time, the cutter 84 is disposed along cutter guide grooves (flow channels, fluid discharge grooves) 94, 96 described later of a first holding member 52 and a second holding member 54.
It is to be noted that engagement portions 84c which engage with the movement regulation pin 86 and which control the movement of the cutter 84 are formed on one end of the longitudinal groove 84b of the cutter 84, the other end and between one end and the other end.
As shown in
It is preferable that the first holding member 52 and the second holding member 54 entirely have insulating properties, respectively. The first holding member 52 integrally includes a first holding portion main body (hereinafter referred to mainly as the main body) 62 provided with the first high-frequency electrode 56 and a base portion 64 disposed at a proximal end of the main body 62. The second holding member 54 integrally includes a second holding portion main body 66 provided with the second high-frequency electrode 58 and a base portion 68 disposed at a proximal end of the main body 66.
The base portion 64 of the first holding member 52 is fixed to a distal end of the cylindrical member 42 of the shaft 24. On the other hand, the base portion 68 of the second holding member 54 is rotatably supported at the distal end of the cylindrical member 42 of the shaft 24 by a support pin 72 disposed in a direction crossing the axial direction of the shaft 24 at right angles. The second holding member 54 can rotate around an axis of the support pin 72 to open or close with respect to the first holding member 52. Moreover, the second holding member 54 is urged so as to open with respect to the first holding member 52 by an elastic member 74 such as a leaf spring.
Outer surfaces of the main bodies 62, 66 of the first holding member 52 and the second holding member 54 are formed into smooth curved surfaces. Similarly, outer surfaces of the base portions 64, 68 of the first holding member 52 and the second holding member 54 are also formed into smooth curved surfaces. While the second holding member 54 is closed with respect to the first holding member 52, sections of the main bodies 62, 66 of the holding members 52, 54 are formed to be substantially circular or elliptical. When the second holding member 54 is closed with respect to the first holding member 52, holding surfaces 62a, 66a of the main bodies 62, 66 of the first and second holding members 52, 54 are opposite to each other, and the base portions 64, 68 are formed to be cylindrical. In this state, a diameter of each of the proximal ends of the main bodies 62, 66 of the first holding member 52 and the second holding member 54 is formed to be larger than a diameter of each of the base portions 64, 68. Moreover, stepped portions 76a, 76b are formed between the main bodies 62, 66 and the base portions 64, 68, respectively.
Here, in the first holding member 52 and the second holding member 54, while the second holding member 54 is closed with respect to the first holding member 52, a substantially circular or elliptical outer peripheral surface formed by combining the base portions 64, 68 of the holding members 52, 54 is substantially the same plane as that of an outer peripheral surface of the distal end of the cylindrical member 42, or a diameter of the outer peripheral surface is formed to be slightly larger than that of the outer peripheral surface of the distal end of the cylindrical member 42. Therefore, the sheath 44 can be slid with respect to the cylindrical member 42 to cover the base portions 64, 68 of the first holding member 52 and the second holding member 54 with a distal end of the sheath 44. In this state, as shown in
As shown in
The continuous electrode 56a is continuously formed into, for example, a substantially U-shape to have two ends at the proximal ends of the main body 62 of the first holding member 52. It is to be noted that a distance between proximal ends of the continuous electrode 56a is substantially equal to the width of the cutter guide groove 94 described later (see
On the other hand, the plurality of discrete electrodes 56b of the same shape are arranged at substantially equal intervals along a substantially U-shaped virtual track. Each of the discrete electrode 56b is formed to be, for example, circular. The discrete electrodes 56b are arranged to have a predetermined space therebetween, and each of the discrete electrodes 56b is disposed at a distance from the continuous electrode 56a. The discrete electrodes 56b are positioned to allow a living tissue between the discrete electrode 56b and discrete electrodes 58b described later to be denatured by heat when a treatment is performed, but to maximally prevent the denaturation of a living tissue between the discrete electrodes 56b due to heat and also maximally prevent the denaturation of a living tissue between the discrete electrodes 56b and the continuous electrode 56a.
The cutter guide groove 94 for passing the cutter 84 therethrough is formed in the main body 62 and the base portion 64 of the first holding member 52. This cutter guide groove 94 is formed along the axial direction of the shaft 24. Thus, the cutter 84 is movable within the first holding member 52 along the cutter guide groove 94. The cutter 84 is also movable within the second holding member 54 along the cutter guide groove 96.
Furthermore, the second high-frequency electrode 58 is also disposed in the second holding member 54 symmetrically with the first holding member 52. This is omitting a description thereof in detail.
In addition, although not shown, reference number 58a is given to a continuous electrode of the second high-frequency electrode 58 for convenience, and reference number 58b is given to discrete electrodes thereof, so that the following function will be described.
A function of the treatment system 10 according to this embodiment will now be explained.
As shown in
The holding section opening/closing knob 32 of the handle 22 is operated to hold (grasp) the living tissue as a treatment target by using the first holding member 52 and the second holding member 54. At this time, the sheath 44 is moved toward a proximal end side of the shaft 24 with respect to the cylindrical member 42. A space between the base portions 64, 68 cannot remain cylindrical due to an urging force of the elastic member 74, and the second holding member 54 is then opened with respect to the first holding member 52.
Moreover, the living tissue as a treatment target is arranged between the first high-frequency electrode 56 of the first holding member 52 and the second high-frequency electrode 58 of the second holding member 54. In this state, the holding section opening/closing knob 32 of the handle 22 is operated. At this time, the sheath 44 is moved to a distal end side of the shaft 24 with respect to the cylindrical member 42. The base portions 64, 68 are closed to form the cylindrical shape therebetween against the urging force of the elastic member 74 by using the sheath 44. Therefore, the first holding member main body 62 integrally formed on the base portion 64 and the second holding member main body 66 integrally formed on the base portion 68 are closed. That is, the second holding member 54 is closed with respect to the first holding member 52. Therefore, the living tissue LT as a treatment target is grasped between the first holding member 52 and the second holding member 54.
At this time, the living tissue as a treatment target is in contact with both the first high-frequency electrode 56 provided on the first holding member 52 and the second high-frequency electrode 58 provided on the second holding member 54. A surrounding tissue of the living tissue LT as a treatment target is closely contacted with both a holding surface 62a of the main body 62 of the first holding member 52 and a holding surface 66a of the main body 66 of the second holding member 54.
In this state, the foot switch or the hand switch is operated. Energy is respectively applied to the first high-frequency electrode 56 and the second high-frequency electrode 58 from the energy source 14 through the cable 28, the first and second energization lines 92a, 92b, and the first and second energization connectors 88a, 88b.
The first high-frequency electrode 56 passes a high-frequency current between this first high-frequency electrode 56 and the second high-frequency electrode 58 via the living tissue LT as a treatment target. Thus, the living tissue LT between the first high-frequency electrode 56 and the second high-frequency electrode 58 is heated. Then, the living tissue LT is denatured in a continuous manner (in a substantially U-shaped state) by the continuous electrodes 56a, 58a of the first and second high-frequency electrodes 56, 58. Moreover, the living tissue LT between the discrete electrodes 56b, 58b is discretely denatured by the discrete electrodes 56b, 58b of the first and second high-frequency electrodes 56, 58.
When a treatment is finished, the operation of the foot switch or the hand switch is stopped. Then, the supply of energy from the energy source 14 to the first high-frequency electrode 56 and the second high-frequency electrode 58 is stopped.
Here, a case will be described where the treatment system 10 having such a function is used to anastomose, for example, intestinal tracts IC1 and IC2 of the small intestine to each other as shown in
The pair of intestinal tracts IC1 and IC2 provided side by side is held by the holding surfaces 62a, 66a of the first and second holding members 52, 54 so that wall surfaces of these intestinal tracts IC1 and IC2 are caught in between. In this state, energy is supplied to the first and second high-frequency electrodes 56, 58. Then, the intestinal tracts IC1 and IC2 held between the continuous electrode 56a of the first holding member 52 and the continuous electrode 58a of the second holding member 54 are heated and denatured. Thus, the wall surfaces of the intestinal tracts IC1 and IC2 are continuously denatured. Consequently, the intestinal tracts IC1 and IC2 are jointed to each other.
Furthermore, simultaneously with the jointing through the denaturation of the living tissues by the continuous electrodes 56a, 58a, the intestinal tracts IC1 and IC2 between the discrete electrode 56b of the first holding member 52 and the discrete electrode 58b of the second holding member 54 are denatured and jointed to each other. Thus, the living tissues of the intestinal tracts IC1 and IC2 are discretely denatured and jointed to each other.
Then, after the supply of energy to the first and second high-frequency electrodes 56, 58 is stopped, the cutter driving knob 34 shown in
In this state, the first holding member 52 is opened with respect to the second holding member 54. At this time, there are formed a first anastomosed part AN1 on the side of a mesentery M, and a second anastomosed part AN2 opposite to the side where the mesentery M is located. For example, as shown in
Furthermore, energy is provided while the second holding member 54 is closed with respect to the first holding member 52 to hold the ends of the intestinal tracts IC1 and IC2. Thus, as shown in
It is to be noted that extra parts of the seal portion SP are cut by, for example, the cutter 84. At this time, parts around the continuously jointed portion of the sealed ends (seal portion SP) of the intestinal tracts IC1 and IC2 are discretely denatured as shown in
Therefore, force acts on the first anastomosed part AN1 on the side of the mesentery M in such a direction as to cause the intestinal tracts IC1 and IC2 to be closely contacted with each other. Then, force functions in the part where the living tissues are denatured by the discrete electrodes 56b, 58b so that the living tissues are more firmly closely contacted with each other. Moreover, force F1 acts in the second anastomosed part AN2 opposite to the side where the mesentery M is located in such a direction as to open the intestinal tracts IC1 and IC2, but the force functions so that part where the living tissues are denatured by the discrete electrodes 56b, 58b causes the living tissues to be closely contacted with each other. Therefore, an inter-network is produced between the non-denatured living tissues of the intestinal tracts IC1 and IC2 such that the living tissues exercise their tissue regeneration power, and the living tissues of the intestinal tracts IC1 and IC2 are regenerated earlier.
As explained above, according to the embodiment, the following effect can be obtained.
The continuous electrodes 56a, 58a and the discrete electrodes 56b, 58b are arranged on the holding surfaces 62a, 66a of the first and second holding members 52, 54, respectively. Thus, the living tissues (e.g., the intestinal tracts IC1 and IC2) between the continuous electrode 56a of the first holding member 52 and the continuous electrode 56a of the second holding member 54 can be heated, denatured and continuously jointed to each other. Consequently, for example, tubular living tissues can be closely contacted with each other or sealed with each other. Moreover, the living tissues (e.g., the intestinal tracts IC1 and IC2) between the discrete electrodes 56b of the first holding member 52 and the discrete electrodes 58b of the second holding member 54 can be heated, denatured and jointed to each other. That is, the living tissues can be discretely jointed to each other.
At this time, the part where the living tissues are continuously denatured and jointed to each other is positioned in proximity to the part where the living tissues are discretely denatured and jointed to each other, for example, as shown in
For example, when the two intestinal tracts IC1 and IC2 are anastomosed to each other, the force F1 acts in such a direction as to separate the intestinal tracts IC1 and IC2 from each other on the side shown in
Therefore, the parts of the living tissues jointed by the discrete electrodes 56b, 58b serve to draw the living tissues close to each other and keep them closely contacted with each other. That is, the parts of the living tissues jointed by the discrete electrodes 56b, 58b serve to maintain the conglutination of living organisms. Thus, an inter-network is produced between the closely contacted (closed up) living tissues such that the living tissues more easily exercise their tissue regeneration power and can be regenerated earlier.
Although the discrete electrodes 56b of the first holding member 52 are arranged at substantially equal intervals and have about the same area in the embodiment described above, it is also preferable that the distance between the adjacent discrete electrodes 56b varies and that the areas of the discrete electrodes 56b are different from each other. When the tissue is discretely treated with the discrete electrodes 56b, parts contacting the discrete electrodes 56b are denatured, but various modifications of the discrete electrodes 56b are allowed as long as the contact between the living tissues can be maintained without denaturing the part of the living tissue between the discrete electrode 56b and the discrete electrode 56b adjacent thereto.
While the cutter 84 is provided in this embodiment described above, the cutter 84 may not be provided depending on the treatment target. In this case, as described later, the cutter guide groove 94 can function as, for example, a fluid discharge groove (flow channel) for guiding a fluid such as vapor or liquid generated from the living tissues toward the handle 22 of the electro-surgical device 12. Alternatively, the cutter guide groove 94 itself may not be provided.
Next, a first modification of the discrete electrode 56b will be explained using
In the example of this embodiment described above, the discrete electrodes 56b are arranged at equal intervals on the substantially U-shaped virtual track outside the substantially U-shaped continuous electrode 56a, as shown in
Next, a second modification of the discrete electrodes 56b will be explained using
As shown in
Moreover, the first embodiment has been described using the holding section 26 in which the structure of the main body 62 of the first holding member 52 is symmetrical to (the same as) the structure of the main body 66 of the second holding member 54. In addition, as shown in
Although using the bipolar-type electro-surgical device 12 has been explained in the embodiment, using a monopolar-type electro-surgical device is also preferable as shown in
Furthermore, although not shown, when the monopolar-type electro-surgical device is used, arranging the high-frequency electrodes on one of the first holding member 52 and the second holding member 54 alone is also preferable.
While using the first and second high-frequency electrodes 56, 58 has been described in the embodiment, it is also preferable to use heaters (not specifically shown because there is no diagrammatic change from, for example,
In this embodiment, the linear electro-surgical device 12 (see
The electro-surgical device 12a includes a handle 22 and a holding section 26. That is, unlike the electro-surgical device 12 for treating the tissue through the abdominal wall, the shaft 24 (see
A second embodiment will now be explained with reference to
As shown in
The branched electrodes 56c are formed with about the same length and about the same width. That is, the areas of the branched electrodes 56c extending from the continuous electrode 56a are about the same. Moreover, the distances between the branched electrodes 56c are about the same.
It is to be noted that the branched electrodes 56c denature living tissues LT in contact therewith, but the outputs of the branched electrodes 56c are at such a level that prevents the denaturation of the living tissue LT between the adjacent branched electrodes 56c.
The function and effect of a treatment system 10 according to this embodiment are similar to the function and effect described in the first embodiment and are therefore omitting a description thereof.
It is to be noted that the length and width (thickness) of each of the branched electrodes 56c, the distance between the branched electrodes 56c, and the number of branched electrodes 56c are suitably set. Although the thickness of the continuous electrode 56a is larger than the thickness of the branched electrodes 56c in the illustration of
Next, a first modification of the branched electrodes 56c will be explained using
As shown in
Furthermore, the branched electrodes 56c on the most distal side shown in
The branched electrodes 56d shown in
This can increase the resistance to the force F2 applied to the intestinal tracts IC1 and IC2, and thus create a condition where the anastomosis of the intestinal tracts IC1 and IC2 is not easily released.
Next, a second modification of the branched electrodes 56c will be explained using
As shown in
Thus, as shown in
In addition, as shown in
Furthermore, the branched electrodes 56f shown in
The purpose is to, for example, when the intestinal tracts IC1 and IC2 are anastomosed to each other, increase the force to joint the intestinal tracts IC1 and IC2 to each other and prevent the release of the anastomosis in the case in which the force F2 acts to release the anastomosis of the intestinal tracts IC1 and IC2 from the distal end of a part denatured by the continuous electrode 56a, that is, the part Bi where the intestinal tracts IC1 and IC2 separate in two directions.
In this embodiment, the branched electrodes 56d having the first portions 56d1 and the second portions 56d2, and the branched electrodes 56f have been described as the branched electrodes located on the most distal side of the main body 62 of the first holding member 52 in the case of increasing the area of a junction corresponding to the force F2. However, the shapes of the branched electrodes located on the most distal side of the main body 62 of the first holding member 52 are not limited to the shapes of the branched electrodes 56d, 56f as long as the area of the junction corresponding to the force F2 is increased.
A third embodiment will now be explained with reference to
As shown in
Electrodes of a part denoted by reference number 56h in
Furthermore, electrodes of a part denoted by reference number 56i in
However, these electrodes 56g, 56h and 56i form one continuous high-frequency electrode 56 as a whole, and therefore have the same effect as the effect of the continuous electrode 56a described in the first and second embodiments.
On the other hand, the electrodes 56h are separate from each other in the same manner as the branched electrodes 56c shown in
That is, these electrodes 56h, 56i are used not only for exerting the function of the continuous electrode to continuously joint the living tissues LT by their denaturation but also for exerting the function of the discrete electrodes 56b shown in
Although the electrodes denoted by reference number 56g are about the same as the electrodes denoted by reference number 56i in terms of the length and the distance between the electrodes in the illustration of
The function and effect of a treatment system 10 according to this embodiment are similar to the function and effect described in the first and second embodiments and are omitting therefore description thereof.
Next, a first modification of the first high-frequency electrode 56 will be explained using
While the substantially square-wave-shaped high-frequency electrode 56 is continuously disposed in the described third embodiment, it is also preferable that this electrode is formed into a substantially sine curve shape as shown in
Electrodes at positions of inflection points of the substantially sine curve shape denoted by reference number 56k function as replacements of the electrodes 56h described in the third embodiment. In addition, the electrodes 56k can be regarded as being formed longer than the parts denoted by reference number 56h in
Similarly, electrodes at top positions (positions distant from the cutter guide groove 94) of the substantially sine curve shape denoted by reference number 56l function as replacements of the electrodes 56i described in the third embodiment.
Next, a second modification of the first high-frequency electrode 56 will be explained using
As shown in
Furthermore, electrodes of a part denoted by reference number 56m and proximate to a cutter guide groove 94 (at bottom positions of the curve) function as replacements of the electrodes 56g shown in
For example, the length of the electrode 56m can be longer than the length of the electrode 56n as in this modification. Naturally, it is also preferable that the length of the electrode 56m is shorter than the length of the electrode 56n.
A fourth embodiment will now be explained with reference to
In a cylindrical member 42 and a sheath 44 of a shaft 24 of an electro-surgical device 12 shown in
Although not shown here, it is also preferable that a connection cap is provided on an outer peripheral surface of the fluid discharge port 48b of the sheath 44. At this time, the fluid described later is discharged through a cutter guide groove 94, the fluid discharge port 48a of the cylindrical member 42 of the shaft 24, the fluid discharge port 48b of the sheath 44 of the shaft 24, and the connection cap. In this case, the fluid such as the vapor or liquid can be easily discharged from the fluid discharge ports 48a, 48b by suction through the connection cap.
In addition, it is preferable that the fluid discharge ports 48a, 48b are provided in the shaft 24, but it is also preferable that the fluid discharge ports 48a, 48b are provided in a handle 22 rather than the shaft 24.
The structures of the handle 22 and the shaft 24 are the same as the structures described in the first embodiment in other respects, and other members are therefore omitting an explanation thereof.
As shown in
In a main body 62, a first fluid discharge groove (fluid discharge groove for continuous electrode) 94a is formed on an outer periphery of the continuous electrode 56a as a channel for a fluid such as vapor or high-temperature liquid. In the main body 62, second fluid discharge grooves (fluid discharge grooves for discrete electrode) 94b are also formed on outer peripheries of the discrete electrodes 56b as channels for the fluid such as vapor or high-temperature liquid. The first fluid discharge groove 94a is in communication with the second fluid discharge grooves 94b through communicating passages 94c. Each of the communicating passages 94c is formed as a groove. Moreover, each of the communicating passages 94c is exposed in a holding surface 62a.
As shown in
Next, a function of a treatment system 10 according to this embodiment will be described.
As described in the first embodiment, a living tissue LT as a treatment target is held between the first holding member 52 and the second holding member 54. At this time, the barrier portions 98 are closely contacted with the living tissue LT, and the living tissue LT contacts a first high-frequency electrode 56 and a second high-frequency electrode 58.
In this state, a foot switch and a hand switch are operated. An energy source 14 supplies energy to the first high-frequency electrode 56 and the second high-frequency electrode 58. Then, the living tissue LT held between the first high-frequency electrode 56 and the second high-frequency electrode 58 is heated. At this time, for example, a fluid such as vapor or liquid is generated from the heated part of the living tissue LT.
Here, the first fluid discharge groove 94a is disposed outside the continuous electrode 56a, and the second fluid discharge grooves 94b are disposed outside the discrete electrodes 56b. Therefore, the fluid such as the vapor or the liquid flows into the first and second fluid discharge grooves 94a, 94b. At this time, the fluid is prevented from escaping out of the first and second fluid discharge grooves 94a, 94b by the barrier portions 98. That is, the barrier portions 98 serve as the dams for preventing the fluid generated from living tissue LT from leaking out. Therefore, the fluid flown into the second fluid discharge grooves 94b flows into the first fluid discharge groove 94a through the communicating passages 94c. Then, this fluid flows toward a base portion 64 of the first holding member 52 and the second holding member 54. Further, the fluid flows into the cutter guide groove 94 which is in communication with the first fluid discharge groove 94a in, for example, the base portion 64. Alternatively, although not shown, the first fluid discharge groove 94a is in communication therewith inside the cylindrical member 42 of the shaft 24.
Subsequently, the fluid is discharged from the fluid discharge port 48b to the outside of the electro-surgical device 12 through the fluid discharge port 48a of the cylindrical member 42 of the shaft 24.
As explained above, according to this embodiment, the following effects can be obtained.
Effects similar to the effects described in the first embodiment are omitting a description thereof.
When a high-frequency current is applied by the electro-surgical device 12 to the living tissue LT as a treatment target held by the holding section 26, the barrier portions 98 are closely contacted with the living tissue LT, such that the fluid generated from the living tissue LT as a treatment target can be introduced into the first and second fluid discharge grooves 94a, 94b and the communicating passages 94c of the first and second high-frequency electrodes 56, 58 even if the fluid flows toward the barrier portions 98 of the first holding member 52.
In consequence, it can be prevented that the peripheral tissue other than the target tissue is influenced by the fluid generated from the portion to which the high-frequency current has been conducted during the treatment of the living tissue LT. That is, the position influenced during the treatment of the living tissue LT can be limited to the living tissue LT where the high-frequency current has been conducted between the first high-frequency electrode 56 and the second high-frequency electrode 58.
Therefore, according to this embodiment, the fluid such as the vapor or the liquid (high-temperature body fluid) generated from the living tissue LT is discharged to the outside of the electro-surgical device 12, for example, on the proximal side of the shaft 24 or on the side of the handle 22, such that the living tissues LT on the periphery of the living tissue LT as a treatment target can be inhibited from being influenced by the fluid such as the vapor or the liquid (body fluid).
It is important to guide the fluid such as the vapor or the liquid to a position where the fluid does not come into contact with the tissue, when inhibiting a thermal influence on the living tissue LT. It is possible to obtain an especially large effect that the thermal influence can be prevented from being exerted outside the holding section 26, in a case where the tissue is larger than the holding section 26 to such an extent that a surrounding area of the holding section 26 is covered. When an only small opening (space) is made in the holding section 26 but a fluid such as the vapor or the liquid leaks from the opening, the fluid is discharged from the opening, and the living tissue LT around the holding section 26 is thermally influenced.
Furthermore, even if the peripheries of the high-frequency electrodes (energy release portions) 56, 58 are covered with the barrier portions 98 to eliminate such an opening, there is a possibility that an opening is formed by fluid pressure such as vapor pressure generated from the living tissue LT and the fluid is discharged therefrom. Therefore, it is a useful means to provide the flow channels 94a, 94b and 94c which suppress unnecessary discharge of the fluid due to the increase of the fluid pressure and which guide the fluid in a predetermined direction for discharge.
Next, a first modification of the communicating passages 94c shown in
As shown in
Thus, the fluid generated from the living tissue LT can be passed through the conduit-shaped communicating passages 94c to maximally prevent the living tissue LT from being touched by the fluid which might be, for example, at a high temperature.
Next, a second modification of the communicating passages 94c shown in
As shown in
Thus, the fluid generated from the living tissue LT can be passed through the first and second conduit-shaped communicating passages 94c, 94d to maximally prevent the living tissue LT from being touched by the fluid which might be, for example, at a high temperature.
A fifth embodiment will now be explained with reference to
As shown in
The function and effect of a treatment system 10 according to this embodiment are similar to the function and effect described in the fourth embodiment and are omitting an explanation thereof.
A sixth embodiment will now be explained with reference to
As shown in
As shown in
A cooling plate 104 made of, for example, a copper plate and having good thermal conductivity is disposed in a holding surface 62a of the main body 62. This cooling plate 104 is fixed to the main body 62 so that it is in close contact with the cooling pipe 102. Therefore, when the cooling medium is passed through the cooling pipe 102, heat from the cooling medium is conducted to the cooling plate 104 from the cooling pipe 102. That is, the cooling plate 104 is cooled off.
A function of a treatment system 10 according to this embodiment will now be explained.
As described in the first embodiment, a living tissue LT as a treatment target is held between first and second holding members 52, 54. At this time, barrier portions 98a, 98b are closely contacted with the living tissue LT, and the living tissue LT contacts first and second high-frequency electrodes 56, 58. Further, the living tissue LT is closely contacted with the cooling plates 104 provided in the main bodies 62, 66 of the first and second holding members 52, 54.
In this state, a foot switch and a hand switch are operated. An energy source 14 supplies energy to the first high-frequency electrode 56 and the second high-frequency electrode 58, respectively. On the other hand, cooling water as a cooling medium is supplied to the cooling pipe 102.
The first high-frequency electrode 56 conducts a high-frequency current between the first high-frequency electrode 56 and the second high-frequency electrode 58 via the living tissue LT. Thus, the living tissue LT between the first high-frequency electrode 56 and the second high-frequency electrode 58 is heated.
Thus, when the living tissue LT as a treatment target is heated, a fluid such as vapor or liquid is generated from the heated part of the living tissue LT. Then, the fluids generated from the living tissue LT meet in the cutter guide groove 94 through the vapor discharge groove 94a provided outside a continuous electrode 56a and through fluid discharge grooves 94b provided outside discrete electrodes 56b, and guided to the proximal side of a shaft 24 and discharged to the outside.
Furthermore, when the living tissue LT as a treatment target is heated, thermal spread is caused from the living tissue LT as a treatment target to the living tissues LT around the treatment target.
Here, the cooling water is supplied to the cooling pipes 102 outside the first and second holding members 52, 54. Thus, the living tissue LT is cooled off via the cooling plates 104 in close contact with the outer peripheral surfaces of the cooling pipes 102 having high thermal conductivity. Therefore, the influence of heat spread from the living tissue LT as a treatment target between the first high-frequency electrode 56 and the second high-frequency electrode 58 is suppressed by parts in close contact with the cooling plates 104. That is, the spread of heat from the living tissue LT as a treatment target is suppressed by cooling off the living tissues LT on the periphery of the living tissue LT as a treatment target.
Moreover, if there are gaps between the living tissues LT and the barrier portions 98a, 98b, the fluid escapes to the outside through the gaps between the living tissues LT and the barrier portions 98a, 98b. In this case, the fluid touches the cooling plates 104. As a result, the fluid is cooled off.
As explained above, according to the embodiment, the following effect can be obtained.
The effects of the treatment system 10 according to this embodiment similar to the effects in the first and fourth embodiments are omitting an explanation thereof.
When a high-frequency current is applied by an electro-surgical device 12 to the living tissue LT as a treatment target held by a holding section 26, the barrier portions 98a, 98b of the first and second holding members 52, 54 can be closely contacted with the living tissue LT. Thus, the fluid generated from the living tissue LT as a treatment target can be introduced into the cutter guide groove 94 through the vapor discharge groove 94a between the continuous electrode 56a and the barrier portion 98a and through the fluid discharge groove 94b between the discrete electrodes 56b and the barrier portion 98b, and discharged to the outside of the electro-surgical device 12, even if the fluid flows toward the barrier portions 98a, 98b of the first and second holding members 52, 54.
In consequence, it can be prevented that the peripheral tissue other than the target tissue is influenced by the fluid generated from the portion to which the high-frequency current has been conducted during the treatment of the living tissue LT. That is, the position influenced during the treatment of the living tissue LT can be limited to the living tissue LT where the high-frequency current has been conducted between the first high-frequency electrode 56 and the second high-frequency electrode 58.
Furthermore, when a high-frequency current is applied by an electro-surgical device 12 to the living tissue LT as a treatment target held by a holding section 26, the cooling plate 104 of the first holding member 52 and the cooling plate 104 of the second holding member 54 that are cooled off can be closely contacted with the living tissue LT. Thus, the living tissue LT closely contacted with the cooling plates 104 can be cooled off. Therefore, the influence of the thermal spread caused from the living tissue LT as a treatment target to the living tissues LT around the treatment target can be suppressed by the portions contacting the cooling plates 104. In consequence, it can be prevented that the peripheral tissue other than the target tissue is influenced by the head spreading from the living tissue LT as a treatment target to which the high-frequency current has been conducted during the treatment of the living tissue LT.
Therefore, the cooling plate 104 capable of cooling off the surface is provided in the holding section 26 such that it is possible to ensure that the thermal spread is caused within the first and second holding members 52, 54.
Still further, even when a high-temperature fluid is to escape out of the first and second holding members 52, 54, this fluid touches the cooling plates 104 and can be cooled off. This can prevent the influence on the living tissues LT on the periphery of the living tissue LT held by the holding section 26.
Moreover, it can be prevented that the peripheral tissue other than the target tissue is influenced by the fluid generated from the portion to which the high-frequency current has been conducted during the treatment of the living tissue LT. That is, the range of the treatment can be restricted to the inside of the barrier portions 98a, 98b, and the living tissue LT around the barrier portions 98a, 98b are kept in a normal condition, which can contribute to earlier curing.
Next, a first modification of this embodiment will be explained using
As shown in
The cooling plate 104 is disposed in the holding surface 62a of the main body 62. The ducts 112a, 112b are sealed by this cooling plate 104. Therefore, when a fluid is passed through the ducts 112a, 112b, the heat of this fluid is conducted to the cooling plate 104.
Next, a second modification of this embodiment will be explained using
As shown in
In addition, a communicating passage 94f for communication between the fluid discharge groove 94a and the cutter guide groove 94 is formed under the second duct 112b.
A thin flexible sheet-like member (heat releasing member) 114 is disposed in the holding surface 62a of the main body 62. This sheet-like member 114 is formed of, for example, a silicone member. The ducts 112a, 112b are sealed by this sheet-like member 114. Therefore, when a fluid is passed through the ducts 112a, 112b, the heat of this fluid is conducted to the living tissue LT through the sheet-like member 114.
A seventh embodiment will now be explained with reference to
As shown in
As shown in
It is to be noted that the slots 134 shown in
That is, this treatment system 10 is equipped with an electro-surgical device 12 for performing a physical treatment using the high-frequency electrodes 58a, 58b and also performing a mechanical treatment using the staples.
Next, a function of the treatment system 10 according to this embodiment will be described.
As described in the first embodiment, a living tissue LT as a treatment target is held between the first holding member 52 and the second holding member 54. At this time, the living tissue LT contacts the continuous electrodes 56a, 58a of first and second high-frequency electrodes 56, 58.
In this state, a foot switch and a hand switch are operated. An energy source 14 supplies energy to the continuous electrodes 56a, 58a, respectively. Then, the living tissue LT between the continuous electrodes 56a, 58a is heated. Thus, the living tissues LT are continuously jointed.
The staple operating unit (not shown) of the handle 22 is operated while the living tissue LT as a treatment target is being held between the first holding member 52 and the second holding member 54. Then, the actuation sled 140 moves forward. Here, as shown in
When the actuation sled 140 moves forward, the inclined surface 136a of the staple pusher 136 in the slot 134 is pushed down by the inclined surface 140a at the distal end of the actuation sled 140. Thus, the staple 132 in the slot 134 projects and is inserted into the living tissues LT targeted for anastomosis. The pair of legs 132a of the inserted staple 132 penetrates the living tissues LT. Then, the legs 132a are folded inwards by the deforming groove 142 of the second holding member 54. Thus, the tissues targeted for anastomosis are anastomosed to each other by the staple 132. As a result, the living tissues LT, for example, are discretely jointed to each other in a mechanical manner.
As explained above, according to the embodiment, the following effect can be obtained.
The continuous electrodes 56a, 58a are disposed in the holding surfaces 62a, 66a of the first and second holding members 52, 54, respectively. Thus, the living tissues LT (e.g., the intestinal tracts IC1 and IC2) between the continuous electrode 56a of the first holding member 52 and the continuous electrode 56a of the second holding member 54 can be heated, denatured and continuously jointed to each other. Consequently, for example, tubular living tissues LT can be closely contacted with each other or sealed with each other.
Furthermore, the staple 132 is discharged from the slot 134 outside the continuous electrode 56a of the first holding member 52, and the pair of legs 132a of the staple 132 is folded inwards in the staple deforming grooves 142 outside the continuous electrode 58a of the second holding member 54. Consequently, the living tissues LT can be discretely jointed mechanically by the staples 132 in the vicinity of the outer side of the continuously jointed part.
At this time, for example, as shown in
For example, when the two intestinal tracts IC1 and IC2 are anastomosed to each other, force acts in such a direction as to separate the intestinal tracts IC1 and IC2 from each other on the side shown in
Therefore, the parts of the living tissues LT jointed by the staples 132 serve to draw the living tissues LT close to each other and keep them closely contacted with each other. Thus, an inter-network is produced between the closely contacted living tissues LT such that the living tissues LT more easily exercise their tissue regeneration power and can be regenerated earlier.
Although the staples 132 are used to mechanically joint the living tissues LT to each other in the example explained in this embodiment, it is also preferable that, for example, a living tissue adhesive is used to joint the living tissues LT to each other.
An eighth embodiment will now be explained with reference to
As shown in
The slots 134 for discharging the staples 132 are formed in, for example, two lines along each of the two sides of a cutter guide groove 94 in a closely spaced and dense manner. That is, the arrangement of the discrete electrodes 56b, 58b, the slots 134 of the staples 132 and staple deforming grooves 142 in this embodiment is opposite to the arrangement of the continuous electrodes 56a, 58a, the slots 134 of the staples 132 and the staple deforming grooves 142 described in the seventh embodiment (see
A function of a treatment system 10 according to this embodiment will now be explained.
As described in the first embodiment, a living tissue LT as a treatment target is held between the first holding member 52 and a second holding member 54. At this time, the living tissue LT contacts the discrete electrodes 56b, 58b of the first and second high-frequency electrodes 56, 58.
In this state, a staple operating unit (not shown) of a handle 22 is operated. Then, as described in the seventh embodiment, the staple 132 in the slot 134 projects and is inserted into the living tissues LT targeted for anastomosis. A pair of legs 132a of the inserted staple 132 penetrates the living tissues LT. Then, the legs 132a are folded inwards by the deforming groove 142 positioned in proximity to a cutter guide groove 96 of the second holding member 54. Thus, the tissues LT targeted for anastomosis are anastomosed to each other by the staples 132. As a result, the living tissues LT are mechanically jointed to each other in a closely spaced and continuous manner.
In this state, a foot switch and a hand switch are operated. An energy source 14 supplies energy to the discrete electrodes 56b, 58b, respectively. Then, the living tissue LT between the discrete electrodes 56b, 58b is heated, denatured and jointed.
As explained above, according to the embodiment, the following effect can be obtained.
The staple 132 is discharged from the slot 134 inside the discrete electrodes 56b of the first holding member 52, and the pair of legs 132a of the staple 132 is folded inwards in the staple deforming grooves 142 inside the discrete electrodes 58b of the second holding member 54. Consequently, the living tissues LT can be mechanically jointed to each other by the staples 132 in a closely spaced and continuous manner.
Furthermore, the discrete electrodes 56b, 58b are disposed in the holding surfaces 62a, 66a of the first and second holding members 52, 54, respectively. Thus, the living tissues LT (e.g., the intestinal tracts IC1 and IC2) between the discrete electrodes 56b of the first holding member 52 and the discrete electrodes 58b of the second holding member 54 can be heated, denatured, and discretely jointed to each other.
Therefore, the living tissues LT can be continuously jointed (sealed) to each other by the staples 132, and the living tissues LT can be discretely jointed to each other by the discrete electrodes 56b, 58b. Thus, according to the eighth embodiment, the effects similar to the effects described in the seventh embodiment can be obtained.
A ninth embodiment will now be explained with reference to
Here, as an example of an energy treatment device, a circular-type bipolar electro-surgical device (a treatment device for curing) 12b will be described which performs a treatment, for example, through an abdominal wall or outside the abdominal wall.
As shown in
The handle 202 is provided with a holding section opening/closing knob 212 and a cutter driving lever 214. The holding section opening/closing knob 212 is rotatable with respect to the handle 202. When the holding section opening/closing knob 212 is rotated, for example, clockwise with respect to the handle 202, a detachable side holding portion (a detachable side grasping portion) 224 of the holding section 206 described later comes away from a main body side holding portion (a main body side grasping portion) 222 (see
The shaft 204 is formed into a cylindrical shape. This shaft 204 is appropriately curved in consideration of insertability into a living tissue. Needless to say, the shaft 204 may be linearly formed.
A distal end of the shaft 204 is provided with the holding section 206. As shown in
The main body side holding portion 222 includes a cylindrical member 232, a frame 234 and an electro-conductive pipe 236. The cylindrical member 232 and the frame 234 have an insulating property. The cylindrical member 232 is connected with the distal end of the shaft 204. The frame 234 is fixed to the cylindrical member 232.
A central axis of the frame 234 is opened. The opened central axis of the frame 234 is provided with the electro-conductive pipe 236 which is movable in a predetermined region along the central axis of the frame 234. When the holding section opening/closing knob 212 is rotated, as shown in
As shown in
A first fluid flow path (a fluid passage) 246a is formed between the pusher 244 for the cutter and the frame 234. Moreover, the shaft 204 or the handle 202 is provided with a fluid discharge port (not shown) from which the fluid passed through the first fluid flow path 246a is discharged to the outside.
As shown in
As shown in
The continuous electrode 254a is continuously disposed on an outer edge of the cutter guide groove 246, for example, in a substantially annular shape. The discrete electrodes 254b of about the same shape are arranged at substantially equal intervals along a substantially annular virtual track. Each of the discrete electrodes 254b is formed into, for example, a circular shape. The discrete electrodes 254b are arranged to have a predetermined space therebetween, and each of the discrete electrodes 254b is disposed at a distance from the continuous electrode 254a. The discrete electrodes 254b are positioned to, when a treatment is performed, maximally prevent the denaturation of a living tissue LT between the adjacent discrete electrodes 254b due to heat and also maximally prevent the denaturation of a living tissue LT between the discrete electrode 254b and the continuous electrode 254a due to heat.
On the other hand, the detachable side holding portion 224 includes an energization shaft 262 having a connecting portion 262a, and a head portion 264. The energization shaft 262 has a circular cross section, one end formed into a tapered shape, and the other end being fixed to the head portion 264. The connecting portion 262a is formed into a concave groove shape allowing engagement with a protrusion 236a of the energization pipe 236. An outer surface of the energization shaft 262 except the connecting portion 262a is insulated by using, e.g., a coating.
A cutter receiving portion 270 having an annular shape is provided in the head portion 264. A second high-frequency electrode 274 as an output member or an energy applying portion is provided outside the cutter receiving portion 270. The second high-frequency electrode 274 is provided between the cutter receiving portion 270 and an edge of the head portion 264. One end of a second energization line 275 is fixed to the second high-frequency electrode 274. The other end of the second energization line 275 is electrically connected with the energization shaft 262.
In addition, the second high-frequency electrode 274 includes a seamlessly and continuously formed continuous electrode (sealing member, first jointing member) 274a, and a plurality of discrete electrodes (maintaining member, second jointing member) 274b discretely disposed outside the continuous electrode 274a. The continuous electrode 274a is positioned opposite to the continuous electrode 254a of the main body side holding portion 222, and each of the discrete electrodes 274b is positioned opposite to each of the discrete electrodes 254b of the main body side holding portion 222. That is, the continuous electrode 274a is continuously disposed outside the cutter receiving portion 270, for example, in a substantially annular shape. The discrete electrodes 274b of substantially the same shape are arranged at substantially equal intervals along a substantially annular virtual track. Each of the discrete electrodes 274b is formed into, for example, a circular shape. The discrete electrodes 274b are arranged to have a predetermined space therebetween, and each of the discrete electrodes 274b is disposed at a distance from the continuous electrode 274a. The discrete electrodes 274b are positioned to maximally prevent the denaturation of a living tissue LT between the adjacent discrete electrodes 274b due to heat and also maximally prevent the denaturation of a living tissue LT between the discrete electrode 274b and the continuous electrode 274a due to heat.
It is to be noted that the electro-conductive pipe 236 is connected with the cable 28 via the shaft 204 and the handle 202. Therefore, when the connecting portion 262a of the electro-conductive shaft 262 of the detachable side holding portion 224 is engaged with the protrusion 236a of the electro-conductive pipe 236, the second high-frequency electrode 274 is electrically connected with the electro-conductive pipe 236.
Next, a function of a treatment system 10 according to this embodiment will be described.
As shown in
The holding section opening/closing knob 212 of the handle 202 is operated in order to hold the living tissue to be treated between the main body side holding portion 222 and the detachable side holding portion 224. At this time, the knob 212 is rotated, for example, clockwise with respect to the handle 202. In this case, as shown in
Moreover, the living tissue to be treated is disposed between the first high-frequency electrode 254 of the main body side holding portion 222 and the second high-frequency electrode 274 of the detachable side holding portion 224. The electro-conductive shaft 262 of the detachable side holding portion 224 is inserted into the electro-conductive pipe 236 of the main body side holding portion 222. In this state, the holding section opening/closing knob 212 of the handle 202 is rotated, for example, counterclockwise. Therefore, the detachable side holding portion 224 closes with respect to the main body side holding portion 222. In this manner, the living tissue of the treatment target is held between the main body side holding portion 222 and the detachable side holding portion 224.
In this state, a foot switch and a hand switch are operated. The energy source 14 supplies energy to the first high-frequency electrode 254 and the second high-frequency electrode 274 via the cable 28, respectively. The continuous electrode 254a and the discrete electrodes 254b of the first high-frequency electrode 254 conduct a high-frequency current to the continuous electrode 274a and the discrete electrodes 274b of the second high-frequency electrode 274 via the living tissue. Thus, the living tissue between the main body side holding portion 222 and the detachable side holding portion 224 is heated.
Then, the living tissue LT is continuously (substantially annularly) denatured by the continuous electrode 254a and the continuous electrode 274a of the first and second high-frequency electrodes 254, 274. Further, the living tissues LT around the part denatured by the continuous electrode 254a of the first high-frequency electrode 254 and the continuous electrode 274a of the second high-frequency electrode 274 are discretely denatured by the discrete electrodes 254b, 274b of the first and second high-frequency electrodes 254, 274.
When a treatment is finished, the operation of the foot switch or the hand switch is stopped. Then, the supply of energy from the energy source 14 to the first high-frequency electrode 254 and the second high-frequency electrode 274 is stopped.
Additionally, when the cutter driving lever 214 of the handle 202 is operated, the cutter 242 protrudes from the cutter guide groove 246 of the main body side holding section 222 and moves toward a cutter receiving portion 270 of the detachable side holding portion 224. Since the cutter 242 has a blade at a distal end thereof, the treated living tissue is cut into a circular shape.
As explained above, according to this embodiment, the following effects can be obtained.
The continuous electrodes 254a, 274a and the discrete electrodes 254b, 274b are disposed in the main body side holding section 222 and the detachable side holding portion 224. Thus, the living tissue LT between the continuous electrode 254a of the main body side holding section 222 and the continuous electrode 274a of the detachable side holding portion 224 can be heated, denatured, and jointed to each other. Therefore, the living tissues LT can be substantially annularly sealed with each other. Moreover, the living tissue LT between the discrete electrodes 254b of the main body side holding section 222 and the discrete electrodes 274b of the detachable side holding portion 224 can be heated, denatured, and jointed to each other. As a result, the living tissues LT can be discretely jointed to each other.
At this time, the part where the living tissues LT are continuously denatured and jointed to each other is located in proximity to the discretely jointed part. Moreover, the living tissues LT around the discretely denatured and jointed part are not denatured. Thus, the non-denatured living tissues LT around the discretely denatured and jointed part can be in contact with (pressed against) each other. Therefore, the discrete electrodes 254b, 274b play a major role in maintaining the closely contacted state of the living tissues LT to which, for example, force in a direction to separate them is applied. Therefore, the parts of the living tissues LT jointed by the discrete electrodes 254b, 274b serve to draw the living tissues LT close to each other. Thus, an inter-network is produced between the living tissues LT such that the living tissues LT more easily exercise their tissue regeneration power and can be regenerated earlier.
Although the discrete electrodes 254b of the main body side holding section 222 are arranged at equal intervals and have a substantially equal area in the embodiment described above, it is also preferable that the areas of the discrete electrodes 254b are different from each other and that the distance between the adjacent discrete electrodes 254b varies. In this case, when the tissue is discretely treated with the discrete electrodes 254b, a part contacting the discrete electrode 254b is denatured, but various modifications of the discrete electrodes 254b are allowed as long as the living tissues LT can be left in contact with each other without denaturing the living tissues LT around the denatured part. This holds true with the detachable side holding portion 224.
Although using the bipolar-type electro-surgical device 12b has been explained in the embodiment, using a monopolar-type electro-surgical device is also preferable as shown in
While using the first and second high-frequency electrodes 254, 274 has been described in the embodiment, it is also preferable to use heaters (not specifically shown because there is no diagrammatic change from, for example,
A tenth embodiment will now be explained with reference to
As shown in
The branched electrodes 254c are formed with about the same length and about the same width. That is, the areas of the branched electrodes 254c extending from the continuous electrode 254a are about the same. Moreover, the distances between the branched electrodes 254c are about the same.
It is to be noted that the adjacent branched electrodes 254c denature living tissue in contact therewith, but the outputs of the branched electrodes 254c are at such a level that prevents the denaturation of the living tissue between the adjacent branched electrodes 254c.
The function and effect of a treatment system 10 according to this embodiment are similar to the function and effect described in the ninth embodiment and are omitting an explanation thereof.
An eleventh embodiment will now be explained with reference to
As shown in
However, these electrodes 254d, 254e and 254f form one continuous high-frequency electrode 254 as a whole, and therefore have the same effects as the effects of the continuous electrode 254a described in the ninth and tenth embodiments.
The electrodes 254d serve as parts of the continuous electrode, and discontinuously formed separately from each other and therefore function as discrete electrodes. The electrodes 254e are separated from each other in the same manner as the branched electrodes 254c shown in
That is, these electrodes 254d, 254e and 254f are used not only for exerting the function of the continuous electrode to continuously joint the living tissues through their denaturation but also for exerting the functions similar to those of the discrete electrodes 254b shown in
Although the length and the distance between the electrodes are about the same in the electrodes denoted by reference number 254d, the electrodes denoted by reference number 254e and the electrodes denoted by reference number 254f in the illustration of
The effects of a treatment system 10 according to this embodiment are similar to the effects in the ninth and tenth embodiments and are therefore omitting a description thereof.
Therefore, various modifications of the electrode 254 are allowed as in, for example,
A twelfth embodiment will now be explained with reference to
As shown in
A vapor discharge groove 256b is annularly formed outside a discrete electrode 254b of the first high-frequency electrode 254. This fluid discharge groove 256b is in communication with the fluid discharge groove 256a and the first fluid flow path 246a. A barrier portion 258b is formed outside the fluid discharge groove 256b at a position higher than the surface of the vapor discharge groove 256b. That is, the barrier portion 258b of the main body side holding section 222 is closer to the head portion 264 of the detachable side holding portion 224 than the surface of the first high-frequency electrode 254.
It is to be noted that the surfaces of the barrier portions 258a, 258b are substantially flush with each other.
A fluid discharge groove 276a is annularly formed outside a continuous electrode 274a of a second high-frequency electrode 274. A barrier portion 278a is formed outside the fluid discharge groove 276a at a position higher than the continuous electrode 274a. That is, the barrier portion 278a of the detachable side holding portion 224 is closer to the main body side holding section 222 than the surface of the continuous electrode 274a.
A vapor discharge groove 276b is annularly formed outside a discrete electrode 274b of the second high-frequency electrode 274. This fluid discharge groove 276b is in communication with the above-mentioned fluid discharge groove 276a. A barrier portion 278b is formed outside the fluid discharge groove 276b at a position higher than the surface of the discrete electrode 274b. That is, the barrier portion 278b of the detachable side holding portion 224 is closer to the main body side holding section 222 than the surface of the discrete electrode 274b.
It is to be noted that the surfaces of the barrier portions 278a, 278b are substantially flush with each other.
Furthermore, the fluid discharge grooves 276a, 276b are in communication with a fluid discharge passage 280 of the head portion 264 and an electro-conductive shaft 262. This fluid discharge passage 280 is in communication with a second fluid flow path (a fluid passage) 246b of an electro-conductive pipe 236. Moreover, a shaft 204 or a handle 202 is provided with a fluid discharge port (not shown) from which the fluid passed through the second fluid flow path 246b is discharged to the outside.
A function of a treatment system 10 according to this embodiment will now be explained.
The same function of the treatment system 10 according to this embodiment as the function in the ninth embodiment is omitting an explanation thereof.
As shown in
The living tissue as a treatment target is held between the main body side holding portion 222 and the detachable side holding portion 224. At this time, the living tissue as a treatment target contacts the first high-frequency electrode 254 and the second high-frequency electrode 274. Tissues around the living tissue as a treatment target are closely contacted with the barrier portions 258a, 258b, 278a and 278b of the main body side holding portion 222 and the detachable side holding portion 224.
In this state, a foot switch and a hand switch are operated. An energy source 14 supplies energy to the first high-frequency electrode 254 and the second high-frequency electrode 274 via a cable 28, respectively.
The first high-frequency electrode 254 conducts a high-frequency current between the first high-frequency electrode 254 and the second high-frequency electrode 274 via the living tissue. Thus, the living tissue between the first high-frequency electrode 254 and the second high-frequency electrode 274 is heated.
Then, a fluid such as high-temperature vapor or liquid is generated from the heated part of the living tissue. Here, when the first high-frequency electrode 254 is fixed to the main body side holding portion 222, the surface of the first high-frequency electrode 254 exposed on the side of the detachable side holding portion 224 is positioned slightly lower than the barrier portions 258a, 258b of the main body side holding portion 222. In the same manner, when the second high-frequency electrode 274 is fixed to the detachable side holding portion 224, the surface of the second high-frequency electrode 274 exposed on the side of the main body side holding portion 222 is positioned slightly lower than the barrier portions 278a, 278b of the detachable side holding portion 224. Thus, the barrier portions 258a, 258b of the main body side holding portion 222 and the barrier portions 278a, 278b of the detachable side holding portion 224 serve as dams to bring the fluid generated from the living tissue by electric conduction between the first high-frequency electrode 254 and the second high-frequency electrode 274 into the fluid discharge grooves 256a, 256b, 276a and 276b and prevent the leakage of the fluid.
Then, in a state in which the main body side holding portion 222 is closed with respect to the detachable side holding portion 224, the barrier portions 258a, 258b of the main body side holding portion 222 are in contact with the barrier portions 278a, 278b of the detachable side holding portion 224, such that the fluid generated from the living tissue flows into the fluid discharge grooves 256a, 256b, 276a and 276b.
Subsequently, the fluid flown into the fluid discharge grooves 256a, 256b at the main body side holding portion 222 is passed toward the handle 202 inside a pusher 244 for the cutter through the first fluid flow path 246a in which the cutter 242 is disposed, and discharged to the outside of the electro-surgical device 12b.
On the other hand, the fluid flown into the fluid discharge grooves 276a, 276b at the detachable side holding portion 224 is passed toward the handle 202 through the fluid discharge passage 280 and the second fluid flow path 246b and discharged to the outside of the electro-surgical device 12b.
As explained above, according to the embodiment, the following effect can be obtained.
The same effects of the treatment system 10 according to this embodiment as the effects in the ninth embodiment are omitting an explanation thereof.
When a high-frequency current is applied by the electro-surgical device 12b to the living tissue as a treatment target held by the holding section 206, the barrier portions 258a, 258b of the main body side holding portion 222 and the barrier portions 278a, 278b of the detachable side holding portion 224 can be closely contacted with the living tissue. Thus, the fluid generated from the living tissue as a treatment target can be introduced into the first fluid flow path 246a through the vapor discharge groove 256a between the continuous electrode 254a of the first high-frequency electrode 254 and the barrier portion 258a and through the vapor discharge groove 256b between the discrete electrodes 254b and the barrier portion 258b, even if the fluid flows toward the barrier portions 258a, 258b of the main body side holding portion 222 and the barrier portions 278a, 278b of the detachable side holding portion 224. Further, the fluid can be introduced into the second fluid flow path 246b through the fluid discharge groove 276a between the continuous electrode 274a of the second high-frequency electrode 274 and the barrier portion 278a and through the fluid discharge groove 276b between the discrete electrode 274b and the barrier portion 278b.
In consequence, it can be prevented that the peripheral tissue other than the target tissue is influenced by the fluid generated from the portion to which the high-frequency current has been conducted during the treatment of the living tissue. That is, the position influenced during the treatment of the living tissue can be limited to the living tissue where the high-frequency current has been conducted between the first high-frequency electrode 254 and the second high-frequency electrode 274.
In addition, in the structure described in this embodiment, the barrier portions 258a, 258b are provided around the fluid discharge grooves 256a, 256b on the outer periphery of the first high-frequency electrode 254, and the barrier portions 278a, 278b are provided around the fluid discharge grooves 276a, 276b on the outer periphery of the second high-frequency electrode 274, in order to prevent thermal spread. Moreover, as described in the sixth embodiment (see
A thirteenth embodiment will now be explained with reference to
As shown in
As shown in
Discrete electrodes 274b are eliminated from a detachable side holding portion 224, and deforming grooves 292 of the staples 282 are provided instead. That is, a plurality of staple deforming grooves 292 are formed in a holding surface 224a of the detachable side holding portion 224. Each of the staple deforming grooves 292 is formed with, for example, a substantially arc-shaped bottom so that a pair of legs of the staple 282 can be folded inwards and deformed. Therefore, the detachable side holding portion 224 also functions as an anvil of the staple 282.
It is to be noted that the slots 284 at the distal end of the main body side holding portion 222 are formed opposite to the staple deforming grooves 292 of the detachable side holding portion 224.
That is, this treatment system 10 is equipped with an electro-surgical device 12b for performing a physical treatment using the continuous electrodes 254a, 274a and also performing a mechanical treatment using the staples.
A function of a treatment system 10 according to this embodiment will now be explained.
As described in the ninth embodiment, a living tissue LT as a treatment target is held between the main body side holding portion 222 and the detachable side holding portion 224. At this time, the living tissue LT contacts the continuous electrodes 254a, 274a.
In this state, a foot switch or a hand switch is operated. Energy is respectively applied to the continuous electrodes 254a, 274a from an energy source 14. Then, the living tissue LT between the continuous electrodes 254a, 274a is heated.
While the living tissue LT as a treatment target is held between the main body side holding portion 222 and the detachable side holding portion 224, tissues targeted for anastomosis are interposed between the slots 284 of the main body side holding portion 222 and the staple deforming grooves 292 of the detachable side holding portion 224. In this state, the staple operating unit (not shown) of the handle 202 is operated. Then, the actuation sled 288 moves forward. Here, as shown in
When the actuation sled 288 moves forward, the staple 282 in the slot 134 projects and is inserted into the tissues targeted for anastomosis. The pair of legs of the inserted staple 282 penetrates the living tissues LT. Then, the legs are folded inwards by the deforming groove 292 of the detachable side holding portion 224. Thus, the tissues targeted for anastomosis are anastomosed to each other by the staples 282. As a result, the living tissues LT are discretely jointed to each other in a mechanical manner.
As explained above, according to the embodiment, the following effect can be obtained.
The continuous electrode 254a, 274a are disposed in the main body side holding portion 222 and the detachable side holding portion 224, respectively. The staple 282 is discharged from the slot 284 outside the continuous electrode 254a of the main body side holding portion 222, and the pair of legs of the staple 282 is folded inwards in the staple deforming grooves 292 outside the continuous electrode 274a of the detachable side holding portion 224. The living tissues LT between the continuous electrode 254a of the main body side holding portion 222 and the continuous electrode 274a of the detachable side holding portion 224 can be heated, denatured, and continuously jointed to each other. Consequently, the living tissues LT can be closely contacted with each other or sealed with each other. Moreover, the living tissues LT can be discretely jointed mechanically by the staples 282 in the vicinity of the outer side of the part where these living tissues are continuously jointed.
Therefore, the parts of the living tissues LT jointed by the staples 282 serve to draw the living tissues LT close to each other and keep them closely contacted with each other. Thus, an inter-network is produced between the living tissues LT such that the closely contacted living tissues LT more easily exercise their tissue regeneration power and can be regenerated earlier.
Although the staples 282 are used to mechanically joint the living tissues LT to each other in the example explained in this embodiment, it is also preferable that, for example, a living tissue adhesive is used to joint the living tissues LT to each other.
Moreover, as shown in
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.
