The present disclosure relates to an ultrasonic treatment instrument.
In the related art, there has been known an ultrasonic treatment instrument that treats a treatment target site (hereinafter, referred to as a target site) in a living tissue by applying ultrasonic energy to the target site (see, for example, WO 2018/011918A).
The ultrasonic treatment instrument described in WO 2018/011918A includes a rod, a holder, and a pad (hereinafter, referred to as a resin pad) described below.
The rod includes a treatment portion for treating a living tissue at a distal end, and transfers ultrasonic vibration from a proximal end toward the treatment portion.
The holder opens and closes with respect to the treatment portion.
The resin pad is held with respect to the holder, and has an abutment surface that grips the living tissue between the resin pad and the treatment portion.
In some embodiments, an ultrasonic treatment instrument includes: a vibration transmitter including a treatment portion for treating a living tissue at a distal end of the vibration transmitter, the vibration transmitter being configured to transfer ultrasonic vibration from a proximal end of the vibration transmitter toward the treatment portion; a holder configured to open and close with respect to the treatment portion; a resin pad including a gripping surface for gripping the living tissue between the resin pad and the treatment portion; and a heat transmitter that is configured separately from the holder and extends from the holder to an inside of the resin pad.
In some embodiments, an ultrasonic treatment instrument includes: a vibration transmitter including a treatment portion for treating a living tissue at a distal end of the vibration transmitter, and the vibration transmitter being configured to transfer ultrasonic vibration from a proximal end of the vibration transmitter toward the treatment portion; a holder configured to open and close with respect to the treatment portion; a resin pad including a gripping surface for gripping the living tissue between the resin pad and the treatment portion; and a heat transmitter disposed between the holder and the resin pad.
The above and other features, advantages and technical and industrial significance of this disclosure will be better understood by reading the following detailed description of presently preferred embodiments of the disclosure, when considered in connection with the accompanying drawings.
Hereinafter, modes for carrying out the disclosure (hereinafter, embodiments) will be described with reference to the drawings. The disclosure is not limited by the embodiments described below. Furthermore, in the description of the drawings, the same portions are denoted by the same reference numerals.
Schematic Configuration of Ultrasonic Treatment Instrument
The ultrasonic treatment instrument 1 applies ultrasonic energy and high-frequency energy to a treatment target site (hereinafter, referred to as a target site) in a living tissue to treat the target site. Here, the treatment means, for example, coagulation and incision of the target site. As illustrated in
As illustrated in
The holding case 4 supports the entire ultrasonic treatment instrument 1.
The operation handle 5 is movably attached to the holding case 4 and receives an opening/closing operation by an operator.
The switch 6 is provided in a state of being exposed to an outside of the holding case 4, and receives an output start operation by the operator. Then, the switch 6 outputs an operation signal corresponding to the output start operation to a control device (not illustrated) electrically coupled to the ultrasonic treatment instrument 1.
The sheath 7 has a substantially cylindrical shape as a whole. Hereinafter, one side along the central axis Ax of the sheath 7 is referred to as a distal end side Art (
In the sheath 7, an outer peripheral surface is covered with an electrically insulating outer tube TO (see
In addition, in the sheath 7, an inner peripheral surface is covered with an electrically insulating inner tube TI (see
In the following description of the configuration of the jaw 8 and the resin pad 9, a side away from a treatment portion 101 configuring the vibration transmitter will be referred to as a back surface side Ar3 (see
The jaw 8 corresponds to a holder. The jaw 8 can be opened and closed with respect to the treatment portion 101 (
The arm 81 is made of an electrically conductive material. As illustrated in
The arm body 811 is formed of a substantially long plate body. In the present first embodiment, a longitudinal direction of the arm body 811 is a direction along a curve toward a left side as it goes toward the distal end side Ar1 when viewed from the proximal end side Ar2 in a state where the jaw 8 is positioned on an upper side with respect to the treatment portion 101.
In the arm body 811, as illustrated in
As illustrated in
In addition, an electrically insulating resin cover RC (
Each of the pair of bearing portions 812 is provided at the proximal end of the arm body 811, and is formed of plate bodies facing each other in the width direction.
As illustrated in
In addition, as illustrated in
The wiper jaw 82 is made of an electrically conductive material such as stainless steel or a titanium alloy, and is attached to the arm 81. As illustrated in
The wiper jaw body 83 is formed of an elongated plate body extending along the longitudinal direction of the arm body 811. In addition, an outer shape of the wiper jaw body 83 is set to be substantially the same as an inner surface shape of the first recess 811a. Then, the wiper jaw body 83 is disposed in the first recess 811a.
In the wiper jaw body 83, a second recess 831 (see
In addition, as illustrated in
The plurality of first tooth portions 84 protrude from the one side wall portion 831b toward the treatment portion side Ar4 respectively, and are arranged side by side along the longitudinal direction of the wiper jaw body 83.
The plurality of second tooth portions 85 protrude from the other side wall portion 831b toward the treatment portion side Ar4 respectively, and are arranged side by side along the longitudinal direction of the wiper jaw body 83.
Then, the plurality of first tooth portions 84 and the plurality of second tooth portions 85 are provided in a state where the resin pad 9 is sandwiched in a state where the resin pad 9 is attached to the wiper jaw 82 (see
The resin pad 9 is softer than the vibration transmitter 10, is made of a resin material having electrical insulation and biocompatibility, for example, polytetrafluoroethylene (PTFE), and has a substantially rectangular parallelepiped shape extending along the longitudinal direction of the arm body 811. In addition, in the resin pad 9, a third recess 91 (see
The attachment structure of the resin pad 9 to the jaw 8 will be described later in “Attachment Structure of Resin Pad to Jaw”.
The vibration transmitter 10 has an elongated shape and is made of an electrically conductive material. Then, as illustrated in
The treatment portion 101 is provided at the distal end of the shaft 102. Similarly to the jaw 8, the treatment portion 101 extends along a curve toward the left side as it goes toward the distal end side Ar1 as viewed from the proximal end side Ar2 in a state where the jaw 8 is positioned on the upper side.
The shaft 102 has an elongated shape extending along the central axis Ax, and an end portion on the proximal end side Ar2 is coupled to a bolted Langevin type transducer (BLT) constituting the ultrasonic transducer 3. Then, the shaft 102 transfers the ultrasonic vibration generated by the BLT from the end portion on the proximal end side Ar2 to the treatment portion 101. In the present first embodiment, the ultrasonic vibration is longitudinal vibration that vibrates in a direction along the central axis Ax. At this time, the treatment portion 101 vibrates with a desired amplitude by the longitudinal vibration of the vibration transmitter 10.
An annular lining LI (see
The ultrasonic transducer 3 is detachably coupled to an end portion of the holding case 4 on the proximal end side Ar2. Although not specifically illustrated, the ultrasonic transducer 3 includes a BLT that generates ultrasonic vibration in response to supply of AC power.
The control device (not illustrated) electrically coupled to the ultrasonic treatment instrument 1 described above controls the operation of the ultrasonic treatment instrument 1 as described below according to the operation signal from the switch 6.
The control device supplies high-frequency power between the jaw 8 and the treatment portion 101 via the sheath 7 and the shaft 102. Then, a high-frequency current flows between the treatment portion 101 and the plurality of first and second tooth portions 84 and 85 having the same potential. That is, the high-frequency current flows through the target site gripped between the jaw 8 and the treatment portion 101. In other words, high-frequency energy is applied to the target site.
In addition, the control device supplies AC power to the BLT constituting the ultrasonic transducer 3 to generate ultrasonic vibration in the BLT. Then, ultrasonic vibration is applied from the treatment portion 101 to the target site gripped between the jaw 8 and the treatment portion 101. In other words, ultrasonic energy is applied to the target site.
Then, Joule heat is generated in the target site by the flow of the high-frequency current. In addition, frictional heat is generated between the treatment portion 101 and the target site by the vertical vibration of the treatment portion 101. As a result, the target site is incised while coagulating.
Attachment Structure of Resin Pad to Jaw
Next, an attachment structure of the resin pad 9 to the jaw 8 will be described.
As illustrated in
The heat transmitter 11 is configured separately from the jaw 8, and is a member that transfers the heat of the resin pad 9 from the resin pad 9 to the jaw 8 (wiper jaw 82). In the present first embodiment, the heat transmitter 11 is made of a material having higher thermal conductivity than the resin pad 9 and the wiper jaw 82. As a material of the heat transmitter 11, for example, aluminum, gold, silver, copper, or the like can be exemplified. In addition, the heat transmitter 11 may be made of the same material as the wiper jaw 82. In addition, as illustrated in
Then, in a state where the heat transmitter 11 penetrates the resin pad 9 in the width direction, end portions on one end side and the other end side are respectively coupled to the side wall portions 831b on both sides of the wiper jaw body 83 in the width direction. That is, the heat transmitter 11 is bridged between the wiper jaw body 83 and the resin pad 9. In this state, the substantially central portion of the heat transmitter 11 is positioned in a projection area ArP obtained by projecting the gripping surface 911 toward the back surface side Ar3 along the opening/closing direction of the jaw 8. Then, the heat of the gripping surface 911 moves along a heat transfer path of the resin pad 9 to the heat transmitter 11 to the wiper jaw body 83 to the first pin Pit and to the arm 81 as indicated by arrows in
Although not specifically illustrated, a plurality of the heat transmitters 11 are arranged side by side at predetermined intervals along the longitudinal direction of the resin pad 9. That is, the resin pad 9 is attached to the wiper jaw body 83 by the plurality of heat transmitters 11 inside the second recess 831.
According to the present first embodiment described above, the following effects are obtained.
The ultrasonic treatment instrument 1 according to the present first embodiment includes the heat transmitter 11 that is configured separately from the jaw 8 and transfers the heat of the resin pad 9 from the resin pad 9 to the jaw 8 (wiper jaw 82).
Therefore, frictional heat generated in the resin pad 9 (gripping surface 911) by application of ultrasonic vibration can be moved along the heat transfer path of the resin pad 9 to a heat transmitter 11 and to the jaw 8.
Therefore, according to the ultrasonic treatment instrument 1 according to the present first embodiment, deterioration of the resin pad 9 can be suppressed.
In particular, the heat transmitter 11 is made of a material having higher thermal conductivity than the resin pad 9. Therefore, a dissipation efficiency of heat from the resin pad 9 along the heat transfer path described above can be improved, and the deterioration of the resin pad 9 can be further suppressed.
In addition, a portion of the heat transmitter 11 is positioned in the projection area ArP where frictional heat generated on the gripping surface 911 is easily transferred in the resin pad 9. Therefore, the heat of the resin pad 9 can be effectively received by the heat transmitter 11, and the heat can be dissipated along the heat transfer path described above, and the deterioration of the resin pad 9 can be further suppressed.
Next, the present second embodiment will be described. In the following description, the same reference numerals are given to the same configurations as those of the above-described first embodiment, and a detailed description thereof will be omitted or simplified.
The present second embodiment is different from the above-described first embodiment in the attachment structure of the resin pad 9 to the jaw 8. Hereinafter, for convenience of description, the jaw 8 and the wiper jaw 82 according to the present second embodiment are referred to as a jaw 8A and a wiper jaw 82A, respectively. In addition, the resin pad 9 according to the present second embodiment is referred to as a resin pad 9A.
The jaw 8A is different from the jaw 8 described in the above-described first embodiment in that a wiper jaw 82A having a different shape from the wiper jaw 82 is adopted.
As illustrated in
As illustrated in
In addition, as illustrated in
As illustrated in
The installation method of the resin pad 9A is not limited to the sliding method described above. For example, by using the elasticity of the resin pad 9A, an installation method in which the resin pad 9A is screwed until the pair of claws 831d enter the pair of slits 92 from the lower side to the upper side in
In the present second embodiment, as illustrated in
Similarly to the heat transmitter 11 described in the above-described first embodiment, the heat transmitter 11A is a member that is configured separately from the jaw 8A and transfers the heat of the resin pad 9A from the resin pad 9A to the jaw 8A (wiper jaw 82A). In the present second embodiment, the heat transmitter 11A has a sheet shape and is made of a material having higher thermal conductivity than the resin pad 9A. For example, the heat transmitter 11A is a graphite sheet. Then, the heat of the gripping surface 911 moves along a heat transfer path of the resin pad 9A to the heat transmitter 11A to the wiper jaw 82A to the first pin Pit and to the arm 81.
The heat transmitter 11A may have the same length dimension as the entire length of the resin pad 9A in the longitudinal direction, or may have a length dimension shorter than the entire length.
Even in the case of adopting the structure in the above-described present second embodiment, the same effects as those of the above-described first embodiment are obtained.
In the above-described first embodiment, the heat transmitter 11A may be disposed between the outer surface of the resin pad 9 and the bottom surface 831a, the side wall portions 831b, and the first and second tooth portions 84 and 85.
In the above-described second embodiment, as in the present Modification 2-1 illustrated in
Next, the present third embodiment will be described.
In the following description, the same reference numerals are given to the same configurations as those of the above-described first embodiment, and a detailed description thereof will be omitted or simplified.
The present third embodiment is different from the above-described first embodiment in the attachment structure of the resin pad 9 to the jaw 8. Hereinafter, for convenience of description, the jaw 8 and the wiper jaw 82 according to the present second embodiment are referred to as a jaw 8B and a wiper jaw 82B, respectively. In addition, the resin pad 9 according to the present second embodiment will be referred to as a resin pad 9B.
The jaw 8B is different from the jaw 8 described in the above-described first embodiment in that the wiper jaw 82B having a different shape from the wiper jaw 82 is adopted.
As illustrated in
The sixth insertion hole 831e is positioned substantially at the center of the wiper jaw body 83 in the longitudinal direction, and penetrates from the upper outer surface to the inside of the second recess 831 through the fifth insertion hole 831c in
In addition, as illustrated in
The groove portion 93 corresponds to an engagement receiving portion. The groove portion 93 linearly extends from the surface facing the bottom surface 831a toward the gripping surface 911 in the resin pad 9B, and has a T-shaped cross section in which the extended distal end portions linearly extend in the width direction, respectively. Then, the groove portion 93 penetrates from the distal end to the proximal end of the resin pad 9B along the longitudinal direction of the resin pad 9B.
Then, as illustrated in
Similarly to the heat transmitter 11 described in the above-described first embodiment, the heat transmitter 11B is a member that is configured separately from the jaw 8B and transfers the heat of the resin pad 9B from the resin pad 9B to the jaw 8B (wiper jaw 82B). In the present third embodiment, the heat transmitter 11B is made of a material having higher thermal conductivity than the resin pad 9B and the wiper jaw 82B. As a material of the heat transmitter 11B, for example, aluminum, gold, silver, copper, or the like can be exemplified. In addition, the heat transmitter 11B may be made of the same material as the wiper jaw 82B. Then, as illustrated in
The pad side coupling portion 111 is a portion coupled to the resin pad 9B and corresponds to an engaging portion. The pad side coupling portion 111 is formed in an elongated shape having a length dimension substantially the same as the entire length of the resin pad 9B in the longitudinal direction, and has a T-shaped cross section substantially the same as the groove portion 93. Then, as illustrated in
The jaw side coupling portion 112 is a portion coupled to the jaw 8B and corresponds to a coupling portion. The jaw side coupling portion 112 protrudes upward in
In the heat transmitter 11B described above, the first pin Pit is inserted into the seventh insertion hole 112a together with the fifth insertion hole 831c in a state where the jaw side coupling portion 112 is inserted into the sixth insertion hole 831e. As a result, the heat transmitter 11B and the resin pad 9B are pivotally supported with respect to the arm 81 so as to be swingable about the first pin Pit together with the wiper jaw 82B.
Then, the heat of the gripping surface 911 moves along a heat transfer path of the resin pad 9B to the heat transmitter 11B to the wiper jaw 82B and to the arm 81.
The coupling between the heat transmitter 11B and the jaw 8B is not limited to the above-described structure, and other mechanical coupling structures may be adopted, or a thermally conductive adhesive may be used.
Even in the case of adopting the structure in the above-described present third embodiment, the same effects as those of the above-described first embodiment are obtained.
Next, the present fourth embodiment will be described. In the following description, the same reference numerals are given to the same configurations as those of the above-described first embodiment, and a detailed description thereof will be omitted or simplified.
The present fourth embodiment is different from the above-described first embodiment in the attachment structure of the resin pad 9 to the jaw 8. Hereinafter, for convenience of description, the jaw 8 and the wiper jaw 82 according to the present fourth embodiment are referred to as a jaw 8C and a wiper jaw 82C, respectively. In addition, the resin pad 9 according to the present fourth embodiment is referred to as a resin pad 9C.
The jaw 8C is different from the jaw 8 described in the above-described first embodiment in that the wiper jaw 82C having a different shape from the wiper jaw 82 is adopted.
As illustrated in
In addition, as illustrated in
The installation method of the resin pad 9C is not limited to the sliding method described above. For example, by using the elasticity of the resin pad 9C, an installation method in which the resin pad 9C is screwed until the pair of claws 831d enter the pair of slits 92 in the direction indicated by an arrow in
In the present fourth embodiment, as illustrated in
Similarly to the heat transmitter 11 described in the above-described first embodiment, the heat transmitter 11C is a member that is configured separately from the jaw 8C and transfers the heat of the resin pad 9C from the resin pad 9C to the jaw 8C (wiper jaw 82C). In the present third embodiment, the heat transmitter 11C is an adhesive including a thermal conductive substance or a heat sealing sheet. As the thermal conductive substance, boron nitride, alumina, metal powder, carbon nanotube, silicon carbide, and the like can be exemplified.
Then, for example, as described below, the heat transmitter 11C is provided between the outer surface of the resin pad 9C and the inner surface of the second recess 831 inside the second recess 831.
First, as illustrated in
Then, the heat of the gripping surface 911 moves along a heat transfer path of the resin pad 9C to the heat transmitter 11C to the wiper jaw 82C to the first pin Pit and to the arm 81.
The heat transmitter 11C may have the same length dimension as the entire length of the resin pad 9C in the longitudinal direction, or may have a length dimension shorter than the entire length.
Even in the case of adopting the structure in the present fourth embodiment described above, the same effects as those of the above-described first embodiment are obtained.
In addition, the heat transmitter 11C is an adhesive including a thermal conductive substance or a heat sealing sheet. Therefore, a cross-sectional area of the heat transfer path of the resin pad 9C to the wiper jaw 82C can be enlarged, and a thermal resistance in the heat transfer path can be reduced.
In the above-described fourth embodiment, a plurality of coupling holes 94 may be provided on the surface of the resin pad 9C facing the bottom surface 831a as in the present Modification 4-1 illustrated in
As illustrated in
Then, as described in the above-described fourth embodiment, after the heat transmitter 11C is applied or disposed on the bottom surface 831a and the pair of claws 831d enter the pair of slits 92, the resin pad 9C is pressed toward the bottom surface 831a. As a result, as illustrated in
Therefore, a bonding strength of the resin pad 9C to the wiper jaw 82C is improved, the cross-sectional area of the heat transfer path of the resin pad 9C to the wiper jaw 82C is enlarged, and the thermal resistance in the heat transfer path can be reduced.
Next, the present fifth embodiment will be described.
In the following description, the same reference numerals are given to the same configurations as those of the above-described first embodiment, and a detailed description thereof will be omitted or simplified.
The present fifth embodiment is different from the above-described first embodiment in the attachment structure of the resin pad 9 to the jaw 8. Hereinafter, for convenience of description, the jaw 8 and the wiper jaw 82 according to the present fifth embodiment are referred to as a jaw 8D and a wiper jaw 82D, respectively. In addition, the resin pad 9 according to the present fifth embodiment will be referred to as a resin pad 9D.
The jaw 8D is different from the jaw 8 described in the above-described first embodiment in that the wiper jaw 82D having a different shape from the wiper jaw 82 is adopted.
As illustrated in
As illustrated in
The groove portion 95 corresponds to a recess. As illustrated in
In the present fifth embodiment, as illustrated in
Similarly to the heat transmitter 11 described in the above-described first embodiment, the heat transmitter 11D is a member that is configured separately from the jaw 8D and transfers the heat of the resin pad 9D from the resin pad 9D to the jaw 8D (wiper jaw 82D). In the present fifth embodiment, the heat transmitter 11D is made of a material having higher thermal conductivity than the resin pad 9D and the wiper jaw 82D. As a material of the heat transmitter 11D, for example, aluminum, gold, silver, copper, graphite, or the like can be exemplified. In addition, the heat transmitter 11D may be made of the same material as the wiper jaw 82B. Then, as illustrated in
The abutment portion 113 is formed of a plate body having a length dimension substantially equal to the length dimension of the bottom surface 831a in the width direction, and one plate surface abuts on the bottom surface 831a.
The protrusion 114 linearly protrudes from a substantially central position in the width direction toward the resin pad 9D on the other plate surface of the abutment portion 113 and is fitted into the groove portion 95.
The heat transmitter 11D may have the same length dimension as the entire length of the resin pad 9D in the longitudinal direction, or may have a length dimension shorter than the entire length.
Then, for example, as described below, the heat transmitter 11D is provided between an outer surface of the resin pad 9D and the bottom surface 831a inside the second recess 831.
First, as illustrated in
The installation method of the resin pad 9D is not limited to the sliding method described above. For example, by using the elasticity of the resin pad 9D, an installation method in which the resin pad 9D is screwed until the pair of claws 831d enter the pair of slits 92 and the protrusion 114 enters the groove portion 95 in the direction indicated by an arrow in
Then, the heat of the gripping surface 911 moves along a heat transfer path of the resin pad 9D to the heat transmitter 11D to the wiper jaw 82D to the first pin Pit and to the arm 81.
The coupling between the heat transmitter 11D and the resin pad 9D is not limited to the above-described structure, and other mechanical coupling structures may be adopted, or a thermally conductive adhesive may be used. In addition, the heat transmitter 11D and the wiper jaw 82D may be coupled by a thermally conductive adhesive.
Even in the case of adopting the structure in the present fifth embodiment described above, the same effects as those of the above-described first embodiment are obtained.
In the above-described fifth embodiment, a plurality of coupling holes 96 may be provided on the surface of the resin pad 9D facing the bottom surface 831a as in the present Modification 5-1 illustrated in
As illustrated in
In addition, as illustrated in
The ridge portion 115 is a portion that linearly protrudes from the other plate surface (the plate surface on which the protrusion 114 is provided) of the abutment portion 113 toward the resin pad 9D and is fitted into the coupling hole 96. Then, the plurality of ridge portions 115 are arranged side by side along the longitudinal direction of the heat transmitter 11D.
Then, in the present Modification 5-1, the worker uses the elasticity of the resin pad 9D to screw the resin pad 9D from the lower side to the upper side in
Next, the present sixth embodiment will be described.
In the following description, the same reference numerals are given to the same configurations as those of the above-described first embodiment, and a detailed description thereof will be omitted or simplified.
The present sixth embodiment is different from the above-described first embodiment in the attachment structure of the resin pad 9 to the jaw 8. Hereinafter, for convenience of description, the jaw 8 and the wiper jaw 82 according to the present sixth embodiment are referred to as a jaw 8E and a wiper jaw 82E, respectively. In addition, the resin pad 9 according to the present sixth embodiment will be referred to as a resin pad 9E.
In the present sixth embodiment, the heat transmitter 11 described in the above-described first embodiment is omitted.
The jaw 8E is different from the jaw 8 described in the above-described first embodiment in that the wiper jaw 82E having a different shape from the wiper jaw 82 is adopted.
As illustrated in
The heat receiving portion 12 is a portion that receives heat of the resin pad 9. The heat receiving portion 12 protrudes downward from the bottom surface 831a in
Then, the resin pad 9E according to the present sixth embodiment is provided inside the second recess 831 by insert-molding so as to follow the inner surface of the second recess 831. In this state, the central portion of the heat receiving portion 12 in the width direction is positioned in the projection area ArP as illustrated in
In the present sixth embodiment, the heat receiving portion 12 has an entire length substantially equal to the entire length of the wiper jaw 82E in the longitudinal direction, but the disclosure is not limited thereto, and the heat receiving portion 12 may be present more than half of the entire length of the wiper jaw 82E in the longitudinal direction. In addition, when the wiper jaw 82E has a curved portion, the heat receiving portion 12 preferably extends over the entire length of the curved portion.
Even in the case of adopting the structure in the present sixth embodiment described above, the same effects as those of the above-described first embodiment are obtained.
In addition, in the heat receiving portion 12, the cross-sectional area of the proximal end coupled to the bottom surface 831a is larger than the area of the tip end. That is, in the heat receiving portion 12, a path for moving the heat received from the resin pad 9E at the tip end toward the proximal end coupled to the bottom surface 831a is widened. Therefore, the heat of the resin pad 9 can be effectively received by the heat receiving portion 12, and the dissipation efficiency of heat from the resin pad 9 can be improved.
In the above-described sixth embodiment, instead of the heat receiving portion 12, a pair of heat receiving portions 12F according to the present Modification 6-1 illustrated in
As illustrated in
Then, also in the present Modification 6-1, the resin pad 9E is provided inside the second recess 831 by insert-molding so as to follow the inner surface of the second recess 831 as in the above-described sixth embodiment. In this state, the tip end portions of the pair of heat receiving portions 12F are positioned in the projection area ArP as illustrated in
Even in a case where the structure of the present Modification 6-1 described above is adopted, the same effects as those of the above-described sixth embodiment are obtained.
In addition, by configuring the pair of heat receiving portions 12F as described above, the pair of heat receiving portions 12F can also function as a stopper for the resin pad 9E.
In the above-described sixth embodiment, instead of the heat receiving portion 12, a pair of heat receiving portions 12G according to the present Modification 6-2 illustrated in
As illustrated in
Even in a case where the structure of the present Modification 6-2 described above is adopted, the same effects as those of the sixth embodiment and Modification 6-1 described above are obtained.
In the above-described sixth embodiment, instead of the heat receiving portion 12, a pair of heat receiving portions 12H according to the present Modification 6-3 illustrated in
As illustrated in
Even in a case where the structure of the present Modification 6-3 described above is adopted, the same effects as those of the above-described Modification 6-1 are obtained.
In addition, the heat receiving portion 12H is formed such that the area of the tip end is larger than the cross-sectional area of the proximal end coupled to the side wall portion 831b. That is, by increasing the area of the tip end, the heat receiving area from the resin pad 9E can be increased, the heat of the resin pad 9E can be effectively received by the heat receiving portion 12, and the dissipation efficiency of heat from the resin pad 9E can be improved.
In the above-described sixth embodiment, instead of the heat receiving portion 12, a pair of heat receiving portions 12I according to the present Modification 6-4 illustrated in
As illustrated in
Even in a case where the structure of the present Modification 6-4 described above is adopted, the same effects as those of the above-described Modification 6-1 are obtained.
In addition, the heat receiving portion 12I protrudes from the side wall portion 831b toward the gripping surface 911. That is, the tip end of the heat receiving portion 12I is brought close to the gripping surface 911. Therefore, the heat of the resin pad 9E can be effectively received by the heat receiving portion 12, and the dissipation efficiency of heat from the resin pad 9E can be improved.
In the above-described sixth embodiment, instead of the heat receiving portion 12, a heat receiving portion 12J according to the present Modification 6-5 illustrated in
As illustrated in
Even in a case where the structure of the present Modification 6-5 described above is adopted, the same effects as those of the above-described Modification 6-1 are obtained.
In the above-described sixth embodiment, instead of the heat receiving portion 12, a heat receiving portion 12K according to the present Modification 6-6 illustrated in
As illustrated in
The through-hole 121 is a hole penetrating from the treatment portion side Ar4 to the back surface side Ar3 in the heat receiving portion 12K. In the present Modification 6-6, as illustrated in
Even in a case where the structure of the present Modification 6-6 described above is adopted, the same effects as those of the above-described Modification 6-5 are obtained.
In addition, the heat receiving portion 12K is provided with the above-described through-hole 121. Therefore, when the resin pad 9E is insert-molded, the resin material constituting the resin pad 9E easily flows, and the insert-molding is facilitated.
In the above-described sixth embodiment, instead of the heat receiving portion 12, a heat receiving portion 12L according to the present Modification 6-7 illustrated in
As illustrated in
Even in a case where the structure of the present Modification 6-7 described above is adopted, the same effects as those of the above-described Modification 6-6 are obtained.
In the above-described sixth embodiment, instead of the heat receiving portion 12, a heat receiving portion 12M according to the present Modification 6-8 illustrated in
As illustrated in
Even in a case where the structure of the present Modification 6-8 described above is adopted, the same effects as those of the above-described Modification 6-7 are obtained.
In addition, the through-hole 121 is provided at a position avoiding the projection area ArP where frictional heat generated on the gripping surface 911 is easily transferred in the resin pad 9E. Therefore, the heat of the resin pad 9E can be effectively received by the heat receiving portion 12M, and the dissipation efficiency of heat from the resin pad 9E can be improved.
In the above-described sixth embodiment, the resin pad 9E is provided inside the second recess 831 by insert-molding, but the disclosure is not limited thereto.
In the above-described sixth embodiment, instead of the resin pad 9E, a resin pad 9N according to the present Modification 6-9 illustrated in
As illustrated in
The groove portion 97 is provided on a surface of the resin pad 9N facing the bottom surface 831a, and has an inner surface shape corresponding to the outer shape of the heat receiving portion 12.
Then, the resin pad 9N is slid along the longitudinal direction of the wiper jaw 82E in a state where the pair of claws 831d enter the pair of slits 92 and the heat receiving portion 12 enters the groove portion 97 inside the second recess 831. As a result, the resin pad 9N is attached to the wiper jaw 82E. That is, a clearance is provided between the resin pad 9N (groove portion 97) and the heat receiving portion 12. Then, in the heat receiving portion 12, when the living tissue is gripped between the treatment portion 101 and the resin pad 9N, the clearance decreases, whereby a heat transfer path is generated between the heat receiving portion 12 and the resin pad 9N.
The installation method of the resin pad 9N is not limited to the sliding method described above. For example, by using the elasticity of the resin pad 9N, an installation method in which the resin pad 9A is screwed until the pair of claws 831d enter the pair of slits 92 from the lower side to the upper side in
Even in a case where the structure of the present Modification 6-9 described above is adopted, the same effects as those of the above-described sixth embodiment are obtained.
Although the embodiments for carrying out the disclosure have been described so far, the disclosure should not be limited only by the above-described first to sixth embodiments.
In the above-described first embodiment, the shapes of the jaw 8 (wiper jaw 82) and the resin pad 9 may be changed as in the present Modification 7-1. Hereinafter, for convenience of description, the jaw 8 and the wiper jaw 82 according to the present Modification 7-1 are referred to as a jaw 8O and a wiper jaw 820, respectively. In addition, the resin pad 9 according to the present Modification 7-1 will be referred to as a resin pad 9O. In the other second to sixth embodiments as well, the jaw 8O (wiper jaw 820) and the resin pad 9O may be adopted.
The jaw 8O is different from the jaw 8 described in the above-described first embodiment in that the wiper jaw 820 having a different shape from the wiper jaw 82 is adopted.
As illustrated in
The seventh insertion hole 831f penetrates from the outer surface of the wiper jaw body 83 on the back surface side Ar3 to the inside of the second recess 831.
The first bulging portion 841 is a portion bulging from a surface of the first tooth portion 84 on the back surface side Ar3 toward the back surface side Ar3.
The second bulging portion 851 is a portion bulging from a surface of the second tooth portion 85 on the back surface side Ar3 toward the back surface side Ar3.
As illustrated in
The coupling portion 98 is a portion that protrudes from a surface facing the bottom surface 831a toward the back surface side Ar3 and is coupled to the wiper jaw 820.
The resin pad 9O described above is attached to the wiper jaw 820 as described below.
That is, the worker press-fits the resin pad 9O into the second recess 831 while inserting the coupling portion 98 into the seventh insertion hole 831f. Then, the worker thermally caulks the tip end portion of the coupling portion 98 on the back surface side Ar3 toward the treatment portion side Ar4. As a result, the resin pad 9O is attached to the wiper jaw 820.
According to the present Modification 7-1 described above, the following effects are obtained.
In the structure according to the present Modification 7-1, when the living tissue is gripped between the resin pad 9O and the treatment portion 101 and the wiper jaw 820 is swung with respect to the arm 81, the tip end portion of the coupling portion 98 on the back surface side Ar3 abuts on the surface of the arm 81 on the treatment portion side Ar4. As a result, it is possible to secure a heat transfer path from the resin pad 9O to the arm 81 in addition to the heat transfer path from the resin pad 9O to the wiper jaw 820.
In addition, when the living tissue is treated in a state where the living tissue is gripped between the resin pad 9O and the treatment portion 101, in a case where the resin pad 9O has a high temperature, the tip end portion of the coupling portion 98 on the back surface side Ar3 is further crushed by heat and gripping force. As a result, the entire wiper jaw 820 moves to the back surface side Ar3, and an overload state can be avoided.
Furthermore, by providing the first and second bulging portions 841 and 851 in the wiper jaw 820, a heat capacity of the wiper jaw 820 can be increased, and the dissipation efficiency of heat from the resin pad 9O can be improved.
In addition, the resin pad 9O is attached to the wiper jaw 820 by thermal caulking. Therefore, it is not necessary to provide a structure for holding the resin pad in the wiper jaw 820, and the structure of the wiper jaw 820 can be simplified.
In the above-described first embodiment, the shape of the jaw 8 may be changed as in the present Modification 7-2. Hereinafter, for convenience of description, the jaw 8, the arm 81, and the wiper jaw 82 according to the present Modification 7-2 are referred to as a jaw 8P, an arm 81P, and a wiper jaw 82P, respectively. In the other second to sixth embodiments as well, the jaw 8P may be adopted.
The jaw 8P is different from the jaw 8 described in the above-described first embodiment in that the arm 81P and the wiper jaw 82P having different shapes from the arm 81 and the wiper jaw 82 are adopted.
As illustrated in
As illustrated in
As illustrated in
The pair of thick portions 86 are portions provided at positions facing the pair of notch portions 811d and bulging toward the back surface side Ar3.
According to the present Modification 7-2 described above, the following effects are obtained.
In the structure of the present Modification 7-2, the wiper jaw 82P includes the pair of thick portions 86 described above. Therefore, the heat capacity of the end portion of the wiper jaw 82P on the distal end side Ar1 can be increased, and the dissipation efficiency of heat from the end portion of the resin pad 9 on the distal end side Ar1 can be improved by the pair of thick portions 86.
In the above-described first embodiment, a heat diffuser 13 may be adopted as in the ultrasonic treatment instrument 1Q according to the present Modification 7-3 illustrated in
The heat diffuser 13 is made of graphite, copper foil, or the like, and is provided between the inner tube TI and the sheath 7 as illustrated in
According to the present Modification 7-3 described above, the following effects are obtained.
In the structure of the present Modification 7-3, the heat diffuser 13 described above is adopted. Therefore, the heat diffuser 13 can diffuse the heat stored in the portion around the lining LI in the sheath 7 by moving along a heat transfer path of the treatment portion 101 to the shaft 102 to the lining LI and to the sheath 7.
In the above-described first embodiment, a heat diffuser 13R may be adopted as in an ultrasonic treatment instrument 1R according to the present Modification 7-4 illustrated in
The heat diffuser 13R according to the present Modification 7-4 is made of the same material as the heat diffuser 13 according to the above-described Modification 7-3, but is disposed at a different site. As illustrated in
Even in a case where the structure of the present Modification 7-4 described above is adopted, the same effects as those of the above-described Modification 7-3 are obtained.
In the above-described first embodiment, as in the ultrasonic treatment instrument 1S according to the present Modification 7-5 illustrated in
According to the present Modification 7-5 described above, the following effects are obtained.
In the structure of the present Modification 7-5, the fifth insertion hole 831c is provided closer to the proximal end side Ar2 than the center of the wiper jaw 82 in the longitudinal direction. Therefore, it is possible to reduce the gripping pressure applied to the living tissue on the distal end side Ar1 and to suppress deterioration of the resin pad 9 on the distal end side Ar1.
In the above-described first embodiment, the shape of the resin pad 9 may be changed as in the present Modification 7-6. Hereinafter, for convenience of description, the resin pad 9 according to the present Modification 7-6 will be referred to as a resin pad 9T. In the other second to sixth embodiments as well, the resin pad 9T may be adopted.
As illustrated in
The thick portion 99 is provided on the proximal end side Ar2 of the surface of the resin pad 9T facing the bottom surface 831a. Then, when the living tissue is gripped between the treatment portion 101 and the resin pad 9T, the thick portion 99 is pressed against the bottom surface 831a and elastically deformed by the gripping pressure applied to the living tissue.
According to the present Modification 7-6 described above, the following effects are obtained.
In the structure of the present Modification 7-6, the resin pad 9T includes the above-described thick portion 99. Therefore, it is possible to suppress non-uniformity of the gripping pressure applied to the living tissue in the longitudinal direction of the resin pad 9T.
In the above-described first embodiment, an elastic material 14 may be adopted as in an ultrasonic treatment instrument 1U according to the present Modification 7-7 illustrated in
The elastic material 14 is configured by a material having thermal conductivity and being elastically deformable, and is provided closer to the proximal end side Ar2 than the fifth insertion hole 831c between the arm 81 and the wiper jaw 82. Then, when the living tissue is gripped between the treatment portion 101 and the resin pad 9, the elastic material 14 is crushed between the arm 81 and the wiper jaw 82 by the gripping pressure applied to the living tissue and elastically deformed.
Even in a case where the structure of the present Modification 7-7 described above is adopted, the same effects as those of the above-described Modification 7-6 are obtained.
In addition, the elastic material 14 has thermal conductivity. Therefore, the elastic material 14 can secure a heat transfer path of the wiper jaw 82 to the arm 81.
In the above-described first embodiment, the configuration of the resin pad 9 may be changed as in the present Modification 7-8. Hereinafter, for convenience of description, the wiper jaw 82 and the resin pad 9 according to the present Modification 7-8 are referred to as a wiper jaw 82V and a resin pad 9V, respectively. In the other second to sixth embodiments, the configuration of the resin pad 9V may be adopted.
As illustrated in
In addition, as illustrated in
Here, the resin pad 9V is formed by multicolor molding. In the present Modification 7-8, the resin pad 9V is formed by two-color molding, and as illustrated in
The first site 90V1 is a site including the gripping surface 911, and is made of, for example, polytetrafluoroethylene.
The second site 90V2 is provided on the back surface side Ar3 of the first site 90V1, and is made of a material having higher thermal conductivity than the first site for example, polyether ether ketone (PEEK), or polyimide (PI).
According to the present Modification 7-8 described above, the following effects are obtained.
In the structure of the present Modification 7-8, the resin pad 9V includes the first and second sites 90V1 and described above. Therefore, frictional heat generated in the resin pad 9V (gripping surface 911) by application of ultrasonic vibration can be moved along a heat transfer path of the first site 90V1 to the second site 90V2 and to the wiper jaw 82V. Therefore, deterioration of the resin pad 9V can be suppressed.
Modification 7-9 of First to Sixth Embodiments
In the above-described first embodiment, the configuration of the resin pad 9 may be changed as in the present Modification 7-9. Hereinafter, for convenience of description, the wiper jaw 82 and the resin pad 9 according to the present Modification 7-9 are referred to as a wiper jaw 82W and a resin pad 9W, respectively. In the other second to sixth embodiments as well, the configuration of the resin pad 9W may be adopted.
As illustrated in
In addition, as illustrated in
Even in a case where the structure of the present Modification 7-9 described above is adopted, the same effects as those of the above-described Modification 7-8 are obtained.
In addition, the second site 90V2 is also provided on both sides of the first site 90V1 in the width direction. Therefore, the heat of the first site 90V1 can also be moved to both sides in the width direction.
In the above-described Modification 7-8 and Modification 7-9, the first and second sites 90V1 and 90V2 are made of different materials, but the disclosure is not limited thereto. For example, polytetrafluoroethylene may be used as a main material, and the first and second sites 90V1 and 90V2 may be formed by varying a content of a thermally conductive filler included in the main material. At this time, the content of the thermally conductive filler in the second site 90V2 is made larger than the content of the thermally conductive filler in the first site 90V1. In addition, as the thermally conductive filler, boron nitride, alumina, and the like can be exemplified.
In the above-described first embodiment, as in the present Modification 7-11 illustrated in
The processed portion 101X is provided at a position facing the gripping surface 911 on the surface of the treatment portion 101. The processed portion 101X is made of a material of which relative wear between the processed portion 101X and the resin pad 9 is smaller than that of the treatment portion 101. Specifically, in a case where the treatment portion 101 is made of a titanium alloy, as the material of the processed portion 101X, carbon steel, cast iron, bronze, and the like can be exemplified.
According to the present Modification 7-11 described above, the following effects are obtained.
In the structure of the present Modification 7-11, the treatment portion 101 is provided with the processed portion 101X described above. Therefore, frictional heat generated in the resin pad 9 (gripping surface 911) by application of ultrasonic vibration can be reduced.
In the above-described Modification 7-10, the processed portion 101X is made of a material different from that of the treatment portion 101, but the disclosure is not limited thereto. For example, the processed portion 101X may be formed by reducing a surface roughness of the treatment portion 101 by surface treatment. Here, the surface roughness of the processed portion 101X is preferably 0.5 μm to 4.0 μm.
Even in a case where the structure of the present Modification 7-12 described above is adopted, the same effects as those of the above-described Modification 7-11 are obtained.
In the above-described first embodiment, the wiper jaw 82 and the arm 81, and the arm 81, and the sheath 7 may be coupled by a flexible wire material having thermal conductivity. In the other second to sixth embodiments as well, the wire material may be adopted.
According to the present Modification 7-13 described above, the following effects are obtained.
In the structure of the present Modification 7-13, the above-described wire material is adopted. For this reason, the heat of the resin pad 9 can be moved to the arm 81 side and the sheath 7 side by the wire material, and the dissipation efficiency of heat from the resin pad 9 can be improved.
In the above-described first embodiment, as illustrated in
In the wiper jaw 82Y, the shape of the surface on the back surface side Ar3 is changed with respect to the wiper jaw 82 described in the above-described first embodiment.
Specifically, in the wiper jaw 82Y, the surface on the back surface side Ar3 is provided with a bulging portion 87 positioned on the back surface side Ar3 of the fifth insertion hole 831c and extending in the width direction.
As illustrated in
In the arm 81Y, the shape of the surface of the treatment portion side Ar4 is changed with respect to the arm 81 described in the above-described first embodiment.
Specifically, in the arm 81Y, a groove portion 813 having an inner surface shape substantially the same as an outer surface shape of the bulging portion 87 is provided at a position facing the bulging portion 87 on the surface of the treatment portion side Ar4.
Then, in a state where the jaw 8 is closed with respect to the treatment portion 101, as illustrated in
According to the present Modification 7-14 described above, the following effects are obtained.
In the structure of the present Modification 7-14, the groove portion 813 and the bulging portion 87 that abut on each other are provided by the gripping pressure applied to the living tissue. Therefore, the heat of the resin pad 9 can be moved to the arm 81Y side by the groove portion 813 and the bulging portion 87, and the dissipation efficiency of heat from the resin pad 9 can be improved.
In the above-described first embodiment, the configuration in which both the ultrasonic energy and the high-frequency energy are applied to the target site is adopted, but the disclosure is not limited thereto. For example, a configuration of applying only ultrasonic energy to the target site or a configuration of applying at least one of high-frequency energy and thermal energy in addition to ultrasonic energy to the target site may be adopted. Here, applying thermal energy to the target site means transferring heat of a heater or the like to the target site. The same applies to the other second to sixth embodiments.
In the above-described first to sixth embodiments, as the holder, a configuration including the arm 81 and the wiper jaw 82 swingably attached to the arm 81 is adopted, but the disclosure is not limited thereto. The holder may be openable and closable with respect to the treatment portion 101, and a configuration in which the wiper jaw 82 is not provided may be adopted.
According to an ultrasonic treatment instrument of the disclosure, deterioration of the resin pad can be suppressed.
Additional advantages and modifications will readily occur to those skilled in the art. Therefore, the disclosure 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 International Application No. PCT/JP2021/007919, filed on Mar. 2, 2021, the entire contents of which are incorporated herein by reference.
Number | Date | Country | |
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Parent | PCT/JP2021/007919 | Mar 2021 | US |
Child | 18454540 | US |