JPH11169381A - High frequency treating device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a high frequency treating device which achieves a shortening of operation time by enabling the grasping, peeling, coagulating and incising of a tissue with one treating device to reduce troublesomeness with limited frequency of changes in treating devices during the operation. SOLUTION: There are an inserting part which comprises an outer sheath and an inner sheath 6 inserted into the outer sheath axially free to adverse or retract and an operating part on the hand side of the inserting part. Grasping members 11a and 11b and a needle-shaped electrode 19 are arranged at the tip part of the inserting part to grasp, peel or coagulate a tissue by the operation of the operating part. In a high frequency treating device of such a type, the operating part is provided with a needle-shaped electrode operating means to incise the tissue protruding a forceps operating means to open or close the grasping members 11a and 11b and the needle-shaped electrode 19 from the tip part of the inserting part.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a high-frequency treatment device which can be inserted into a body cavity of a living body to grasp, peel, coagulate, and incise tissue.

[0002]

2. Description of the Related Art In general, there has been known a bipolar forceps having a pair of gripping members for gripping a living tissue, each of which is provided with an electrode for energizing a high frequency. When using the bipolar forceps, a high-frequency current is applied between the electrodes of each gripping member to coagulate the living tissue between the gripping members while the living tissue to be treated is gripped between the pair of gripping members. Has become.

[0003] Bipolar forceps of this kind are usually used in various cases such as hemostasis of blood vessels contained in living tissue, lesions on the surface layer of living tissue, cauterization of bleeding points, occlusion of fallopian tubes for contraception, and the like. Can be Bipolar forceps are used for hemostasis of blood vessels and occlusion of fallopian tubes, so that a living tissue to be treated by a patient can be coagulated, and the coagulated living tissue can be incised. ing.

[0004] Conventionally, as this type of endoscopic high-frequency treatment instrument, for example, DE34233356C2, DE40324
71C2, DE 4138116 A1 and the like.
DE3423356 C2 is provided with an electrode such as tweezers capable of gripping tissue and an incision electrode at the distal end of the insertion portion. A high-frequency current can flow between the distal ends of both electrodes to coagulate. The tissue can be dissected.

[0005] DE4032471 C2 has two coagulation electrodes and one cutting electrode at the distal end of the insertion portion, can coagulate and cut tissue, and has a changeover switch for switching between coagulation and cutting in the operation portion. ing.

DE 4138116 A1 has a fixed coagulating electrode in the form of a hook and one movable excision electrode made of a diamond-shaped wire at the tip of the insertion portion, and grasps tissue between the coagulation electrode and the excision electrode. Then, the cutting electrode is advanced to cut the tissue.

[0007]

However, the above-mentioned DE 34223356 C2 is a coagulation in a narrow area only at the tip of an electrode such as a pair of tweezers. In this structure, the tissue cannot be removed. Also, DE4
In the case of 032471 C2, since the coagulation electrode and the cutting electrode are rod-shaped bodies and the intervals between the coagulation electrodes and between the coagulation electrodes and the cutting electrode are determined, a wide area coagulation, fine coagulation operation and tissue exfoliation operation are performed. Can not. Also, it is possible to cut tissue, but it is not possible to cut tissue. Furthermore, since the coagulation electrode is fixed, DE4138116 A1 cannot perform wide-area coagulation, fine coagulation operation and tissue exfoliation operation as described above, and can cut tissue. ,
The tissue cannot be dissected.

[0008] The present invention has been made in view of the above circumstances, and its object is to grasp, exfoliate, and remove tissue.
Coagulation and incision can be performed with a single treatment tool, the replacement of the treatment tool at the time of surgery can be reduced, the complexity can be reduced, the operation time can be reduced, and the coagulation of a relatively wide range of tissue can be achieved. Another object of the present invention is to provide a high-frequency treatment instrument capable of performing fine coagulation operation and exfoliation by grasping tissue.

[0009]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention has an insertion portion and an operation portion at a hand side of the insertion portion, and a distal end portion of the insertion portion is operated by operating the operation portion. In a high-frequency treatment instrument having a pair of gripping members for gripping, peeling and coagulating and a needle-like electrode for making an incision, forceps operating means for opening and closing the pair of gripping members on the operating unit and the needle-shaped A high-frequency treatment instrument is provided with a needle-like electrode operating means for moving the electrode forward and backward from the distal end of the insertion portion and incising the tissue.

[0010] In a procedure such as coagulation and hemostasis of the tissue, the tissue is coagulated by flowing a coagulation current between the grasping portions in a state where the tissue is grasped by the forceps, and an incision current is caused to flow between the forceps and the needle electrode. The tissue can be dissected using

[0011]

Embodiments of the present invention will be described below with reference to the drawings.

1 to 4 show a first embodiment, and FIG.
FIG. 1 is an overall configuration diagram of a high-frequency treatment instrument as an endoscopic surgical instrument. As shown in FIG. 1, a bipolar forceps 1 as a high-frequency treatment instrument has an elongated insertion portion 2 inserted into a body cavity of a patient, and is disposed at a distal end portion of the insertion portion 2 to grasp a living tissue in the body cavity. A treatment section 3 that can be energized for exfoliation and coagulation, and an operation section 4 connected to a base end of the insertion section 2 are provided.

The insertion section 2 comprises an outer sheath 5 and an inner sheath 6 which is inserted into the outer sheath 5 so as to be able to advance and retreat in the axial direction. The proximal end of the outer sheath 5 constitutes the operation section 4. The proximal end of the inner sheath 6 is fixed to a grip 7 and is fixed to an inner sheath driving member 8 provided in the operation section 4.

The treatment section 3 is provided with an elongated rod 10 inserted into the inner sheath 6. A pair of gripping members 1 as gripping portions constituting an electrode are provided at the distal end of the rod 10.
1a and 11b, and elastic members 12a and 12b for urging the gripping members 11a and 11b in a direction for expanding the gripping members 11a and 11b are provided. The elastic members 12a and 12b are formed of spring steel or the like, and have bent portions 13a and 13b which are bent in a substantially U-shape at the end portions.
Is covered with insulating materials 14a and 14b.

As shown in FIG. 2, the holding members 11a, 11
b is formed with a saw-toothed part that meshes with each other when closed,
The living tissue A is formed so that it can be securely grasped.
Semi-circular recesses 15 facing each other in the front-rear direction are provided in the widthwise intermediate portion of the meshing portions of the gripping members 11a and 11b.
11b, the insertion passage 16 is formed when closed.

Further, a through passage 17 is formed at the axial center of the inner sheath 6 over the entire length of the inner sheath 6.
A needle electrode 19 covered with an insulating tube 18 over its entire length is inserted through the needle 7 so as to be able to advance and retreat in the axial direction. That is, the tip of the needle electrode 19 is inserted into the insertion passage 1 formed when the gripping members 11a and 11b are closed.
6 so as to be able to protrude from the distal ends of the gripping members 11a and 11b.

The rod 10 and the needle electrode 19 of the gripping members 11a and 11b of the treatment section 3 thus configured are inserted into the inner sheath 6 constituting the insertion section 2, and the rod 10 and the needle electrode Reference numeral 19 protrudes from the base end of the inner sheath 6 and extends to the operation unit 4.

As shown in FIG. 1, the grip 7 of the operation section 4 is provided with a distal extension 20 extending toward the distal end. The distal extension 20 is provided with a connection ring 21 that is connected and fixed to the base end of the outer sheath 5. Further, a treatment section unit connection section 22 for electrically and mechanically connecting to the rear end of the treatment section 3 is provided behind the distal extension section 20. Here, the treatment section unit connection section 22 is provided with a lumen for accommodating the rear end of the rod 10 of the treatment section 3 and connection means connected to the rear end of the rod 10 accommodated in this lumen. ing. In addition, a cable connection part 23 is provided in the treatment part unit connection part 22, and this cable connection part 23 is connected to a high-frequency ablation power supply device (not shown) via a connection cable.

The grip 7 is provided with a trigger 24 as forceps operating means. The trigger 24 is connected to the upper end of the grip 7 so as to be rotatable around a rotation pin 25. Further, a long hole 26 is formed in the trigger 24 above the pivot point. An engagement pin 27 projecting from a side surface of the inner sheath driving member 8 is inserted into the elongated hole 26.

A trigger 24 is provided inside the grip 7.
There is provided an urging member (not shown) for urging the handle 24a at the lower end of the gripper 7 in the direction away from the grip 7 (clockwise direction around the pivot pin 25 in FIG. 1). The trigger 24 is always held at a fixed position (release position) farthest from the grip 7 by the spring force of the urging member.

Further, a needle-like electrode operating lever 2 as needle-like electrode operating means is provided on a side surface at an upper portion of a rear end of the grip 7.
8 are provided. The needle-shaped electrode operation lever 28 is connected to the grip 7 so as to be rotatable around a rotation pin 29. Further, a long hole 30 is formed above the center of rotation of the needle electrode operation lever 28, and an engagement pin 31 projecting from the rear end side surface of the needle electrode 19 is inserted into the long hole 30. I have.

The needle electrode operating lever 28 is provided with front and rear arm portions 32a and 32b arranged in a substantially V shape. A finger hook 33 is in contact with one arm 32a, and the other arm 32b is in contact with a stopper pin 34, and serves to regulate the rotation range of the needle electrode operating lever 28. Further, the needle-like electrode operating lever 28 is
A biasing member (not shown) that biases the clockwise direction is mounted.

Here, by pulling the handle portion 24a of the trigger 24 toward the grip 7 against the spring force of the biasing member, the inner sheath 6 is moved through the inner sheath driving member.
Moves axially forward of the outer sheath 5 and protrudes from the front end of the outer sheath 5. As the inner sheath 6 advances, the elastic member 12
a, 12b are relatively drawn into the inner sheath 6, and the gripping members 11a, 11b are closed. When the trigger 24 is released, the elastic member 12a, 12b relatively returns from the inner sheath 6 by the spring force of the biasing member in the grip 7, and the gripping members 11a, 11b.
Are opened by the elastic restoring force of the elastic members 12a and 12b.

When a finger is put on the finger hook 33 of the needle electrode operating lever 28 and the needle electrode operating lever 28 is turned counterclockwise against the urging force of the urging member, the slot 30
The needle-shaped electrode 19 is driven forward through an engaging pin 31 inserted into the gripping member 11a,
11b through the insertion passage 16 of the holding member 11a, 11b
It protrudes from the tip.

When the needle electrode operating lever 28 is released, the needle electrode 19 returns to the home position by the spring force of the urging member, the needle electrode 19 retreats and is drawn into the through passage 17 of the inner sheath 6, and the arm portion 32b stops. When it comes into contact with the pin 34, it stops.

Next, the operation of the first embodiment will be described.

A connection cable is connected to the cable connecting portion 23 of the bipolar forceps 1, and the bipolar forceps 1 and the high-frequency ablation power supply device are electrically connected. Operation unit 4 in the initial state
The handle portion 24a of the trigger 24 is held at a fixed position furthest from the grip 7, and the treatment unit connection portion 22 is held at the rearmost position of the axial movement range of the insertion portion 2. In this state, as shown in FIG. 1B, the pair of elastic members 12a and 12b of the treatment section 3 protrude from the inner sheath 6 and the grip members 11a and 11b are open.

Then, by pulling the handle 24a of the trigger 24 toward the grip 7 against the spring force of the leaf spring member, the inner sheath 6 is moved in the axial direction of the outer sheath 5 via the inner sheath driving member 8. It moves forward and protrudes from the front end of the outer sheath 5. As the inner sheath 6 advances, the elastic members 12a and 12b are relatively drawn into the inner sheath 6, and as shown in FIG.
a and 11b are closed.

In this state, the insertion portion 2 of the bipolar forceps 1
Is inserted into the patient's body, and the treatment section 3 at the distal end of the insertion section 2 guides the patient to a position near the living tissue A to be treated in the body. When the trigger 24 is released, it returns to the home position by the spring force of the biasing member in the grip 7, and the elastic members 12a, 1
2b relatively protrudes from the inner sheath 6 and
a and 11b are opened by the elastic restoring force of the elastic members 12a and 12b.

Subsequently, the expanded gripping members 11a, 11b
After the living tissue A is inserted, the grip 24a of the trigger 24 is pulled toward the grip 7 against the spring force of the urging member, whereby the inner sheath 6 is moved through the inner sheath driving member 8. It moves forward in the axial direction of the outer sheath 5 and projects from the front end of the outer sheath 5. As the inner sheath 6 advances, the elastic members 12a and 12b are relatively drawn into the inner sheath 6, and the grip members 11a and 11b are closed.
As shown in FIG. 2, the living tissue A has a pair of gripping members 11.
a and 11b.

At this time, the gripping members 11a and 11b are formed as saw-toothed portions that mesh with each other when closed, so that the living tissue A can be reliably gripped. In this state, a high-frequency current flows from the high-frequency ablation power supply device to the cord connection portion 23 via the connection cable, and a coagulation current flows between the grip members 11a and 11b, whereby the living tissue A is coagulated. After the coagulation is completed, when the trigger 24 is released, the inner sheath 6 returns to the initial position with respect to the outer sheath 5 by the spring force of the biasing member in the grip 7, and the elastic members 12a and 12b relatively move from the inner sheath 6. The holding members 11a and 11b project and open by the elastic restoring force of the elastic members 12a and 12b,
1a and 11b are released from the living tissue A.

Therefore, when the living tissue A is peeled off, the gripping members 11a and 11b are closed by the trigger 24 and the gripping members 11a and
When the trigger 24 is released with the distal end of the grip 11b pressed, the inner sheath 6 returns to the initial position with respect to the outer sheath 5 by the spring force of the biasing member in the grip 7, and the gripping members 11a and 11b are elastic members. Since the opening is performed by the elastic restoring force of the holding members 12a and 12b, the living tissue A can be separated by repeatedly opening and closing the holding members 11a and 11b.

When a cutting current flows from the high-frequency ablation power supply device to the cord connection portion 23 via the connection cable in a state where the gripping members 11a and 11b are closed, the cutting current flows through the needle-shaped electrode 19. In this state, the needle electrode operating lever 28
When the finger is hooked on the finger hook 33 and the needle-shaped electrode operating lever 28 is rotated counterclockwise against the urging force of the urging member, the needle-shaped electrode operating lever 28 is rotated through the engaging pin 31 inserted into the elongated hole 30. The needle electrode 19 moves forward, and the tip of the needle electrode 19 passes through the insertion passage 16 between the grip members 11a and 11b, and protrudes from the distal ends of the grip members 11a and 11b as shown in FIG.

In this state, the bipolar forceps 1 is tilted as shown in FIG.
9 is pressed against the living tissue A, and the bipolar forceps 1
Is moved in the direction of arrow a, the living tissue A
Is electrically incised by the incision current flowing through the incision.

After the incision is completed, the needle electrode operating lever 2
When the needle 8 is released, the needle electrode 19 returns to the home position by the spring force of the urging member, the needle electrode 19 is relatively drawn into the inner sheath 6, the needle electrode 19 retreats, and the arm portion 32b contacts the stopper pin 34. Then it stops.

According to the present embodiment, grasping of the living tissue A,
Exfoliation, coagulation, and incision can be performed with one bipolar forceps 1, and replacement of the bipolar forceps 1 at the time of surgery can be reduced to reduce inconvenience, shorten the operation time, and achieve a relatively wide range. Coagulation of living tissue A and fine coagulation operation and exfoliation by grasping the tissue can be performed.

FIGS. 5 and 6 show a second embodiment. The same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. In the present embodiment, a pair of gripping members 11a, 11
b is formed of pipes 35a and 35b made of spring steel or the like so as to open and close freely.
The gripping members 11a and 11b are attached to the distal ends of the a and 35b. The pipes 35a, 35b are urged in a direction to expand the gripping members 11a, 11b.

The other end of the pipe 35b is left
A needle electrode 19 covered with an insulating tube 18 over the entire length is inserted so as to be able to advance and retreat in the axial direction. The needle-shaped electrode 19 is inserted into an insertion passage 36 formed in the holding member 11b, so that the tip of the needle-shaped electrode 19 can protrude from the tip of the holding member 11b.

Next, the operation of the second embodiment will be described.

The opening / closing operation of the gripping members 11a and 11b and the advance / retreat operation of the needle-shaped electrode 19 are the same as those in the first embodiment, but as shown in FIG. The needle-shaped electrode 19 curves together with the bending of the pipe 35b accompanying the opening and closing of the gripping members 11a, 11b. When the living tissue A is incised, the needle electrode 1 is operated by operating the needle electrode operating lever 28 as in the first embodiment.
9 is advanced, the distal end protrudes from the distal end of the gripping member 11b, the distal end of the gripping member 11b and the needle-shaped electrode 19 are pressed against the living tissue A, and the bipolar forceps 1 is moved in the direction of arrow b as shown in FIG. The living tissue A is electrically incised by an incision current flowing through the needle electrode 19.

In this embodiment, the gripping member 1
The case where the needle-shaped electrode 19 is protruded and incised in a state where 1a and 11b are closed has been described.
Even when 11b is open, the needle electrode 19 can be cut by protruding the tip of the needle-like electrode 19 from the tip of the holding member 11b. Further, both elastic members for supporting the pair of gripping members 11a and 11b so as to be openable and closable are formed of a pipe 35 made of spring steel or the like.
Although it is formed by a and 35b, one of the sides through which the needle electrodes 19 are inserted may be a pipe made of spring steel or the like, and the other may be a leaf spring.

FIGS. 7 to 9 show a third embodiment.
The same components as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted. In the present embodiment, as shown in FIG. 7, an elastic member 12 for supporting a pair of gripping members 11a and 11b so as to be openable and closable.
An insulating tube 37 is provided on the outer periphery of the rod 10 to which the rods 10a and 12b are attached so as to freely advance and retreat the rod 10. A cylindrical incision electrode 38 is provided between the insulating tube 37 and the inner sheath 6 on the outer periphery. It is interposed so that it can move forward and backward.

As shown in FIG. 8, a needle-shaped electrode 39 is formed by cutting off the other part of the cutting electrode 38 while leaving a part of the tip part in the axial direction. The needle electrode 39 is immersed in the inner sheath 6 by retracting the incision electrode 38, and is projected from the tip of the inner sheath 6 by advancing the needle electrode 39. Incision electrode 3
8 is driven forward and backward by operating the needle electrode operating lever 28 as in the first embodiment.

Next, the operation of the third embodiment will be described.

The opening / closing operation of the gripping members 11a and 11b is the first operation.
However, when the living tissue A is incised, the incision electrode 38 is advanced by operating the needle electrode operation lever 28 and the needle electrode 39 is cut in the same manner as in the first embodiment.
Is protruded from the distal end of the inner sheath 6, and as shown in FIG. 9, the distal end portions of the gripping members 11a and 11b and the needle-shaped electrode 39 are pressed against the living tissue A, and the bipolar forceps 1 is moved in the direction of arrow c. Is electrically cut by a cutting current flowing through the needle-shaped electrode 39.

FIGS. 10 and 11 show a fourth embodiment, in which the same components as those in the first embodiment have the same reference numerals and description thereof will be omitted. In the present embodiment, as shown in FIG.
The opening of the distal end of the inner sheath 6 is closed by an insulating member 40, and an insulating tube 41 is fitted on the outer periphery of the inner sheath 6. Four fitting holes 42 are formed in the outer peripheral edge of the insulating member 40 at intervals of 90 °, and a rod-shaped coagulation electrode 43 is fixed to these fitting holes 42 so as to protrude from the insulating member 40. . The coagulation electrode 43 is electrically connected to the cable connection part 23 of the operation unit 7 via a lead wire 44 inserted in the inner sheath 6.

Further, a through-hole 45 is formed in the center of the insulating member 40, and the tip of the through-hole 45 is left in the through-hole 45.
A needle electrode 19 covered with an insulating tube 18 over the entire length is inserted so as to be able to advance and retreat in the axial direction. The needle-shaped electrode 19 can protrude from the tip of the insulating member 40.

Next, the operation of the fourth embodiment will be described.

When coagulating the living tissue A, as shown in FIG. 10, when the distal end of the insertion portion 3 is pressed perpendicularly to the living tissue A to be coagulated, the four coagulating electrodes 4 are pressed.
3 are simultaneously in contact with the living tissue A, and in this state, each coagulation electrode 4
When a high-frequency current is passed through 3, the living tissue A is coagulated. At this time, since four coagulation electrodes 43 are provided at the distal end of the insertion portion 3, any two coagulation electrodes 43 can contact and coagulate even if the insertion portion 3 is tilted in an arbitrary direction. .

When incising the living tissue A, the first
In the same manner as in the embodiment, the needle-like electrode operating lever 28 is operated to project the needle-like electrode 19 from the tip of the insulating member 40, and as shown in FIG. When the bipolar forceps 1 is moved in the direction indicated by the arrow d while pressed against the living tissue A, the living tissue A is electrically incised by the incision current flowing through the needle-shaped electrode 19.

In this embodiment, the insulating member 4
0, four coagulation electrodes 43 are provided.
The number and arrangement of are not limited. Further, the coagulation electrode 43 may be selectively protruded and retracted from the tip of the insulating member 40.

FIGS. 12 and 13 show the fifth embodiment. The same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. In the present embodiment, as shown in FIG.
A first switch 46 for flowing a coagulation current and a second switch 4 for flowing an incision current are provided on the grip 7 of the operation unit 4.
7 are provided. And the first and second switches 4
The electrode switching unit 48 shown in FIG.
Can be switched. The electrode switching section 48 will be described. The movable contact 52 has a gripping contact 49a, 49b that conducts with the gripping members 11a, 11b, a cutting contact 50 that conducts with the needle electrode 19, and a movable contact 52 that conducts with the connection cable 51. 53. The connection cable 51 is connected to the high-frequency ablation power supply 54.

As shown in FIG. 13A, at the time of coagulation, coagulation-side contacts 49a and 49b, movable contact 52 and fixed contact 53
And open the incision side contact 50 to release the gripping member 11a.
And a coagulation current is passed between 11b. As shown in FIG. 13B, at the time of incision, the coagulation-side contact 49b and the fixed contact 53 are connected, and the movable contact 52 and the incision-side contact 50 are connected to connect the gripping members 11a and 11b to the needle-shaped electrode 19. An incision current is passed between them. In FIG. 13B, the coagulation-side contact 49a is open, but since the pair of gripping members 11a and 11b are closed, the coagulation-side contact 4a is electrically connected.
By connecting the fixed contact 9b and the fixed contact 53, the holding member 11a is brought into a conductive state.

According to the present embodiment, switching between coagulation and incision can be easily performed by operating the first and second switches 46 and 47 while holding the grip 7 of the operation section 3, and the operability can be improved.

According to the above-described embodiment, the following configuration can be obtained.

(Supplementary Note 1) An insertion portion and an operation portion near the insertion portion, and a pair of grip members at the distal end of the insertion portion for gripping, peeling, and coagulating tissue by operating the operation portion. And a high-frequency treatment instrument having a needle-like electrode, a forceps operating means for opening and closing the pair of gripping members in the operating portion, and a needle-like electrode operation for incising tissue by moving the needle-like electrode forward and backward from the distal end of the insertion portion. A high-frequency treatment instrument comprising means.

(Supplementary Note 2) The high-frequency treatment instrument according to Supplementary Note 1, wherein the needle-like electrode can protrude from the distal end of the insertion portion with the pair of holding members closed.

(Supplementary Note 3) The high-frequency treatment instrument according to Supplementary Note 1, wherein the needle-like electrode can protrude from one end of a pair of gripping members.

(Supplementary Note 4) The high-frequency treatment instrument according to Supplementary Note 1, wherein a plurality of pairs of coagulation electrodes are arranged so as to protrude from a peripheral portion at a distal end portion of the insertion portion.

According to Appendix 1, grasping, peeling,
Coagulation and incision can be performed with one high-frequency treatment device,
It is possible to reduce the annoyance by reducing the exchange of high-frequency treatment tools during surgery, shorten the operation time, and to coagulate a relatively wide range of living tissue and grasp the tissue to perform fine coagulation operation and exfoliation. It can be carried out.

According to appendix 2, the living tissue can be incised by moving the high-frequency treatment instrument in a direction perpendicular to the axial direction thereof.

According to appendix 3, even when the forceps are closed or opened, the living tissue can be incised by moving the high-frequency treatment instrument in a direction perpendicular to the axial direction thereof.

According to Appendix 4, even if the high-frequency treatment instrument is tilted at an arbitrary angle, the coagulation electrode can be brought into contact with the living tissue to coagulate.

In general, a bipolar electric scalpel which is inserted into the abdominal cavity of a living body through a trocar and coagulates a living tissue is
A first electrode is provided at the tip of the elongated rod portion, and a second electrode is provided so as to surround the first electrode while being insulated from the first electrode. The first electrode advances and retreats by operating the hand operation unit, and the depth of puncturing can be adjusted by adjusting the amount of protrusion of the second electrode from the tip.

The first electrode is formed in a sharp pointed tip and is an elongated rod-shaped portion.
If the first electrode is inserted into the trocar with the tip of the first electrode protruding from the tip of the electrode, the first electrode may be erroneously bent or broken. In addition, before the coagulation current flows, the tip of the first electrode may puncture the living tissue to damage the living tissue and cause bleeding.

FIGS. 14 and 15 show a bipolar electric scalpel as a high-frequency treatment instrument which has solved the above-mentioned problems. That is, as shown in FIG. 14, the insertion portion 60 of the bipolar electric scalpel has the first electrode 61 provided at the tip of the elongated rod-like portion. A conductive member 63 insulated by an insulating member 62 is provided around the first electrode 61. A second electrode 65 having a ring-shaped cross section is provided at the tip of the conductive member 63 so as to freely advance and retreat so as to surround the first electrode 61 via a coil-shaped urging spring 64.
Further, the outer circumferences of the conductive member 63 and the second electrode 65 are covered with an insulating sheath 66.

The second electrode 65 is urged toward the distal end by the urging spring 64, and the first position in which the first electrode 61 is housed,
When the second electrode 65 is retracted against the urging force of the urging spring 64, the first electrode 61 can relatively move to the second position protruding from the second electrode 65, and in the first position Is the distance e from the tip of the second electrode 65 to the tip of the first electrode 61.
Only immersive.

The bipolar electric scalpel thus configured is inserted into the abdominal cavity of a living body via a trocar, and when the living tissue A is coagulated, the distal end of the insertion section 60 is connected to the living tissue A.
First, the second electrode 65 contacts the living tissue A. When the insertion portion 60 is further advanced, the second electrode 65 in which the urging spring 64 is compressed is retracted, and the first electrode 6 is relatively moved.
1 protrudes from the second electrode 65 and is punctured into the living tissue A. Therefore, the first and second electrodes 61 and 65 are simultaneously brought into contact with the living tissue A and coagulated, and the puncturing depth of the first electrode 61 into the living tissue A can be adjusted by adjusting the pushing amount of the insertion portion 60. The living tissue A can also be incised.

FIG. 16 shows a bipolar electric scalpel, in which the shape of the first electrode is different from FIGS. 14 and 15. The first electrode 67 surrounded by the second electrode 65 has a flat plate shape, an acute angle portion 68 is provided on one side in the width direction, and an obtuse angle portion 69 is provided on the other side, and a front end surface is formed on a flat portion 70. Have been.

According to the above configuration, the flat portion 70 of the first electrode 67 and the front end surface of the second electrode 65 are brought into contact with the living tissue A, or the insertion portion 60 is inclined to form the acute angle portion 68 of the first electrode 67. A part of the front end of the second electrode 65 is brought into contact with the living tissue A, or the insertion portion 60 is further inclined in the opposite direction so that the obtuse portion 69 of the first electrode 67 and a part of the front end of the second electrode 65 are connected to the living tissue A. Can be contacted. Therefore, the wide-range coagulation, the narrow-range coagulation, and the incision of the living tissue A can be selectively used depending on how the insertion section 60 is inclined with respect to the living tissue A.

Therefore, according to the above configuration, the following configuration is obtained.

(Supplementary Note 5) A first electrode is provided at the tip of the elongated rod-like portion, and a second electrode is provided so as to surround the first electrode in a state insulated from the first electrode. In the bipolar electric scalpel, the second electrode is a first electrode.
A bipolar position wherein the first electrode is housed and a second position in which the first electrode protrudes from the second electrode, and is normally biased to be in the first position. Electric scalpel.

(Supplementary Note 6) The bipolar electric scalpel according to Supplementary Note 5, wherein the first electrode has a needle-like tip, and the second electrode has a ring-shaped cross section surrounding the first electrode.

(Supplementary Note 7) The first electrode is a plate-like body having an acute angle portion and an obtuse angle portion at the tip end, and the second electrode has a ring-shaped cross section surrounding the first electrode. A bipolar electric scalpel according to attachment 5.

According to Supplementary Notes 5 and 6, the first and second electrodes are simultaneously brought into contact with the living tissue to coagulate, and the puncture depth of the first electrode into the living tissue is adjusted by increasing or decreasing the insertion amount of the insertion portion. It can be adjusted and the living tissue can be dissected.

According to Appendix 7, extensive coagulation of living tissue,
Narrow range coagulation and incision can be selectively used depending on how the insertion section is inclined with respect to the living tissue.

FIGS. 17 to 19 show a bipolar electric scalpel. An elongated rod-shaped first electrode 72 is provided at the axial center of the insertion portion 71.
Are provided so as to freely advance and retreat. An outer sheath 74 is provided around the first electrode 72 via an insulating member 73. An engagement receiving portion 75 is provided at a distal end portion of the insertion portion 71,
A cam lock ring 76 is provided at the distal end of the outer sheath 74.

A second electrode 77 having an engaging claw 77a to be engaged with the engagement receiving portion 75 is detachably provided at the distal end of the insertion portion 71, and the engaging claw 77a is engaged with the engagement receiving portion 75. At the same time, it is fixed by being locked by the cam lock ring 76. The second electrode 77 has a cylindrical shape, and an engagement portion 78 having a semicircular concave portion is provided on a part of the outer peripheral surface on the distal end side so as to engage with the elongated tubular tissue B. Further, an insulating member 7 is provided inside the second electrode 77.
9 are provided, and the insulating member 79 is provided with an insertion passage 80 through which the first electrode 72 is inserted.

Therefore, the tip of the first electrode 72 is
It is surrounded by the electrode 77, and projects forward from the tip of the second electrode 77 when moving forward. In addition, since the second electrode 77 is provided with the engaging portion 78, by engaging the engaging portion 78 of the second electrode 77 with the tubular tissue B, the distal end of the first electrode 72 is placed in the tubular tissue B. Approach. Therefore, the tubular tissue B can be dissected in the longitudinal axis direction by flowing an incision current between the first and second electrodes 72 and 77 and moving the bipolar electric knife in the longitudinal axis direction of the tubular tissue B.

FIG. 20 shows a modification of the second electrode 77, in which the second electrode 80 having a shallow engagement portion 78 is shown.
And can be mounted on the distal end of the insertion section 71 depending on the thickness of the insertion section 71.

FIGS. 21 to 25 show a bipolar electric scalpel, and FIG. 21 shows a case where an engaging portion 83 formed of a concave portion is provided on the side of a second electrode 82 provided at the distal end of an insertion portion 81. is there. Tip 8 of second electrode 82 forming engagement portion 83
2a is substantially perpendicular to the axis of the insertion portion 81, and the first electrode 7
2 to clamp the tubular tissue B, and in this state, the first
By moving a bipolar electric scalpel in the longitudinal direction of the tubular tissue B by flowing an incision current between the first and second electrodes 72 and 82, the tubular tissue B can be incised in the longitudinal direction.

FIG. 22 shows a hook-like shape in which the distal end portion 82a of the second electrode 82 forming the engaging portion 83 is curved into a substantially circular arc.
The structure is such that the tubular tissue B can be held without jumping out from the engaging portion 83, and the operation is the same as that in FIG.

FIG. 23 shows a second electrode having an engaging portion 85 by providing a cylindrical conductive member 84 inside the insertion portion 81 so as to be able to advance and retreat, and by notching a side portion at the distal end of the conductive member 84. 86 is provided. The second electrode 86 includes a bar-shaped portion 86a formed by the notch and a ring-shaped portion 86b provided integrally with the tip of the bar-shaped portion 86a. The first electrode 72 is positioned substantially at the center of the ring-shaped portion 86b. doing.

Therefore, by advancing the conductive member 84, the second electrode 86 protrudes from the distal end of the insertion portion 81 to form an engagement portion 85.
Can be engaged. After engaging the tubular tissue B with the engaging portion 85, the first
By moving the electrode 72 forward, the first and second electrodes 7
By moving the bipolar electric scalpel in the longitudinal direction of the tubular tissue B by flowing an incision current between the tubular tissue B and the tubular tissue B,
Can be cut in the vertical axis direction. Also, the second electrode 86 is
By setting the position, the same usage as that of a normal needle-shaped electrode is possible.

FIG. 24 shows a state in which the operation section 9 is provided at the base end of the insertion section 81.
0 is provided. The insertion portion 81 has a rod-shaped first electrode 7.
2 is inserted so as to be able to advance and retreat, so that the operation of the first electrode 72 can be performed by the operation unit 90. That is, the operation unit 90 is provided with an operation lever 92 that is rotatable around a pivot shaft 91 as a fulcrum, and the operation lever 92 is provided on a first casing 93 provided on a casing 93 of the operation unit 90.
A connection pin 95 is provided to penetrate through the long hole 94 and connect to the first electrode 72. Therefore, the first electrode 72 can move forward and backward by rotating the operation lever 92.

The casing 93 has a second elongated hole 96.
The second long hole 96 is provided with a lever lock member 97 composed of a lock screw that can be fixed at an arbitrary position within the range of the long hole 96, and restricts the amount of rotation of the operation lever 92 so that the second It constitutes a positioning means for positioning the maximum protrusion amount of one electrode 72.

FIG. 25 shows that a rod 98 connected to a rod-shaped first electrode 72 which is inserted into the insertion section 81 so as to be able to advance and retreat is inserted into an operation section 90 provided at the base end of the insertion section 81 so as to be able to advance and retreat. ing. The proximal end side of the rod 98 penetrates the operating portion 90 and projects rearward. A finger hook portion 99 is provided on the proximal end portion and the casing 93 of the operating portion 90. Therefore, the first electrode 72 can be moved forward / backward by moving the rod 98 forward / backward by putting a finger on the finger rest 99.

A screw portion 98a is formed at a portion of the rod 98 projecting rearward from the operating portion 90, and a lock member 100 is screwed to the screw portion 98a. Therefore, by rotating the lock member 100 and moving the lock member 100 in the front-rear direction, the moving amount of the rod 98 is regulated in the forward direction, thereby forming a positioning means for positioning the maximum protrusion amount of the first electrode 72.

Therefore, according to the above configuration, the following configuration is obtained.

(Supplementary Note 8) In a bipolar electric scalpel having a first electrode and a second electrode at the distal end of the insertion portion, the second electrode is provided at the distal end of the insertion portion so as to surround the rod-shaped first electrode. A bipolar electric scalpel, which is a cylindrical body and has an engaging portion formed on at least a part of an outer peripheral surface thereof, the concave portion engaging with an elongated tubular tissue.

(Supplementary note 9) The bipolar electrode according to supplementary note 8, wherein the second electrode is formed of a plurality of types having different depths of the engaging portions, and is replaceably and detachably attached to the distal end portion of the insertion portion. Electric scalpel.

(Supplementary note 10) The bipolar electric scalpel according to Supplementary note 8, wherein the first electrode is movable with respect to the insertion portion, and the length of protrusion of the first electrode from the distal end portion of the insertion portion can be adjusted.

(Supplementary Note 11) The tip of the second electrode forming the engaging portion has a hook shape.
The bipolar electric scalpel as described.

(Supplementary note 12) The bipolar electric scalpel according to Supplementary note 8, wherein the first electrode is movable with respect to the second electrode and is protrudable through the second electrode.

(Supplementary note 13) The bipolar electric scalpel according to supplementary note 8, wherein the first electrode has a positioning means for presetting a position where the first electrode protrudes most from the distal end of the insertion portion.

(Supplementary note 14) The bipolar electric scalpel according to supplementary note 13, wherein the positioning means is a lock member screwed into a screw portion coaxial with the first electrode.

(Supplementary note 15) The bipolar electric scalpel according to supplementary note 8, wherein the first electrode is movable forward and backward by an operation lever provided on an operation unit.

(Supplementary note 16) The bipolar electric scalpel according to supplementary note 15, wherein the operating range of the operation lever is set by a positioning means provided on an operation unit.

FIGS. 26 to 28 show a bipolar electric scalpel. As shown in FIG. 26, an elongated rod-shaped first electrode 102 is provided at the axial center of the insertion portion 101 so as to be able to advance and retreat. A cylindrical second electrode 104 is provided around the first electrode 102 via an insulating member 103. An insulating tube 105 is provided on the outer periphery of the second electrode 104, and a sheath 106 is provided outside the insulating tube 105 so as to be able to advance and retreat in the axial direction. The inner layer of the sheath 106 is a hard pipe 1
07, the outer layer at the distal end of the hard pipe 107 is formed by an elastic tube 108 having an elastic deformation portion 108a. The hard pipe 107 extends to the proximal side of the insertion portion 101 and
Reference numeral 8 is fixed in the middle of the hard pipe 107.

Then, the first electrode 1 is
The first position (see FIG. 26) where the distal end portions of the second electrode 102 and the second electrode 104 are housed inside the sheath 106 and the first electrode 10
The tip of the second and second electrodes 104 is movable between a second position (see FIG. 27) where the tip of the sheath 106 projects from the tip of the sheath 106. At the time of use, that is, when inserting the bipolar electric scalpel into the trocar 109, the sheath 106 is set to the first position in which the sheath 106 has advanced, and when not in use, the hard pipe 107 is retracted by a manual operation, so that the elastic deformation portion 108a
Is deformed into a disk shape in a direction perpendicular to the axial direction of the insertion portion 101, and cannot be inserted into the trocar 109. Therefore, it is possible to prevent an erroneous operation of inserting the bipolar electric scalpel into the abdominal cavity or the like in a state where the distal ends of the first electrode 102 and the second electrode 104 protrude from the sheath 106.

FIG. 29 shows a modification of the sheath 106. A plurality of cuts 108b are provided in the elastic deformation portion 108a of the elastic tube 108 in the axial direction, and the hard pipe 107 is retracted by a manual operation so as to be viewed from the front. The diameter is expanded and deformed in a substantially cross shape.

FIG. 30 shows a modification of the first electrode, in which the tip of the first electrode 110 is curved in a substantially sickle shape. Then, the sharp portion 1 is attached to the tip of the curved portion 111 of the first electrode 110.
11a and an obtuse angle portion 111b formed on the back surface of the curved portion 111. Therefore, a wide range of coagulation, narrow range coagulation, and incision of the living tissue can be selectively used depending on how the insertion section 101 is inclined with respect to the living tissue.

FIG. 31 shows a modification of the first electrode and the second electrode. The first electrode 113 and the second electrode 114 are symmetrically integrated with the tip of the insertion portion 101 with an insulating member 112 interposed therebetween. It is formed in a substantially wedge shape in a front view as a whole. An acute angle portion 115a is formed on one side of the first electrode 113 and the second electrode 114, and an obtuse angle portion 115b is provided on the other side. Therefore, a wide range of coagulation, narrow range coagulation, and incision of the living tissue can be selectively used depending on how the insertion section 101 is inclined with respect to the living tissue.

FIGS. 32 and 33 show modified examples of the first electrode and the second electrode, and the first electrode 11 with the insulating member 116 interposed therebetween.
7 is an electrode block 119 formed integrally with the second electrode 118. The shape of the electrode block 119 is such that the left and right side surfaces 119a and 119b are parallel and have a flat surface perpendicular to the upper surface 119c. The lower surface 119d is gradually inclined upward from the left side surface 119a toward the right side surface 119b, and the right side surface 119b is formed to be narrower than the left side surface 119a. Further, the front surface 119e is on the left side surface 11e.
9a toward the right side surface 119b from the left side to the right side surface 119b.
20a, the intersection of the right side surface 119b and the front surface 119e is formed at an obtuse angle portion 120b.

Therefore, according to the above configuration, the following configuration is obtained.

(Supplementary Note 17) In a bipolar electric scalpel having a pair of electrodes insulated from each other at the tip of an elongated rod-shaped portion, at least the tip of the insertion portion has a first electrode housing the first electrode and the second electrode. And a sheath movable between a first position and a second position exposing the first electrode and the second electrode, and a shaft is provided near the distal end of the sheath along with the movement from the first position to the second position. A bipolar electric scalpel having an elastically deformable portion which is deformed in a direction perpendicular to the bipolar electric knife.

(Supplementary note 18) The supplementary note 17, wherein the second electrode is a ring-shaped electrode provided at the distal end of the insertion portion, and the first electrode is a needle-like electrode having a sharp distal end. Bipolar electric scalpel.

(Supplementary Note 19) The second electrode is a ring-shaped electrode provided at the distal end of the insertion portion, and the first electrode is substantially a sickle having a sharp portion and an obtuse angle portion. The bipolar electric scalpel according to supplementary note 17.

(Supplementary Note 20) Each of the first electrode and the second electrode has a narrow acute angle portion and a wide obtuse angle portion, and the acute angle portion and the obtuse angle portion are on the same side with an insulating member interposed therebetween. 18. The bipolar electric scalpel according to appendix 17, wherein the bipolar scalpel is arranged so as to be arranged as follows.

(Supplementary Note 21) The first electrode is formed to have a narrow width and the second electrode is formed to have a wide width, and has a treatment section comprising an insulating member disposed between the first and second electrodes. 18. The bipolar electric scalpel according to claim 17, wherein an edge formed by two intersecting slopes and an intersection of the slopes is provided across the first electrode, the insulating member, and the second electrode.

FIGS. 34 and 35 show a bipolar electric scalpel, which comprises an insertion portion 121 and an operation portion 122 provided at the base end of the insertion portion 121. FIG. Insertion part 1
21 is provided with a rod-shaped first electrode 123 that can move forward and backward.
A cylindrical second electrode 125 is provided on the outer periphery of the first electrode 123 via an insulating member 124, and the outer periphery of the second electrode 125 is covered by a sheath 126. Second electrode 1
A base end 25 is always connected to a high frequency power supply (not shown) via a lead wire 133b.

A support table 127 is provided inside the operation section 122 along the front-rear direction, and a slider piece 129 urged in a retreating direction by an urging spring 128 is placed on the upper surface of the support table 127. The slider piece 129 has the first
The base end of the electrode 123 is connected. Slider piece 12
An upper surface of the upper surface 9 is provided with an upwardly inclined surface 129a, and the lower surface of an operation button 130 provided on an upper portion of the operation unit 122 so as to be movable up and down is in contact with the inclined surface 129a. Then, the slider piece 129 is attached to the urging spring 1.
28, the distal end of the first electrode 123 is immersed, but when the operation button 130 is pressed down, the lower end of the operation button 130
A component force is applied to slide the slider piece 129 forward by sliding with 29a, so that the tip of the first electrode 123 projects.

Further, between the front end of the support stand 127 and the front end of the slider piece 129, electrical contacts 131a and 131a are provided.
b are provided to face each other, and the electrical contact 131a is connected to a high-frequency power supply via a lead wire 133a.
“b” is electrically connected to the first electrode 123 via the slider piece 129. Then, the operation button 130 is depressed so that the slider piece 129 moves forward and the electrical contacts 131a and 1
When the first electrode 123b comes into contact with the high-frequency power supply, the high-frequency power supply and the first power supply 123 are electrically connected, and the high-frequency current flows from the first electrode 123 to the second electrode 125 at the same time that the tip of the first electrode 123 protrudes. I have.

FIG. 36 shows a bipolar electric scalpel. A solenoid 132 for moving the first electrode 123 forward and backward is provided inside the operation section 122, and the solenoid 132 is connected to a power supply (not shown). Further, the first electrode 1
A current detection unit 134 is provided to be connected to a lead wire 133 for flowing a high-frequency current to the 23 and the second electrode 125. When the current detection unit 134 detects a high-frequency current, an operation signal is input to the solenoid 132. Has become.

FIG. 37 shows a bipolar electric scalpel, in which a screw hole 135 is provided at the front end of the operating portion 122, and the screw hole 135 has a base for an insertion portion 121 having a first electrode 123 and a second electrode 125. A screw portion 136 is provided at the end. Then, the screw portion 136 of the insertion portion 121 is
22 is screwed into the screw hole 135 of the operation unit 12.
2, the insertion portion 121 is detachably attached.

Therefore, by preparing a plurality of insertion portions 121 having different lengths, the insertion portion 121 can be used for a purpose of use, a treatment site, an operation method, for example, both open surgery and laparoscopic surgery.

FIG. 38 shows a bipolar trocar, which is composed of an outer tube 137 and a trocar body 138 inserted into the outer tube 137. An outer tube electrode 139 is provided at the tip of the outer tube 137, and the trocar body 1
A needle electrode 140 is provided at the tip of 38. The outer cylinder electrode 139 and the needle electrode 140 are connected to the conductive wires 139a, 140
a to a high frequency power supply (not shown). Further, the rear end of the outer tube 137 and the trocar body 1
An urging spring 141 for urging the trocar main body 138 in the retreating direction is provided between the rear end of the trocar 38 and the rear end of the trocar main body 138.

Therefore, the trocar main body 138 is advanced against the urging force of the urging spring 141, and the needle electrode 140 of the trocar main body 138 penetrates the abdominal wall or the like in a state of protruding from the distal end of the outer tube 137. A treatment portion can be coagulated by flowing a coagulation current between the outer cylinder electrode 139 and the needle electrode 140.

According to the above configuration, the following configuration is obtained.

(Supplementary Note 22) In a bipolar electric scalpel having a first electrode provided at the insertion portion so as to be able to advance and retreat and a second electrode provided on the outer periphery of the first electrode, a high-frequency wave is applied between the first electrode and the second electrode. A bipolar electric scalpel, wherein the first electrode protrudes from the second electrode only when a current flows.

(Supplementary Note 23) In a bipolar electric scalpel having a first electrode provided at the insertion portion so as to be movable forward and backward and a second electrode provided on the outer periphery of the first electrode, the first electrode and the second electrode are supplied from a high-frequency power supply. And a slide means for receiving the output signal when the high-frequency current is output to the first electrode and projecting the first electrode from the second electrode.

(Supplementary note 24) The bipolar electric knife according to supplementary note 23, wherein the sliding means is a solenoid.

According to Supplementary Notes 22 to 24, when not in use, the first
The electrode does not bend or break due to interference with other members, and there is no risk of inadvertently damaging the living tissue,
Operability and safety can be improved.

[0124]

As described above, according to the present invention, grasping, exfoliation, coagulation, and incision of tissue can be performed by one treatment tool, and replacement of the treatment tool at the time of surgery is reduced, thereby reducing inconvenience. Can reduce the time required for surgery,
In addition, there is an effect that the coagulation of the tissue in a relatively wide range and the fine coagulation operation and exfoliation can be performed by grasping the tissue.

[Brief description of the drawings]

FIG. 1 is an overall side view of a high-frequency treatment instrument according to a first embodiment of the present invention.

FIG. 2 is a longitudinal sectional side view showing the treatment section of the embodiment and holding a living tissue.

3A and 3B show a treatment section of the embodiment, wherein FIG. 3A is a longitudinal side view, and FIG. 3B is a front view.

FIG. 4 is a longitudinal sectional side view showing the treatment unit of the embodiment and in which a living tissue is incised.

FIG. 5 is a longitudinal sectional side view showing a treatment section according to a second embodiment of the present invention, and holding a living tissue.

FIG. 6 is a longitudinal sectional side view showing the treatment section of the embodiment and in which a living tissue is incised.

FIG. 7 is a longitudinal sectional side view showing a treatment section according to a third embodiment of the present invention, with a living tissue being gripped.

FIGS. 8A and 8B show a needle electrode of the embodiment, wherein FIG. 8A is a side view and FIG. 8B is a front view.

FIG. 9 is a longitudinal sectional side view showing the treatment section of the embodiment and in which a living tissue is incised.

FIG. 10 shows a treatment section according to a fourth embodiment of the present invention;
(A) is a longitudinal sectional side view of a state where a living tissue is coagulated,
(B) is sectional drawing which follows the aa line.

FIG. 11 is a longitudinal sectional side view showing the treatment section of the embodiment and in which a living tissue is incised.

FIG. 12 is an overall side view of a high-frequency treatment device according to a fifth embodiment of the present invention.

FIG. 13 shows the same embodiment, and is an explanatory diagram of an electrode switching unit.

FIG. 14 is a longitudinal side view showing a treatment section according to a sixth embodiment of the present invention.

FIG. 15 is a longitudinal sectional side view showing the same embodiment, in a state where a living tissue is coagulated.

FIG. 16 is a perspective view showing a treatment section according to a seventh embodiment of the present invention.

FIG. 17 is a perspective view showing a distal end portion of an insertion portion according to an eighth embodiment of the present invention.

FIG. 18 is a vertical side view of the distal end portion of the insertion section of the embodiment.

FIG. 19 is a front view of the distal end portion of the insertion section of the embodiment.

FIG. 20 is an exemplary front view showing a modification of the embodiment.

FIG. 21 shows a distal end portion of an insertion portion according to a ninth embodiment of the present invention, where (a) is a side view showing a state where a tubular tissue is held;
(B) is a side view of a state where the tubular tissue is incised.

FIG. 22 is a side view showing a modified example of the same embodiment and in a state where a tubular tissue is held.

23A and 23B show a distal end portion of an insertion portion according to a tenth embodiment of the present invention, wherein FIG. 23A is a side view showing a state where the second electrode is advanced, and FIG. 23B is a view showing a state where the second electrode is retracted. Side view,
(C) is a front view as seen from the direction of arrow C in (b).

FIG. 24 is an overall side view of the bipolar electric scalpel according to the first disclosure example;

FIG. 25 is a side view of the entire bipolar electric scalpel according to the second disclosed example;

FIG. 26 is a longitudinal sectional side view showing a distal end portion of the bipolar electric knife of the third disclosure example, in a state where the first and second electrodes are housed.

FIG. 27 is a longitudinal sectional side view showing a distal end portion of the bipolar electric scalpel according to the embodiment of the disclosure, in a state where first and second electrodes are exposed.

FIG. 28 is a front view as seen from the direction of arrow D in FIG. 27;

FIG. 29 is a front view showing a modification of the third disclosure example;

FIG. 30 is a perspective view showing a distal end portion of the bipolar electric knife according to the fourth disclosure example;

FIG. 31 is a perspective view showing a distal end portion of a bipolar electric scalpel according to a fifth disclosure example;

FIGS. 32A and 32B show an electrode block at the distal end of the bipolar electric knife of the sixth disclosure example, wherein FIG. 32A is a plan view, FIG. 32B is a front view, and FIG.

FIG. 33 is a perspective view showing an electrode block at the distal end of the bipolar electric scalpel according to the embodiment of the disclosure;

FIG. 34 is an overall side view of a bipolar electric scalpel according to a seventh disclosure example;

FIG. 35 is a vertical side view of the entire bipolar electric knife according to the embodiment of the disclosure;

FIG. 36 is a longitudinal sectional side view of the operation unit of the bipolar electric scalpel according to the eighth disclosure example;

FIG. 37 is a vertical sectional side view of the operation unit of the bipolar electric scalpel according to the ninth disclosure example.

FIG. 38 is a longitudinal sectional side view of a bipolar trocar according to the tenth disclosed example.

[Explanation of symbols]

 2 insertion part 3 treatment part 4 operation part 11a, 11b gripping member 19 needle electrode

 ────────────────────────────────────────────────── ─── Continued on the front page (72) Inventor Kenji Harano 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd.

Claims (1)

[Claims] 1. An insertion section and an operation section at a hand side of the insertion section, and a pair of grip members and an incision at an end of the insertion section for gripping, peeling, and coagulating tissue by operating the operation section. A high-frequency treatment instrument having a needle-shaped electrode for performing a forceps operation, a forceps operating means for opening and closing the pair of gripping members in the operating portion, and a needle for incising tissue by moving the needle-shaped electrode forward and backward from a distal end portion of the insertion portion. A high-frequency treatment instrument provided with an electrode-like electrode operating means.