JP4311978B2 - Ultrasonic treatment device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an ultrasonic treatment instrument for performing a surgical process such as incision or coagulation of a living tissue using ultrasonic vibration.
[0002]
[Prior art]
In this type of ultrasonic treatment instrument, the tip has a saddle shape, a vibrator incorporating an element that converts an electrical signal into ultrasonic vibration, a probe that is connected to the vibrator and transmits ultrasonic vibration, and a tip treatment What is provided with the sheath which covers a probe except a site | part is known (for example, refer patent document 1).
[0003]
In this ultrasonic treatment tool, a jaw that grips a living tissue together with a probe in a bowl shape is rotatably provided at the tip, and this jaw can be operated by an operation means such as a handle provided on the proximal side. An operating shaft is extended between the handle on the hand side and the jaw, and the jaw is rotated by operating the handle to advance and retract the operating shaft. As a result, the living tissue can be grasped between the jaw and the probe, and a necessary treatment such as incision or coagulation can be performed. In addition, in order to prevent tissue from adhering during treatment such as coagulation and incision, and to improve the wear resistance of the probe, the probe and the jaw portion facing the probe are made of resin such as PTFE. A gripping member is attached. Since this scissors-type ultrasonic treatment tool can excise the tissue including blood vessels without bleeding, the operation can proceed safely and quickly.
[0004]
In addition, a saddle type ultrasonic treatment tool to which an ultrasonic suction function is added by using a pipe-like probe has been proposed (for example, see Patent Document 2).
The ultrasonic suction function in this ultrasonic treatment instrument has tissue selectivity and can expose blood vessels.
Furthermore, a saddle-type ultrasonic treatment instrument that has improved usability by making it possible to remove the handle when using such an ultrasonic suction function has been developed (for example, see Patent Document 3).
[0005]
[Patent Document 1]
JP 2000-197640 A
[0006]
[Patent Document 2]
JP 2000-23994
[0007]
[Patent Document 3]
JP2000-249
[0008]
[Problems to be solved by the invention]
According to the scissors-type ultrasonic treatment tool described in Patent Document 1 described above, since the tissue including blood vessels can be excised without bleeding, the operator can proceed with the surgery safely and quickly. However, since there is a limit to the size of blood vessels that can be hemostatic, there is also a demand for exposing blood vessels firmly, particularly for thick blood vessels.
On the other hand, the ultrasonic treatment instrument described in Patent Document 2 can expose blood vessels due to the tissue selectivity of the ultrasonic suction function, but it is narrow when the jaws are open because of the presence of the jaws. It is difficult to enter the site and perform fine treatment. In addition, the ultrasonic treatment instrument described in Patent Document 3 can remove the handle when using the ultrasonic suction function, but it imposes troublesome work for the operator such as removing the handle during the operation. Will do.
[0009]
In particular, in the conventional scissors-type ultrasonic treatment device as described above, when the ultrasonic suction function is used, there is a possibility that the jaws obstruct the visual field or come into contact with normal living tissue. In addition to the ultrasonic suction function, there is also a demand to perform fine treatment with the tip of the probe of the saddle type ultrasonic treatment tool. In this case, the phenomenon that Joe gets in the way occurs. Further, if the treatment is performed in a state where the jaw is closed so as not to interfere with the jaw, that is, in a state where the gripping member and the probe are in firm contact with each other, wear of the gripping member proceeds and the life of the gripping member is shortened.
[0010]
The present invention has been made on the basis of the circumstances as described above, and in a surgery using a saddle type ultrasonic treatment tool, smoothly performs fine treatment such as exposure of blood vessels in addition to the conventional saddle type function. An object of the present invention is to provide an ultrasonic treatment device capable of performing the above.
[0011]
[Means for Solving the Problems]
  Achieve the above objectivesTherefore, the invention of claim 1Hold the probe that transmits ultrasonic vibration on the handle,Operate with the tip of the probe and the handleBy operating the gripping member to grip the tissue between the tip of the probe and the gripping member, the ultrasonic vibration transmitted from the probeAboveAn ultrasonic treatment tool for treating tissue, wherein an arrangement position of a tip portion of the probe isIn order to perform treatment at the tip of the probe, theFrom gripping memberAdjustable to protrude furtherA position adjusting means is provided.
  According to the second aspect of the present invention, a probe that transmits ultrasonic vibration is held in a handle portion, a tissue is gripped between a tip portion of the probe and a gripping member that is operated by the handle portion, and is transmitted from the probe. An ultrasonic treatment tool for treating the tissue by ultrasonic vibration, wherein the position of the distal end portion of the probe includes a first treatment position for grasping the tissue with the grasping member, and a distal end of the probe. A position adjusting means that allows a second treatment position to be protruded from the gripping member and to be treated by the tip of the probe.It is characterized by that.
  According to a third aspect of the present invention, when the distal end portion of the probe is disposed at a position protruding from the gripping member, the gripping member and the probe in the closed position are disposed between the gripping member and the probe. The ultrasonic treatment device according to claim 1, further comprising a contact prevention unit that prevents contact of the ultrasonic treatment device.
  The invention according to claim 4 is a protective member in which the contact preventing means can cover the vicinity of the tip of the probe so that the exposed length at which the tip of the probe is exposed from the protective member can be adjusted. The ultrasonic treatment instrument according to claim 3, wherein the distal end position of the protection member can be adjusted relative to the distal end portion of the probe.
[0012]
In this ultrasonic treatment instrument, by operating the position adjusting means, the arrangement position of the tip of the probe with respect to the gripping member provided on the handle is adjusted, and the living tissue is moved between the tip of the probe and the gripping member. A necessary treatment can be performed by gripping in a hook shape, and further, a fine treatment can be performed at the distal end portion of the probe by protruding the distal end portion of the probe from the gripping member.
[0013]
DETAILED DESCRIPTION OF THE INVENTION
1 to 5 show a scissors ultrasonic treatment tool 1 according to a first embodiment of the present invention.
As shown in FIGS. 1 and 2, a saddle type ultrasonic treatment instrument 1 according to this embodiment includes a casing 2 that accommodates an ultrasonic transducer, an elongated probe 3 that is connected to and extends from the casing 2, and the casing. 2 and a protection member 5 for preventing contact between the probe 3 and surrounding members, and these members are detachable from each other.
[0014]
This saddle type ultrasonic treatment instrument 1 accommodates an ultrasonic transducer in a casing 2 positioned on the proximal end side. This ultrasonic transducer generates ultrasonic vibration by converting electric energy supplied from an external power source (not shown) into vibration energy. To communicate. The probe 3 for transmitting the ultrasonic vibration is fastened to the distal end side connecting portion of the horn integrated with the ultrasonic vibrator with, for example, a screw to cause the blade 13 at the distal end portion to vibrate ultrasonically. As a result, frictional heat can be generated in a required living tissue to be coagulated and incised.
[0015]
The protective member 5 for preventing the ultrasonic vibrating probe 3 and the surrounding members from contacting each other includes a protective sheath 6 that penetrates the probe 3 and covers the periphery of the side portion, and the protective sheath 6 is a casing. The connecting portion 7 is detachably connected to the distal end portion of the two. When the probe 3 and the protection member 5 are assembled in the casing 2, the protective sheath 6 protrudes only the portion of the blade 13 provided at the distal end portion of the probe 3 and covers a portion other than the portion used for coagulation / incision. It is preferable to form as a cylindrical member having a thickness. As will be described later, the protective sheath 6 can reduce the generation of frictional heat and at least the distal end portion 14 (see FIG. 4) that acts as a means for preventing contact between the jaw 9 and the meshing member 10 and the probe 3, and further heat resistance. It is preferable to form with a fluororesin having excellent properties. In order to increase the strength, the inner surface side of the protective sheath 6 that is a contact surface with the blade 13 may be formed of a low friction member, and the outer surface side may be formed of metal.
[0016]
The handle portion 4 to which the casing 2 is attached includes a main body portion 4a having a substantially cylindrical outer shape, and a sheath 8 projects from the tip. A protective sheath 6 of the protective member 5 is inserted into the sheath 8, and the distal end portion of the probe 3, that is, the blade 13 inserted through the protective sheath 6 can be protruded from the distal end opening. Further, as will be described later, a jaw 9 as a gripping member for gripping the living tissue is rotatably provided at the distal end portion of the sheath 8, and the living tissue is provided on the blade 13 side of the jaw 9. A meshing member 10 that directly contacts is attached to the jaw 9. The meshing member 10 is formed with a large number of teeth (see FIG. 3) on the side opposite to the jaw 9, that is, on the side facing the tip of the probe 3, and can reliably grip a required part of the living tissue. The engagement member 10 can be formed of a resin such as PTFE.
[0017]
The main body 4a is provided with an immovable fixed operating portion 11a and a rotatable movable operating portion 11b. A ring-shaped finger hook is formed at the tips of these operating portions 11a and 11b. is there. The movable operation portion 11b is connected to the jaw 9 via a connecting member (not shown) such as a rod or a wire. By moving the movable operation portion 11b with respect to the fixed operation portion 11a, the jaw 9 and the engagement member 10 are rotated between a position where the required portion of the living tissue is sandwiched together with the probe 3 and a position separated from the probe 3. Can be moved.
[0018]
Furthermore, the connection part 12 which connects the above-mentioned casing 2 is formed in the base end side of the main-body part 4a, and the front-end | tip part of the casing 2 can be connected through this connection part 12 so that attachment or detachment is possible. In the present embodiment, the connection portion 12 is formed as a position adjusting means, holds the casing 2 in at least two arrangement positions, and adjusts the length of the distal end portion of the probe 3 protruding from the distal end opening of the sheath 8. can do. In the first position, which is the normal position, as shown in FIG. 3, the blade 13 provided at the tip of the probe 3 is disposed at a position corresponding to the jaw 9 or the meshing member 10 attached thereto. Further, at the second position which is the pushing position, as shown in FIGS. 4A and 4B, the blade 13 protrudes further to the tip side than the jaw 9.
[0019]
When using this ultrasonic treatment instrument 1, the probe 3 is connected to the casing 2, the probe 3 is inserted into the protective sheath 6 of the protective member 5, and the protective member 5 is connected to the distal end portion of the casing 2 via the connecting portion 7. Install to. Thereafter, the probe 3 and the protective sheath 6 are inserted through the sheath 8 of the handle portion 4, and the casing 2 is attached to the handle portion 4 via the connecting portion 12 disposed on the proximal end side of the main body portion 4a, as shown in FIG. Assemble to the state.
[0020]
The ultrasonic treatment instrument 1 assembled in this way can operate the position adjusting means, that is, change the arrangement position of the casing 2 with respect to the handle portion 4 at the connection portion 12. That is, the blade 13 is adjusted to an arrangement position corresponding to the jaw 9 and the meshing member 10 provided on the handle portion 4, and the living tissue is gripped between the blade 13 and the meshing member 10 to perform a required treatment. It can be carried out. Further, the blade 13 can protrude longer than the meshing member 10, and fine treatment can be performed with this blade 13.
[0021]
Specifically, as shown in FIG. 3, when the connection portion 12 holds the casing 2 in the first position, the blade 13 corresponds to the jaw 9 and the engagement member 10 from the distal end opening of the sheath 8. It protrudes to a position and faces the jaw 9 and the meshing member 10. In this state, the movable operation portion 11b is moved and operated, and a necessary living tissue can be sandwiched between the jaw 9 and the meshing member 10 and the blade 13, and can be coagulated and excised.
[0022]
Moreover, when performing a fine treatment, the casing 2 is pushed forward with respect to the handle portion 4 and is disposed at the second position shown in FIGS. 4 (A) and 4 (B). Since the protective member 5 is fixed in its position relative to the probe 3, the protective sheath 6 also moves to the distal end side together with the probe 3, and the distal end portion 14 of the protective sheath 6 protrudes from the distal end opening of the sheath 8 of the handle portion 4. To do. The length by which the distal end portion 14 of the protective sheath 6 protrudes is substantially the same as that of the blade 13, and therefore, the lengths of the jaw 9 and the engagement member 10 are also substantially the same. When the casing 2 is moved with respect to the handle portion 4, the movable operation portion 11b is operated, and the jaw 9 and the engagement member 10 are arranged at positions separated from the probe 3 as shown in FIG. Then, it is preferable to prevent the distal end portion 14 of the protective sheath 6 from being caught by the teeth of the meshing member 10.
[0023]
After the blade 13 of the probe 3 and the distal end portion 14 of the protective sheath 6 are thus projected from the distal end opening of the sheath 8, the jaw 9 and the engagement member 10 are closed as shown in FIG. The meshing member 10 contacts the distal end portion 14 of the protective sheath 6 and does not contact the blade 13. Therefore, the meshing member 10 does not frictionally engage with the blade 13. The distal end portion 14 of the protective sheath 6 forms contact prevention means for preventing contact between the jaw 9 and the meshing member 10 and the probe 3. Further, since the jaw 9 and the meshing member 10 are closed and in contact with the distal end portion 14 of the protective sheath 6, the jaw 9 and the meshing member 10 obstruct the operator's field of view when performing a fine treatment. Nor.
[0024]
In the ultrasonic treatment instrument 1 of this embodiment, the casing 2 is pushed into the handle portion 4 to move from the first position to the second position, and the jaw 9 and the meshing member 10 are moved over the distal end portion 14 of the protective sheath 6. When closed, the blade 13 is disposed at a position protruding from the jaw 9, and the diameter of the sheath 8 on the distal end side is reduced. As a result, it is possible to ensure a wide field of view suitable for the procedure and perform a fine treatment via the blade 13. Even in a state where the jaw 9 is closed, the meshing member 10 comes into contact with the distal end portion 14 of the protective sheath 6 and therefore does not come into contact with the blade 13 which vibrates at high speed. Therefore, the engagement member 10 does not wear or melt due to frictional heat. The surgeon can use each function as needed as a saddle type ultrasonic treatment instrument and a rod-shaped ultrasonic treatment instrument without replacing this ultrasonic treatment instrument 1 with another type of treatment instrument. It becomes.
[0025]
Therefore, according to this ultrasonic treatment instrument 1, in an operation using the saddle type ultrasonic treatment instrument, it is possible to smoothly perform fine treatment such as exposure of blood vessels in addition to the conventional saddle type function.
[0026]
Instead of using the probe 3 having a solid rod-like structure, an ultrasonic wave can be obtained by using the casing 2 having the vibrator having the suction path formed therein together with the pipe-shaped probe having the suction path formed therein. The suction function can be used as well.
[0027]
FIG. 5 shows a scissors-type ultrasonic treatment instrument 1A according to the second embodiment. The following various embodiments are basically the same as the above-described embodiments, and therefore, the same parts as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted. .
[0028]
As shown in FIG. 5, in this embodiment, the protrusion 15 protrudes from the vicinity of the tip of the casing 2. On the other hand, a crank groove 16 capable of locking the protrusion 15 is formed as the connection portion 12 in the main body portion 4 a of the handle portion 4. The crank groove 16 includes an axial groove 16a that extends along the axial direction of the main body 4a and opens at the base end side, and two locking grooves 16b and 16c that communicate with the axial groove 16a and extend in the circumferential direction. And formed. The protrusion 15 of the casing 2 is moved along the axial groove 16a, and is held in the first position by being fitted to the locking groove 16b on the proximal end side, and is fitted to the locking groove 16c on the distal end side. Thus, it can be held at the second position. These locking grooves 16b and 16c act as holding means for holding the probe 3 in a predetermined position.
[0029]
The locking groove portions 16b and 16c may be inclined with respect to the axial groove 16a as long as they can lock and hold the projection 15 and are disposed on both sides of the axial groove portion 16a. May be. Furthermore, the number of such locking grooves is not limited to two, and may be three or more. The locking groove 16c on the distal end side preferably communicates with the axial groove 16a at the distal end of the axial groove 16a.
[0030]
This saddle type ultrasonic treatment tool 1A is used as a normal saddle type ultrasonic treatment tool by holding the casing 2 in the first position by fitting the projection 15 into the locking groove 16b on the proximal end side. be able to. Further, when performing a fine treatment, the casing 2 is rotated to extract the protrusion 15 from the locking groove 16b and to be fitted into the locking groove 16c on the distal end side. As a result, the casing 2 is held at the second position, and the blade 13 protrudes to the state shown in FIG.
[0031]
According to the scissors-type ultrasonic treatment instrument 1A according to this embodiment, the protrusion 15 of the casing 2 is fitted into the locking grooves 16b and 16c so that the first and second positions do not move in the axial direction. It is held securely fixed. Further, when the locking groove portion 16c on the distal end side communicates with the axial groove portion 16a at the distal end portion, when the casing 2 is moved to the distal end side, it is surely disposed at the second position, and the blade 13 is Protruding more than necessary can be prevented.
[0032]
6 and 7 show a scissors-type ultrasonic treatment instrument 1B according to the third embodiment.
In this embodiment, as the connection part 12 of the handle part 4, an axial groove 17 is provided in the main body part 4 a, and a knob 18 that protrudes outward through the axial groove 17 is provided in the casing 2. Further, in the main body 4a, a spring 19 as a return means for biasing the casing 2 toward the proximal end and returning to the initial position, and a second position on the distal end side against the biasing force of the spring 19 are provided. There is provided a locking piece for locking the casing 2 that has been moved, that is, a stop member (not shown). The stop member is engaged with a release button 20 exposed to the outside of the main body portion 4a. When the release button 20 is pressed, the stop member in the main body portion 4a can release the lock of the casing 2. .
[0033]
The knob 18 is formed in an external structure that is attached to the casing 2 via the axial groove 17 after the casing 2 is assembled in the state shown in FIG. It is possible to form an appropriate structure as necessary, such as a structure protruding outward from the axial groove 17 when aligned. Further, the protruding piece 18a protrudes from the knob 18 to the side, and the knob 18 is tightened via the protruding piece 18a, so that the knob 18 is held at an arbitrary position between the first position and the second position. Is also possible.
[0034]
When the casing 2 is in the first position shown in FIG. 6, the saddle type ultrasonic treatment instrument 1B operates as the normal saddle type ultrasonic treatment instrument by operating the operation portions 11a and 11b as described above. Can be used. And when a fine treatment is required, the knob 19 is pressed to the front end side with a finger. When the specified amount of probe protrusion is reached, the stop member provided on the main body 4a locks the casing 2 and is held at the second position.
[0035]
When normal treatment is performed again, the release button 20 is pressed. A stop member (not shown) releases the locking of the casing 2, and the casing 2 is moved to the proximal end side by the urging force of the spring 19 and is again arranged at the first position.
[0036]
According to the scissors-type ultrasonic treatment tool 1B of this embodiment, when a surgeon who is normally using wants to perform a fine treatment, the knob 18 is moved forward by the hand operating the handle, and at a predetermined position. Can be locked. When returning to normal use again, the normal use state can be instantaneously returned by pressing the release button 20. Therefore, the surgeon can be used properly as a saddle type ultrasonic treatment instrument or a rod-shaped ultrasonic treatment instrument with only one hand depending on the situation, and the operability is improved.
[0037]
8 and 9 show a scissors-type ultrasonic treatment instrument 1C according to the fourth embodiment.
This embodiment is different from the above-described embodiment in that the protective member 5, that is, the protective sheath 6 is formed so that the arrangement position with respect to the probe 3 can be adjusted.
As shown in FIG. 9, in the assembled state, the connection portion 7 provided on the proximal end side of the protection member 5 protrudes from the main body portion 4a of the handle portion 4 to the proximal end side and is exposed to the outside.
[0038]
In this embodiment, when the probe 3 is moved to the distal end side, the distal end portion 14 of the protective sheath 6 is moved further forward than the jaw 9 by moving the connecting portion 7 of the protective member 5 forward. Can do.
[0039]
As a result, it is possible to cover as many portions of the blade 13 as possible with the protective sheath 6, the vibration energy supply unit is limited, and the normal tissue can be prevented from being burned due to unexpected contact with the normal tissue. For example, when a high frequency is passed through the probe 3, unnecessary high frequency energy supply units can be reduced by moving the protective member 5 forward. In this case, the protective sheath 6 is preferably made of an insulating member such as resin.
[0040]
FIG. 10 shows the distal end portion of the ultrasonic treatment apparatus according to the fifth embodiment.
In the ultrasonic treatment instrument of this embodiment, the shape of the probe 3 is different from that of the above-described embodiment.
The probe 3 of this embodiment has a pipe-like structure having a suction path 21 inside. A water supply path 22 is provided in the gap between the protective sheath 6 and the probe 3. The suction path 21 is connected to an external suction means (not shown) through a suction path of the casing 2 (not shown). The water supply path 22 is connected to an external water supply means (not shown).
[0041]
In this ultrasonic treatment instrument, when an ultrasonic wave is output in a state where the probe 3 is moved to the distal end side as shown in FIG. 10, the tissue is sucked from the suction path 21 by the ultrasonic suction function. Further, the water supply liquid necessary for ultrasonic suction can be supplied from the water supply path 22.
[0042]
According to this ultrasonic treatment instrument, since the distal end portion 14 of the protective sheath 6 is disposed forward to the vicinity of the distal end portion of the blade 13, ultrasonic spraying due to ultrasonic vibration of the water supply liquid is minimized.
[0043]
Note that the present invention is not limited to the above-described embodiments, and various embodiments can be appropriately used, for example, by combining the probe 3 in the fifth embodiment with the above-described first to fourth embodiments. It is clear that they can be combined, and at least the following features are obtained.
<Additional items>
1) In an ultrasonic treatment tool for surgery using ultrasonic vibration,
Having a grasping member for grasping tissue with a probe that transmits ultrasonic vibrations;
An ultrasonic treatment instrument comprising a moving means capable of moving the probe forward relative to the gripping member.
[0044]
2) In Additional Item 1
An ultrasonic treatment instrument comprising means for preventing contact between a gripping member and a probe between the gripping member and the probe when the probe moves.
[0045]
3) In Additional Item 2,
The ultrasonic treatment instrument, wherein the contact preventing means is a cylindrical member having a fixed positional relationship with the probe.
[0046]
4) In Appendix 2,
The ultrasonic treatment instrument, wherein the contact preventing means is a cylindrical member whose positional relationship with the probe is relatively movable.
[0047]
5) In Appendix 1,
An ultrasonic treatment device comprising a fixing means for fixing a probe at an arbitrary position.
[0048]
6) In Appendix 1,
An ultrasonic treatment instrument having a release button for instantaneously returning the probe from the moved position to the initial position.
[0049]
7) A probe that transmits ultrasonic vibration is held by a handle portion, and a grasping member provided on the handle portion is operated to grasp tissue between the tip portion of the probe and the grasping member, and transmitted from the probe. An ultrasonic treatment tool for treating tissue by ultrasonic vibration,
An ultrasonic treatment instrument comprising position adjusting means for adjusting an arrangement position of a distal end portion of the probe with respect to a gripping member.
[0050]
8) Contact preventing means for preventing contact between the gripping member and the probe by being disposed between the gripping member and the probe when the tip of the probe is disposed at a position protruding from the gripping member. Item 8. The ultrasonic treatment instrument according to Item 7, wherein the ultrasonic treatment device comprises the ultrasonic treatment device.
[0051]
9) The ultrasonic treatment instrument according to appendix 8, wherein the contact preventing means is formed of a cylindrical member having a fixed arrangement position with respect to the probe.
[0052]
10) The ultrasonic treatment instrument according to appendix 8, wherein the contact preventing means is formed of a cylindrical member capable of adjusting an arrangement position with respect to the probe.
[0053]
11) The ultrasonic treatment instrument according to item 7, wherein the position adjusting means includes holding means for holding the probe at a predetermined position with respect to the gripping member.
[0054]
12) The ultrasonic treatment instrument according to any one of appendices 7 to 11, wherein the position adjusting means includes return means for returning the probe moved from the initial position to the initial position.
[0055]
13) The ultrasonic treatment instrument according to item 10, further comprising a water supply path formed between the cylindrical member and the probe.
[0056]
【The invention's effect】
As is apparent from the above, according to the present invention, in an operation using a saddle type ultrasonic treatment tool, an ultrasonic treatment tool capable of smoothly performing fine treatment such as exposure of blood vessels in addition to the conventional saddle type function. Can be provided.
[Brief description of the drawings]
FIG. 1 is a schematic view showing the overall structure of an ultrasonic treatment device according to a first embodiment of the present invention.
2 is an exploded view showing each member of the ultrasonic treatment device in FIG. 1; FIG.
3 is an explanatory view showing the operation of the distal end portion of the ultrasonic treatment instrument of FIG. 1. FIG.
4 shows a state in which the probe of the ultrasonic treatment device of FIG. 1 is projected, (A) is a state where the jaw is opened, and (B) is an explanatory view showing a state where the jaw is closed.
5A and 5B show an ultrasonic treatment apparatus according to a second embodiment, in which FIG. 5A is an explanatory view in an assembled state, and FIG. 5B is a perspective view showing details of a tip portion of a casing portion.
FIG. 6 is a schematic side view of an ultrasonic treatment apparatus according to a third embodiment.
7 is a schematic partial cross-sectional view showing the inside of a handle portion of the ultrasonic treatment instrument in FIG. 6. FIG.
FIG. 8 is an explanatory view showing the distal end portion of the ultrasonic treatment apparatus according to the fourth embodiment in a state after the protective sheath is moved.
FIG. 9 is a partial cross-sectional view showing an overall structure of an ultrasonic treatment apparatus according to a fourth embodiment.
FIG. 10 is an explanatory view showing details of a distal end portion of an ultrasonic treatment apparatus according to a fifth embodiment.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... Sponge type ultrasonic treatment tool, 3 ... Probe, 4 ... Handle part, 9 ... Jaw, 13 ... Blade.

Claims (4)

A probe that transmits ultrasonic vibration is held in a handle portion, and a tissue is grasped between the tip portion of the probe and the grasping member by operating a distal end portion of the probe and a grasping member operated by the handle portion. , an ultrasonic treatment apparatus for treating the tissue by ultrasonic vibration transmitted from the probe,
An ultrasonic treatment instrument comprising position adjusting means for adjusting the arrangement position of the tip of the probe so as to protrude further from the gripping member so that treatment can be performed at the tip of the probe . A probe that transmits ultrasonic vibration is held in a handle portion, a tissue is gripped between a tip portion of the probe and a gripping member operated by the handle portion, and the tissue is transmitted by ultrasonic vibration transmitted from the probe. An ultrasonic treatment device for treating
The arrangement position of the tip of the probe is a first treatment position for grasping a tissue with the grasping member, and the tip of the probe is protruded more to the tip than the grasping member. An ultrasonic treatment instrument comprising position adjusting means for selecting a second treatment position to be treated. Contact prevention that prevents contact between the gripping member in the closed position and the probe, which is disposed between the gripping member and the probe when the tip of the probe is disposed at a position protruding from the gripping member. The ultrasonic treatment device according to claim 1, further comprising means. The contact preventing means is a protective member capable of covering the vicinity of the tip of the probe, and the tip position of the protection member is adjusted so that the exposed length at which the tip of the probe is exposed from the protection member can be adjusted. The ultrasonic treatment device according to claim 3, wherein the ultrasonic treatment device can be adjusted relative to the distal end portion of the probe.

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