JP7151142B2 - high frequency treatment - Google Patents

Description

The present invention relates to a high-frequency treatment instrument.

2. Description of the Related Art A high-frequency surgical instrument that is used by being inserted into a forceps hole of an endoscope is known as a medical instrument for performing a procedure of incising a body tissue (including a procedure of excising a lesion site) within a body cavity.

For example, Patent Literature 1 describes a high-frequency treatment instrument having a pair of scissors that can be opened and closed at its distal end.

International Publication No. 2011-043340 pamphlet

However, according to the studies of the inventors of the present application, the technique of Patent Document 1 still has room for improvement in terms of the hemostatic properties of living tissue.

SUMMARY OF THE INVENTION The present invention has been made in view of the above problems, and provides a high-frequency treatment instrument having a structure that improves the hemostatic property of living tissue.

The present invention is a medical high-frequency treatment instrument provided with a knife for high-frequency treatment instrument having a pair of scissors and used for incising living tissue at the distal end thereof,
Each of the pair of scissors is formed in a long plate shape,
base ends of the pair of scissors are mutually supported by a rotation shaft that intersects the plate surface direction of the scissors;
The pair of scissors is configured to be able to shear the living tissue by rotating in a direction toward each other,
Each of the pair of scissors includes a blade surface, a sliding contact surface that is in sliding contact with each other, an outer surface that is the back surface of the sliding contact surface, and an inclined surface that is positioned between the outer surface and the blade surface. and
the inclined surface is inclined from the sliding contact surface side toward the outer side surface side in a direction away from the other scissor portion,
Each surface of the pair of scissors includes a non-conductive layer formation region and an electrode region where the non-conductive layer is not formed,
A high-frequency treatment instrument is provided in which the electrode region is formed on the blade surface and the inclined surface for at least one of the pair of scissors.

According to the present invention, the hemostatic property of living tissue is improved.

BRIEF DESCRIPTION OF THE DRAWINGS It is a schematic diagram which shows the whole structure of the high frequency treatment tool which concerns on 1st Embodiment. FIG. 2 is a side view of the high-frequency treatment instrument knife provided at the distal end portion of the high-frequency treatment instrument according to the first embodiment, showing a state in which a pair of scissors is closed. FIG. 2 is a side view of the high-frequency treatment instrument knife provided at the distal end portion of the high-frequency treatment instrument according to the first embodiment, showing a state in which a pair of scissors is opened. FIG. 2 is a plan view of the high-frequency treatment instrument knife provided at the distal end portion of the high-frequency treatment instrument according to the first embodiment, showing a state in which a pair of scissors is closed; FIG. 5(a) is a side view showing the outer side surface of the scissors portion of the high-frequency treatment device according to the first embodiment, and FIG. 5(b) is the inner side surface ( is a side view showing a sliding contact surface). FIG. 6(a) is a plan view of the scissors portion of the high-frequency treatment device according to the first embodiment, and FIG. 6(b) is a perspective view of the scissors portion of the high-frequency treatment device according to the first embodiment. FIG. 7(a) is a perspective view of the scissors of the high-frequency treatment device according to the first embodiment as viewed from the distal end side, and FIG. It is the perspective view seen from the side. 3 is a cut end view along line AA of FIG. 2; FIG. Fig. 10 is a perspective view of the high-frequency treatment instrument knife of the high-frequency treatment instrument according to the second embodiment, viewed from the base end side; FIG. 10(a) is a plan view of the scissors portion of the high-frequency treatment device according to the third embodiment, and FIG. 10(b) is a perspective view of the scissors portion of the high-frequency treatment device according to the third embodiment.

BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, embodiments of the present invention will be described with reference to the drawings. In addition, in all the drawings, the same reference numerals are given to the same constituent elements, and the description thereof will be omitted as appropriate.
Various components of the medical high-frequency treatment device according to the present embodiment do not need to exist independently of each other. It is allowed that it is formed from the members of the .

[First embodiment]
First, a first embodiment will be described with reference to FIGS. 1 to 8. FIG.
The side views shown in FIGS. 2 and 3 show a side cross section along the center line of the portion on the proximal side of the illustrated range of the sheath 70 .
5(a), 6(a), 6(b), 7(a), and 7(b), dots are formed in the electrode formation region (electrode region 19) of the scissors portion 10. are hatched. In each of FIGS. 5(a), 6(a), 6(b), 7(a) and 7(b), the area not hatched with dots is the insulating film 12 ( non-conductive layer). However, the insulating film 12 may not be formed on the inside of the first shaft support hole 21 and the inside of the second shaft support hole 22 .

As shown in FIG. 1, a high-frequency treatment device 200 according to this embodiment is a medical high-frequency treatment device 200. As shown in FIG. The high-frequency treatment instrument 200 has a high-frequency treatment instrument knife 100 having a pair of scissors 10 and used for incising living tissue at the distal end of the high-frequency treatment instrument 200 .
The high-frequency treatment instrument 200 is used by inserting the high-frequency treatment instrument knife 100 of the high-frequency treatment instrument 200 into a forceps hole of an endoscope (not shown).

One scissors portion 10 of the pair of scissors portions 10 is called a scissors portion 10a, and the other scissors portion 10 is called a scissors portion 10b.
Each of the pair of scissors 10 is formed in a long plate shape (see FIGS. 7(a) and 7(b)).
As shown in FIGS. 2 to 4, the base ends of the pair of scissors 10 are mutually pivotally supported by a rotation shaft (shaft member 61) that intersects the direction of the plate surfaces of the scissors 10. there is
The pair of scissors 10 are configured so as to be able to shear a living tissue by rotating in a direction toward each other.
Each of the pair of scissors 10 includes a blade surface 13, a sliding contact surface 14 that is in sliding contact with each other, an outer surface 15 that is the back surface of the sliding contact surface 14, and is positioned between the outer surface 15 and the blade surface 13. and a back surface 17 opposite to the blade surface 13 .

The inclined surface 16 is inclined in a direction away from the scissors portion 10 on the other side from the side of the sliding contact surface 14 toward the side of the outer surface 15 . That is, as shown in FIG. 8, the inclined surface 16 of the scissors portion 10a is inclined downward from the sliding contact surface 14 side (left side in FIG. 8) of the scissors portion 10a toward the outer surface 15 side (right side in FIG. 8). The inclined surface 16 of the scissors portion 10b is inclined upward from the sliding contact surface 14 side (right side in FIG. 8) of the scissors portion 10b toward the outer surface 15 (left side in FIG. 8).
In other words, the inclined surface 16 is inclined from the blade surface 13 side toward the outer surface 15 side in a direction away from the scissors portion 10 on the other side. That is, as shown in FIG. 8, the slanted surface 16 of the scissors portion 10a is inclined downward from the blade surface 13 side of the scissors portion 10a toward the outer surface 15 side, and the slanted surface 16 of the scissors portion 10b is The scissors portion 10b is inclined upward from the blade surface 13 side toward the outer surface 15. - 特許庁

Each surface of the pair of scissors 10 includes a non-conductive layer (insulating coating 12) formed region and an electrode region 19 where the non-conductive layer is not formed.
At least one of the pair of scissors 10 has an electrode region 19 formed on the blade surface 13 and the inclined surface 16 . In this embodiment, electrode regions 19 are formed on the blade surface 13 and the inclined surface 16 for each of the pair of scissors 10 .

According to the high-frequency treatment instrument 200 according to this embodiment, the electrode region 19 is formed not only on the blade surface 13 but also on the inclined surface 16 of at least one of the pair of scissors 10 . Therefore, when the living tissue is incised, current can be applied to the living tissue from the electrode region 19 of the inclined surface 16 that touches the living tissue together with the blade surface 13, thereby enhancing the hemostatic property of the living tissue.

As shown in FIGS. 7(a) and 7(b), each of the pair of scissors 10 includes a base end piece 20 which is a portion on the base end side of the scissors 10 and a distal end portion of the scissors 10. and a tip piece 30 that is part of the
A first shaft support hole 21 is formed in the distal end portion of the base end piece 20 so as to pass through the base end piece 20 in the thickness direction. A common shaft member 61 (FIGS. 2 to 4) is inserted through the first shaft support holes 21 of the pair of scissors 10, and the pair of scissors 10 are supported.
The tip piece 30 is a portion of the scissors portion 10 closer to the tip side than the first shaft support hole 21 .
A second shaft support hole 22 is formed in the proximal end portion of the proximal piece 20 so as to pass through the proximal piece 20 in the thickness direction.

As shown in FIG. 1, the high-frequency treatment instrument 200 includes an elongated operation wire 68, a high-frequency treatment instrument knife 100 provided at the tip of the operation wire 68, and a flexible sheath in which the operation wire 68 is accommodated. 70, and a hand-held operation section 90 provided on the proximal side of the sheath 70 and connected to the proximal end of the operation wire 68. As shown in FIG.

The sheath 70 is an elongated tubular member that accommodates the manipulation wire 68 . In the case of this embodiment, the sheath 70 is composed of a metal coil 71 (FIGS. 2 and 3) produced by tightly winding a conductive wire such as a stainless wire. An insulating coating 72 (FIGS. 2 and 3) is provided in close contact with the outer surface of the sheath 70 . However, as the sheath 70, an insulating tubular member (tube) may be used instead of the metallic coil 71. FIG.

The hand operation unit 90 is for opening and closing the pair of scissors 10 , and is arranged on the base end side of the high-frequency treatment device 200 .
The hand operation portion 90 includes, for example, a shaft portion 95 through which the operation wire 68 is inserted, a finger ring 92 provided at the proximal end portion of the shaft portion 95, and a shaft portion in which the proximal end of the operation wire 68 is connected. A slider 93 that moves forward and backward with respect to 95 and a rotary operation part 94 are provided. The operation wire 68 is slidably inserted through the shaft portion 95 . The user inserts, for example, the thumb into the finger ring 92 , pinches the slider 93 with the other two fingers, and drives the shaft portion 95 forward and backward along the longitudinal direction. Thereby, the operation wire 68 advances or retreats with respect to the hand operation portion 90 . The base end of the sheath 70 is fixed to the hand operation portion 90 , and the operation wire 68 is inserted through the sheath 70 so as to be able to move back and forth. move forward or backward relative to As a result, as will be described later, the advance/retreat portion 67 (FIGS. 2 and 3) of the high-frequency treatment instrument knife 100 is driven to advance and retreat, and the pair of scissors 10 are opened and closed.
The axial direction of the rotating shaft of the pair of scissors 10 is the direction orthogonal to the plate surface of the scissors 10 (thickness direction of the scissors 10). Sliding surfaces 14 of the scissors 10 slide against each other.

As shown in FIG. 1 , the handheld operation unit 90 includes a power supply unit 91 . The power feeder 91 is a terminal for applying a high-frequency current to the pair of scissors 10 . A high-frequency power source (not shown) is connected to the power supply unit 91 via a power cable. The pair of scissors 10, the link pieces 65 and 66 (described later), and the retractable portion 67 (described later), which constitute the high-frequency treatment instrument knife 100, are all made of a conductive metal material. The operation wire 68 is also made of a conductive metal material. Therefore, the high-frequency current input to the power supply portion 91 is applied to the pair of scissor portions 10 .

An operation wire 68 is connected to the rotary operation portion 94 , and by rotating the rotary operation portion 94 about the shaft portion 95 , the operation wire 68 , the proximal end of which is fixed to the slider 93 , moves inside the sheath 70 . Rotate. Thereby, the high-frequency treatment instrument knife 100 can be oriented in a desired direction.
The rotary operation unit 94 is rotatably attached to the power supply unit 91, and rotates with a power cable (not shown) connecting the power supply unit 91 and a high frequency power supply (not shown) suspended downward. The operating portion 94 can be rotated around the shaft portion 95 .

Instead of this embodiment, the slider 93 may be configured to be axially rotatable around the shaft portion 95 so that the slider 93 also functions as the rotation operation portion 94 . That is, by driving the slider 93 forward and backward along the longitudinal direction of the shaft portion 95 , the operation wire 68 is moved forward and backward to open and close the knife 100 for high-frequency treatment instruments, and the slider 93 is axially rotated around the shaft portion 95 . Thus, the high-frequency treatment instrument knife 100 may be rotated and oriented in a desired direction.
Further, the rotation operation portion 94 may be provided on the shaft portion 95 so as to be rotatable with respect to the power supply portion 91 . In this case, the slider 93 may be configured to be axially rotatable around the shaft portion 95 .

As shown in FIGS. 2 to 4, the high-frequency treatment instrument knife 100 includes a pair of plate-like scissors 10, a shaft member 61 pivotally supporting the scissors 10 so that they can be opened and closed, and two links. It has pieces 65 , 66 , a retractable part 67 , and a holding frame 80 .
The axial direction of the shaft member 61 is a direction orthogonal to the planes of FIGS. 2 and 3, and is the vertical direction in FIG. The axial direction of the shaft member 61 is the direction in which the pair of scissors 10 overlap each other, in other words, the thickness direction of the pair of scissors 10 .
The pair of scissors 10 are driven to open and close by pushing and pulling the operation wire 68 . The operating wire 68 is made of a conductive metallic material such as stainless steel.

The advance/retreat portion 67 is integrally connected to the tip of the operation wire 68 with the operation wire 68 . Base end portions of two link pieces 65 and 66 are rotatably connected to the forward/backward portion 67 by a shaft member 64 . Furthermore, the proximal end piece 20 of one of the scissors portion 10 (the scissors portion 10a) is rotatably connected to the distal end portion of the link piece 65 by the shaft member 63 . That is, by inserting the shaft member 63 through the second shaft support hole 22 of one of the scissors portion 10a and the tip portion of the link piece 65, the scissors portion 10a and the link piece 65 are rotatably supported to each other. ing. Similarly, the base end piece 20 of the other scissors portion 10 (scissors portion 10b) is rotatably connected to the distal end portion of the link piece 66 by the shaft member 62 . That is, by inserting the shaft member 62 through the second shaft support hole 22 of the other scissors portion 10b and the tip portion of the link piece 66, the scissors portion 10b and the link piece 66 are rotatably supported to each other. ing.
The axial direction of each of the shaft members 62 , 63 , 64 is parallel to the axial direction of the shaft member 61 .
The pair of scissors 10 and the link pieces 65 and 66 rotate relatively within the plane shown in FIGS. 2 and 3 (the plane perpendicular to the axial direction of the shaft member 61).
A rhombic four-bar link is formed by the base end pieces 20 of the pair of scissors 10 and the link pieces 65 and 66 .
The shaft members 62 and 63 are located on the tip side of the shaft member 64 , and the shaft member 61 is located on the tip side of the shaft members 62 and 63 .

As shown in FIGS. 7A and 7B, a stepped portion 23 is formed on the outer surface of the base end piece 20 . A portion of the proximal end piece 20 on the proximal side of the stepped portion 23 is thinner than a portion of the proximal end piece 20 on the distal side of the stepped portion 23 .
As shown in FIG. 4, the difference in thickness between the portion of the base end piece 20 on the base end side and the portion on the tip side of the stepped portion 23 is set to be slightly larger than the thickness of the link pieces 65 and 66. or is set equal to the thickness of the link pieces 65 and 66 .

A holding frame 80 is fixed to the distal end of the sheath 70 .
The holding frame 80 includes a proximal end portion 81 fixed to the distal end of the sheath 70 and a pair of brackets 82 protruding from the proximal end portion 81 to the distal side.
Each of the pair of brackets 82 is formed in a plate shape, for example.
The pair of scissors 10 are pivotally supported by shaft members 61 with respect to the tip portions of the pair of brackets 82 . That is, the shaft member 61 is inserted through the first shaft support holes 21 of the base end pieces 20 of the pair of scissors 10 and the pair of brackets 82, whereby the base end pieces 20 of the pair of scissors 10 are It is pivotally supported by a pair of brackets 82 .
In the gap between the pair of brackets 82, the base end pieces 20 of the pair of scissors 10 and the link pieces 65 and 66 are rotatable, respectively, and the portion protruding from the sheath 70 to the distal side in the advancing/retracting portion 67. can advance and retreat.
Further, either the bracket 82 is rotatable relative to the proximal end 81 about the axis of the sheath 70 or the bracket 82 is rotatable relative to the sheath 70 about the axis of the sheath 70 .

As shown in FIG. 2, when the operation wire 68 and the retractable portion 67 are pulled toward the base end side (to the right in FIG. 2), the pair of scissor portions 10 are closed. Conversely, as shown in FIG. 3, when the operation wire 68 and the advance/retreat portion 67 are pushed forward (to the left in FIG. 3), the pair of scissors 10 are opened.

An insulating coating 12 (non-conductive layer) is formed on the surface of each of the pair of scissors 10 . The insulating coating 12 is formed at least on the entire surface of the tip piece 30 excluding the area where the electrode area 19 is formed.
The insulating film 12 is made of an insulating material such as fluororesin, polyetheretherketone (PEEK), diamond-like carbon (DLC), or a ceramic material (a ceramic material such as titanium oxide or silicon). can be formed by coating the surface of the scissors portion 10.
The electrode region 19 is a linear portion of the tip piece 30 where the insulating coating 12 is not formed. The pair of scissors 10 is applied with a high-frequency voltage of the same phase from the feeding section 91 and becomes a monopolar type high-frequency electrode. By applying a high-frequency current to the pair of scissors 10 while the living tissue is gripped by the pair of scissors 10, the living tissue is cauterized and incised. Instead of this embodiment, a bipolar high-frequency treatment instrument 200 may be used in which one of the pair of scissors 10 is an active electrode and the other is a return electrode.

The shape of the pair of scissors 10 may be the same or different. In this embodiment, the pair of scissors 10 have the same shape.
The details of the shape of the scissors portion 10 will be described below with reference to FIGS.

As described above, the scissors portion 10 includes the blade surface 13, the sliding contact surface 14, the outer surface 15 that is the back surface of the sliding contact surface 14, and the slope positioned between the outer surface 15 and the blade surface 13. surface 16 (see FIG. 8).
The sliding contact surface 14 and the outer surface 15 are arranged parallel to each other, for example.
In the case of this embodiment, the blade surface 13 is orthogonal to both the sliding contact surface 14 and the outer surface 15, for example. That is, the blade surface 13 is arranged parallel to the axial direction of the shaft member 61 that is the rotating shaft of the scissors portion 10 .
The inclined surface 16 is inclined with respect to both the blade surface 13 and the outer surface 15 .
In this embodiment, the inclined surface 16 includes a first inclined surface 161 located on the outer surface 15 side and a second inclined surface 162 located on the blade surface 13 side.
The angle formed by the blade surface 13 and the first inclined surface 161 is larger than the angle formed by the blade surface 13 and the first inclined surface 161 . Also, the angle formed between the outer surface 15 and the first inclined surface 161 is larger than the angle formed between the outer surface 15 and the second inclined surface 162 .

A distal claw portion 40 is formed at the distal end portion of the distal piece 30 of the scissors portion 10 (the left end portion of the distal piece 30 in FIG. 5A). The distal claw portion 40 protrudes in the closing direction. The closing direction is the direction from one scissor portion 10 to the other scissor portion 10b, and the opposite direction is called the opening direction. The tip claw portion 40 protrudes upward in FIG. 5(a).
The distal claw portion 40 is a projection that digs into living tissue.
Along the edge of the tip piece 30 on the proximal side (right side in FIG. 5(a)) of the tip piece 30 (on the right side in FIG. 5(a)), that is, along the upper edge of the tip piece 30 in FIG. 5(a) A blade surface 13 is formed at the end.
In a state in which the living tissue is clamped by the tip claws 40 of the pair of scissors 10 to prevent the living tissue from falling off, the blade surfaces 13 of the pair of scissors 10 can shear and incise the living tissue. ing.

In the case of this embodiment, as shown in FIG. 5(a), the scissors 10 have an intermediate protrusion 51 that protrudes toward the other scissors 10 at an intermediate portion in the longitudinal direction of the scissors 10; Concave portions 55 and 56 are arranged adjacent to the proximal end side and the distal end side of the intermediate projection portion 51 respectively in the longitudinal direction of the scissors portion 10 and recessed toward the side away from the other scissors portion. . A portion adjacent to the proximal side of the concave portion 55 on the proximal side and having a higher step than the concave portion 55 is referred to as a proximal side high step portion 58 .
At the edge of the distal end piece 30 in the closing direction, the distal claw portion 40, the concave portion 56, the intermediate projection portion 51, the concave portion 55, and the base end side high step portion 58 are arranged in this order from the distal end side of the distal end piece 30. .

The blade surface 13 includes the top surface 52 of the intermediate protrusion 51 and the surfaces of the recesses 55 and 56 . More specifically, in the case of this embodiment, the blade surface 13 is formed continuously over the recess 56 , the intermediate protrusion 51 and the recess 55 .
An electrode region 19 is formed over the entire area of the blade surface 13 (the surface of the recess 55, the top surface 52 of the intermediate protrusion 51, and the entire surface of the recess 56).

Each of the distal claw portion 40 , the recessed portion 56 , the intermediate protruding portion 51 , the recessed portion 55 and the base end side high stepped portion 58 has a predetermined width in the thickness direction of the scissors portion 10 .
For example, the width dimension in the thickness direction of the scissors portion 10 is substantially constant in the range covering the tip claw portion 40, the recessed portion 56, the intermediate projection portion 51, and the recessed portion 55 (FIGS. 6A and 6B). reference).
Each of the recessed portion 56 and the recessed portion 55 is elongated in the tip-base end direction of the tip piece 30 (horizontal direction in FIG. 6A).

The blade surface 13 is formed flat on the bottom surface of the recess 55, the bottom surface of the recess 56, and the top surface 52 of the intermediate protrusion 51, for example. The bottom surface of the recess 55, the bottom surface of the recess 56, and the top surface 52 of the intermediate protrusion 51 are arranged substantially parallel to each other, for example. The bottom surface of the recessed portion 56 and the bottom surface of the recessed portion 55 extend in the tip-basal direction of the tip piece 30 .

Further, an electrode region 19 is also formed on the inclined surface 16 between the recess 56 and the outer side surface 15 (see FIGS. 6(a) to 7(b)). That is, the electrode region 19 is formed on the inclined surface 16 between the recess 56 closer to the distal end of the scissors 10 than the intermediate protrusion 51 and the outer surface 15 .
More specifically, for example, of the inclined surface 16 between the recessed portion 56 and the outer side surface 15, the electrode region is formed on a portion (portion on the recessed portion 56 side) of the second inclined surface 162 on the recessed portion 56 side (on the blade surface 13 side). 19 is formed.

Moreover, in the case of this embodiment, the electrode region 19 is formed continuously over the blade surface 13 and the inclined surface 16 .
The electrode regions 19 of the second inclined surface 162 between the recess 56 and the outer side surface 15 are arranged continuously over the entire length of the recess 56 .

On the other hand, the electrode region 19 is not formed on the inclined surface 16 between the recess 55 and the outer side surface 15 .
That is, between the inclined surface 16 closer to the distal end of the scissors 10 than the top surface 52 of the intermediate protrusion 51 and the inclined surface 16 closer to the proximal end of the scissors 10 than the top surface 52 of the intermediate protrusion 51, An electrode region 19 is selectively formed on the inclined surface 16 closer to the tip of the scissors 10 than the top surface 52 of the protrusion 51 .
Since the part closer to the tip side of the scissors part 10 gets under the mucous membrane when resecting the living tissue and is used for the resection, the effect of increasing the current flowing from the electrode region 19 to the living tissue and enhancing the hemostatic property is further desired. It is possible to satisfy the request for the circumstances where it is possible.

The second inclined surface 162 is formed, for example, between the recess 56 and the outer surface 15 and between the recess 55 and the outer surface 15, and between the top surface 52 and the outer surface 15. not formed. That is, for example, only the first inclined surface 161 is formed between the top surface 52 and the outer side surface 15 .
On the other hand, the first inclined surface 161 exists continuously between the recess 56 and the outer surface 15, between the top surface 52 and the outer surface 15, and between the recess 55 and the outer surface 15. there is

Also, the insulating film 12 is formed on the inclined surface 16 on the side surface of the intermediate protrusion 51 on the side of the outer surface 15, and the electrode region 19 is not formed.
That is, the inclined surface 16 is also formed on the intermediate projection 51, the non-conductive layer (insulating film 12) is formed on the inclined surface 16 of the intermediate projection 51, and the electrode region 19 is not formed. It has become.

Further, for example, the insulating coating 12 is also formed on the tip surface 42 of the tip claw portion 40 facing the tip side, the top surface 43 of the tip claw portion 40, and the side surface of the tip claw portion 40, respectively. The electrode regions 19 are not formed on the tip surface 42 , the top surface 43 and the side surfaces of the claw portion 40 .
On the other hand, the insulating film 12 is not formed on the base end surface 41, which is the surface facing the base end side of the distal claw portion 40, and the electrode region 19 is formed. The electrode region 19 of the base end surface 41 is continuous with the electrode region 19 of the recess 56 (see FIG. 7B).

A stopper portion 11 is formed on at least one scissors portion 10 of the pair of scissors portions 10 . The closing operation of the pair of scissors 10 is restricted by the contact of the stopper 11 with the blade surface 13 of the other scissors 10 .
In the case of this embodiment, a stopper portion 11 is formed on each of the pair of scissors portion 10, and the stopper portion 11 of the scissors portion 10a abuts on the blade surface 13 of the scissors portion 10b, and the stopper portion 11 of the scissors portion 10b contact with the blade surface 13 of the scissors 10a, the closing operation of the pair of scissors 10 is restricted.

The stopper portion 11 is formed on the sliding contact surface 14 of the scissors portion 10 as shown in FIG. 5B. A portion of the stopper portion 11 facing the scissors portion 10 is a flat surface 11a.
The stopper portion 11 is arranged, for example, at an intermediate portion in the longitudinal direction of the concave portion 55 .
The flat surface 11a is arranged flush with the bottom surface of the recess 55, for example. When the pair of scissors 10 are closed, the flat surface 11a comes into surface contact with the bottom surface of the concave portion 55 of the other scissors 10, thereby restricting the pair of scissors 10 from closing.
For example, the insulating film 12 is not formed on the flat surface 11 a as well, and the flat surface 11 a is also part of the electrode region 19 .

The flat surface 11 a of the stopper portion 11 is not included in the blade surface 13 .
The base end surface 41 of the distal claw portion 40 , the surface of the recess 56 , the top surface 52 of the intermediate protrusion 51 , the surface of the recess 55 , a portion of the second inclined surface 162 between the recess 56 and the outer surface 15 , and the stopper portion 11 . An insulating coating 12 is formed on the entire surface of the tip piece 30 except for the flat surface 11a.
It is assumed that the tip-side inclined surface of the intermediate protrusion 51 is part of the surface of the recess 56 , and the proximal-side inclined surface of the intermediate protrusion 51 is part of the surface of the recess 55 .

According to the first embodiment as described above, for at least one of the pair of scissors 10 , the electrode region 19 is formed not only on the blade surface 13 but also on the inclined surface 16 . Therefore, when the living tissue is incised, current can be applied to the living tissue from the electrode region 19 of the inclined surface 16 that touches the living tissue together with the blade surface 13, thereby enhancing the hemostatic property of the living tissue.
Moreover, since the outer surface 15, which is likely to come into contact with living tissue, is covered with the insulating film 12, the outer surface 15 is sufficiently insulated, and it is preferable that the living tissue is not accidentally cauterized by the outer surface 15. can be suppressed to

[Second embodiment]
Next, a second embodiment will be described with reference to FIG.
The high-frequency treatment device according to this embodiment differs from the high-frequency treatment device 200 according to the above-described first embodiment in the points described below. It is configured in the same manner as the tool 200 .
In FIG. 9, an electrode forming region (electrode region 19) in the scissors portion 10 is hatched in dots. In FIG. 9, the area not hatched with dots in the scissors portion 10 is the formation area of the insulating film 12 (non-conductive layer). However, the insulating film 12 may not be formed inside the first shaft support hole 21 .

As shown in FIG. 9, in the case of the present embodiment, the inclined surface 16 on the tip end side of the scissors portion 10 relative to the top surface 52 of the intermediate projection portion 51 and the base of the scissors portion 10 relative to the top surface 52 of the intermediate projection portion 51 An electrode region 19 is formed on both the inclined surface 16 on the end side.
More specifically, not only is the electrode region 19 formed on the second slanted surface 162 between the recess 56 and the outer surface 15 , but also on the second slanted surface 162 between the recess 55 and the outer surface 15 . An electrode region 19 is formed.

[Third embodiment]
Next, 3rd Embodiment is described using Fig.10 (a) and FIG.10(b).
The high-frequency treatment device according to this embodiment differs from the high-frequency treatment device 200 according to the above-described first embodiment in the points described below. It is configured in the same manner as the tool 200 .
In each of FIGS. 10(a) and 10(b), an electrode formation region (electrode region 19) in the scissors portion 10 is hatched in dots. In each of FIGS. 10(a) and 10(b), the areas of the scissors 10 that are not hatched with dots are areas where the insulating coating 12 (non-conductive layer) is formed. However, the insulating film 12 may not be formed inside the first shaft support hole 21 .

As shown in FIG. 10A, in the case of this embodiment, the width dimension of the electrode region 19 on the inclined surface 16 becomes wider toward the distal end side of the scissors portion 10 . The width dimension of the electrode region 19 is the width dimension of the electrode region 19 in the direction parallel to the rotation axis of the scissors portion 10 (the width dimension of the electrode region 19 in the thickness direction of the scissors portion 10).

More specifically, as shown in FIGS. 10(a) and 10(b), not only is the electrode region 19 formed on the second inclined surface 162 between the recess 56 and the outer surface 15, but also the top surface 19 is formed. The electrode regions 19 are also formed on the inclined surface 16 (first inclined surface 161 ) between the surface 52 and the outer side surface 15 and on the second inclined surface 162 between the concave portion 55 and the outer side surface 15 .

Although each embodiment has been described above with reference to the drawings, these are examples of the present invention, and various configurations other than those described above can be adopted.

For example, in each of the above-described embodiments, an example in which the electrode region 19 is formed continuously over the blade surface 13 and the inclined surface 16 has been described, but the present invention is not limited to this example, and the blade surface The electrode regions 19 of 13 and the electrode regions 19 of the inclined surface 16 may be arranged discontinuously.

Moreover, each of the above-described embodiments can be appropriately combined without departing from the gist of the present invention.

This embodiment includes the following technical ideas.
(1) A medical high-frequency treatment instrument having a knife for high-frequency treatment instruments having a pair of scissors and used for incising living tissue at the distal end thereof,
Each of the pair of scissors is formed in a long plate shape,
base ends of the pair of scissors are mutually supported by a rotation shaft that intersects the plate surface direction of the scissors;
The pair of scissors is configured to be able to shear the living tissue by rotating in a direction toward each other,
Each of the pair of scissors includes a blade surface, a sliding contact surface that is in sliding contact with each other, an outer surface that is the back surface of the sliding contact surface, and an inclined surface that is positioned between the outer surface and the blade surface. and
the inclined surface is inclined from the sliding contact surface side toward the outer side surface side in a direction away from the other scissor portion,
Each surface of the pair of scissors includes a non-conductive layer formation region and an electrode region where the non-conductive layer is not formed,
A high-frequency treatment instrument, wherein the electrode region is formed on the blade surface and the inclined surface of at least one of the pair of scissors.
(2) The high-frequency treatment instrument according to (1), wherein the electrode region is formed continuously over the blade surface and the inclined surface.
(3) The scissors part
an intermediate protruding portion protruding toward the other scissors portion at an intermediate portion in the longitudinal direction of the scissors portion;
recesses arranged adjacent to the base end side and the tip end side of the intermediate projection in the longitudinal direction of the scissors, respectively, and recessed toward the side away from the other scissors;
has
The blade surface includes the top surface of the intermediate protrusion and the surface of the recess,
The high-frequency treatment according to (1) or (2), wherein the electrode region is formed on the inclined surface between the recess on the distal end side of the scissors portion relative to the intermediate protrusion and the outer surface. equipment.
(4) Of the inclined surface on the tip end side of the scissors portion relative to the top surface of the intermediate projection portion and the inclined surface on the base end side of the scissors portion relative to the top surface of the intermediate projection portion, The high-frequency treatment instrument according to (3), wherein the electrode region is selectively formed on the inclined surface closer to the distal end of the scissors than the top surface of the intermediate protrusion.
(5) Both the inclined surface on the tip side of the scissors from the top surface of the intermediate protrusion and the inclined surface on the base end side of the scissors from the top surface of the intermediate protrusion. The high-frequency treatment instrument according to (3), in which an electrode region is formed.
(6) The inclined surface is also formed on the intermediate protrusion,
The high-frequency treatment instrument according to any one of (3) to (5), wherein the non-conductive layer is formed on the inclined surface of the intermediate protrusion, and the electrode region is not formed. .
(7) The high-frequency treatment instrument according to any one of (1) to (6), wherein the width dimension of the electrode region on the inclined surface increases toward the distal end of the scissors.

10, 10a, 10b scissors portion 11 stopper portion 11a flat surface 12 insulating film (non-conductive layer)
13 Blade surface 14 Sliding surface 15 Outer surface 16 Inclined surface 161 First inclined surface 162 Second inclined surface 17 Back surface 19 Electrode region 20 Base end piece 21 First shaft support hole 22 Second shaft support hole 23 Stepped portion 30 Tip piece 40 Tip claw portion 41 Base end face 42 Tip face 43 Protruding direction edge 51 Intermediate protrusion 52 Top face 55 Recess 56 Recess 58 Base end high stepped portions 61, 62, 63, 64 Shaft members 65, 66 Link piece 67 Retraction portion 68 Operation wire 70 Sheath 71 Coil 72 Insulating coating 80 Holding frame 81 Base end 82 Bracket 90 Hand operation unit (operation unit)
91 Power supply part 92 Finger ring 93 Slider 94 Rotation operation part 95 Shaft part 100 Knife 200 for high-frequency treatment instrument High-frequency treatment instrument

Claims (6)

A medical high-frequency treatment instrument having a high-frequency treatment instrument knife having a pair of scissors and used for incising living tissue at the tip,
Each of the pair of scissors is formed in a long plate shape,
base ends of the pair of scissors are mutually supported by a rotation shaft that intersects the plate surface direction of the scissors;
The pair of scissors is configured to be able to shear the living tissue by rotating in a direction toward each other,
Each of the pair of scissors includes a blade surface, a sliding contact surface that is in sliding contact with each other, an outer surface that is the back surface of the sliding contact surface, and an inclined surface that is positioned between the outer surface and the blade surface. and
the inclined surface is inclined from the sliding contact surface side toward the outer side surface side in a direction away from the other scissor portion,
Each surface of the pair of scissors includes a non-conductive layer formation region and an electrode region where the non-conductive layer is not formed,
For at least one of the pair of scissors, the electrode region is formed on the blade surface and the inclined surface ,
The scissors part
an intermediate protruding portion protruding toward the other scissors portion at an intermediate portion in the longitudinal direction of the scissors portion;
recesses arranged adjacent to the base end side and the tip end side of the intermediate projection in the longitudinal direction of the scissors, respectively, and recessed toward the side away from the other scissors;
has
The blade surface includes the top surface of the intermediate protrusion and the surface of the recess,
The electrode region is formed on the inclined surface between the recess on the distal end side of the scissors portion relative to the intermediate protrusion and the outer surface,
The inclined surface is also formed on the intermediate protrusion,
The high-frequency treatment instrument , wherein the non-conductive layer is formed on the inclined surface of the intermediate protrusion, and the electrode region is not formed . A medical high-frequency treatment instrument having a high-frequency treatment instrument knife having a pair of scissors and used for incising living tissue at the tip,
Each of the pair of scissors is formed in a long plate shape,
base ends of the pair of scissors are mutually supported by a rotation shaft that intersects the plate surface direction of the scissors;
The pair of scissors is configured to be able to shear the living tissue by rotating in a direction toward each other,
Each of the pair of scissors includes a blade surface, a sliding contact surface that is in sliding contact with each other, an outer surface that is the back surface of the sliding contact surface, and an inclined surface that is positioned between the outer surface and the blade surface. and
the inclined surface is inclined from the sliding contact surface side toward the outer side surface side in a direction away from the other scissor portion,
Each surface of the pair of scissors includes a non-conductive layer formation region and an electrode region where the non-conductive layer is not formed,
For at least one of the pair of scissors, the electrode region is formed on the blade surface and the inclined surface,
The high- frequency treatment instrument, wherein the width dimension of the electrode region on the inclined surface is wider toward the distal end side of the scissors. The scissors part
an intermediate protruding portion protruding toward the other scissors portion at an intermediate portion in the longitudinal direction of the scissors portion;
recesses arranged adjacent to the base end side and the tip end side of the intermediate projection in the longitudinal direction of the scissors, respectively, and recessed toward the side away from the other scissors;
has
The blade surface includes the top surface of the intermediate protrusion and the surface of the recess,
3. The high-frequency treatment instrument according to claim 2 , wherein the electrode region is formed on the inclined surface between the recess on the distal end side of the scissors portion relative to the intermediate protrusion and the outer surface. Of the inclined surface on the tip end side of the scissors portion relative to the top surface of the intermediate projection portion and the inclined surface on the base end side of the scissors portion relative to the top surface of the intermediate projection portion, the intermediate projection portion 4. The high-frequency treatment instrument according to claim 1 , wherein the electrode region is selectively formed on the inclined surface closer to the distal end of the scissors than the top surface of the. The electrode regions are provided on both the inclined surface on the tip side of the scissors with respect to the top surface of the intermediate protrusion and the inclined surface on the base end side of the scissors with respect to the top surface of the intermediate protrusion. The high-frequency treatment instrument according to claim 1 or 3 , which is formed. The high-frequency treatment instrument according to any one of claims 1 to 5 , wherein the electrode region is formed continuously over the blade surface and the inclined surface.

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