JP7443171B2 - cutting edge device - Google Patents

Description

TECHNICAL FIELD The present invention relates to advanced devices.

Patent Document 1 discloses a hemostatic device that includes a plurality of hemostatic elements, particularly for actively stopping bleeding after open thoracotomy, laparoscopic or endoscopic surgery on a patient. This hemostasis device consists of a thermal coagulation hemostasis device for tissue coagulation, which uses a coagulation electrode to generate a temperature higher than the coagulation temperature of biological tissue, and a biochemical hemostatic device, in which an insulating device is placed between the discharge electrode and the tissue to be treated. and a delivery device for delivering a procoagulant to the tissue to be treated.

Special Publication No. 2013-544122

In the hemostasis device of Patent Document 1, the tube is arranged so that gas flows in the same direction as the longitudinal direction of the discharge electrode that acts on living tissue, and the direction of the irradiated plasma is regulated in the same direction as the longitudinal direction of the discharge electrode. Therefore, plasma could not be irradiated from the vicinity of the discharge electrode in a direction different from the longitudinal direction (a direction intersecting the longitudinal direction). In addition, in the hemostatic device of Patent Document 1, when the plasma discharge port is located far away from the discharge electrode toward the rear end, a portion of the plasma discharged from the discharge port reaches the vicinity of the discharge electrode and the living tissue. There was also concern that the plasma would not reach the target level, and there was room for improvement in terms of stable plasma supply.

The present invention has been made to solve at least a part of the above-mentioned problems, and it is possible to irradiate plasma in a direction intersecting the longitudinal direction of an action member, and to achieve an action that acts on living tissue. The purpose of the present invention is to provide an advanced device that can stably supply plasma to the vicinity of the tip.

The advanced device that is one of the present inventions is
an action member that extends in the longitudinal direction and has an action part that acts on living tissue on its distal end side;
A gas guide path including a flow path through which gas flows and a discharge port provided at an end of the flow path and discharges gas to the acting portion side via the discharge port, a first electrode and a second electrode. a plasma irradiation device comprising: a discharge section that generates plasma discharge within the gas guide path;
has
A tip device in which the action portion is provided outside the discharge port,
The discharge port is provided around the action portion and discharges gas at least in a direction intersecting the longitudinal direction.

In the tip device, a discharge port is arranged around the working part so as to discharge gas in a direction intersecting the longitudinal direction of the working member. Therefore, the above-mentioned tip device can irradiate plasma in a direction crossing the longitudinal direction of the action member, and stably irradiates the plasma near the action part that acts on the living tissue from the discharge port provided around the action part. Plasma can be supplied directly.

In the above-mentioned tip device, the acting part may include a first acting part that acts on living tissue and a second acting part that acts on living tissue, and the acting member controls the first acting part of itself. It may include a first action member provided on its distal end side, and a second action member provided with a second action portion on its distal end side. Further, this tip device includes a first action member and a second action member, and the first action part and the second action part are configured to be able to approach and separate from each other, and the first action part and the second action part are It may also include a gripping instrument that grips the living tissue by sandwiching it therebetween. The direction in which the first action part and the second action part approach and separate may be the above-mentioned "direction intersecting the longitudinal direction".
This tip device is capable of gripping living tissue by sandwiching it between two action members, and is capable of irradiating plasma in a direction crossing the longitudinal direction of the action members, and has an action part that acts on the living tissue. Plasma can be stably supplied to the vicinity. Moreover, since the direction in which the plasma is irradiated from the discharge port (i.e., the above-mentioned "direction intersecting the longitudinal direction") is the direction in which the first action part and the second action part approach and separate, the biological tissue is Plasma irradiation can be performed near the pinching portion along the direction of the pinching motion.

In the above-mentioned tip device, the plasma irradiation device may be attached to either the first action section or the second action section. A discharge port may be disposed on at least one side of the object to be attached in the longitudinal direction and the orthogonal direction perpendicular to the direction intersecting the longitudinal direction.
In this tip device, the discharge port can be arranged in a manner that does not easily interfere with the approaching/separating movements of the first action section and the second action section. This makes it easier to stably supply plasma to a wider range from a position that avoids the action area.

In the above-mentioned tip device, the opening width of the discharge port in the longitudinal direction may be larger than the opening width in the orthogonal direction that is orthogonal to the longitudinal direction and the intersecting direction.
In this tip device, since the opening of the discharge port extends in the longitudinal direction of the action member, plasma can be irradiated over a wider range in the longitudinal direction of the action member.

In the above-mentioned tip device, a plurality of discharge ports may be arranged in a longitudinal direction around the working part.
In this tip device, since the plurality of discharge ports are lined up in the longitudinal direction of the action member, plasma can be irradiated over a wider range in the longitudinal direction of the action member.

In the above-mentioned tip device, the plasma irradiation device may have a diameter-reducing portion whose outer surface shape is reduced toward the emission port. The reduced diameter portion may be arranged around the action portion.
This tip device has a configuration in which the reduced diameter part is arranged around the action part, so that the discharge port can be arranged near the action part, which has a large space restriction, and has a large advantage in terms of space. Furthermore, if the size is reduced by providing a part that reduces in diameter toward the discharge port, even if the discharge port is provided near the action part, it will be easier to work (especially if the part near the action part does not act on living tissue). It is possible to suppress the decline in workability (when performing detailed work).

According to the present invention, plasma can be irradiated in a direction intersecting the longitudinal direction of the action member, and plasma can be stably supplied to the vicinity of the action portion that acts on living tissue.

FIG. 1 is a schematic diagram schematically showing a tip device according to a first embodiment and a surgical apparatus including the tip device. FIG. 2 is a perspective view conceptually showing the structure of the plasma irradiation device in the advanced device of the first embodiment. FIG. 3 is an exploded perspective view conceptually showing a configuration in which the structure shown in FIG. 2 is divided into three parts. FIG. 4 is a cross-sectional schematic diagram schematically showing a cross-sectional configuration of a cut surface of the structure shown in FIG. 2 cut at the center position in the third direction (width direction) in a direction perpendicular to the third direction. FIG. 5 is a schematic cross-sectional view schematically showing a cross-sectional configuration of a cut surface obtained by cutting the structure of FIG. 2 at the center position in the second direction (thickness direction) in a direction perpendicular to the second direction. FIG. 6 is a cross-sectional schematic diagram schematically showing the cross-sectional configuration of a cut surface obtained by cutting the structure of FIG. 2 in a direction perpendicular to the first direction at the AA position (position of the creeping discharge part) in FIG. be. FIG. 7 is an enlarged view conceptually showing a part of the vicinity of the action part in the tip device of the first embodiment. FIG. 8 is a perspective view schematically showing the configuration of the vicinity of the action section of the tip device of the first embodiment. FIG. 9 is a schematic diagram schematically showing a tip device of a second embodiment and a surgical apparatus including the tip device. FIG. 10 is a perspective view schematically showing the configuration near the action section of the tip device of the third embodiment. FIG. 11 is a perspective view conceptually showing the structure of the plasma irradiation device in the advanced device of the fourth embodiment. FIG. 12 is a cross-sectional schematic diagram schematically showing a cross-sectional configuration of a cut surface of the structure shown in FIG. 11 cut at the center position in the second direction (thickness direction) in a direction orthogonal to the second direction. FIG. 13 is a perspective view schematically showing the configuration near the action section of the tip device of the fifth embodiment. FIG. 14 is a perspective view conceptually showing the structure of the plasma irradiation device in the advanced device of the fifth embodiment. FIG. 15 is a cross-sectional schematic diagram illustrating a structure used in a tip device (first example) of another embodiment, in which the center position in the second direction (thickness direction) is different from that in FIG. 12. FIG. 3 is a schematic cross-sectional view schematically showing a cross-sectional configuration of a cut surface taken in a direction perpendicular to the second direction. FIG. 16 is an explanatory diagram schematically illustrating the vicinity of the second action part in the tip device (second example) of another embodiment. FIG. 17 is an explanatory diagram schematically illustrating the vicinity of the action part in the tip device (third example) of another embodiment. FIG. 18 is an explanatory diagram schematically illustrating the vicinity of the action part in the tip device (fourth example) of another embodiment.

<First embodiment>
1-1. Overview of Surgical Apparatus The surgical apparatus 1 shown in FIG. 1 is configured as a treatment apparatus that can perform incision, ablation, or hemostasis on a living tissue to be treated. The surgical apparatus 1 supplies gas to the tip device 3, a control device 5 that is a device that controls the ultrasonic vibrating section 12 (drive section), and a gas guide path 30 (FIG. 4) in the tip device 3. and a power supply device 9 capable of applying voltage to the plasma irradiation device 20.

The control device 5 is a device that provides an electric signal to the ultrasonic vibrating section 12 to generate ultrasonic vibrations. The control device 5 is configured to be able to give an electrical signal to the ultrasonic vibrating section 12 via a flexible signal cable (not shown) interposed between the tip device 3 and the control device 5 .

The gas supply device 7 is a device that supplies an inert gas (hereinafter also simply referred to as gas) such as helium gas or argon gas. For example, the gas supply device 7 supplies an inert gas to a gas guide path 30 (described later) via a flexible ventilation member (not shown in FIG. 1) interposed between the tip device 3 and the gas supply device 7. supply The gas supply device 7 includes, for example, a regulator that reduces the pressure of high-pressure gas supplied from a cylinder or the like, and a control section that controls the flow rate.

The power supply device 9 is a device that supplies power to the high frequency voltage generation circuit 11, and is a circuit including a step-up transformer and the like. In FIG. 1, illustration of flexible wiring (such as a power line) interposed between the tip device 3 and the power supply device 9 is omitted. The high-frequency voltage generating circuit 11 is a device that applies a desired voltage between a discharge electrode 42 (FIG. 4) and a ground electrode 44 (FIG. 4), which will be described later. An alternating current voltage of a predetermined frequency is applied between the ground electrode 42 and the ground electrode 44 . The high-frequency voltage generation circuit 11 may employ various known circuits as long as they can generate a high voltage (for example, a high voltage with an amplitude of 0.5 kV to 10 kV) at a high frequency (for example, about 20 kHz to 300 kHz). It is possible. Note that the frequency of the high voltage generated by the high frequency voltage generation circuit 11 may be fixed to a constant value or may be varied. Further, the voltage applied between the ground electrode 44 and the discharge electrode 42 by the high-frequency voltage generation circuit 11 may be a voltage that changes periodically, may be a sinusoidal alternating current voltage, or may be a non-sinusoidal voltage ( For example, it may be an alternating current voltage with a rectangular wave, a triangular wave, etc. In addition, in FIG. 1, illustration of the wiring between the high frequency voltage generation circuit 11, the discharge electrode 42, and the ground electrode 44 is omitted.

In FIG. 1, the tip device 3 and the surgical apparatus 1 are illustrated in which the high frequency voltage generation circuit 11 is provided inside the case body 14, but the high frequency voltage generation circuit 11 is provided outside the case body 14 (for example, the tip device 3).

The tip device 3 is a device that is held and used by an operator who performs surgery, and mainly includes a case body 14, a gripping instrument 15, a plasma irradiation device 20, an ultrasonic vibrating section 12, and the like. The case body 14, the gripping device 15, the plasma irradiation device 20, and the ultrasonic vibrating unit 12 are integrally configured as a gripping unit that is gripped by the user, and is connected to an inert gas via a flexible member. and electricity are being supplied.

The case body 14 has a cylindrical shape and extends in a predetermined direction, and mainly includes a base portion 14B and a cylindrical extension portion 14A that is integrally formed with the base portion 14B and extends in a predetermined direction. The ultrasonic vibrator 12 and the like are housed inside the base 14B.

The ultrasonic vibrating section 12 is configured as a known ultrasonic vibrator, and is driven to generate ultrasonic vibration when a predetermined electric signal is applied by the above-mentioned control device 5. It operates to transmit ultrasonic vibrations to. The ultrasonic vibrating section 12 corresponds to an example of a driving section, and drives the first action member 16 so that an action of incising, exfoliating, or thermocoagulating hemostasis on living tissue occurs near the first action section 16A.

The grip part 60 is a part to be gripped by the user who uses the tip device 3, and is configured as a movable member displacement mechanism employing a known movable mechanism. The gripping part 60 includes a fixed gripping part 62 fixed to the base 14B of the case body 14 and integrated with the case body 14, and a shaft-shaped second action member 64 attached to the fixed gripping part 62 so as to be movable relative to the fixed gripping part 62. It is composed of.

The grasping instrument 15 is an instrument that can be used to sandwich and grasp living tissue, and includes a first action member 16 and a second action member 64.

The first acting member 16 is a shaft-shaped member extending in the longitudinal direction, and is a member that includes a first acting portion 16A that acts on living tissue on its distal end side. The first action portion 16A is a portion near the tip of the first action member 16 that functions as a fixed blade. The first action member 16 has a first action part 16A and a shaft part 16B that transmits the vibration given from the ultrasonic vibration part 12 to the first action part 16A, and the vibration generated in the ultrasonic vibration part 12. is transmitted to the first action section 16A via the shaft portion 16B, thereby causing the first action section 16A to vibrate. The first action member 16 causes a cutting action, a peeling action, or a hemostasis action on the living tissue by vibrating the first action member 16A while the first action member 16A approaches or is in contact with the living tissue. It works like this.

The second action member 64 is a shaft-shaped member that functions as a movable member and extends in the longitudinal direction. The second acting member 64 is a member that includes a second acting portion 64A that acts on living tissue on its distal end side (one end side). The second action part 64A is a part that functions as a movable blade. The second action member 64 includes a movable grip portion 64C near its rear end side (other end side). In the gripping instrument 15, the shaft-shaped second action member 64 is rotatable around a rotation axis Z near the tip of the extension part 14A, and the first action part 16A and the second action part 64A are brought close to each other. and can be freely separated. The gripping device 15 is configured such that the second action portion 64A (movable blade) approaches the first action portion 16A (fixed blade) in response to an operation to bring the movable grip portion 64C closer to the fixed grip portion 62 side. The second action member 64 rotates. Conversely, in response to an operation to separate the movable grip portion 64C from the fixed grip portion 62, the second action member 64 rotates so that the second action portion 64A separates from the first action portion 16A. .

The distal end device 3 configured in this manner can perform incision, ablation, and hemostasis on living tissue using ultrasonic vibration. For example, when living tissue is sandwiched between the first acting part 16A (fixed blade) and the second acting part 64A, the living tissue can be excised by transmitting ultrasonic vibrations to the first acting part 16A. . In addition, it is also possible to bring the first action section 16A, through which ultrasonic vibrations are transmitted, into contact with living tissue to generate frictional heat to stop bleeding. It is also possible to perform the ablation treatment by holding the biological tissue between the first acting part 16A and the second acting part 64A while applying or not applying ultrasonic vibration to the first acting member 16. In this way, the advanced device 3 enables incision, ablation, or thermal coagulation hemostasis using ultrasonic vibration, and can also perform minimally invasive hemostasis by irradiating low-temperature plasma from the plasma irradiation device 20, which will be described later. You can also do it.

1-2. Basic Configuration of Plasma Irradiation Apparatus As shown in FIG. 1, the plasma irradiation apparatus 20 is incorporated as a part of the tip device 3, and is configured as a device that generates a dielectric barrier discharge inside the tip device 3. The two plasma irradiation apparatuses 20 shown in FIG. 1 have the same configuration. Below, the common configuration of both plasma irradiation devices 20 will be explained.

As shown in FIG. 2, each plasma irradiation device 20 has a structure 20A configured in a predetermined three-dimensional shape (for example, plate-like and rectangular parallelepiped shape), and has a longitudinal end portion of the structure 20A. It is configured to irradiate low-temperature plasma P from the formed discharge port 34.

As conceptually shown in FIG. 3, the structure 20A includes a dielectric layer 53 provided at the center in the thickness direction, and a dielectric layer 54 provided on one side of the dielectric layer 53 in the thickness direction. ing. Further, in the structure 20A, a dielectric layer 51 and a dielectric layer 52 are provided on the other side of the dielectric layer 53 in the thickness direction. A discharge electrode 42 and a ground electrode 44 are embedded inside a dielectric region formed by the dielectric layer 51 and the dielectric layer 52. Although FIG. 3 conceptually shows a configuration in which the structure 20A is divided into three parts as an exploded perspective view, the actual configuration includes a dielectric layer 51, a dielectric layer 52, a dielectric layer 53, and a dielectric layer 52. Each layer 54 is constructed as part of an integral dielectric portion 50 (FIG. 6).

As shown in FIG. 4, the structure 20A includes a gas guide path 30 and a creeping discharge section 40.

The gas guide path 30 has an introduction port 32 for introducing gas, a discharge port 34 for releasing the gas, and a flow path 36 provided between the introduction port 32 and the discharge port 34. It is provided at the end (tip) of the flow path 36 and functions to release the gas that has flowed through the flow path 36 . The flow path 36 functions to flow gas toward the discharge port 34 arranged on the tip side, and is arranged so as to flow the gas along the first direction at least in the area where the creeping discharge section 40 is provided. . The gas guide path 30 introduces an inert gas supplied from the gas supply device 7 (FIG. 1) provided outside the tip device 3 through the pipe line 7A through the introduction port 32, and introduces the inert gas from the introduction port 32 side. This serves as a guide path for guiding the released gas to the discharge port 34 through the space within the flow path 36. In addition, in FIG. 4, the conduit 7A for supplying gas toward the introduction port 32 is conceptually shown by a two-dot chain line. In the tip device 3, the first action section 16A and the second action section 64A are arranged outside the discharge port 34. The gas guide path 30 has a flow path configuration that discharges gas from the discharge port 34 to the second action section 64A side, and discharges the low temperature plasma P along with the gas from the discharge port 34 to the second action section 64A side. Function.

As shown in FIG. 4, in this specification, the direction in which the gas guide path 30 extends in the plasma irradiation device 20 is the first direction, and the thickness direction of the dielectric portion 50 is the direction perpendicular to the first direction. This is the second direction, and the direction perpendicular to the first direction and the second direction is the third direction (FIG. 6). In the configuration of FIG. 4, the first direction is the longitudinal direction of the structure 20A in which the dielectric portion 50, the discharge electrode 42, and the ground electrode 44 are integrally provided. The lateral direction of the structure 20A in a cut plane (FIG. 6) obtained by cutting the structure 20A in a plane direction perpendicular to the first direction is the second direction, and the longitudinal direction of this cut plane is the third direction ( Figure 6). The third direction (FIG. 6) is the width direction of the structure 20A, and the second direction is the height or thickness direction of the structure 20A. In addition, in the following description, the discharge port 34 side is the front end side of the structure 20A in the first direction, and the inlet port 32 side is the rear end side of the structure 20A in the first direction.

As shown in FIG. 4, the structure 20A has a gas guide path 30 configured to flow gas along a predetermined direction (first direction), and a second direction perpendicular to the predetermined direction (first direction). The discharge electrode 42, which is an example of a first electrode, the ground electrode 44, which is an example of a second electrode, and a dielectric portion 50 are laminated in such a configuration that the lamination direction is .

The creeping discharge section 40 corresponds to an example of a discharge section, and includes a dielectric layer 51, and a discharge electrode 42 and a ground electrode 44 that are arranged to face each other with the dielectric layer 51 interposed therebetween. The creeping discharge section 40 functions to generate an electric field within the gas guide path 30 based on the potential difference between the discharge electrode 42 and the ground electrode 44, and to generate a low-temperature plasma discharge within the gas guide path 30 due to creeping discharge. Specifically, the creeping discharge section 40 maintains the potential of the ground electrode 44 at a constant reference potential (for example, 0V ground potential) and responds to the periodically changing voltage being applied to the discharge electrode 42. A creeping discharge is generated within the flow path 36 to generate low-temperature plasma.

The creeping discharge section 40 responds to a periodically changing voltage being applied to the discharge electrode 42 while one of the discharge electrode 42 or the ground electrode 44 faces the space of the flow path 36 directly or through another member. This is to generate creeping discharge within the flow path 36. Note that "a configuration in which one of the discharge electrode 42 or the ground electrode 44 directly faces the flow path 36" means that one of the discharge electrode 42 or the ground electrode 44 is exposed to the space inside the flow path 36, and the one is exposed to the space inside the flow path 36. This applies to structures that form part of the inner wall. Furthermore, "a configuration in which one of the discharge electrode 42 or the ground electrode 44 faces the flow path 36 via another member" means that one of the discharge electrode 42 or the ground electrode 44 is disposed at a position close to the flow path 36. This corresponds to a configuration in which both parts are partially or completely covered by another member. In this configuration using another member, the other member forms a part of the inner wall of the flow path, and the above-mentioned "one" main surface is arranged facing the flow path 36. Note that in the configuration shown in FIG. 4, the discharge electrode 42 corresponds to the above-mentioned "one side", and is "a configuration in which the discharge electrode 42 faces the flow path 36 through another member", but in FIG. A dielectric layer 52 corresponding to an example of the member is shown in an omitted form (see FIGS. 5 and 6).

1-3. Specific configuration of gas guide path and creeping discharge section As shown in FIG. 5, the flow path 36 constituting the gas guide path 30 has a space surrounded on both sides in the second direction (FIG. 4) and on both sides in the third direction. It is configured to continue in the first direction. The flow path 36 includes a first flow path 36A extending along the first direction, a second flow path 36B provided on the downstream side of the first flow path 36A, and a third flow path 36B provided on the upstream side of the first flow path 36A. A flow path 36C is provided. The first flow path 36A is provided in the first region AR1 in the first direction in the structure 20A. The second flow path 36B is provided in the second region AR2 in the first direction in the structure 20A, and includes a reduced width flow path 37A and a constant flow path 37B. The third flow path 36C is provided in the third region AR3 in the first direction in the structure 20A, and includes an enlarged flow path 38A and a constant flow path 38B. In FIG. 5, the range in which the first flow path 36A is provided in the first direction is represented as a first region AR1, the range in which the second flow path 36B is provided in the first direction is represented as a second region AR2, and the range in which the first flow path 36A is provided in the first direction is represented as a second region AR2. The range in which the third flow path 36C is provided in the direction is expressed as a third region AR3.

As shown in FIG. 5, the second flow path 36B has a narrower width than the first flow path 36A between the first flow path 36A and the discharge port 34. In the second flow path 36B, the reduced width flow path 37A is provided over a partial area AR21 of the second area AR2 in the first direction. The width of the inner wall surface of the reduced width channel 37A gradually becomes narrower as it approaches the discharge port 34. The height of the reduced width channel 37A is constant over the entire range of the region AR21. The constant flow path 37B is provided over a partial area AR22 of the second area AR2 in the first direction. The height and width of the constant flow path 37B are constant over the entire range of the region AR22.

As shown in FIG. 5, the third flow path 36C has a narrower width than the first flow path 36A between the introduction port 32 and the first flow path 36A. In the third flow path 36C, the widened flow path 38A is provided over a partial region AR31 of the third region AR3 in the first direction, and the width of the inner wall surface gradually increases as it approaches the first flow path 36A. The height of the widened channel 38A is constant over the entire range of the region AR31. The constant flow path 38B is provided over a partial area AR32 of the third area AR3 in the first direction. The height and width of the constant flow path 38B are constant over the entire range of the region AR32.

As shown in FIG. 5, the structure 20A includes a first regular portion 22 and a second regular portion 26, each of which has a constant external shape on a cut surface perpendicular to the first direction over a predetermined range in the first direction. Furthermore, the structure 20A has a diameter-reducing portion 24 that reduces in diameter so that the outer shape of the cut surface perpendicular to the first direction becomes smaller toward the distal end (see also FIG. 2). A reduced diameter portion 24 continues on the distal end side of the first regular shaped portion 22, and a second fixed shaped portion 26 continues on the distal end side of the reduced diameter portion 24. The distal end position of the first regular shaped part 22 is the rear end position of the reduced diameter part 24, and the distal end position of the reduced diameter part 24 is the rear end position of the second regular shaped part 26. The first regular portion 22 is provided in the first region AR1 and the third region AR3, and the width of the outer wall surface (length in the third direction) and the height of the outer wall surface (length in the second direction) are constant. ing. The reduced diameter portion 24 is provided in a partial region AR21 of the second region AR2, and has a constant height (length in the second direction) of the outer wall surface and a width (length in the third direction) of the outer wall surface. It has a shape that decreases in diameter toward the tip. The second regular part 26 is provided in a partial area AR22 of the second area AR2, and has a constant width (length in the third direction) and height (length in the second direction) of the outer wall surface. ing. The first regular part 22, the reduced diameter part 24, and the second regular part 26 all have the same predetermined height on their outer wall surfaces. On the other hand, the width of the outer wall surface of the first regular portion 22 is larger than the width of the outer wall surface of the second regular portion 26, and is the same as the maximum width (width at the rear end) of the outer wall surface of the reduced diameter portion 24. . The width of the outer wall surface of the second regular portion 26 is the same as the minimum width (width at the tip) of the outer wall surface of the reduced diameter portion 24 .

With respect to the flow path 36 configured in this way, the ground electrode 44 extends linearly in the first direction along the flow path 36, and is disposed in a predetermined area in the first direction. A portion of the ground electrode 44 on its own tip side is arranged closer to the discharge port 34 than the discharge electrode 42 is. A part of the ground electrode 44 is located in the arrangement area AR2 of the second flow path 36B in the first direction, and in the example of FIG. 37B), and is located in the arrangement region AR22 of the constant flow path 37B in the first direction. The rear end of the ground electrode 44 is located on the rear end side of the first flow path 36A, the rear end of the discharge electrode 42, and the rear end of the discharge electrode 42. . At least a part of the ground electrode 44 (the whole part in FIG. 5) is located within the arrangement region AR1 of the first flow path 36A in the third direction. More specifically, the ground electrode 44 has at least a part of itself (a part of itself in FIG. 5) located within the arrangement region AR4 of the constant flow path 37B in the third direction, and At least a part of itself (a part of itself in FIG. 5) is located within the formation region of.

As shown in FIG. 5, the discharge electrode 42 includes a plurality of (specifically, three) linear electrode parts 42A configured in a straight line, and these linear electrode parts 42A are arranged along the flow path 36. The linear electrode portions 42A extend linearly in the first direction, and each linear electrode portion 42A functions as a linear electrode. Each linear electrode portion 42A is made of a conductor having a constant width and a constant thickness, and is arranged in a predetermined area in the first direction. The plurality of linear electrode portions 42A are connected at their rear ends, electrically connected to each other, and have the same potential. The discharge electrode 42 is located so as to straddle the arrangement region of the first flow path 36A (first region AR1) and the arrangement region of the third flow path 36C (third region AR3) in the first direction. That is, the distal end of the discharge electrode 42 is located on the rear end side of the first flow path 36A, and the rear end of the discharge electrode 42 is located on the rear end side (specifically, , between the tip and rear end of the third flow path 36C). Further, the width (length in the third direction) of each linear electrode portion 42A is smaller than the width (length in the third direction) of the ground electrode 44. The entire discharge electrode 42 falls within the arrangement region AR5 of the ground electrode 44 in the third direction.

As shown in FIG. 6, the dielectric section 50 includes a dielectric layer 51, a dielectric layer 52, a dielectric layer 53, and a dielectric layer 54, and has a hollow shape as a whole.

The dielectric layer 51 is arranged on one side in the second direction (thickness direction) with respect to the space of the flow path 36, and is configured such that the ground electrode 44 is embedded therein. The dielectric layer 52 is a ceramic protective layer configured to cover the discharge electrode 42 using a ceramic material, and is arranged so as to cover the discharge electrode 42 on the flow path space side of the dielectric layer 51 . The dielectric layer 51 and the dielectric layer 52 constitute an inner wall portion of the flow path 36 on one side in the second direction. In the example of FIG. 6, the discharge electrode 42 and the ground electrode 44 face each other with the dielectric layer 51 in between. The discharge electrode 42 faces the flow path 36 via the dielectric layer 52, and is disposed within the dielectric portion 50 at a first position in the second direction and with a first thickness. The ground electrode 44 is disposed within the dielectric portion 50 at a second position in the second direction and has a second thickness, and is provided on the opposite side of the discharge electrode 42 from the flow path 36 . It is further away from the flow path 36 than the With such a configuration, the creeping discharge section 40 is arranged on one side in the second direction of the space within the flow path 36.

The dielectric layer 54 is disposed on the other side in the second direction (thickness direction) of the space of the flow path 36 and constitutes an inner wall portion of the flow path 36 on the other side in the second direction. The dielectric layer 53 is disposed between the dielectric layer 51 and the dielectric layer 54 in the second direction, and forms a side wall portion on one side in the third direction and a side wall portion on the other side in the third direction in the flow path 36. . In this way, the flow path 36 is defined by the dielectric layer 51 , the dielectric layer 52 , the dielectric layer 53 , and the dielectric layer 54 .

As the material of the dielectric layer 51, the dielectric layer 52, the dielectric layer 53, and the dielectric layer 54, ceramics such as alumina, glass materials, and resin materials can be suitably used. Note that by using alumina, which has high mechanical strength, as the dielectric material, it becomes easier to reduce the size of the creeping discharge section 40.

1-4. Arrangement of Plasma Irradiation Device As shown in FIG. 7, the structure 20A of the plasma irradiation device 20 is fixed to the second action portion 64A, and the discharge port 34 (FIG. 8) is arranged around the second action portion 64A. ing. The low temperature plasma P generated inside the structure 20A is irradiated around the second working part 64A and around the first working part 16A from the discharge port 34 arranged near the second working part 64A. It has become. In addition, in FIG. 7, the position of the first action member 16 when the first action part 16A and the second action part 64A are in contact is conceptually shown by a two-dot chain line.

As shown in FIG. 7, the discharge port 34 of each plasma irradiation device 20 is configured to discharge gas in a direction intersecting the longitudinal direction of the second action member 64 around the second action section 64A. . More specifically, each of the discharge ports 34 is arranged in a direction ( More specifically, they are arranged to emit gas in a perpendicular direction).

In FIG. 8, the configuration of the vicinity of the first action section 16A and the second action section 64A in the tip device 3 is simply shown. As shown in FIG. 8, in the tip device 3, the first action section 16A and the second action section 64A are configured to approach and separate from each other along a predetermined plane direction. Specifically, the direction perpendicular to the rotation axis when the second action member 64 rotates with respect to the first action member 16 is the plane direction, and the first action member 16 and the second action member 64 extends along the plane direction. The tip of the first acting portion 16A and the tip of the second acting portion 64A are configured to approach and separate from each other along one of the plane directions (approaching/separating direction).

In the tip device 3, two structures 20A are attached to one side of the second action section 64A to be attached in a direction perpendicular to the above-mentioned planar direction (hereinafter also referred to as an orthogonal direction). This orthogonal direction is a direction orthogonal to the "longitudinal direction of the second action member 64" and the "approach/separation direction." A plurality of (two in FIG. 8) discharge ports 34 are arranged on one side in the direction orthogonal to the attachment target (the second action portion 64A). The plurality of discharge ports 34 are lined up in the longitudinal direction of the second action member 64 around the second action portion 64A, and each of the release ports 34 is aligned in the above-mentioned approach/separation direction (first action portion 16A and second action portion 64A). The gas is disposed so as to emit gas along the direction in which the action portion 64A approaches and separates from the action portion 64A. That is, the above-mentioned approach/separation direction is the direction in which gas is released from the discharge port 34, and is "the direction intersecting the longitudinal direction of the second action member 64." In this configuration, the above-mentioned first direction (FIG. 5) is a direction along the approach/separation direction, and the gas flowing along the first direction in the gas guide path 30 (FIG. 5) is directed to the discharge port 34. Immediately after release, most of the gas flows along the above-mentioned approach/separation direction.

Furthermore, in the tip device 3, the opening width W1 in the longitudinal direction of the second action member 64 is larger than the opening width W1 in the longitudinal direction of the second action member 64 (the longitudinal direction and the approach/separation direction (gas release direction) of the second action member 64) in the tip device 3. The opening width W2 is larger than the opening width W2 in the direction perpendicular to the opening width W2.

Further, in the structure 20A of the plasma irradiation device 20, the above-mentioned reduced diameter portion 24 (a portion whose outer surface shape is reduced in diameter toward the discharge port 34) is arranged around the second action portion 64A. Specifically, the reduced diameter part 24 and the second regular part 26 are arranged on one side in the orthogonal direction to the second action part 64A at adjacent positions near the second action part 64A, and The bulk of the structure 20A is suppressed.

1-5. Example of Effect of Present Configuration In the tip device 3, the discharge port 34 is arranged so as to discharge gas in a direction intersecting the longitudinal direction of the second action member 64 around the second action portion 64A. Therefore, the tip device 3 can irradiate plasma in a direction intersecting the longitudinal direction of the second action member 64, and can also irradiate the living tissue from the discharge port 34 provided around the second action member 64A. Plasma can be stably supplied to the vicinity of the second acting portion 64A.

Furthermore, the tip device 3 has a gripping tool 15, and the gripping tool 15 is configured such that the first action section 16A of the first action member 16 and the second action section 64A of the second action member 64 can approach and separate from each other. , functions to sandwich and grasp the biological tissue between the first action section 16A and the second action section 64A. The approaching/separating direction of the gripping tool 15 (the direction in which the first acting part 16A and the second acting part 64A approach and separate) is the direction in which the gas is released from the outlet 34 (i.e., relative to the "longitudinal direction"). ”). This tip device 3 is capable of gripping living tissue by sandwiching it between two working members, and is capable of irradiating plasma in a direction crossing the longitudinal direction of the second working member 64, and is capable of irradiating plasma onto the living tissue. Plasma can be stably supplied to the vicinity of the first acting part 16A and the second acting part 64A. Moreover, the direction in which the plasma is irradiated from the discharge port 34 (that is, the above-mentioned "direction intersecting the longitudinal direction of the second action member 64") is such that the first action part 16A and the second action part 64A approach and separate. Therefore, plasma irradiation can be performed in the direction of the pinching operation near the portion where the biological tissue is pinched.

In the tip device 3, the plasma irradiation device 20 is attached to either the first action section 16A or the second action section 64A (the second action section 64A in the example shown in FIG. 1). Then, in the orthogonal direction perpendicular to the longitudinal direction of the second action member 64 and the plasma irradiation direction (i.e., the direction intersecting the longitudinal direction), a discharge port is provided on one side of the attachment target (the second action part 64A). 34 are arranged. In this tip device 3, the discharge port 34 can be arranged in such a manner that it does not easily interfere with the approaching/separating movements of the first action section 16A and the second action section 64A. Moreover, this tip device 3 can easily supply plasma stably to a wider range from a position avoiding the second action part 64A to the living tissue sandwiched between the first action part 16A and the second action part 64A. .

In the tip device 3, the opening width W1 of the second action member 64 in the longitudinal direction of the discharge port 34 is larger than the opening width in the orthogonal direction (direction orthogonal to the longitudinal direction and the approach/separation direction (crossing direction)). It is larger than W2. In this way, in the tip device 3, since the opening of the discharge port 34 expands in the longitudinal direction of the second action member 64, plasma can be irradiated over a wider range in the longitudinal direction of the second action member 64.

Furthermore, in the tip device 3, the plurality of discharge ports 34 are arranged in the longitudinal direction of the second action member 64 around the second action portion 64A. Therefore, plasma can be irradiated over a wider range in the longitudinal direction of the second action member 64, and the plasma irradiation mode can be changed from linear irradiation to planar irradiation.

Furthermore, the plasma irradiation device 20 has a diameter-reducing portion 24 whose outer surface shape decreases toward the discharge port 34, and the diameter-reducing portion 24 is arranged around the second action portion 64A. In this way, in the tip device 3, the reduced diameter part 24 is arranged around the second action part 64A, so there is a space advantage in arranging the discharge port 34 near the action part where there is a large space restriction. growing. Furthermore, if miniaturization is achieved by providing a portion that decreases in diameter toward the discharge port 34, even if the discharge port 34 is provided near the second action section 64A, the workability (especially around the action section) will be improved. It is possible to suppress the decline in workability when performing detailed work by acting on living tissue.

<Second embodiment>
Next, a second embodiment will be described.
FIG. 9 illustrates a surgical apparatus 201 including a tip device 203 of a second embodiment. In the following description, parts of the surgical apparatus 201 including the tip device 203 having the same configuration as the surgical apparatus 1 (FIG. 1) including the tip device 3 of the first embodiment will be referred to as the surgical apparatus 1 ( The same reference numerals as the corresponding parts in FIG. 1) are given, and detailed explanation will be omitted. For example, in the surgical apparatus 201 and the tip device 203, the plasma irradiation device 20 has the same configuration and the same function as the plasma irradiation device 20 provided in the tip device 3 of the first embodiment. Further, the gas supply device 7 and the power supply device 9 have the same configuration as that used in the surgical device 1 (FIG. 1). In addition, in FIG. 9, the high frequency voltage generation circuit 11 (FIG. 1) interposed between the power supply device 9 and the plasma irradiation device 20 is omitted.

As shown in FIG. 8, the distal end device 203 includes an operating member 216 that is provided with an operating section 216A that acts on living tissue on its distal end side and extends in the longitudinal direction, and a control device 205 (driving section) that drives the operating member 216. ) and a plasma irradiation device 20. In this tip device 203 as well, the plasma irradiation device 20 is incorporated as a part of the tip device 203. The gas guide path 30 is configured to release gas from the release port 34 to the acting portion 216A side. The case body 214, the action member 216, and the plasma irradiation device 20 are integrally configured as a gripping unit that is gripped by a user, and are supplied with inert gas and electric power via a flexible member. It looks like this.

The control device 205 is configured as a high-frequency current supply unit that supplies a high-frequency current, and corresponds to an example of a drive unit. The action member 216 is made of, for example, a metal material and has a shaft shape, and functions as an electrode section through which a high frequency current supplied from the control device 205 (high frequency current supply section) flows. The action member 216 can function as a known electric scalpel, and can produce an incision action, an ablation action, or a thermocoagulation hemostasis action on living tissue by means of a high-frequency current flowing through the action member 216 (electrode section). Note that although FIG. 9 conceptually shows a configuration in which the control device 205 (driving section) is provided outside the case body 214, the control device 205 is connected to the case body 214 inside or outside the case body 214. It may be provided integrally.

The common tip device 203 performs incision, ablation, or thermocoagulation hemostasis of biological tissues by high-frequency current flowing through the action member 216 and minimally invasive hemostasis by irradiation with low-temperature plasma from the plasma irradiation device 20. I can do it.

In the tip device 203 as well, an action portion 216A is provided outside the discharge port 34. The discharge port 34 is provided around the action portion 216A, and is configured to emit gas at least in a direction intersecting the longitudinal direction of the action member 216. Note that FIG. 9 shows the positional relationship when the plasma irradiation device 20 is viewed in the first direction.

In the example of FIG. 9 as well, the opening width of the discharge port 34 in the longitudinal direction of the action member 216 is larger than the opening width in the orthogonal direction (direction perpendicular to the longitudinal direction and the cross direction (direction in which gas is released from the discharge port 34)). is also getting bigger. Specifically, the above-mentioned intersecting direction (direction in which gas is released from the release port 34) is the above-mentioned first direction (FIG. 5, etc.) in the structure 20A. Further, in the example of FIG. 9 as well, it is preferable that the plasma irradiation device 20 is provided with a reduced diameter portion (a reduced diameter portion similar to the reduced diameter portion 24 of the first embodiment (FIG. 2, etc.)). This reduced diameter portion is preferably arranged around the action portion 216A.

<Third embodiment>
Next, a third embodiment will be described.
In the description of the tip device 3 of the first embodiment, an example (FIG. 8) was shown in which the plasma irradiation device 20 was provided on one side in the orthogonal direction, but as shown in FIG. In this case, plasma irradiation devices 20 are provided on both sides in the orthogonal direction. The configuration of FIG. 10 differs from the configuration of the first embodiment (FIG. 8, etc.) only in that the plasma irradiation device 20 is provided not only on one side in the orthogonal direction but also on the other side in the orthogonal direction. This is the same as in the first embodiment. In this way, if the plasma irradiation device 20 is provided on both sides in the orthogonal direction to the second action section 64A, and the discharge ports 34 are arranged on both sides in the orthogonal direction, plasma can be irradiated over a wider range in the orthogonal direction. can.

<Fourth embodiment>
Next, a fourth embodiment will be described.
FIG. 11 shows a plasma irradiation device 420 used in the advanced device of the fourth embodiment. The tip device of the fourth embodiment may have a configuration in which a plasma irradiation device 420 in FIG. 11 is provided in place of the plasma irradiation device 20 in the tip device 3 in FIG. 1. Note that, below, a configuration in which the plasma irradiation device 420 of FIG. 11 is provided in place of the plasma irradiation device 20 in the advanced device 3 of FIG. It can also be used in advanced devices.

As shown in FIG. 11, the structure 420A of the plasma irradiation device 420 has two discharge ports 34, and is configured to be able to discharge plasma from the two discharge ports 34. As shown in FIG. 12, the structure 420A has a configuration including two structures 20A (FIG. 5, etc.) used in the tip device 3 of the first embodiment, and has a configuration in which the two structures 20A are integrated. is doing. In the example of FIG. 12, an intermediate position in the third direction of the structure 420A is indicated by a dashed dot line C, and regions on one side and the other side of the dashed dot line C have the same configuration as the structure 20A. There is. Although the electrode corresponding to the ground electrode 44 (FIG. 5) is omitted in FIG. 12, the ground electrode may be provided facing each discharge electrode 42 as in FIG. A common ground electrode may be provided across 42. Note that the outer shape of the structure 420A shown in FIGS. 11 and 12 is just an example, and the outer shape can be various shapes.

When the plasma irradiation device 420 shown in FIG. 12 is attached to the second action member 64 (FIG. 8), the direction of the gas from the discharge port 34 is the direction that intersects with the longitudinal direction of the second action member 64 (FIG. 8). Arrange it so that Specifically, it is arranged so that the first direction of the structure 420A is a direction intersecting the longitudinal direction of the second action member 64 (FIG. 8). For example, the first direction of the structure 420A is arranged to be perpendicular to the longitudinal direction of the second action member 64 (FIG. 8), and more preferably, the first direction of the structure 420A is the above-mentioned direction. Arrange along the approach/separation direction. Furthermore, the plurality of discharge ports 34 provided in the structure 420A may be arranged so as to be lined up in the longitudinal direction of the second action member 64.

<Fifth embodiment>
Next, the tip device 503 of the fifth embodiment will be described with reference to FIG. 13 and the like.
The tip device 503 differs from the tip device 3 of the first embodiment (FIG. 1, etc.) only in the configuration and arrangement of the plasma irradiation device 20 and the specific shapes of the first action member 16 and the second action member 64, and has other configurations. And the function is the same as the advanced device 3. Therefore, detailed description of the same points as in the first embodiment will be omitted. Further, the tip device 503 can be used in the surgical apparatus 1 similarly to the tip device 3 shown in FIG. That is, the tip device 503 can be provided in place of the tip device 3 in the surgical apparatus 1 of FIG.

Note that in the tip device 503, the ultrasonic vibration from the ultrasonic vibrating section 12 may be applied to the first action member 16 as in the first embodiment, and the ultrasonic vibration may be applied to the second action member 64. Alternatively, the ultrasonic vibration from the ultrasonic vibrating section 12 may be applied. Further, in the example of FIG. 13, the specific shapes of the first action member 16 and the second action member 64 are different from those of the first embodiment, but they may be the same as those of the first embodiment.

As shown in FIG. 14, the structure 520A of the plasma irradiation device 520 has three discharge ports 34 arranged in a predetermined direction, and is configured to be able to discharge plasma from the three discharge ports 34. Note that although the plasma irradiation device 520 differs from the plasma irradiation device 20 in the flow path configuration of the gas guide path 30 and the external shape of the dielectric section 50, the configuration and function of the creeping discharge section 40 are the same as those of the plasma irradiation device 20. It is. The plasma irradiation device 520 of FIG. 13 flows gas along the first direction from the introduction port 32 toward the discharge port 34, and applies plasma generated in the flow path 36 by the creeping discharge section 40 to the three discharge ports 34. The structure is such that it can be released from The flow path 36 in the gas guide path 30 branches into three branch flow paths on the tip side (on the discharge port 34 side in the first direction) of the creeping discharge section 40, and a discharge port is provided at the end of each branch flow path. 34 are provided.

The plasma irradiation device 520 configured in this manner is attached to the second action member 64 as shown in FIG. 13, and the direction of gas from the three discharge ports 34 intersects with the longitudinal direction of the second action member 64. It is arranged so that the direction is the same. Specifically, the plasma irradiation device 520 is arranged so that the first direction (FIG. 14) of the structure 520A is a direction intersecting the longitudinal direction of the second action member 64. In the example of FIG. 13, the plasma irradiation device 520 is arranged so that the first direction (FIG. 14) is perpendicular to the longitudinal direction of the second action member 64 in the structure 520A, and more specifically, The first direction of the structure 520A is arranged along the above-mentioned approach/separation direction.Furthermore, in the example of FIG. In this example, plasma is irradiated in a planar manner so as to spread in the longitudinal direction from two plasma irradiation devices 520 arranged on both sides of the second action section 64A in the orthogonal direction. This makes it easier to irradiate the biological tissue held by the gripping instrument 15 with plasma more reliably.

In the example of FIG. 13, the structure 520A includes a first regular part 522 and a second regular part 526, each of which has a constant external shape on a cut surface perpendicular to the first direction over a predetermined range in the first direction. Further, the structure 520A has an enlarged diameter portion 524 that expands in diameter so that the outer shape of the cut surface perpendicular to the first direction becomes larger toward the distal end (see also FIG. 14). The enlarged diameter portion 524 and the second regular portion 526 are fixed adjacent to the second action portion 64A. In this example, it is possible to secure a wider area of the structure 520A facing the second action part 64A, so that it becomes easier to more stably attach the structure 520A to the second action part 64A.

<Other embodiments>
The invention is not limited to the embodiments described above and illustrated in the drawings. For example, the features of the embodiments described above or below can be combined in any combination without contradicting each other. Furthermore, any feature of the embodiments described above or below may be omitted unless explicitly stated as essential. Furthermore, the embodiment described above may be modified as follows.

In the description of the first, third to fifth embodiments, an example was shown in which the plasma irradiation device was attached to the second action member 64, but in any configuration, the plasma irradiation device was attached to the first action member 16. may be attached. Alternatively, the plasma irradiation device may be attached to both the first action member and the second action member.

In the description of the fourth embodiment, a plasma irradiation device 420 including a plurality of discharge ports 34 is shown as an example, and plasma is discharged from each discharge port 34 along the first direction (the longitudinal direction of the structure 420A). Although an example has been shown in which the direction of the plasma is directed, the direction of the plasma is not limited to this example. For example, like the plasma irradiation device 620 shown in FIG. 15, plasma may be irradiated in a direction oblique to the first direction. In the structure 620A of the plasma irradiation device 620 shown in FIG. 15, the flow paths near each discharge port 34 are inclined flow paths with respect to the first direction. The structure 620A is configured such that plasma emitted from the discharge port 34 on one side in the third direction is directed to one side in the first direction and to the other side in the third direction. Further, the structure 620A is configured such that the plasma emitted from the discharge port 34 on the other side in the third direction is directed to one side in the first direction and to one side in the third direction. Note that in configurations other than the fourth embodiment, plasma may be irradiated in a direction oblique to the first direction.

In the description of each embodiment described above, an example was shown in which the structure forming the plasma irradiation device was formed in a straight line, but the structure forming the plasma irradiation device may be adapted to the shape of the object to be attached. Good too. For example, when the first action member, the second action member, or a member adjacent to either action member has an outer surface such as a curved surface or a bent surface, the structure is configured with an outer shape that matches this outer surface. may have been done. Specifically, for example, the configuration near the action member may be as shown in FIG. 16. In the tip device 703 shown in FIG. 16, the plasma irradiation device 420 (specifically, the structure 420A) of the fourth embodiment is curved in a shape that matches the curved second action section 64A as shown in FIG. . The curved structure 420A is attached along the curved second action section 64A, and the plurality of discharge ports 34 are lined up along the curved second action section 64A. Note that the configuration of the tip device 703 other than the plasma irradiation device 420 and the second action section 64A is the same as that of the tip device 3 shown in FIG. 1 and the like.

In the description of the second embodiment, the tip device 203 (FIG. 9) configured as an electric scalpel with one working member 216 was shown, but this example shows an example of a tip device with only one working member. but not limited to. For example, like the tip device 803 illustrated in FIG. 17, a plurality of (specifically two) plasma irradiation devices 20 may be attached to the action member 216. A plurality of discharge ports 34 may be arranged in a predetermined direction (for example, the longitudinal direction of the action member 216) around the action portion 216A. In the example of FIG. 17 as well, each discharge port 34 discharges gas in a direction intersecting the longitudinal direction of the action member 216. Specifically, two discharge ports 34 discharge gas in the same direction (action Gas is released in a direction (perpendicular to the longitudinal direction of the member 216). Alternatively, a plasma irradiation device 20 may be provided as in the tip device 903 illustrated in FIG. 18 . In this example as well, a plurality of (specifically, three) plasma irradiation devices 20 are attached to the action member 216, and a plurality of discharge ports 34 are arranged in a predetermined direction (for example, along the longitudinal direction of the action member 216) around the action portion 216A. direction). In the example of FIG. 18 as well, each discharge port 34 discharges gas in a direction crossing the longitudinal direction of the action member 216, but in the example of FIG. The emission direction of each is different.

In the embodiments described above, an example is given of an advanced device that can supply ultrasonic vibrations or high-frequency current, but a configuration in which a plasma irradiation device having any of the configurations described above is incorporated into an advanced device having other electrical functions is also possible. There may be. Alternatively, a plasma irradiation device having any of the above configurations may be incorporated into a tip device configured as a known surgical instrument (for example, forceps, etc.) that does not have an electrical function. Any of the tip devices may have a configuration in which a discharge port is provided around the working part and releases gas at least in a direction intersecting the longitudinal direction of the working member.

In the above embodiment, a creeping discharge section that performs creeping discharge is illustrated as an example of the discharge section, but the discharge section may be configured as a space discharge section that performs space discharge.

In the embodiments described above, an example was given in which the drive section is arranged inside the case body (the case body in which the action member is incorporated) that constitutes a part of the tip device, but it is also possible to arrange the drive section outside the case body. You can leave it there. When the drive unit is disposed outside the case body in this way, the drive unit may be considered as part of the tip device, or may not be considered as part of the tip device.

In the specification, "acting on living tissue" means that the action member affects living tissue and performs at least one of incision, exfoliation, and hemostasis. The action members exemplified in the above-mentioned embodiments are merely examples, and as long as the action members can affect living tissue and perform at least one of incision, exfoliation, and hemostasis, embodiments other than those described above may be used. Various configurations can be adopted.

It should be noted that the embodiments disclosed herein are illustrative in all respects and should not be considered restrictive. The scope of the present invention is not limited to the embodiments disclosed herein, and includes all modifications within the scope indicated by the claims or within the scope equivalent to the claims. is intended.

3,203,303,503,703,803,903... Tip device 15... Grasping instrument 16... First action member (action member)
16A...first action part (action part)
20, 420, 520, 620... Plasma irradiation device 24... Diameter reduction part 30... Gas guide path 34... Discharge port 36... Flow path 40... Creeping discharge part (discharge part)
42...Discharge electrode (first electrode)
44...Ground electrode (second electrode)
64...Second action member (action member)
64A...Second action part (action part)
216...Action member 216A...Action part

Claims (6)

an action member that extends in the longitudinal direction and has an action part that acts on living tissue on its distal end side;
A gas guide path including a flow path through which gas flows and a discharge port provided at an end of the flow path and discharges gas to the acting portion side via the discharge port, a first electrode and a second electrode. a plasma irradiation device comprising: a discharge section that generates plasma discharge within the gas guide path;
has
A tip device in which the action portion is provided outside the discharge port,
The discharge port is provided around the action part and discharges gas at least in a direction intersecting the longitudinal direction. The tip device. The acting part includes a first acting part that acts on living tissue and a second acting part that acts on living tissue,
The acting member includes a first acting member having the first acting portion on its distal end side, and a second acting member having the second acting portion on its distal end side,
Furthermore, the first action member and the second action member are provided, and the first action part and the second action part are configured to be able to approach and separate, and the first action part and the second action part It has a grasping instrument that pinches and grasps the biological tissue between the
The tip device according to claim 1, wherein a direction in which the first action part and the second action part approach and separate is a direction intersecting the longitudinal direction. The plasma irradiation device is attached to either the first action section or the second action section,
The tip device according to claim 2, wherein the discharge port is arranged on at least one side of the attachment target in the longitudinal direction and a direction perpendicular to the direction intersecting the longitudinal direction. The discharge port has an opening width in the longitudinal direction that is larger than an opening width in a direction orthogonal to the longitudinal direction and the intersecting direction. cutting edge device. The tip device according to any one of claims 1 to 4, wherein a plurality of the discharge ports are arranged in the longitudinal direction around the action section. The plasma irradiation device has a reduced diameter portion whose outer surface shape reduces toward the emission port,
The tip device according to any one of claims 1 to 5, wherein the reduced diameter portion is arranged around the action portion.

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