CN101099691A - 外科用处理器具 - Google Patents

外科用处理器具 Download PDF

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CN101099691A
CN101099691A CNA2007101229696A CN200710122969A CN101099691A CN 101099691 A CN101099691 A CN 101099691A CN A2007101229696 A CNA2007101229696 A CN A2007101229696A CN 200710122969 A CN200710122969 A CN 200710122969A CN 101099691 A CN101099691 A CN 101099691A
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clamping components
clamping
mentioned
electrode part
tissue
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增田信弥
宫泽太郎
冈部洋
谷口一德
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Olympus Medical Systems Corp
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Abstract

本发明提供外科用处理器具，其能凝固和切开生物体组织，其特征在于，包括：第1夹持构件；第2夹持构件，其设置成能相对于上述第1夹持构件进行开闭，在其与该第1夹持构件之间夹持生物体组织；超声波振动部，其设置在上述第1夹持构件或第2夹持构件中的一方上，与超声波振子连接而进行超声波振动；超声波凝固切开部件，其设置在上述第1夹持构件或第2夹持构件的另一方上，与上述超声波振动部相对，具有在其与该超声波振动部之间推压生物体组织的作为推压部的衬垫构件；高频凝固部件，其用于凝固生物体组织，由设置在第1夹持构件上的第1电极部和设置在第2夹持构件上的第2电极部构成，并将该第1电极部和第2电极部相对设置。

Description

外科用处理器具
技术领域
本发明涉及在夹持生物体组织之后，由超声波振动和高频电流使生物体组织凝固并将其切开的外科用处理器具。
背景技术
作为外科用处理器具，公知有使用超声波振动的超声波处理器具和使用高频电流的高频处理器具。超声波处理器具可以通过超声波振动发热而使生物体组织凝固并将其切开。高频处理器具可以通过使通电了的电极接触生物体组织来对其进行凝固和切开。
另外，例如，在专利文献1～3中公知有组合由超声波振动进行的处理和由高频电流进行的处理而成的外科用处理装置。该外科用处理装置利用振动传递构件把由设置在操作部上的超声波振子产生的超声波振动传递给超声波探头的顶端部，并且具有相对于该超声波探头自由转动的爪，在该爪与超声波探头之间夹持生物体组织。而且，使高频电流从设置在外部的高频电源流向超声波探头，使高频电流流向夹持着的生物体组织而对生物体组织进行凝固和切开。
专利文献1：日本特开2003-79633号公报
专利文献2：日本特开2004-129870号公报
专利文献3：日本特开2004-216180号公报
发明内容
但是，在专利文献1中，由产生超声波振动的圆棒状的喇叭(horn)和对该喇叭进行开闭的圆弧形截面的开闭罩夹持生物体组织，由来自喇叭的超声波振动和来自设置在开闭罩上的电极的高频电流，使生物体组织凝固并将其切开。因此，是由圆棒状的喇叭和圆弧形截面的开闭罩夹持生物体组织的结构，用沿着夹持方向的表面部夹持生物体组织，存在不能得到较强的夹持力(压缩力)这样的问题。
在专利文献2及3中，由产生超声波振动的圆棒状的喇叭和对该喇叭进行开闭的夹持构件夹持生物体组织，由来自喇叭的超声波振动和来自设置在夹持构件上的电极的高频电流，使生物体组织凝固并将其切开。因此，是由圆棒状的喇叭和夹持构件夹持生物体组织的结构，相对于夹持构件的夹持方向用曲面承受并夹持生物体组织，存在不能得到较强的夹持力(压缩力)这样的问题。
本发明是着眼于上述情况而作出的，其目的在于提供一种可以用较强的夹持力可靠地夹持生物体组织并将其凝固和切开、可以缩短处理时间的外科用处理器具。
为了达到上述目的，本发明的技术方案1是一种外科用处理器具，其特征在于，具有：第1夹持构件；第2夹持构件，其设置成能相对于上述第1夹持构件进行开闭，在其与该第1夹持构件之间夹持生物体组织；超声波振动部，其设置在上述第1夹持构件或第2夹持构件中的一方上，与超声波振子连接而进行超声波振动；超声波凝固切开部件，其设置在上述第1夹持构件或第2夹持构件的另一方上，与上述超声波振动部相对，具有在其与该超声波振动部之间推压生物体组织的推压部；高频凝固部件，其用于凝固生物体组织，由设置在上述第1夹持构件上的第1电极部和设置在上述第2夹持构件上的第2电极部构成，并将该第1电极部和第2电极部相对设置。
技术方案2是一种外科用处理器具，其特征在于，具有：第1夹持构件；第2夹持构件，其设置成能相对于上述第1夹持构件进行开闭，在其与该第1夹持构件之间夹持生物体组织；超声波振动部，其设置在夹持构件上述第1或第2夹持构件中的一方上，与超声波振子连接而进行超声波振动；超声波凝固切开部件，其设置在上述第1夹持构件或第2夹持构件中的另一方上，与上述超声波振动部相对，具有在其与该超声波振动部之间推压生物体组织的推压部；高频凝固部件，其用于凝固生物体组织，由设置在上述第1夹持构件上的第1电极部和设置在上述第2夹持构件上的第2电极部构成，通过上述第1夹持构件和上述第2夹持构件的夹持操作使上述超声波振动部和构成上述超声波凝固切开部件的推压部相结合时，处于在上述第1电极部和第2电极部之间形成有间隙的位置关系。
技术方案3，其特征在于，技术方案1或2的相互相对的上述第1电极部和第2电极部的接近和分离方向，与上述第1夹持构件和第2夹持构件的开闭方向一致。
技术方案4，其特征在于，技术方案1或2的上述推压部和上述超声波振动部的切开接合面、与上述第2电极部的凝固接合面，在上述第1和第2夹持构件的开闭方向上相分离着。
技术方案5，其特征在于，设置在技术方案1或2的上述第2夹持构件上的、与上述推压部相对的上述超声波振动部的切开接合面和上述第2电极部的与生物体组织接合的凝固接合面，设置在不连续的面上。
根据本发明，具有在用第1夹持构件和第2夹持构件夹持生物体组织时能得到较强的夹持力、可以可靠地凝固和切开目的部位、可以缩短处理时间这样的效果。
附图说明
图1是表示本发明第1实施方式的超声波处理器具的整体结构图。
图2是上述实施方式的超声波处理器具的操作部的纵向剖视图。
图3是上述实施方式的超声波处理器具的操作部的纵向剖视图。
图4是图2的A-A剖视图。
图5表示上述实施方式的处理部，(a)是俯视图，(b)是纵向剖视图。
图6中，(a)是图5的B-B剖视图，(b)是图5的C-C剖视图，(c)是图5的D-D剖视图。
图7是上述实施方式的处理部的横向剖视图。
图8是上述实施方式的处理部的横向剖视图。
图9表示本发明的第2实施方式，(a)是处理部的纵向剖视图，(b)是E-E剖视图。
图10表示本发明的第3实施方式，(a)是处理部的纵向剖视图，(b)是F-F剖视图。
图11表示本发明的第4实施方式，(a)是处理部的纵向剖视图，(b)是G-G剖视图。
图12表示本发明的第5实施方式，(a)是处理部的立体图，(b)是横向剖视图。
图13表示本发明的第6实施方式，是处理部的立体图。
图14表示本发明的第7实施方式，(a)是处理部的立体图，(b)是H-H剖视图。
图15表示本发明的第8实施方式，是处理部的纵向剖视图。
图16表示本发明的第9实施方式，是处理部的立体图。
图17表示本发明的第10实施方式，是处理部的纵向剖视图。
图18表示本发明的第11实施方式，是处理部的纵向剖视图。
图19表示公开例，(a)是处理部的立体图，(b)是I-I剖视图。
具体实施方式
下面，参照附图说明本发明的实施方式。
图1～图8表示第1实施方式，图1是作为外科用处理器具的超声波处理器具的整体结构图。如图1所示，超声波处理器具10由操作部11、插入部12和振子单元13构成，该插入部12能相对于该操作部11装卸，该振子单元13从操作部11的后方能装卸地插入到该插入部12中。
对操作部11进行说明。在操作部11上设置具有圆筒状的壳体14a的操作部主体14。在该操作部主体14的基端部设置有用于连接振子单元13的振子连接部15。固定手柄16与壳体14a一体地设置在操作部主体14上。
另外，在操作部主体14上设置有能以枢支轴17为支点转动的可动手柄18。在固定手柄16上设置有供手术者选择性地插入拇指以外的多个手指的插指孔16a，在可动手柄18上设置有供同一手的拇指插入的插指孔18a。另外，在操作部主体14的上部突出设置有高频连接用的第1电极销19和第2电极销20，从而使操作部主体14能与高频电源装置(未图示)连接。
对插入部12进行说明。插入套21能相对于操作部主体14装卸地连接于操作部主体14上。该插入套21由管状构件22形成，该管状构件22由外周面被绝缘层22b覆盖的导电性材料构成。在该管状构件22的顶端部设置有保持构件22a，在该保持构件22a上设置有处理部23。在该处理部23上设置有第1夹持构件25，该第1夹持构件25用枢支销24可在上下方向上自由转动地枢支在保持构件22a上。
对振子单元13进行说明。在振子单元13上设置有能相对于操作部主体14的振子连接部15装卸地与该振子连接部15连接的振子壳体26。在该振子壳体26中内置有用于产生超声波振动的超声波振子。在振子壳体26的顶端部设置有单元连接部27，在该单元连接部27上安装有切去环构件一部分而形成为C字形的卡合环28。在单元连接部27上可装卸地设置有作为超声波振动传递构件的探头29。在探头29基端部设置有可旋入到单元连接部27中的安装螺蚊部30，在探头29顶端部设置有构成超声波振动部的探头顶端部31。而且，在把振子单元13的探头29插入到上述插入套21中时，探头顶端部31从保持构件22a向前方突出，从而构成处理部23。另外，附图标记32是与振子壳体26连接的超声波用电缆。
参照图2～图4对操作部11的内部结构进行说明。图2及图3是超声波处理器具的操作部的纵向剖视图，图4是图2的A-A剖视图。操作部主体14的壳体14a由合成树脂材料等绝缘构件形成，设置有用于安装第2电极销20的电极安装部33。第2电极销20，其中间部被绝缘罩34覆盖，其顶端部形成为用于与插头(未图示)相连接的连接部20a，其基端部形成为用于与壳体14a内部的连接构件35电连接的接点部20b。
在操作部主体14的基端部的内周面上设置有内螺纹部36，连接构件35和固定环37通过螺纹结合固定在该内螺纹部36上。在连接构件35的内部设置有与其同心的导电筒38。在该导电筒38的顶端部设置有作为导电性构件的探头保持构件39，该探头保持构件39用具有弹性的硅橡胶形成为环状。在上述振子单元13的探头29插入到操作部主体14中时，该探头保持构件39与探头29紧密贴合而将第2电极销20和探头29相互电导通。
在导电筒38的外周沿操作部主体14的前后方向设置有用绝缘材料形成的圆筒状的滑块安装构件40。在滑块安装构件40的顶端部上用连接销42能装卸地连接连接筒41，在该连接筒41的顶端部连接有供探头29穿过的主通道管42a。主通道管42a插入到管状构件22内部，在该管状构件22的基端部设置有圆筒状的导电构件43。该导电构件43利用导电橡胶170能导通地与覆盖探头保持构件39外侧的圆筒状导电延长部44连接。
另外，突出设置在操作部主体1 4的壳体14a上的第1电极销19的销主体19a用绝缘罩45覆盖其中间部，其顶端部设有用于连接插头(未图示)的连接部19b，其基端部设置有向壳体14a的内部突出的连接销46。把板弹簧弯曲成大致C字形而成的接点板47的中间部被固定在连接销46上，在该接点板47的两端部设置有与导电延长部44的两外侧面弹性接触的接点47a。而且，第1电极销19利用接点板47与导电构件43的导电延长部44电导通，从而从导电构件43电导通到管状构件22。
另外，在设置于操作部主体14内部的探头保持构件39上沿前后方向自由滑动地设置有滑块48，该滑块48被限制弹簧49向后方推压到操作部主体14上。该滑块48利用连接销50与在操作部主体14上能以枢支轴17为支点转动的可动手柄18相连接，在可动手柄18转动时通过滑块48使滑块安装构件40进行进退运动，该进退运动经由连接筒41传递给被插入到上述插入套21内的驱动杆51。也就是说，通过可动手柄18向箭头a方向的转动，使驱动杆51在插入套21的内部前进。
下面，参照图5～图7说明处理部23的结构。图5表示处理部，(a)是俯视图，(b)是纵向剖视图。图6表示处理部，(a)是图5的B-B剖视图，(b)是图5的C-C剖视图，(c)是图5的D-D剖视图。图7是处理部的横向剖视图。
保持构件22a设置在管状构件22的顶端部，利用枢支销24能转动地设置在该保持构件22a上的第1夹持构件25从俯视图上看是比插入套21的轴心稍微向左侧弯曲，使之容易夹持生物体组织。该第1夹持构件25由基端侧的夹持部主体25a和顶端侧的超声波处理构件25b构成，夹持部主体25a由枢支销24枢支在保持构件22a上。而且，在夹持部主体25a的基端部设置有连接销53，驱动杆51的顶端部与该连接销53连接。
夹持部主体25a的顶端部形成两岔形，在其切口部51a上旋入固定有具有螺纹部54a的枢支销54，超声波处理构件25b在上下方向上自由转动地枢支在该枢支销54上。因此，超声波处理构件25b可以与第1夹持构件25朝相同方向转动。该超声波处理构件25b由形成推压部的衬垫构件55和左右对称地设置在该衬垫构件55两侧的分层形状的第1电极部56构成。衬垫构件55例如用PTFE(注册商标)等低摩擦材料形成，在其生物体组织的夹持面侧形成有凹槽57。在第1电极部56的生物体组织的夹持面侧形成有大致锯齿形的齿部58，从而使之可以不相对于生物体组织打滑地夹持生物体组织，齿部58比衬垫构件55更朝夹持面侧突出。
在把振子单元13的探头29插入到上述插入套21中时，探头顶端部31从保持构件22a向前方突出、并与上述那样构成的第1夹持构件25相对。进而，该探头顶端部31构成与第1夹持构件25一起夹持生物体组织的第2夹持构件59。也就是说，第2夹持构件59通过锻造、切削等加工把圆棒状的探头顶端部31形成为非圆形，并设置有夹持面61和第2电极部62，该夹持面61与第1夹持构件25的凹槽57相对，该第2电极部62与左右的第1电极部56(齿部58)相对。
第2夹持构件59的第2电极部62处于远离第1夹持构件25的位置，与夹持面61之间具有高度差。而且，其特征在于：当夹持面61与第1夹持构件25的凹槽57接触时，第2电极部62处于相对于第1电极部56(齿部58)形成有间隙g的位置关系，以防止第1电极部56和第2电极部62之间短路。
因此，当向与第2夹持构件59接近的方向转动(夹持操作)第1夹持构件25时，首先，第2夹持构件59的夹持面61与第1夹持构件25的凹槽57接触，接着，第1电极部56和第2电极部62相接近。
另外，通过上述驱动杆51的操作，第1夹持构件25以枢支销24为支点转动，当处于使第1夹持构件25向夹持生物体组织的方向转动、并与第2夹持构件59一起夹持生物体组织的位置关系时，第1夹持构件25的凹槽57与夹持面61面接触而成为切开接合面。另外，左右的齿部58成为以与第2电极部62大致平行的面与第2电极部62相对的凝固接合面。也就是说，其特征在于：在与第1夹持构件25和第2夹持构件59的开闭方向垂直的方向上具有切开结合面和凝固接合面，能得到对生物体组织的较强的夹持力。
而且，其特征在于：由于在与第1夹持构件25和第2夹持构件59的开闭方向垂直的方向上设置有切开接合面和凝固接合面，因此由探头顶端部31构成的第2夹持构件59成为比第1夹持构件25不向左右方向两侧突出的细径结构，从而可以插入到体腔内狭窄的腔部来进行处理。
下面，对上述那样构成的超声波处理器具10的作用进行说明。
例如，为了进行以封闭血管为目的的处理，利用穿入到腹腔中的套管针(trocar)(未图示)把超声波处理器具10的插入部12插入到腹腔内。把手指搭在操作部11的固定手柄16和可动手柄18上，当相对于固定手柄16向箭头a方向转动可动手柄18时，就可以使驱动杆51前进。当驱动杆51前进时，第1夹持构件25以枢支销24为支点进行转动，可以使第1夹持构件25接近第2夹持构件59。
因此，当使插入部12的处理部23接近于生物体组织的目的部位，相对于第2夹持构件59闭合第1夹持构件25时，如图8所示，生物体组织S被夹持在第1构件25和第2构件59之间。也就是说，生物体组织S被夹持在第1夹持构件25的凹槽57和夹持面61之间的切开接合面处，并且，其夹持部分的两侧被第1电极部56和第2电极部62之间的凝固接合面夹持。这时，由于切开接合面及凝固接合面与第1夹持构件25和第2夹持构件59的夹持方向为同一方向，因此可以得到对生物体组织S较强的夹持力，而且，由于在第1电极部56上设有齿部58，因此可以使生物体组织S不会打滑地可靠地夹持该生物体组织S。
在该状态下，当驱动振子单元13的超声波振子时，超声波振动经由探头29传递到探头顶端部31上，第2夹持构件59进行超声波振动。该超声波振动传递到被第1夹持构件25和第2夹持构件59所夹持的生物体组织S上，在接触部位产生摩擦热而开始凝固，并且开始凝固切开。
而且，当使高频电流从高频电源流到操作部11的第1电极销19时，按第1电极销19→接点板47→导电延长部44→导电构件43→管状构件22→第1夹持构件25→第1电极部56的顺序流动。而且，高频电流还从第1电极部56经由生物体组织S流向第2电极部62，按第2电极部62→探头顶端部31→探头29→探头保持构件39→导电筒38→连接构件35→第2电极销20的顺序流动并返回到高频电源装置。
因此，高频电流流动到生物体组织S上而使其进行凝固，生物体组织S慢慢变薄，生物体组织S在第1夹持构件25的凹槽57和夹持面61之间被切开，并且在第1电极部56和第2电极部62之间凝固。当生物体组织S是血管时，由于切开部位的附近在第1电极部56和第2电极部62之间凝固而成为止血状态，因此完成了以封闭血管为目的的处理。
而且，第1夹持构件25以枢支销24为支点转动，当该第1夹持构件25与第2夹持构件59一起夹持生物体组织S时，由于第1夹持构件25的凹槽57与夹持面61面接触，而且，左右的齿部58成为以与第2电极部62大致平行的面与第2电极部62相对的凝固接合面，因此，可以得到对生物体组织S足够的夹持力。因此，可以提高通过并用超声波振动和高频电流而产生的凝固能力，也可以缩短处理时间。
另外，可以使并用超声波和高频电流的时刻为同时；当优先进行切开时，可以先使用超声波；当优先进行凝固时，可以先使用高频电流。
图9表示第2实施方式，对与第1实施方式相同结构的部分标注相同的附图标记并省略其说明。图9中，(a)是处理部的纵向剖视图，(b)是E-E剖视图。本实施方式是在第1夹持构件71中的衬垫构件72的两侧设置具有倾斜面73a的第1电极部73，并且该倾斜面73a相对于第1夹持构件71的转动方向的轴线CL具有一定角度(例如，45°)。在该第1电极部73的生物体组织的夹持面侧形成有大致锯齿状的齿部74，从而可以不相对于生物体组织打滑地夹持生物体组织。
而且，与第1夹持构件71一起夹持生物体组织的第2夹持构件75是通过锻造、切削等加工把圆棒状的探头顶端部31形成为非圆形(大致八角形)，并设置有夹持面76和第2电极部77，该夹持面76与第1夹持构件71相对，该第2电极部77具有与左右的第1电极部73(齿部74)相对的倾斜面77a。第2电极部77设置在沿第1夹持构件71和第2夹持构件75的夹持方向自夹持面76退避而与该夹持面76不连续的面上，而且，当夹持面76与第1夹持构件71的衬垫构件72接触时，第2电极部77处于相对于第1电极部73(齿部74)形成有间隙g的位置关系。
而且，当处于使第1夹持构件71向夹持生物体组织的方向转动、并与第2夹持构件75一起夹持生物体组织的位置关系时，第1夹持构件71的衬垫构件72与夹持面76面接触而成为切开接合面。另外，左右的齿部74成为以与第2电极部77大致平行的面与第2电极部77相对的凝固接合面。也就是说，在与第1夹持构件71和第2夹持构件75的开闭方向(轴线CL)垂直的方向上存在切开接合面，凝固接合面倾斜大约45°，能得到对生物体组织较强的夹持力。另外，由探头顶端部31构成的第2夹持构件75是比第1夹持构件71不向左右方向两侧突出的细径的结构，可以插入到体腔内狭窄的腔部内而进行处理。
图10表示第3实施方式，对与第1实施方式相同的结构部分标注相同的附图标记并省略其说明，图10中，(a)是处理部的纵向剖视图，(b)是F-F剖视图。本实施方式是在第1夹持构件81中的衬垫构件82的两侧设置板状的第1电极部83，该第1电极部83沿第1夹持构件81的转动方向的轴线CL平行地突出。在该第1电极部83的生物体组织的夹持面侧形成有大致锯齿状的齿部84，从而可以不相对于生物体组织打滑地夹持生物体组织。另外，与第1夹持构件81一起夹持生物体组织的第2夹持构件85是通过锻造、切削等加工把圆棒状的探头顶端部31形成为矩形截面状，并设置有夹持面86和第2电极部87，该夹持面86与第1夹持构件81相对。第2电极部87设置在沿第1和第2夹持构件81、85的夹持方向自夹持面86退避而与该夹持面86不连续的面上，而且，当夹持面86与第1夹持构件81的衬垫构件82接触时，第2电极部87处于相对于第1电极部83(齿部84)形成有间隙g的位置关系。
而且，当处于使第1夹持构件81向夹持生物体组织的方向转动、并与第2夹持构件85一起夹持生物体组织的位置关系时，第1夹持构件81的衬垫构件82与夹持面86面接触而成为切开接合面。另外，左右的第1电极部83成为以与第2电极部87大致平行的面与第2电极部87相对的凝固接合面。也就是说，在与第1夹持构件81和第2夹持构件85的开闭方向(轴线CL)垂直的方向上存在切开接合面，凝固接合面处于大致平行的面，能得到对生物体组织较强的夹持力。而且，由探头顶端部31构成的第2夹持构件85是比第1夹持构件81不向左右方向两侧突出的结构，可以插入到体腔内狭窄的腔部中而进行处理。
图11表示第4实施方式，对与第1实施方式相同结构的部分标注相同的附图标记并省略其说明。图11中，(a)是处理部的纵向剖视图，(b)是G-G剖视图。本实施方式只是第2夹持构件88与第1实施方式不同，与第1夹持构件25一起夹持生物体组织的第2夹持构件88是通过锻造、切削等加工把圆棒形的探头顶端部31形成为截面非圆形，在与第1夹持构件25的衬垫构件55的凹槽57相对的截面上设置有以大致倒V字形突出的夹持面89。而且，在夹持面89的左右设置有具有平坦面的第2电极部90，该平坦面与第1电极部56(齿部58)相对。当夹持构件抵接部25c与保持构件抵接部22c接触时，第2电极部90处于相对于第1电极部56(齿部58)形成有间隙g的位置关系。
而且，当处于使第1夹持构件25向夹持生物体组织的方向转动而与第2夹持构件88一起夹持生物体组织的位置关系时，第1夹持构件25的衬垫构件55与夹持面89形成间隙h。另外，夹持面89的左右的第1电极部56成为以与第2电极部90大致平行的面与第2电极部90相对的凝固接合面。也就是说，在与第1夹持构件25和第2夹持构件88的开闭方向垂直的方向上存在切开接合面，凝固接合面处于大致平行的面，能得到对生物体组织较强的夹持力。另外，由探头顶端部31构成的第2夹持构件88是比第1夹持构件25不向左右方向两侧突出的结构，从而可以插入到体腔内狭窄的腔部内进行处理。
在本实施方式中，因为衬垫构件55和夹持面89不接触，所以在切开生物体组织时，需要在生物体组织和夹持面89较强地接触的方向上给予拉力(tension)，但由于衬垫构件55不会磨损，因此提高了耐用性。
图12表示第5实施方式，对与第1实施方式相同结构的部分标注相同的附图标记并省略其说明。图12中，(a)是处理部的立体图，(b)是处理状态的横向剖视图。本实施方式中是将第1夹持构件91形成为平板形状，并在其夹持面侧设置有凸圆弧状的衬垫构件92。在第1夹持构件91的衬垫构件92的两侧设置有第1电极部93。与第1夹持构件91一起夹持生物体组织S的第2夹持构件94是通过锻造、切削等加工把圆棒形的探头顶端部31形成为非圆形，与第1夹持构件91相对的夹持面95形成为凹圆弧状，以便与衬垫构件92嵌合，在夹持面95的左右设置有由与第1电极部93相对的棱线构成的第2电极部96。
而且，当处于使第1夹持构件91向夹持生物体组织S的方向转动而与第2夹持构件94一起夹持生物体组织S的位置关系时，第1夹持构件91的衬垫构件92与夹持面95面接触而成为切开接合面。另外，左右的第1电极部93成为以与第2电极部96大致平行的面与第2电极部96相对的凝固接合面，能得到对生物体组织S较强的夹持力。根据本实施方式，可以把探头顶端部31做得比第1夹持构件91小，整体可以细径化。
图13表示第6实施方式，对与第1实施方式相同结构的部分标注相同的附图标记并省略其说明。图13是处理部的立体图。本实施方式是使第1夹持构件101的截面为大致半圆形，并在夹持面侧形成有凹槽102，在该凹槽102内埋设有衬垫构件103。在第1夹持构件101的衬垫构件103的两侧设置有第1电极部104。与第1夹持构件101一起夹持生物体组织的第2夹持构件105是通过锻造、切削等加工把圆棒状的探头顶端部31形成为非圆形，与第1夹持构件101相对的夹持面106形成为与衬垫构件103接触的例如波浪形的凹凸部，在该夹持面106的左右设置有由与第1电极部104相对的平坦面构成的第2电极部107。
而且，当处于使第1夹持构件101向夹持生物体组织的方向转动而与第2夹持构件105一起夹持生物体组织的位置关系时，第1夹持构件101的衬垫构件103与夹持面106局部接触而成为切开接合面。另外，左右的第1电极部104成为以与第2电极部107大致平行的面与第2电极部107相对的凝固接合面，能得到对生物体组织较强的夹持力。根据本实施方式，由于没有必要在第1电极部104上设置防滑齿，因此能进行更稳定的凝固。
图14表示第7实施方式，对与第1实施方式相同结构的部分标注相同的附图标记并省略其说明。图14中，(a)是处理部的立体图，(b)是H-H剖视图。本实施方式中使第1夹持构件111的截面为圆柱形，在夹持面侧形成有大致倒三角形状的凹槽112，在该凹槽112内埋设有衬垫构件113。在第1夹持构件111的衬垫构件113的两侧设置有以V字形突出的第1电极部114。与第1夹持构件111一起夹持生物体组织的第2夹持构件115是通过锻造、切削等加工把圆棒状的探头顶端部31形成为非圆形，与第1夹持构件111相对的夹持面116形成为与衬垫构件113接触的三角形的凸部，在该夹持面116的左右设置有由与第1电极部114相对的V字形的凹部构成的第2电极部117。
而且，当处于使第1夹持构件111向夹持生物体组织的方向转动而与第2夹持构件115一起夹持生物体组织的位置关系时，第1夹持构件111的衬垫构件113与夹持面116线接触而成为切开接合面。另外，左右的第1电极部114成为以多个面与第2电极部117接触的凝固范围大的凝固接合面。
图15表示第8实施方式，对与第1实施方式相同结构的部分标注相同的附图标记并省略其说明，图15是处理部的横向剖视图。本实施方式是由夹持衬垫构件122的一对构件形成第1夹持构件121，其截面与衬垫构件122都是凹圆弧状，在夹持面侧形成有凹圆弧状的凹槽123。在第1夹持构件121中的衬垫构件122的两侧设置有由平坦面构成的第1电极部124和第2电极部127。与第1夹持构件121一起夹持生物体组织的第2夹持构件125由圆棒状的探头顶端部31形成，其与第1夹持构件121相对的夹持面126形成为与衬垫构件122接触的凸圆弧状。
而且，当处于使第1夹持构件121向夹持生物体组织的方向转动而与第2夹持构件125一起夹持生物体组织的位置关系时，第1夹持构件121的衬垫构件122与夹持面126面接触而成为切开接合面。另外，夹持面126的左右的第1电极部124及第2电极部127成为凝固接合面，对生物体组织的被压缩的部分通高频电流。
图16表示第9实施方式，对与第1实施方式相同结构的部分标注相同的附图标记并省略其说明。图16是处理部的立体图。本实施方式是将第1夹持构件131分成2部分，这些第1夹持构件131的基端部以枢支轴132为支点自由转动地枢支在保持构件22a的倒V字形面上。衬垫构件133设置在第1夹持构件131的单侧，其与第1夹持构件131一起向圆棒状的探头顶端部31的轴心31a转动。而且，在第1夹持构件131的与探头顶端部31相面对的侧设置有第1电极部134。另外，第1夹持构件131也可以是由施力弹簧等向打开方向施力，沿管状构件22的轴向前进的套构件等向内侧推压而向闭合方向转动。
而且，与第1夹持构件131一起夹持生物体组织的第2夹持构件135是通过锻造、切削等加工把圆棒状的探头顶端部31形成为非圆形，其与第1夹持构件131的衬垫构件133相对的夹持面136由棱线形成，在夹持面136的左右设置有具有倾斜面137a的第2电极部137。
而且，当使第1夹持构件131处于向夹持生物体组织的方向转动而与第2夹持构件135一起夹持生物体组织的位置关系时，第1夹持构件131的衬垫构件133与夹持面136接触而成为切开接合面。另外，左右的第1电极部134成为以与第2电极部137大致平行的面与第2电极部137相对的凝固接合面。也就是说，第1夹持构件131和第2夹持构件135的开闭方向成为探头顶端部31的半径方向，与该开闭方向垂直的方向上存在凝固接合面，能得到对生物体组织较强的夹持力。
图17表示第10实施方式，对与第1实施方式相同结构的部分标注相同的附图标记并省略其说明。图17是处理部的横向剖视图。本实施方式是只有第2夹持构件138与第1实施方式不同，与第1夹持构件25一起夹持生物体组织的第2夹持构件138是通过锻造、切削等加工把圆棒状的探头顶端部31形成为截面非圆形，设置有第2电极部140，该第2电极部140具有夹持面139和平坦面，该夹持面139由与第1夹持构件25的衬垫构件55的凹槽57相对的凸状部构成，该平坦面与左右的第1电极部56(齿部58)相对。当夹持面139与第1夹持构件25的衬垫构件55接触时，第2电极部140处于相对于第1电极部56(齿部58)形成有间隙g的位置关系。而且，第2夹持构件138的由凸状部构成的夹持面139由绝缘涂料形成有绝缘层141，第2电极部140是不涂敷绝缘涂料的结构。因此，可以使第1电极部56和第2电极部140的面积大致相同来提高电流密度，从而可高效率地凝固。
图18表示第11实施方式，对与第1实施方式相同结构的部分标注相同的附图标记并省略其说明。图18是处理部的横向剖视图。本实施方式的第1夹持构件151，在夹着衬垫构件152左右设置有第1电极部153的分层结构的外侧，一体地设置有由合成树脂材料构成的绝缘块154。绝缘块154比第1电极部153更向夹持方向突出，在该绝缘块154的突出部上形成有齿部155。
与第1夹持构件151一起夹持生物体组织的第2夹持构件156是通过锻造、切削等加工把圆棒状的探头顶端部31形成为非圆形，与第1夹持构件151相对的夹持面157形成为与衬垫构件152接触的凸部，在该夹持面157的左右设置有具有倾斜面158a的第2电极部158，该倾斜面158a与第1电极部153相对。
而且，当处于使第1夹持构件151向夹持生物体组织的方向转动、并与第2夹持构件156一起夹持生物体组织的位置关系时，第1夹持构件151的衬垫构件152与夹持面157接触而成为切开接合面。另外，夹持面157左右的第1电极部153与第2电极部158相对并成为凝固接合面。根据本实施方式，即使对探头顶端部31施加横向力等时，由于不会与第1电极部153接触，因此有助于提高探头顶端部31的耐用性。
图19表示公开例，对与第1实施方式相同结构的部分标注相同的附图标记并省略其说明。图19中，(a)是处理部的纵向剖视图，(b)是I-I剖视图。第1夹持构件161是矩形截面的构件，在其夹持面侧形成有锯齿状的齿部162。在第1夹持构件161上沿轴向设置有凹槽163，在该凹槽163内埋设有第1电极部164。在第1夹持构件161中的第1电极部164的两侧设置有衬垫构件165。与第1夹持构件161一起夹持生物体组织的第2夹持构件166由圆棒状的探头顶端部31形成，其与第1夹持构件161相对的夹持面167与衬垫构件165接触。在夹持面167的左右设置有与第1电极部164相对的由圆弧面构成的第2电极部168。
而且，当向夹持生物体组织的方向转动第1夹持构件161并与第2夹持构件166一起夹持生物体组织时，齿部162与生物体组织接触，第1夹持构件161的衬垫构件165与夹持面167局部接触而成为切开接合面。另外，左右的第1电极部164成为与第2电极部168相对的凝固接合面。
另外，本发明不限定于上述的实施方式本身，在实施阶段，可以在不脱离其宗旨的范围内改变结构要素而具体化。另外，通过适当组合上述实施方式中公开的多种结构要素，可以形成各种各样的发明。例如，也可以从实施方式所示的全部结构要素中删除几个结构要素。而且，也可以适当地组合各不同实施方式的结构要素。

Claims (5)

1.一种外科用处理器具，其特征在于，包括：
第1夹持构件；
第2夹持构件，其设置成能相对于上述第1夹持构件进行开闭，在其与该第1夹持构件之间夹持生物体组织；
超声波振动部，其设置在上述第1夹持构件或上述第2夹持构件中的一方上，与超声波振子连接而进行超声波振动；
超声波凝固切开部件，其设置在上述第1夹持构件或上述第2夹持构件中的另一方上，与上述超声波振动部相对，具有在其与该超声波振动部之间推压生物体组织的推压部；
高频凝固部件，其用于凝固生物体组织，由设置在上述第1夹持构件上的第1电极部和设置在上述第2夹持构件上的第2电极部构成，并将该第1电极部和第2电极部相对设置。
2.一种外科用处理器具，其特征在于，包括：
第1夹持构件；
第2夹持构件，其设置成能相对于上述第1夹持构件进行开闭，在其与该第1夹持构件之间夹持生物体组织；
超声波振动部，其设置在上述第1夹持构件或上述第2夹持构件中的一方，与超声波振子连接而进行超声波振动；
超声波凝固切开部件，其设置在上述第1夹持构件或上述第2夹持构件中的另一方，与上述超声波振动部相对，具有在其与该超声波振动部之间推压生物体组织的推压部；
高频凝固部件，其用于凝固生物体组织，由设置在上述第1夹持构件上的第1电极部和设置上述第2夹持构件上的第2电极部构成，当通过上述第1夹持构件和上述第2夹持构件的夹持操作使上述超声波振动部和构成上述超声波凝固切开部件的推压部相结合时，处于在上述第1电极部和第2电极部之间形成有间隙的位置关系。
3.根据权利要求1或2所述的外科用处理器具，其特征在于，
相互相对的上述第1电极部和第2电极部的接近和分离方向，与上述第1夹持构件和第2夹持构件的开闭方向一致。
4.根据权利要求1或2所述的外科用处理器具，其特征在于，
上述推压部和上述超声波振动部之间的切开接合面、与上述第2电极部的凝固接合面，在上述第1夹持构件和第2夹持构件的开闭方向上相分离着。
5.根据权利要求1或2所述的外科用处理器具，其特征在于，
设置在上述第2夹持构件上的、与上述推压部相对的上述超声波振动部的切开接合面和上述第2电极部的与生物体组织接合的凝固接合面，设置在不连续的面上。
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