阅读说明：本技术 能量处置器具和能量处置器具的制造方法 (Energy treatment instrument and method for manufacturing energy treatment instrument ) 是由 铜庸高 于 2017-12-21 设计创作，主要内容包括：包括：母材,其具备通过被供给电能而向处置对象施加高频电流的处置面,该母材具有导电性；以及防粘涂层,其包含具有偶联结构的偶联剂,通过由所述偶联结构引起的键合而形成于所述母材的表面的至少所述处置面,该防粘涂层用于防止处置对象相对于所述母材的所述表面的粘贴。(The method comprises the following steps: a base material having a treatment surface to which a high-frequency current is applied to a treatment target by being supplied with electric energy, the base material having conductivity; and an anti-adhesive coating layer which includes a coupling agent having a coupling structure and is formed on at least the treatment surface of the base material by bonding caused by the coupling structure, the anti-adhesive coating layer being used for preventing adhesion of a treatment object to the surface of the base material.)

1. An energy treatment instrument, wherein the energy treatment instrument comprises:

a base material having a treatment surface to which a high-frequency current is applied to a treatment target by being supplied with electric energy, the base material having conductivity; and

and an anti-adhesive layer which is formed on at least the treatment surface of the base material by bonding caused by the coupling structure, the anti-adhesive layer containing a coupling agent having a coupling structure, and which is used for preventing adhesion of a treatment object to the surface of the base material.

2. The energy treatment appliance of claim 1, wherein the coupling agent of the release coating comprises a molecular chain having carbon and fluorine.

3. The energy treatment appliance of claim 1, wherein the coupling agent of the release coating is provided with the coupling structure at both ends.

4. The energy treatment instrument of claim 1, wherein the parent material is a titanium alloy.

5. The energy treatment instrument of claim 1, further comprising an organic layer bonded to the surface of the base material, the organic layer being provided between the surface of the base material and the release coating layer,

the coupling agent of the release coating is a silane coupling agent,

the coupling structure of the coupling agent of the release coating is bonded to the organic layer.

6. The energy treatment appliance of claim 5, wherein the organic layer comprises a titanate coupling agent having a coupling structure,

the coupling structure of the titanate coupling agent is bonded to the surface of the parent material.

7. The energy treatment appliance of claim 5, wherein the organic layer has: a modified surface formed of an amine-based reactive group on the surface of the base material.

8. The energy management device of claim 1, wherein the coupling agent of the release coating is a titanate coupling agent,

the coupling structure of the coupling agent of the anti-sticking coating layer is bonded with the surface of the parent material.

9. The energy treatment instrument according to claim 1, further comprising a gripping member openable and closable with respect to the base material,

the high-frequency current flows between the treatment surface and the gripping member by supplying electric energy to the base material and the gripping member.

10. The energy treatment instrument according to claim 9, further comprising a 2 nd release coating layer, the 2 nd release coating layer containing a coupling agent having a coupling structure formed on a surface of the grip member by bonding caused by the coupling structure, the 2 nd release coating layer being for preventing sticking of a treatment object.

11. The energy treatment instrument according to claim 1, further comprising an ultrasonic transducer which generates ultrasonic vibration by being supplied with electric energy and transmits the ultrasonic vibration to the base material.

12. The energy treatment instrument according to claim 1, further comprising a thermal insulating coating layer provided on a surface other than the treatment surface among the surfaces of the base material and having thermal insulation properties.

13. The energy treatment appliance of claim 12, wherein the thermal barrier coating is formed of PEEK resin.

14. A method of manufacturing an energy treatment instrument, wherein the method of manufacturing the energy treatment instrument comprises:

forming a base material having conductivity and having a treatment surface to which a high-frequency current is applied to a treatment target by being supplied with electric energy;

forming an organic layer on the surface of the base material by bonding a coupling structure of a titanate coupling agent to the surface of the base material on at least the treatment surface of the base material; and

an anti-sticking coating layer for preventing sticking of a treatment target is formed on at least the treatment surface of the base material by bonding a coupling structure of a silane coupling agent to the organic layer.

Technical Field

The present invention relates to an energy treatment instrument for treating a treatment target with treatment energy and a method of manufacturing the energy treatment instrument.

Background

US2009/0030438a1 discloses an energy treatment instrument that applies a high-frequency current from a treatment surface to a treatment target to thereby treat the treatment target such as a living tissue. In the energy treatment instrument, at least a part of the treatment surface is formed of an electrically conductive material. When electric energy is supplied to the conductive material in a state where the treatment surface is in contact with the treatment object, a high-frequency current flows to the treatment object through the treatment surface.

In the energy treatment device of US2009/0030438a1, a coating for anti-adhesive is applied to the treatment surface. In this case, depending on the thickness of the coating layer, the resistance of the applied coating layer may affect the application of the high-frequency current to the treatment object.

Disclosure of Invention

The present invention has been made in view of the above problems, and an object thereof is to provide an energy treatment instrument that prevents sticking of a treatment target and reduces the influence of an anti-sticking coating when a high-frequency current is applied to the treatment target, and a method for manufacturing the energy treatment instrument.

In order to achieve the above object, an energy treatment instrument according to an aspect of the present invention includes: a base material having a treatment surface to which a high-frequency current is applied to a treatment target by being supplied with electric energy, the base material having conductivity; and an anti-adhesive coating layer which includes a coupling agent having a coupling structure and is formed on at least the treatment surface of the base material by bonding caused by the coupling structure, the anti-adhesive coating layer being used for preventing adhesion of a treatment object to the surface of the base material.

In addition, a method for manufacturing an energy treatment instrument according to an aspect of the present invention includes: forming a base material having conductivity and having a treatment surface to which a high-frequency current is applied to a treatment target by being supplied with electric energy; forming an organic layer on the surface of the base material by bonding a coupling structure of a titanate coupling agent to the surface of the base material on at least the treatment surface of the base material; and forming an anti-sticking coating layer for preventing sticking of a treatment object on the surface of the base material by bonding a coupling structure of a silane coupling agent to the organic layer.

Drawings

Fig. 1 is a view schematically showing an energy treatment instrument according to embodiment 1.

Fig. 2 is a cross-sectional view schematically showing the end effector of embodiment 1 in a cross-section intersecting the longitudinal axis.

Fig. 3 is a view schematically showing a state where an organic layer is formed on a treatment surface in embodiment 1.

Fig. 4 is a view schematically showing a state where an organic layer is formed on a treatment surface in embodiment 1.

Fig. 5 is a view schematically showing a state where an anti-adhesive coating layer is formed on a treatment surface in embodiment 1.

Fig. 6 is a cross-sectional view schematically showing the 1 st gripping piece of the 1 st modification of embodiment 1 in a cross-section intersecting the longitudinal axis.

Fig. 7 is a cross-sectional view schematically showing the 1 st gripping piece of the 2 nd modification of the 1 st embodiment in a cross-section intersecting the longitudinal axis.

Fig. 8 is a cross-sectional view schematically showing the 1 st gripping piece of the 3 rd modification of the 1 st embodiment in a cross-section intersecting the longitudinal axis.

Fig. 9 is a cross-sectional view schematically showing the end effector of embodiment 2 in a cross-section intersecting the longitudinal axis.

Fig. 10 is a view schematically showing a state where an anti-adhesive coating layer is formed on a treatment surface in embodiment 2.

Fig. 11 is a cross-sectional view schematically showing the end effector of embodiment 3 in a cross-section intersecting the longitudinal axis.

Detailed Description

(embodiment 1)

Embodiment 1 of the present invention will be described with reference to fig. 1 to 5.

Fig. 1 is a diagram showing a treatment instrument 1 as an energy treatment instrument of the present embodiment. As shown in fig. 1, the treatment instrument 1 includes a housing 4 and a cylindrical shaft 5 coupled to the housing 4. The housing 4 can be held. One end of the cable 7 is connected to the housing 4. The other end of the cable 7 is detachably connected to the power supply device 3.

The shaft 5 defines a longitudinal axis L, where the direction along the longitudinal axis L is the longitudinal direction, one side in the longitudinal direction is the distal end side (arrow L1 side in fig. 1), the opposite side to the distal end side is the proximal end side (arrow L2 side in fig. 1), and the shaft 5 extends along the longitudinal axis L from the proximal end side to the distal end side and is coupled to the distal end side of the housing 4.

An end effector 6 is provided at the distal end portion of the shaft 5. The end effector 6 includes a1 st gripping tab 13 and a 2 nd gripping tab 14. The 1 st gripping piece 13 and the 2 nd gripping piece 14 can be opened and closed. In the present embodiment, the 1 st gripping piece 13 is supported by the shaft 5, and the 2 nd gripping piece 14 is attached to the shaft 5 so as to be rotatable with respect to the 1 st gripping piece 13.

The 1 st gripping piece 13 includes a treatment surface (opposing surface) 17 that opposes the 2 nd gripping piece 14 and applies treatment energy to a treatment object. The 2 nd grasping piece 14 includes a treatment surface (opposing surface) 18 that opposes the treatment surface 17 of the 1 st grasping piece 13 and applies treatment energy to the treatment object.

The opening/closing direction of the end effector 6 intersects (is perpendicular or substantially perpendicular) the longitudinal axis L, the side of the opening/closing direction of the end effector 6 on which the 2 nd grip piece 14 opens with respect to the 1 st grip piece 13 is defined as the opening direction (arrow Y1) of the 2 nd grip piece 14, and the side of the closing direction of the 2 nd grip piece 14 with respect to the 1 st grip piece 13 is defined as the closing direction (arrow Y2) of the 2 nd grip piece 14, and here, the direction intersecting (perpendicular or substantially perpendicular) the longitudinal axis L and intersecting (perpendicular or substantially perpendicular) the opening/closing direction of the end effector 6 is defined as the width direction of the end effector 6.

The housing 4 includes a housing main body 10 and a grip (fixed handle) 11. the housing main body 10 is extended along a length axis L. the grip 11 is extended from the housing main body 10 toward the side away from the length axis L. the shaft 5 is joined to the housing main body 10 from the tip end side.

The movable handle 12 is rotatably attached to the housing main body 10, the movable handle 12 is located on the side where the grip 11 is located with respect to the longitudinal axis L, the movable handle 12 is located on the tip side with respect to the grip 11 in the present embodiment, the movable handle 12 is opened or closed with respect to the grip 11 by rotating the movable handle 12 with respect to the housing main body 10, and the operation of opening or closing the end effector 6 as described above is input to the movable handle 12 by opening or closing the movable handle 12 with respect to the grip 11, that is, the movable handle 12 is an opening/closing operation input unit.

The movable handle 12 and the 2 nd grip piece 14 are coupled via the movable member 16, the movable member 16 extends along the longitudinal axis L inside the shaft 5, the movable member 16 moves along the longitudinal axis L with respect to the shaft 5 and the housing 4 by opening or closing the movable handle 12 with respect to the grip 11, and the 2 nd grip piece 14 rotates with respect to the shaft 5, whereby the grip pieces 13, 14 are opened or closed, and the treatment object is gripped between the grip pieces 13, 14 by closing the grip pieces 13, 14 in a state where the treatment object is disposed between the grip pieces 13, 14.

In one embodiment, movable handle 12 is located on a proximal side relative to grip 11. additionally, in another embodiment, movable handle 12 is located on a side opposite to the side on which grip 11 is located relative to length axis L and moves in a direction that intersects (perpendicular or substantially perpendicular) length axis L during opening and closing motions.

In addition, in yet another embodiment, an operating member such as a knob is mounted to the housing body 10. in this case, by rotating the operating member relative to the housing 4 about the length axis L, the shaft 5 and end effector 6 rotate together with the operating member relative to the housing 4 about the length axis L.

The power supply device 3 includes a high-frequency power supply and an ultrasonic power supply. The high-frequency power supply includes a waveform generator, a conversion circuit, a transformer, and the like, and converts power from a battery power supply, an outlet power supply, or the like into high-frequency power. As described later, at least a part of each of the 1 st gripping piece 13 and the 2 nd gripping piece 14 is formed of a conductive material. The high-frequency power source is electrically connected to the respective conductive materials of the 1 st gripping piece 13 and the 2 nd gripping piece 14 via an electrical path provided through the inside of the cable 7, the inside of the housing 4, and the inside of the shaft 5. The high-frequency power supply outputs the converted high-frequency power through the electrical path, and supplies the high-frequency power as electrical energy to the 1 st gripping piece 13 and the 2 nd gripping piece 14.

The ultrasonic power supply includes a waveform generator, a conversion circuit, a transformer, and the like, and converts electric power from a battery power supply, an outlet power supply, or the like into ac power. Further, an ultrasonic transducer 9 and a vibration transmission member (probe) 8 connected to the ultrasonic transducer 9 from the distal end side are provided inside the case body 10. The ultrasonic power supply is electrically connected to the ultrasonic transducer 9 via an electrical path provided through the inside of the cable 7 and the inside of the housing 4. Ultrasonic vibration is generated in the ultrasonic transducer 9 by supplying electric energy (ac power) from an ultrasonic power supply. The ultrasonic vibration generated by the ultrasonic transducer 9 is transmitted to the vibration transmission member 8.

The vibration transmission member 8 extends from the inside of the housing body 10 toward the distal end side, passes through the inside of the shaft 5, and protrudes from the distal end of the shaft 5 toward the distal end side. Further, the 1 st grip piece 13 is formed by a protruding portion of the vibration transmission member 8 that protrudes from the shaft 5 to the distal end side. The ultrasonic vibration generated by the ultrasonic transducer 9 is transmitted to the distal end portion of the vibration transmission member 8 where the 1 st gripping piece 13 is formed. Thereby, the ultrasonic vibration is transmitted to the 1 st grasping piece 13 as treatment energy. The vibration transmission member 8 is preferably formed of a material having electrical conductivity and high vibration transmissibility. In the present embodiment, the vibration transmission member 8 is formed of a titanium alloy having good compatibility with the living tissue. The vibration transmission member 8 may be formed of a metal material other than titanium alloy, such as duralumin or stainless steel.

The casing body 10 is provided with an operation button 15. The operation button 15 is an energy operation input unit. When an operation is input by the operation button 15 in a state where the treatment object is held between the grip pieces 13 and 14, electric energy is supplied to the treatment instrument 1 from, for example, a high-frequency power supply and an ultrasonic power supply, respectively. Then, a high-frequency current and ultrasonic vibration are applied as treatment energy to the gripped treatment object. In one embodiment, a foot switch electrically connected to the power supply device 3 is provided separately from the treatment instrument 1 in place of the operation button 15, or a foot switch electrically connected to the power supply device 3 is provided separately from the treatment instrument 1 in addition to the operation button 15.

In one embodiment, the housing body 10 is provided with a plurality of operation buttons 15. In a state where the treatment object is held, a high-frequency current is applied as treatment energy to the treatment object only by an input operation using any one of the plurality of operation buttons 15. In addition, when the treatment object is held and operated by another input operation of the plurality of operation buttons 15, for example, a high-frequency current and ultrasonic vibration are applied to the treatment object as treatment energy.

Fig. 2 is a view showing the end effector 6 in a cross section (perpendicular or substantially perpendicular) intersecting the longitudinal axis L, the 1 st grasping piece 13 has conductivity, the 1 st grasping piece 13 is formed of, for example, a metal, in the present embodiment, the 1 st grasping piece 13 is formed of a protruding portion of the vibration transmission member 8 that protrudes from the shaft 5 to the distal end side and is formed of a titanium alloy, and the 1 st grasping piece 13 includes a treatment surface 17, a back surface 19 facing the side opposite to the treatment surface 17, and a pair of side surfaces 20 facing the outside in the width direction of the end effector 6.

In the present embodiment, the vibration transmission member 8 is a base material having conductivity and forming the treatment surface 17. In the present embodiment, the 1 st gripping piece 13 is formed of a base material.

Inside the casing body 10, one end of an electrical path formed by electrical wiring or the like is connected to the vibration transmission member 8. The electric path extends through the inside of the case 4 and the inside of the cable 7, and the other end is connected to the high-frequency power supply of the power supply device 3. Via this electrical path, the vibration transmission member 8 and the high-frequency power supply are electrically connected. This enables high-frequency power to be supplied from the high-frequency power supply to the 1 st grip piece 13. The 1 st gripping piece 13 functions as a1 st electrode by being supplied with high-frequency power.

The 2 nd gripping piece (gripping member) 14 includes a support body (jaw member) 21. The support body 21 is coupled to be rotatable with respect to the shaft 5. The support 21 has conductivity. The support (conductive member) 21 is formed of, for example, metal. The support body 21 forms part of the treatment surface 18.

One end of an electrical path formed by electrical wiring or the like is connected to the support 21. The electric path extends through the inside of the shaft 5, the inside of the housing 4, and the inside of the cable 7, and the other end is connected to a high-frequency power supply of the power supply device 3. The support 21 and the high-frequency power supply are electrically connected via the electrical path. This enables high-frequency power to be supplied from the high-frequency power supply to the support 21. The support 21 functions as a 2 nd electrode different from the 1 st electrode by being supplied with high-frequency power.

The 2 nd gripping piece 14 includes a short-circuit prevention member (pad member) 23. The short-circuit prevention member 23 is attached to the support body 21 from the grip piece 13 side. The short-circuit prevention member 23 is disposed at the center of the grip piece 14 in the width direction, and forms the center of the treatment surface 18. The short-circuit prevention member 23 has electrical insulation. The short-circuit prevention member 23 is formed of, for example, a resin material.

In a state where the space between the gripping pieces 13 and 14 is closed, the short-circuit prevention member 23 of the gripping piece 14 abuts against the treatment surface 17 of the gripping piece 13. In this state, a gap is formed between the support body 21 and the treatment surface 17 of the gripping piece 13, and the treatment surface 17 of the gripping piece 13 does not contact the support body 21. Therefore, in a state where the support body 21 and the grip piece 13 function as electrodes, a short circuit in a circuit that outputs high-frequency power from the power supply device 3 to the support body 21 and the grip piece 13 is effectively prevented.

The organic layer 41 and the release coating 51 are formed on the surface of the 1 st gripping sheet 13. The organic layer 41 is provided between the release coating 51 and the surface of the 1 st grip piece 13. The organic layer 41 is a monomolecular film formed on the surface of the 1 st gripping sheet 13 with a surface modifier. The organic layer 41 brings the 1 st grip piece 13 into close contact with the release coating 51 by bonding with the surface of the 1 st grip piece 13 and the release coating 51, respectively. The release coat layer 51 is a monomolecular film formed on the surface of the organic layer 41.

In the present embodiment, the organic layer 41 and the release coat layer 51 are provided in the region where the disposal surface 17 is provided in the longitudinal direction, the organic layer 41 and the release coat layer 51 are formed in the region where the disposal surface 17 is included in the direction (outer circumferential surface) around the longitudinal axis L on the surface of the 1 st gripping sheet 13, and the organic layer 41 and the release coat layer 51 are provided in a part of the side surface 20 and the disposal surface 17 on the outer circumferential surface of the 1 st gripping sheet 13.

The organic layer 41 and the release coat layer 51 will be described with reference to fig. 3 to 5. As shown in fig. 3, the surface of the 1 st gripping piece 13 is covered with hydroxyl (hydroxyl) OH groups by the reaction of the metal groups M with oxygen and moisture in the atmosphere. In this embodiment, the metal group M is titanium.

The organic layer 41 is formed of a material containing a titanate coupling agent. The titanate coupling agent of the present embodiment includes a titanium atom Ti, 1 OR more hydrolyzable groups OR, and an organic functional group Y. The titanium atom Ti and 3 hydrolytic groups OR are utilized to form a coupling structure of the titanate coupling agent.

The hydrolyzable groups OR are each chemically bonded to a titanium atom Ti. The hydrolyzable group OR is a reactive group chemically bonded to the inorganic material by hydrolysis OR the like, and is, for example, an alkoxy group such as a methoxy group OR an ethoxy group. The organic functional group Y is chemically bonded to the titanium atom Ti. The organic functional group Y is a functional group bonded to an organic material, and examples thereof include a vinyl group, an epoxy group, an amino group, a methacryloyl group, and a mercapto group. In one embodiment, as the organic functional group Y, for example, an amino group (amine-based reactive group) is used. In this case, as the organic functional group Y, for example, OC is used₂H₄NHC₂H₄NH₂。

As shown in fig. 4, on the surface of the 1 st gripping piece 13, the coupling structure of the titanate coupling agent is bonded to the surface of the 1 st gripping piece 13. Further, the organic layer 41 is formed on the surface of the 1 st gripping piece 13 by bonding to the surface of the 1 st gripping piece 13 through the coupling structure of the titanate coupling agent.

Here, the bonding of the coupling structure of the titanate coupling agent to the surface of the 1 st holding sheet 13 includes chemical bonding (hydrolysis) of the hydrolyzable group OR of the titanate coupling agent to the hydroxyl group OH of the surface of the 1 st holding sheet 13, bonding by chemisorption, bonding by intermolecular force, bonding by other interaction, and the like.

At this time, the modified surface 42 is formed on the surface of the 1 st grip sheet 13 by the organic functional group Y of the titanate coupling agent. In the present embodiment, the modified surface 42 is formed using an organic functional group Y such as an amine group.

As shown in fig. 5, the release coating layer 51 is formed of a material containing a silane coupling agent. The silane coupling agent includes a silicon atom Si, a molecular chain containing a carbon atom C and a fluorine atom F, and a hydrolyzable group OR.

In the silane coupling agent, 3 hydrolyzable groups OR are chemically bonded to silicon atoms Si, respectively. In the silane coupling agent, 3 hydrolyzable groups OR are chemically bonded to a silicon atom Si to form a coupling structure. The coupling structures are respectively arranged at the two tail ends of the molecular chain.

In the molecular chain, fluorine atoms F and the like are bonded to chain-bonded carbon atoms C. The hydrolyzable group OR is a reactive group chemically bonded to the inorganic material by hydrolysis OR the like, and is, for example, an alkoxy group such as a methoxy group OR an ethoxy group.

On the surface of the 1 st holding sheet 13, the coupling structure of the silane coupling agent is bonded to the organic functional group Y (e.g., amine group) forming the modified surface 42 of the organic layer 41. Then, the silane coupling agent is bonded to the organic layer 41, and the release coating 51 is formed on the surface of the 1 st gripping piece 13 with the organic layer 41 interposed therebetween.

Here, the bonding of the silane coupling agent to the modified surface 42 of the organic layer 41 includes chemical bonding of the hydrolyzable group OR of the silane coupling agent to the organic functional group Y (amine group) of the titanate coupling agent, chemical bonding (hydrolysis) of the hydrolyzable group OR of the silane coupling agent to the hydroxyl group OH of the modified surface 42, bonding by chemisorption, bonding by intermolecular force, bonding by other interactions, and the like.

Next, a process of forming the organic layer 41 and the anti-adhesive layer 51 on the surface including the treatment surface 17 of the 1 st gripping sheet 13 at the time of manufacturing the treatment instrument 1 will be described. When the organic layer 41 and the release coating 51 are formed on the disposal surface 17, the worker first applies a titanate coupling agent to the surface of the 1 st gripping sheet 13 (see fig. 3). Thus, as described above, the titanate coupling agent is bonded to the surface of the 1 st holding sheet 13 to form the organic layer 41 of the monomolecular film (see fig. 4). Then, a modified surface 42 is formed on the surface of the 1 st gripping sheet 13 by the organic layer 41.

Next, the worker applies a silane coupling agent to the modified surface 42 formed on the surface of the 1 st gripping sheet 13. Thereby, as described above, the coupling structure of the silane coupling agent is bonded to the modified surface 42 of the organic layer 41, and the release coating layer 51 is formed (see fig. 5).

As described above, the organic layer 41 and the release coat layer 51 are formed on the outer peripheral surface of the 1 st grip piece 13 around the extension axis of the 1 st grip piece 13 in the region including the part of the side surface 20 and the treated surface 17 (see fig. 2). In the step of forming the organic layer 41 and the release coating 51, for example, a masking process is performed on a portion other than a portion where the organic layer 41 and the release coating 51 are to be formed, thereby forming the organic layer 41 and the release coating 51 on a desired region of the surface of the 1 st gripping sheet 13.

Next, the operation and effect of the treatment instrument 1 of the present embodiment will be described. When performing a treatment using the treatment instrument 1, first, the end effector 6 is inserted into a body cavity such as an abdominal cavity. Then, a treatment target such as a blood vessel is placed between the pair of grip pieces 13 and 14, and the end effector 6 is closed. Thereby, the treatment object is gripped between the gripping pieces 13 and 14. In a state where the treatment object is gripped between the grip pieces 13 and 14, the electric energy is supplied from the power supply device 3 to the treatment instrument 1, and at least one of the high-frequency current and the ultrasonic vibration is applied as the treatment energy to the gripped treatment object as described above.

In the present embodiment, the 1 st grip piece 13 and the vibration transmission member 8 are formed of a titanium alloy having a high vibration transmissibility. Therefore, the vibration generated by the ultrasonic transducer is efficiently transmitted to the treatment surface 17 via the vibration transmission member 8 and the 1 st grasping piece 13.

In the present embodiment, the treatment surface 17 of the 1 st gripping sheet 13 is provided with the anti-sticking coating 51. As described above, the release coating layer 51 contains the silane coupling agent, and the silane coupling agent of the present embodiment has a molecular chain containing fluorine atoms F. Therefore, the treatment surface 17 is provided with the anti-adhesive coating 51, thereby imparting the anti-adhesive function and water repellency to the tissue to the treatment surface 17.

In the present embodiment, the titanate coupling agent used for the organic layer 41 and the silane coupling agent used for the release coating layer 51 can form a monomolecular film. Therefore, the organic layer 41 and the release coat layer 51 can be formed thin. By forming the organic layer 41 and the release coating layer 51 to be thin, the electric resistance of the organic layer 41 and the release coating layer 51 can be reduced. Therefore, even when the surface of the 1 st grip piece 13 is coated for anti-sticking, the high-frequency current can be effectively applied to the treatment target from the treatment surface 17. That is, according to the treatment instrument 1 of the present embodiment, the anti-sticking function of the treatment object can be given to the treatment surface 17, and the high-frequency current can be effectively applied to the treatment object from the treatment surface 17.

In the present embodiment, the organic layer 41 is provided between the release coating layer 51 and the surface of the 1 st gripping piece 13. The organic layer 41 is bonded to the release coating 51 and the surface of the 1 st gripping piece 13, respectively, thereby bonding the release coating 51 to the surface of the 1 st gripping piece 13.

In the present embodiment, in the step of applying the titanate coupling agent to the surface of the 1 st gripping sheet 13, the modified surface 42 formed of the organic functional group Y of the organic layer 41 is formed on the surface of the 1 st gripping sheet 13. In general, silane coupling agents are known to have better bonding properties with respect to organic materials than with respect to titanium. Therefore, by forming the modified surface 42 formed of the organic layer 41 on the surface of the 1 st gripping sheet 13, the adhesion strength of the anti-adhesive layer 51 formed of a silane coupling agent to the surface of the 1 st gripping sheet 13 is improved as compared with the case where a silane coupling agent is directly attached to the surface of the 1 st gripping sheet 13. The adhesion strength of the release coat 51 to the surface of the 1 st grip piece 13 is improved, so that the release coat 51 is difficult to peel off, and the deterioration rate of the release coat 51 due to friction and heat during handling is reduced. In addition, this improves the durability of the treatment instrument 1.

In the present embodiment, an amine group is used as the organic functional group Y of the titanate coupling agent. Therefore, the durability of the release coating 51 is improved as compared with the case where another functional group is used as the organic functional group Y.

In addition, in the present embodiment, the organic layer 41 is formed of a titanate coupling agent. In the present embodiment, the 1 st gripping piece 13 is formed of a titanium alloy. Here, it is known that a titanate coupling agent has better bonding property with respect to materials such as titanium than a silane coupling agent. Therefore, by providing the organic layer 41 between the release coating 51 and the surface of the 1 st gripping sheet 13, the adhesion strength of the release coating 51 formed of the silane coupling agent to the surface of the 1 st gripping sheet 13 is improved as compared with the case where the silane coupling agent is directly attached to the surface of the 1 st gripping sheet 13.

The silane coupling agent of the present embodiment has a coupling structure at both ends. Therefore, the adhesion strength of the release coating layer 51 to the surfaces of the organic layer 41 and the 1 st grip sheet 13 is improved as compared with the case of using a silane coupling agent having a coupling structure at a single end.

Here, a method of evaluating the adhesion strength of the release coating layer 51 to the surface of the 1 st grip piece 13 will be described. For example, the adhesion strength of the release coat layer 51 to the 1 st grasping sheet 13 is evaluated by an adhesion test using a simulated tissue that simulates a biological tissue to be treated. In this adhesion test, first, the surgical instrument 1 is used to perform incision of a simulated tissue. In the incision of the simulated tissue, the output of the output at the time of the simulated incision treatment is performed, and the simulated tissue is incised between the grip pieces 13 and 14 a predetermined number of times. At this time, for example, output is performed for a predetermined number of times of 2 seconds to 4 seconds. Next, the treatment surface 17 is evaluated for the state of adhesion using the treatment instrument 1. In the evaluation of the adhesion state, a treatment that may cause adhesion of the simulated tissue is performed a predetermined number of times. At this time, for example, output is performed for a predetermined number of times of 2 seconds to 4 seconds. After the coagulation treatment, the adhesion state of the simulated tissue to the surface of the 1 st grasping piece 13 was evaluated. Then, the procedure of simulating the evaluation of the cut and stuck state of the structure was repeated to evaluate the adhesion strength of the release coat layer 51 to the surface of the 1 st gripping sheet 13 and the durability of the release coat layer 51.

For example, in the case where the anti-sticking coating is not applied to the surface of the 1 st grasping piece 13, that is, in the case where neither the organic layer 41 nor the anti-sticking coating 51 is provided, in the above-described sticking test, in the evaluation of the sticking state after the treatment energy is output for about 100 times in the incision of the simulated tissue, the simulated tissue is not peeled off even if the end effector 6 of the treatment instrument 1 is vibrated and the sticking to the surface of the 1 st grasping piece 13 is performed.

On the other hand, for example, in the case of a coating for releasing adhesion by directly attaching a silane coupling agent having a coupling structure at a single end to the surface of the 1 st grasping piece 13, in the above-described adhesion test, even in the evaluation of the adhesion state after the output of the treatment energy is performed about 500 times in the incision of the simulated tissue, the state in which the simulated tissue is not adhered to the surface of the 1 st grasping piece 13 or the state in which the adhesion of the simulated tissue to the surface of the 1 st grasping piece 13 can be released by vibrating the end effector 6 of the treatment instrument 1 is maintained.

In the case of a coating for preventing adhesion by directly attaching a silane coupling agent having a coupling structure at both ends to the surface of the 1 st grasping piece 13, for example, in the adhesion test described above, even in the evaluation of the adhesion state after the treatment energy is output for about 700 times in the incision of the simulated tissue, the state in which the simulated tissue is not adhered to the surface of the 1 st grasping piece 13 or the state in which the adhesion of the simulated tissue to the surface of the 1 st grasping piece 13 can be peeled off by vibrating the end effector 6 of the treatment instrument 1 is maintained.

For example, in the case of using the treatment instrument 1 of the present embodiment, in the above-described adhesion test, even after 1500 times of treatment energy output during incision of the dummy tissue, in the evaluation of the adhesion state, a state in which the dummy tissue is not adhered to the surface of the 1 st grasping piece 13 or a state in which the adhesion of the dummy tissue to the surface of the 1 st grasping piece 13 can be peeled off by vibrating the end effector 6 of the treatment instrument 1 is maintained.

(1 st modification of embodiment 1)

Fig. 6 is a view showing a1 st modification of the present embodiment, and as shown in fig. 6, in this modification, the organic layer 41 and the release coat layer 51 are provided around the entire circumference of the extending axis (the longitudinal axis L) of the grip piece 13 in the region where the treatment surface 17 is provided in the extending direction.

In the present modification, the organic layer 41 and the release coat layer 51 are provided on the side surface 20 and the back surface 19 in addition to the disposal surface 17 of the grip sheet 13. Therefore, in addition to the treatment surface 17, the back surface 19 and the side surface 20 are also imparted with a release function and water repellency.

In the present modification, since the organic layer 41 and the anti-adhesive layer 51 are formed on the outer peripheral surface of the grip piece 13 over the entire periphery thereof around the extending axis (the longitudinal axis L) of the grip piece 13, the coating agent can be easily applied to the surface of the 1 st grip piece 13.

In the present modification, the organic layer 41 is provided between the release coat layer 51 and the surface of the gripping piece 13, and the adhesion strength of the release coat layer 51 to the surface of the 1 st gripping piece 13 is improved as in the case of the 1 st embodiment.

(modification 2 of embodiment 1)

Fig. 7 is a view showing a 2 nd modification of the present embodiment. As shown in fig. 7, in the present modification, a thermal barrier coating (thermal barrier coating) 61 is provided on at least a part of the surface of the grip piece 13 (for example, the back surface 19 and the side surface 20) except for the treatment surface 17. The thermal barrier coating 61 is formed of a material having high thermal insulation properties and low thermal conductivity. The thermal barrier coating 61 is preferably formed of a material having electrical insulation properties. The thermal barrier coating 61 is formed of, for example, PEEK (polyetheretherketone) resin.

In the present modification, the heat insulating coating 61 is provided on the surface of the grip piece 13, thereby reducing the heat invasion into the living tissue from the region of the surface of the grip piece 13 on which the heat insulating coating 61 is provided. This prevents heat generated during treatment from affecting undesirable living tissues.

In the present modification, the organic layer 41 is also provided between the release coat 51 and the surface of the gripping piece 13, and the adhesion strength of the release coat 51 to the surface of the 1 st gripping piece 13 is improved as in the case of the 1 st embodiment.

(modification 3 of embodiment 1)

Fig. 8 is a view showing a 3 rd modification of the present embodiment. As shown in fig. 8, in the present modification, as in modification 2, a thermal barrier coating 61 is provided on at least a part of the surface of the grip piece 13 except for the treatment surface 17.

In the present modification, the organic layer 41 and the anti-adhesive layer 51 are provided on the outer peripheral surface of the grip piece 13 around the extending axis (the longitudinal axis L) of the grip piece 13 over the entire circumference of the grip piece 13, the organic layer 41 is in close contact with the thermal insulating layer 61 from the outside and the anti-adhesive layer 51 is in close contact with the organic layer 41 from the outside at the portion of the surface of the grip piece 13 where the thermal insulating layer 61 is provided.

In the present modification, the organic layer 41 is also provided between the release coat 51 and the surface of the gripping piece 13, and the adhesion strength of the release coat 51 to the surface of the 1 st gripping piece 13 is improved as in the case of the 1 st embodiment.

The coupling structure of the titanate coupling agent of the present embodiment has good bonding properties to organic materials such as resins. Therefore, by providing the organic layer 41 between the release coating 51 and the thermal barrier coating 61, the adhesion strength of the release coating 51 to the surface of the 1 st gripping sheet 13 is improved even in the portion where the thermal barrier coating 61 is provided.

(embodiment 2)

Embodiment 2 of the present invention will be described with reference to fig. 9 and 10. Embodiment 2 is obtained by modifying the structure of embodiment 1 as follows. The same portions as those in embodiment 1 are denoted by the same reference numerals, and description thereof is omitted.

As shown in fig. 9 and 10, in the present embodiment, an anti-adhesive coating 71 is provided on the surface of the 1 st gripping piece 13. The release coating 71 is bonded directly to the surface of the 1 st grip tab 13.

As shown in fig. 10, release coating 71 is formed from a material that includes a titanate coupling agent. The titanate coupling agent of the present embodiment includes: titanium atom Ti, a molecular chain containing carbon atom C and fluorine atom F, and a hydrolyzable group OR.

In the titanate coupling agent, 3 hydrolyzable groups OR are chemically bonded to titanium atoms Ti, respectively. In the titanate coupling agent, 3 hydrolyzable groups OR are chemically bonded to a titanium atom Ti to form a coupled structure. The coupling structures are respectively arranged at the two tail ends of the molecular chain.

In the molecular chain, fluorine atoms F and the like are bonded to chain-bonded carbon atoms C. The hydrolyzable group OR is a reactive group chemically bonded to the inorganic material by hydrolysis OR the like, and is, for example, an alkoxy group such as a methoxy group OR an ethoxy group.

On the surface of the 1 st holding sheet 13, the coupling structure of the titanate coupling agent is bonded to the surface of the 1 st holding sheet 13. Further, the adhesive coating 71 is formed on the surface of the 1 st grip piece 13 by bonding the surface of the 1 st grip piece 13 with a titanate coupling agent.

Here, the bonding of the titanate coupling agent to the surface of the 1 st grip piece 13 includes: the hydrolyzable group OR of the titanate coupling agent is chemically bonded (hydrolyzed) to the hydroxyl group OH covering the surface of the 1 st grip piece 13, a bond by chemisorption, a bond by intermolecular force, a bond by other interaction, OR the like.

Next, the operation and effect of the treatment instrument 1 of the present embodiment will be described. In the present embodiment, the treatment surface 17 of the 1 st gripping sheet 13 is provided with the release coating 71. As previously described, release coating 71 includes a titanate coupling agent having a molecular chain including fluorine atoms F in the present embodiment. Therefore, in the present embodiment, the release coating 71 is also formed on the treated surface 17 to impart a release function and water repellency to the treated surface 17.

In addition, in the present embodiment, the titanate coupling agent used for the release coating 71 can form a monomolecular film. Therefore, the release coating 71 can be formed thin. Therefore, in the present embodiment as well, as in embodiment 1, the treatment surface 17 can be provided with the anti-sticking function of the treatment object, and the high-frequency current can be efficiently applied from the treatment surface 17 to the treatment object.

In addition, in the present embodiment, the release coating 71 is formed of a titanate coupling agent. In the present embodiment, the 1 st gripping piece 13 is formed of a titanium alloy. It is known that a titanate coupling agent has better bonding properties with respect to materials such as titanium than a silane coupling agent. Therefore, by forming the release coating 71 using a titanate coupling agent, the adhesion strength of the release coating 71 to the surface of the 1 st gripping sheet 13 is improved as compared with the case where the release coating 71 is formed using a silane coupling agent.

In addition, the titanate coupling agent of the present embodiment has a coupling structure at both ends. Therefore, the adhesive strength with respect to the surface of the 1 st grip sheet 13 is improved as compared with the case of using a titanate coupling agent having a coupling structure at a single end.

(embodiment 3)

As shown in fig. 11, in embodiment 3, an organic layer 41 and an anti-adhesion coating (2 nd anti-adhesion coating) 51 are also provided on the treatment surface 18 of the 2 nd gripping piece (gripping member) 14, as in embodiment 1. In this case, the treatment surface 18 of the 2 nd grip piece 14 can be given an anti-sticking function to the treatment object, and a high-frequency current can be effectively applied from the treatment surface 18 to the treatment object.

(other embodiments)

In one embodiment, a heat source such as a heater is provided in at least one of the grip pieces 13 and 14, and heat generated by the heat source is used as treatment energy instead of the ultrasonic vibration. In this case, the heat source is attached to a heat conductive member (e.g., 21) forming at least a part of the treatment surface (e.g., 18) from the side opposite to the treatment surface. The power supply device 3 is electrically connected to a heat source via an electrical path provided through the inside of the cable 7, the inside of the housing 4, and the inside of the shaft 5, and supplies electric power to the heat source. When electric power is supplied from the power supply device 3 to the heat source, heat is generated in the heat source, and the generated heat is applied to the treatment object via the heat conductive member (e.g., 21). In this embodiment, both the 1 st gripping piece 13 and the 2 nd gripping piece 14 may be attached to be rotatable with respect to the shaft 5.

In the above-described embodiments and the like, the bipolar energy treatment instrument (1) having the pair of grip pieces (13, 14) and the electrodes provided on the grip pieces (13, 14) has been described, but the configuration and the like of the embodiments and the like of the present invention can also be applied to a monopolar energy treatment instrument. In this case, the energy treatment instrument includes an end effector formed of a base material, and the end effector has a treatment surface at least a part of which is formed of an electrode. The anti-sticking coating layer is provided on at least the surface of the base material.

(general construction of embodiment, etc.)

An energy treatment instrument (1) comprises: base materials (8, 13) having a treatment surface (17) to which a high-frequency current is applied to a treatment object by being supplied with electric energy, the base materials having conductivity; and an anti-adhesive coating (51; 71) that contains a coupling agent having a coupling structure and is formed on at least the treatment surface (17) of the surface of the base material (8, 13) by bonding caused by the coupling structure, the anti-adhesive coating being used for preventing adhesion of a treatment object to the surface of the base material (8, 13).

The method for manufacturing an energy treatment instrument (1) comprises: forming a base material (8, 13) having conductivity and having a treatment surface (17) to which a high-frequency current is applied to a treatment object by being supplied with electric energy; forming an organic layer (41) on the surface of the parent material (8, 13) by bonding a coupling structure of a titanate coupling agent to the surface of the parent material (8, 13) at least on the treatment surface (17) of the surface of the parent material (8, 13); and forming an anti-sticking coating layer (51; 71) for preventing sticking of a treatment object on the surface of the base material (8, 13) by bonding a coupling structure of a silane coupling agent to the organic layer (41).

The present invention is not limited to the above-described embodiments, and various modifications can be made in the implementation stage without departing from the gist thereof. In addition, the respective embodiments may be combined as appropriate as possible, and in this case, the combined effect is obtained. Further, the embodiments described above include inventions at various stages, and various inventions can be extracted by appropriate combinations of a plurality of disclosed constituent elements.