阅读说明：本技术 医疗用加热器、处置器具以及处置器具的制造方法 (Medical heater, treatment instrument, and method for manufacturing treatment instrument ) 是由 铜庸高 于 2018-09-11 设计创作，主要内容包括：医疗用加热器(13)包括：基板(14),其具有电绝缘性和挠性,具有互为表里的第1板面(14a)和第2板面(14b)；以及导电部(15),其设在第1板面(14a)上。导电部(15)包括：一对连接部(151、152),它们分别设在基板(14)的长度方向的两端部,分别与布线构件(C1)电连接；发热部(153),其通过通电而发热；以及电路径部(154),其从连接部(151、152)连接于发热部(153),并向发热部(153)通电。就发热部(153)而言,发热部(153)的电阻值高于导电部(15)的其他的部位的电阻值,发热部(153)的至少一部分的厚度尺寸小于导电部(15)的其他的部位的厚度尺寸。(A medical heater (13) is provided with: a substrate (14) having electrical insulation and flexibility, and having a1 st plate surface (14a) and a2 nd plate surface (14b) that are opposite to each other; and a conductive part (15) provided on the 1 st plate surface (14 a). The conductive section (15) includes: a pair of connection sections (151, 152) provided at both ends of the substrate (14) in the longitudinal direction and electrically connected to the wiring member (C1); a heat generation unit (153) that generates heat when energized; and a circuit diameter section (154) which is connected to the heat generating section (153) from the connecting sections (151, 152) and which supplies current to the heat generating section (153). The heat generating portion (153) has a higher resistance value than other portions of the conductive portion (15), and at least a part of the heat generating portion (153) has a smaller thickness than other portions of the conductive portion (15).)

1. A medical heater, wherein,

the medical heater comprises:

a substrate having electrical insulation and flexibility, and having a1 st plate surface and a2 nd plate surface facing each other; and

a conductive portion provided on the 1 st plate surface,

the substrate is folded back in a state that the 1 st plate surface forms an outer surface in the longitudinal direction of the substrate,

the conductive part includes:

a pair of connection portions provided at both ends of the substrate in the longitudinal direction, respectively, and electrically connected to the wiring members, respectively;

a heat generating portion that generates heat by energization; and

a circuit diameter portion connected to the heating portion from the connecting portion and configured to apply a current to the heating portion,

as for the heat generating portion, a heat generating portion,

the resistance value of the heating part is higher than that of the other parts of the conductive part,

the thickness of at least a part of the heat generating portion is smaller than the thickness of the other part of the conductive portion.

2. The medical heater according to claim 1,

the conductive portion is made of any one of stainless steel, nickel alloy, palladium, platinum, gold, silver, or a combination thereof.

3. The medical heater according to claim 1,

the heat generating portion is made of a material containing nickel.

4. The medical heater according to claim 3,

at least a part of the surface of the heat generating portion is covered with a passive coating film made of nickel fluoride.

5. The medical heater according to claim 4,

the circuit diameter portion is provided so as to straddle a folding line orthogonal to the longitudinal direction of the substrate and is made of a material containing nickel,

the passive film covers at least a part of a surface of the heat generating portion and a surface of a heat generating side end portion of the circuit diameter portion connected to the heat generating portion.

6. The medical heater according to claim 5,

the medical heater further includes a cover member made of an electrically insulating material and covering a region of the electrical path portion other than the heat-generating-side end portion.

7. The medical heater according to claim 1,

the width dimensions of the heat generating portion, the connecting portion, and the circuit diameter portion that are orthogonal to the longitudinal direction of the substrate are the same.

8. A treatment tool, wherein,

the treatment instrument includes:

a treatment member having a treatment surface for treating a living tissue and a setting surface that is front and back with respect to the treatment surface; and

a medical heater for heating the treatment member,

the medical heater includes:

a substrate having electrical insulation and flexibility, and having a1 st plate surface and a2 nd plate surface facing each other; and

a conductive portion provided on the 1 st plate surface,

the substrate is folded back in a state that the 1 st plate surface forms an outer surface in the longitudinal direction of the substrate,

the conductive part includes:

a pair of connection portions provided at both ends of the substrate in the longitudinal direction, respectively, and electrically connected to the wiring members, respectively;

a heat generating portion that generates heat by energization; and

a circuit diameter portion connected to the heating portion from the connecting portion and configured to apply a current to the heating portion,

as for the heat generating portion, a heat generating portion,

the resistance value of the heating part is higher than that of the other parts of the conductive part,

the thickness of at least a part of the heat generating portion is smaller than the thickness of the other part of the conductive portion,

the medical heater is disposed in a state where the heat generating portion faces the mounting surface.

9. The treatment appliance of claim 8,

the treatment instrument further includes an adhesive sheet made of an electrically insulating material and adhering the 1 st plate surface and the installation surface to each other.

10. The treatment appliance of claim 8,

the heating part is made of a material containing nickel,

at least a part of the surface of the heat generating portion is covered with a passive coating film made of nickel fluoride.

11. A method for manufacturing a treatment instrument, wherein,

a conductive part having a heat generating part is formed on the 1 st plate surface of a substrate,

folding back the substrate in a state that the 1 st plate surface constitutes an outer surface in a longitudinal direction of the substrate to form a medical heater,

the medical heater is provided on the treatment member in a state where the heat generating portion is opposed to a mounting surface of the treatment member for treating a living tissue,

the conductive part includes:

a pair of connection portions provided at both ends of the substrate in the longitudinal direction, respectively, and electrically connected to the wiring members, respectively;

the heating portion that generates heat by being energized; and

a circuit diameter portion connected to the heating portion from the connecting portion and configured to apply a current to the heating portion,

in the process of forming the conductive portion,

the heat generating portion is formed in a state where a thickness dimension of at least a part of the heat generating portion is smaller than a thickness dimension of the other part of the conductive portion.

12. The method of manufacturing a treatment instrument according to claim 11,

in the process of forming the conductive portion,

forming a1 st metal film extending in a longitudinal direction of the substrate on the 1 st plate surface,

forming a2 nd metal film on the 1 st metal film,

in the process of forming the 2 nd metal film,

providing a1 st region for forming the 2 nd metal film and a2 nd region for not forming the 2 nd metal film on the 1 st metal film,

the connection portion and the circuit path portion are formed by the 1 st metal film and the 2 nd metal film of the 1 st region,

the heat generating portion is constituted by the 1 st metal film of the 2 nd region.

13. The method of manufacturing a treatment instrument according to claim 12,

the 1 st metal film is composed of a material containing nickel,

the surface modification of at least a part of the surface of the heat-generating portion is performed in an atmosphere of a gas containing fluorine, whereby a passive coating film made of nickel fluoride is formed on at least a part of the surface of the heat-generating portion.

Technical Field

The present invention relates to a medical heater, a treatment instrument, and a method for manufacturing a treatment instrument.

Background

Conventionally, a treatment instrument is known which: a target site to be treated (hereinafter, referred to as a target site) of a living tissue is treated by applying energy to the target site (for example, see patent document 1).

The treatment instrument described in patent document 1 includes a pair of gripping members for gripping a target portion. The gripping members are provided with a medical heater that generates heat by energization, and a treatment member that comes into contact with a target portion when the target portion is gripped by the pair of gripping members. In this treatment instrument, heat from the medical heater is conducted to the target site gripped by the pair of gripping members through the treatment member. Thereby, the target site is treated.

The medical heater described in patent document 1 includes a substrate and a conductive portion provided on the substrate. The conductive portion includes a1 st connection portion and a2 nd connection portion electrically connected to the wiring member, respectively, and a heat generating portion that generates heat by energization. The 1 st connecting portion and the 2 nd connecting portion are arranged in parallel in the width direction of the substrate on the base end side of the substrate. The heat generating portion has a substantially U-shape extending from the base end side toward the tip end side and folded back at the tip end side to extend toward the base end side on the substrate. Both ends of the heat generating portion are electrically connected to the 1 st connection portion and the 2 nd connection portion, respectively. That is, the conductive portion has two electrical paths arranged in parallel in the width direction of the substrate.

Documents of the prior art

Patent document

Patent document 1: specification of U.S. patent application publication No. 2015/0327909

Disclosure of Invention

Problems to be solved by the invention

However, in the medical heater described in patent document 1, since two electrical paths are provided in parallel in the width direction of the substrate, it is necessary to sufficiently separate the two electrical paths so as to prevent a short circuit between the two electrical paths. That is, there is a problem that the width of the substrate becomes large.

The present invention has been made in view of the above circumstances, and an object thereof is to provide a medical heater, a treatment instrument, and a method for manufacturing a treatment instrument, which can reduce the width of a substrate and prevent a short circuit of a conductive portion provided on the substrate.

Means for solving the problems

In order to solve the above problems and achieve the object, a medical heater according to the present invention includes: a substrate having electrical insulation and flexibility, and having a1 st plate surface and a2 nd plate surface facing each other; and a conductive portion provided on the 1 st plate surface, the substrate being folded back in a longitudinal direction of the substrate in a state where the 1 st plate surface constitutes an outer surface, the conductive portion including: a pair of connection portions provided at both ends of the substrate in the longitudinal direction, respectively, and electrically connected to the wiring members, respectively; a heat generating portion that generates heat by energization; and a circuit diameter portion that is connected to the heating portion from the connection portion and that supplies electricity to the heating portion, wherein the heating portion has a higher resistance value than other portions of the conductive portion, and at least a part of the heating portion has a smaller thickness than other portions of the conductive portion.

The treatment instrument of the present invention includes: a treatment member having a treatment surface for treating a living tissue and a setting surface that is front and back with respect to the treatment surface; and a medical heater for heating the treatment member, the medical heater including: a substrate having electrical insulation and flexibility, and having a1 st plate surface and a2 nd plate surface facing each other; and a conductive portion provided on the 1 st plate surface, the substrate being folded back in a longitudinal direction of the substrate in a state where the 1 st plate surface constitutes an outer surface, the conductive portion including: a pair of connection portions provided at both ends of the substrate in the longitudinal direction, respectively, and electrically connected to the wiring members, respectively; a heat generating portion that generates heat by energization; and a circuit diameter portion that is connected to the heating portion from the connecting portion and that supplies electricity to the heating portion, wherein the heating portion has a higher resistance value than other portions of the conductive portion, at least a part of the heating portion has a smaller thickness dimension than other portions of the conductive portion, and the medical heater is provided in a state where the heating portion is opposed to the installation surface.

A method of manufacturing a treatment instrument according to the present invention is a method of manufacturing a treatment instrument in which a conductive portion including a heat generating portion is formed on a1 st plate surface of a substrate, the substrate is folded back in a longitudinal direction of the substrate in a state where the 1 st plate surface constitutes an outer surface, a medical heater is formed, and the medical heater is provided on a treatment member for treating a living tissue in a state where the heat generating portion faces an installation surface of the treatment member, the conductive portion including: a pair of connection portions provided at both ends of the substrate in the longitudinal direction, respectively, and electrically connected to the wiring members, respectively; the heating portion that generates heat by being energized; and a circuit diameter portion which is connected to the heating portion from the connection portion and which supplies electricity to the heating portion, wherein the conductive portion is formed in a film forming process in a state in which a thickness dimension of at least a part of the heating portion is smaller than a thickness dimension of another part of the conductive portion.

ADVANTAGEOUS EFFECTS OF INVENTION

According to the medical heater, the treatment instrument, and the method for manufacturing the treatment instrument of the present invention, the width of the substrate can be reduced, and short-circuiting of the conductive portion provided on the substrate can be prevented.

Drawings

Fig. 1 is a diagram showing a treatment system according to embodiment 1.

Fig. 2 is a view showing the grip portion.

Fig. 3 is a view showing the grip portion.

Fig. 4 is a diagram showing a medical heater.

Fig. 5 is a view showing a medical heater.

Fig. 6 is a view showing a medical heater.

Fig. 7 is a flowchart showing a method of manufacturing the treatment instrument.

Fig. 8 is a diagram illustrating a method of manufacturing a treatment tool.

Fig. 9 is a diagram illustrating a method of manufacturing a treatment tool.

Fig. 10 is a diagram showing a medical heater according to embodiment 2.

Detailed Description

Hereinafter, embodiments (hereinafter, embodiments) for carrying out the present invention will be described with reference to the drawings. The present invention is not limited to the embodiments described below. In the description of the drawings, the same reference numerals are given to the same parts.

(embodiment mode 1)

[ schematic configuration of treatment System ]

Fig. 1 is a diagram showing a treatment system 1 according to embodiment 1.

The treatment system 1 applies thermal energy to a portion of a living tissue to be treated (hereinafter referred to as a target portion) to treat the target portion. Here, the treatment refers to, for example, coagulation and incision of a target site. As shown in fig. 1, the treatment system 1 includes a treatment instrument 2, a control device 3, and a foot switch 4.

[ Structure of treatment tool ]

The treatment instrument 2 is, for example, a surgical treatment instrument for treating a target site while passing through an abdominal wall. As shown in fig. 1, the treatment instrument 2 includes a handle 5, a shaft 6, and a grip 7.

The handle 5 is a part to be held by the operator. As shown in fig. 1, an operation knob 51 is provided on the handle 5.

The shaft 6 has a substantially cylindrical shape. Hereinafter, one side of the central axis Ax of the shaft 6 is referred to as a distal side Ar1 (fig. 1), and the other side is referred to as a proximal side Ar2 (fig. 1). The shaft 6 is attached to the handle 5 by inserting a part of the proximal end side Ar2 thereof into the handle 5 from the distal end side Ar1 of the handle 5. In addition, a movable member 61 (fig. 1) that moves forward and backward along the center axis Ax is disposed inside the shaft 6 in accordance with an operation of the operation knob 51 by the operator. Further, one end of the cable C (fig. 1) is connected to the control device 3 and passes through the inside of the handle 5 and the shaft 6, and the other end side thereof is disposed to the grip portion 7.

[ Structure of holding part ]

Fig. 2 and 3 are views showing the grip portion 7. Specifically, fig. 2 is a cross-sectional view of the grip portion 7 taken along a plane along the central axis Ax. Fig. 3 is a cross-sectional view of the grip portion 7 taken along a plane orthogonal to the central axis Ax.

The grip portion 7 is a portion that treats a target portion while gripping the target portion. As shown in fig. 1 to 3, the grip portion 7 includes a1 st grip member 8 and a2 nd grip member 9.

The 1 st gripping member 8 and the 2 nd gripping member 9 can be opened and closed in the direction of arrow Y1 (fig. 1) in accordance with the operation of the operation knob 51 by the operator.

[ Structure of the holding member ]

The 1 st gripping member 8 is disposed below the 2 nd gripping member 9 in fig. 2 and 3. As shown in fig. 2 or 3, the first gripping member 8 includes a support member 10, a heat insulating member 11, a treatment member 12, and a medical heater 13.

The support member 10 has a long shape extending in a longitudinal direction (a left-right direction in fig. 2 (a direction along the central axis Ax)) connecting the distal end and the proximal end of the grip portion 7, and one end thereof is fixed to an end portion of the shaft 6 on the distal end side Ar 1. The support member 10 supports the heat insulating member 11, the treatment member 12, and the medical heater 13 by the upper surface in fig. 2 and 3.

Examples of the material constituting the support member 10 described above include metal materials such as stainless steel and titanium.

The heat insulating member 11 has a long shape extending in the longitudinal direction of the grip portion 7, and is fixed to the upper surface of the support member 10 in fig. 2 and 3.

A concave portion 111 extending from the base end of the heat insulating member 11 toward the tip end side Ar1 is formed on the upper surface of the heat insulating member 11 in fig. 2 and 3. The heat insulating member 11 supports the treatment member 12 and the medical heater 13 in the recess 111.

As a material constituting the heat insulating member 11 described above, a resin material having a low thermal conductivity such as PEEK (polyetheretherketone) can be exemplified. That is, by disposing the heat insulating member 11 having a low thermal conductivity between the treatment member 12, the medical heater 13, and the support member 10, the heat from the medical heater 13 can be efficiently and preferably transferred to the treatment member 12.

The treatment member 12 has a long shape extending in the longitudinal direction of the grip 7, and is fixed in the recess 111.

In a state where the target portion is gripped by the 1 st gripping member 8 and the 2 nd gripping member 9, the upper surface of the treatment member 12 in fig. 2 and 3 comes into contact with the target portion. That is, this surface functions as a treatment surface 121 (fig. 2 and 3) that applies thermal energy to the target portion. The phrase "applying thermal energy to the target site" means conducting heat from the medical heater 13 to the target site. In embodiment 1, the treatment surface 121 is configured by a flat surface orthogonal to a direction a1 (fig. 2 and 3) in which the 1 st gripping member 8 and the 2 nd gripping member 9 face each other when the 1 st gripping member 8 and the 2 nd gripping member 9 are set in the closed state of the gripping target portion.

In embodiment 1, the treatment surface 121 is formed of a flat surface, but is not limited thereto, and may be formed of other shapes such as a convex shape and a concave shape. The same applies to a gripping surface 91 described later.

A concave portion 123 (fig. 2 and 3) extending from the proximal end to the distal end of the treatment member 12 is formed on the installation surface 122 of the treatment member 12, which is located on the front and back sides of the treatment surface 121. The treatment member 12 supports the medical heater 13 by the bottom surface of the recess 123.

As a material constituting the treatment member 12 described above, copper, silver, aluminum, molybdenum, tungsten, graphite, or a composite material thereof having high thermal conductivity can be exemplified.

Fig. 4 to 6 are views showing the medical heater 13. Specifically, fig. 4 is a view of the medical heater 13 before the substrate 14 is folded back, as viewed from the 1 st plate surface 14a side of the substrate 14. Fig. 5 is a cross-sectional view of the medical heater 13 in a state before the substrate 14 is folded back, taken along a plane orthogonal to the width direction of the substrate 14 (the left-right direction in fig. 3). Fig. 6 is a sectional view of the medical heater 13 in a state where the substrate 14 is folded back, taken along a plane orthogonal to the width direction of the substrate 14.

The medical heater 13 is a sheet heater that locally generates heat by being energized. As shown in fig. 4 to 6, the medical heater 13 includes a substrate 14, a conductive portion 15, and a passive film 16 (fig. 5 and 6).

The substrate 14 is a sheet-like flexible substrate made of an electrically insulating resin material such as polyimide. The base plate 14 is formed in an elongated shape, and includes a1 st wide portion 141 and a2 nd wide portion 142 located at both ends in the longitudinal direction (the left-right direction in fig. 4 and 5), respectively, and a narrow portion 143 located between the 1 st wide portion 141 and the 2 nd wide portion 142 and connecting the 1 st wide portion 141 and the 2 nd wide portion 142.

Here, the width dimension (the vertical length dimension in fig. 4) of the narrow portion 143 is set to be substantially uniform along the longitudinal direction. Further, the width dimension of the narrow portion 143 is set to be smaller than the width dimensions of the 1 st wide portion 141 and the 2 nd wide portion 142.

The conductive portion 15 is provided on the 1 st plate surface 14a of the 1 st plate surface 14a (fig. 4 to 6) and the 2 nd plate surface 14b (fig. 5 and 6) of the substrate 14, which are the front and back surfaces. As shown in fig. 4 to 6, the conductive portion 15 includes a1 st connection portion 151 and a2 nd connection portion 152, a heat generating portion 153, and a circuit diameter portion 154.

The 1 st connection 151 and the 2 nd connection 152 correspond to the connection of the present invention. As shown in fig. 4, the 1 st connecting portion 151 and the 2 nd connecting portion 152 are provided at the 1 st wide portion 141 and the 2 nd wide portion 142, respectively. That is, the 1 st link 151 and the 2 nd link 152 are provided at both ends of the substrate 14 in the longitudinal direction, respectively. The 1 st connection unit 151 and the 2 nd connection unit 152 are electrically connected to a pair of conductive wires C1 (fig. 6) constituting the cable C, respectively.

One end of the heat generating portion 153 is connected to the 1 st connecting portion 151, and the other end side extends linearly toward the 2 nd connecting portion 152 side.

The circuit diameter portion 154 is a portion that serves as a current path for current to the heat generating portion 153, and has one end connected to the other end of the heat generating portion 153 and the other end linearly extending toward the 2 nd connecting portion 152. Here, one end of the circuit diameter portion 154 connected to the heat generating portion 153 corresponds to a heat generating side end portion 154a (fig. 4 to 6) of the present invention. The other end of the circuit diameter portion 154 is connected to the 2 nd connection portion 152. The 2 nd connecting portion 152 and the circuit diameter portion 154 may be formed separately or integrally. That is, the circuit diameter portion 154 is connected to the heat generating portion 153 from the 1 st connection portion 151 and the 2 nd connection portion 152, and supplies current to the heat generating portion 153.

As described above, the conductive portion 15 is provided on the 1 st plate surface 14a in a state where the 1 st connection portion 151, the heat generating portion 153, the circuit diameter portion 154, and the 2 nd connection portion 152 are connected in series in the order of the 1 st connection portion 151, the heat generating portion 153, the circuit diameter portion 154, and the 2 nd connection portion 152 along the longitudinal direction of the substrate 14.

Further, by setting the 1 st and 2 nd connection parts 151 and 152, the heat generating part 153, and the circuit diameter part 154 to predetermined total lengths and cross-sectional areas, respectively, the resistance value of the heat generating part 153 is set to be higher than the resistance values of the 1 st connection part 151, the 2 nd connection part 152, and the circuit diameter part 154, which are other portions of the conductive part 15. Therefore, when a voltage is applied to the 1 st connection part 151 and the 2 nd connection part 152 through the pair of wires C1 under the control of the control device 3, the heat generating part 153 mainly generates heat.

Specifically, in embodiment 1, the width dimensions (the length dimension in the vertical direction in fig. 4) of the 1 st and 2 nd connection units 151 and 152, the heat generating unit 153, and the circuit path unit 154 are set to be the same. Here, the width of the heat generating portion 153 is preferably at least half of the width of the narrow portion 143. The thickness dimension (length dimension in the vertical direction in fig. 5) of the heat generating portion 153 is set to be smaller than the thickness dimensions of the 1 st connecting portion 151, the 2 nd connecting portion 152, and the circuit diameter portion 154. The thickness dimensions of the 1 st connecting portion 151, the 2 nd connecting portion 152, and the circuit diameter portion 154 are set to be the same.

In embodiment 1, the material, the total length, and the cross-sectional area of the conductive portion 15 are appropriately set so that the resistance value of the conductive portion 15 (hereinafter referred to as heater resistance) is set to be 30 Ω to 150 Ω at normal temperature. Here, the width dimension of the conductive part 15 (the length dimension in the vertical direction in fig. 4) and the total length of the conductive part 15 (the length dimension in the horizontal direction in fig. 4) are limited to a certain extent according to the specification of the treatment instrument 2 (the specification of the grip part 7). Therefore, by controlling the material and thickness dimension (the length dimension in the vertical direction in fig. 5) of the conductive portion 15, the heater resistance at the normal temperature of the conductive portion 15 is set to the above-described value. Specifically, as a material constituting the conductive portion 15, a material containing nickel, specifically, stainless steel, nickel, or a nickel alloy can be exemplified. The thickness of the heat generating portion 153 may be several tens [ nm ] to several [ μm ].

The passive film 16 is made of nickel fluoride, and covers a part of the surface of the conductive portion 15 as shown in fig. 5 or 6. Specifically, the passivation film 16 covers the surface of the heat-generating-side end portion 154a, extends from the surface of the heat-generating-side end portion 154a toward the 1 st connecting portion 151, and covers a part of the surface of the 1 st connecting portion 151. That is, the passive coating 16 covers the entire surface of the heat generating portion 153. The passive film 16 is not limited to covering the entire surface of the heat generating portion 153, and may cover the surface of the heat-generating-side end portion 154a and a part of the surface of the heat generating portion 153.

The medical heater 13 described above is fixed to the bottom surface of the recess 123 by the adhesive sheet 17 (fig. 3) in a state where the substrate 14 is folded back.

Here, the adhesive sheet 17 is positioned between the bottom surface of the recess 123 and the medical heater 13, and bonds the bottom surface and the medical heater 13 together. The adhesive sheet 17 is formed by mixing a material having high thermal conductivity and high temperature resistance and adhesiveness, for example, epoxy resin with a ceramic having high thermal conductivity such as alumina or aluminum nitride.

The substrate 14 is folded back in a state where the 1 st plate surface 14a constitutes the outer surface of the medical heater 13 as shown in fig. 6 with reference to a folded line Ln (fig. 4) which is orthogonal to the longitudinal direction and is located at the substantially center in the longitudinal direction. In other words, the substrate 14 is folded back with the 2 nd plate surface 14b positioned inside with reference to the folded-back line Ln. In this state, the 1 st wide portion 141 and the 2 nd wide portion 142 are opposed to each other. The folding line Ln is not limited to a system that is strictly orthogonal to the longitudinal direction of the substrate 14, and includes a system that intersects the longitudinal direction within a predetermined angle range.

Hereinafter, for convenience of explanation, a region closer to the 1 st connection part 151 than the folding line Ln is referred to as a treatment-side region Sp1, and a region closer to the 2 nd connection part 152 than the folding line Ln is referred to as a back-side region Sp 2.

As shown in fig. 4, the circuit diameter portion 154 is provided in a state of crossing the folded line Ln. Therefore, the 1 st connection part 151, the heat generating part 153, and the heat generating side end 154a are located in the treatment side region Sp 1. Further, the region other than the heat-generating side end 154a in the 2 nd connecting portion 152 and the circuit diameter portion 154 is located in the rear surface side region Sp 2.

The substrate 14 is folded back with the folded line Ln as a reference as described above, and is fixed to the bottom surface of the recess 123 by the adhesive sheet 17 in a state where the treatment-side region Sp1 faces the bottom surface.

[ Structure of the second holding member ]

The 2 nd grip member 9 has a long strip shape extending in the longitudinal direction of the grip portion 7. The 2 nd gripping member 9 is pivotally supported on the shaft 6 so that the proximal end side Ar2 can pivot about a fulcrum P1 (fig. 1 and 2) with respect to the shaft 6. The 2 nd gripping member 9 is pivotally supported by the movable member 61 so that the proximal end side Ar2 can pivot with respect to the movable member 61 about a fulcrum P2 (fig. 1 and 2). That is, when the movable member 61 is moved forward and backward along the central axis Ax in accordance with the operation of the operation knob 51 by the operator, the 2 nd gripping member 9 rotates about the fulcrum P1. Thereby, the 2 nd gripping member 9 is opened and closed with respect to the 1 st gripping member 8.

Here, the lower surface of the 2 nd grasping member 9 in fig. 2 functions as a grasping surface 91 that grasps the target site with the treatment surface 121. In embodiment 1, the gripping surface 91 is a flat surface perpendicular to the direction a 1.

In embodiment 1, the 1 st gripping member 8 (support member 10) is fixed to the shaft 6, and the 2 nd gripping member 9 is pivotally supported by the shaft 6, but the present invention is not limited to this. For example, both the 1 st gripping member 8 and the 2 nd gripping member 9 may be pivotally supported by the shaft 6, and the 1 st gripping member 8 and the 2 nd gripping member 9 may be opened and closed by being rotated respectively. For example, the 1 st gripping member 8 may be pivotally supported by the shaft 6, the 2 nd gripping member 9 may be fixed to the shaft 6, and the 1 st gripping member 8 may be configured to be opened and closed with respect to the 2 nd gripping member 9 by being rotated.

[ Structure of control device and foot switch ]

The foot switch 4 is a part to be operated by the foot of the operator. Also, the treatment control by the control device 3 is executed in accordance with this operation of the foot switch 4.

The treatment control is not limited to the foot switch 4, and a switch operated by hand or the like may be used as a means for executing the treatment control.

The control device 3 includes a CPU (Central Processing Unit) and the like, and executes treatment control for treating a target site by operating the treatment instrument 2 in accordance with a predetermined program.

[ actions of treatment System ]

Next, the operation of the treatment system 1 will be described.

The operator holds the treatment instrument 2 by hand, and inserts the distal end portion (the grip 7 and a part of the shaft 6) of the treatment instrument 2 into the abdominal cavity after passing through the abdominal wall using a trocar or the like, for example. Further, the operator operates the operation knob 51. Then, the operator grips the target site with the grip 7. Thereafter, the operator operates the foot switch 4. Then, the control device 3 executes treatment control shown below.

The control device 3 applies a voltage to the 1 st connection part 151 and the 2 nd connection part 152 through a pair of wires C1. Here, the controller 3 measures the heater resistance by, for example, a voltage drop method based on the voltage value and the current value supplied to the conducting portion 15. Further, the control device 3 refers to the resistance temperature characteristics measured in advance. The resistance temperature characteristic is a characteristic showing a relationship between the heater resistance and the temperature of the heat generating portion 153 (hereinafter referred to as heater temperature). Then, the controller 3 changes the power supplied to the conductor 15 and controls the heater resistance to a target resistance value corresponding to a target temperature of the resistance temperature characteristic. Thereby, the heater temperature is controlled to the target temperature. That is, heat from the heat generating portion 153 controlled to the target temperature is conducted to the target site by passing through the treatment member 12.

By the above treatment control, the target site is coagulated and incised.

[ method for producing treatment tool ]

Next, a method of manufacturing the treatment instrument 2 will be described.

Fig. 7 is a flowchart illustrating a method of manufacturing the treatment instrument 2. Fig. 8 and 9 are diagrams illustrating a method of manufacturing the treatment tool 2. Specifically, fig. 8 is a diagram corresponding to fig. 5. Fig. 9 is a diagram corresponding to fig. 4.

First, as shown in fig. 8 (a), the worker deposits the 1 st metal film 101 extending in the longitudinal direction of the substrate 14 on the 1 st plate surface 14a of the substrate 14 by electroless plating (step S1). The 1 st metal film 101 is made of a material containing nickel, specifically, stainless steel, nickel, or nickel.

After step S1, the worker masks the 2 nd region MA1 ((b) of fig. 8) with the masking tape MT1 ((b) of fig. 8), and the 2 nd region MA1 is located between the 1 st regions Sp3 and Sp4 ((b) of fig. 8) spaced apart in the longitudinal direction of the substrate 14 on the 1 st metal film 101 (step S2).

After step S2, as shown in fig. 8 c, the worker forms a pair of 2 nd metal films 102 in the 1 st regions Sp3 and Sp4 on the 1 st metal film 101 by electrolytic plating (step S3). Thereafter, as shown in fig. 8 (d), the worker removes the masking tape MT 1.

Then, as shown in fig. 8 (d), the 1 st metal film 101 and the 2 nd metal film 102 are configured as the conductive portions 15. The 2 nd region MA1 of the 1 st metal film 101 is configured as the heat generating portion 153. The 1 st regions Sp3 and Sp4 of the 1 st metal film 101 and the pair of 2 nd metal films 102 are respectively configured as the 1 st connection portion 151, the 2 nd connection portion 152, and the circuit path portion 154. In addition, the 2 nd connecting portion 152 and the circuit diameter portion 154 may be formed separately or integrally as described above.

After the process S3, the worker masks the following regions except for the region where the passivation coating film 16 is provided, using the masking tape MT2 (fig. 9): the regions other than the surface of the heat generating portion 153 and the surface of the heat generating side end portion 154a in the present embodiment (step S4). In fig. 9, for convenience of explanation, the 3 rd region MA2 masked by the masking tape MT2 is indicated by oblique lines.

After the step S4, the worker performs surface modification of the region other than the masked 3 rd region MA2 on the surface of the conductive portion 15 by placing the substrate 14 in an atmosphere of a fluorine-containing gas and heating the substrate 14 to a predetermined temperature (step S5). As a result, as shown in fig. 5, the passive film 16 made of nickel fluoride is formed on the surface of the heat generating portion 153 and the surface of the heat-generating-side end portion 154a, which are areas other than the masked 3 rd area MA 2. After that, the worker removes the masking tape MT 2.

In the case where the passive coating 16 is formed on a part of the surface of the heat generating portion 153 and the surface of the heat generating side end portion 154a, the regions other than the part of the surface of the heat generating portion 153 and the surface of the heat generating side end portion 154a may be masked.

After step S5, as shown in fig. 6, the worker folds back the substrate 14 with reference to the folding line Ln to form the medical heater 13 with the 1 st plate surface 14a constituting the outer surface. The operator fixes the medical heater 13 to the bottom surface of the recess 123 with the adhesive sheet 17 in a posture in which the folding line Ln is positioned on the distal end side Ar1 and the treatment side region Sp1 faces the bottom surface (step S6).

The present embodiment 1 described above provides the following effects.

In the medical heater 13 according to embodiment 1, the conductive portion 15 is provided on the 1 st plate surface 14a in a state where the 1 st connection portion 151, the heat generating portion 153, the circuit diameter portion 154, and the 2 nd connection portion 152 are connected in series in the order of the 1 st connection portion 151, the heat generating portion 153, the circuit diameter portion 154, and the 2 nd connection portion 152 along the longitudinal direction of the substrate 14. The substrate 14 is folded back with reference to the folding line Ln in a state where the 1 st plate surface 14a constitutes the outer surface of the medical heater 13.

That is, the substrate 14 having electrical insulation is present between the treatment side region Sp1 of the conductive portion 15 and the back side region Sp2 of the conductive portion 15. Therefore, it is possible to prevent a short circuit from occurring between the treatment-side region Sp1 of the conductive portion 15 and the rear-side region Sp2 of the conductive portion 15.

The conductive portion 15 extends along the longitudinal direction of the substrate 14 (the left-right direction in fig. 4). Then, the substrate 14 is folded back with reference to the folding line Ln, so that the treatment side region Sp1 of the conductive portion 15 and the back side region Sp2 of the conductive portion 15 are aligned in the direction a 1. That is, the width of the substrate 14 can be reduced without arranging two electrical paths in the width direction of the substrate 14.

However, in the medical heater described in patent document 1, the shape of the heat generating portion is formed to extend in a meandering manner in a wavy manner, so that the resistance value of the heat generating portion is increased. That is, the width dimension of the heat generating portion is reduced, and the entire length of the heat generating portion is extended. In the case of such a configuration, when the heat generating portion is covered with the adhesive sheet, a gap may be formed between the wavy peaks or valleys of the heat generating portion. If the heat generating portion is heated in a state where the gap is generated, a portion of the heat generating portion close to the gap may be overheated due to the thermal stuffiness in the gap, and the portion may be broken.

In contrast, in the medical heater 13 according to embodiment 1, the thickness of the heat generating portion 153 is smaller than the thickness of the 1 st connecting portion 151, the 2 nd connecting portion 152, and the circuit diameter portion 154. That is, since the cross-sectional area of the heat generating portion 153 can be reduced, it is not necessary to form the heat generating portion into a wave shape as in the case of the heat generating portion described in patent document 1, and the width of the heat generating portion 153 can be set to a large width as in the case of the 1 st connecting portion 151, the 2 nd connecting portion 152, and the circuit diameter portion 154. Therefore, by setting the width of the heat generating portion 153 to be large, disconnection of the heat generating portion 153 can be avoided.

In the medical heater 13 according to embodiment 1, the heat generating portion 153 is made of a material containing nickel. The surface of the heat generating portion 153 is covered with a passive film 16 made of nickel fluoride.

Here, a case is assumed where a part of the medical heater 13 is peeled off from the bottom surface of the recess 123 in accordance with the use of the treatment instrument 2, and a part of the treatment side region Sp1 of the 1 st plate surface 14a is exposed in the recess 123. In this case as well, since the surface of the heat generating portion 153 is covered with the passive film 16, corrosion or oxidation of the heat generating portion 153, which causes a change in resistance temperature characteristics measured in advance, and rusting of the heat generating portion 153 can be suppressed. That is, even when the treatment instrument 2 is used for a long time, the heater temperature can be controlled to the target temperature by using the resistance temperature characteristics measured in advance.

In particular, the heat generating portion 153 is made of a material containing nickel. In addition, the passive film 16 is made of nickel fluoride.

Therefore, the passive film 16 can be formed by modifying the surface of the heat generating portion 153 by exposing the surface of the heat generating portion 153 to an atmosphere containing fluorine. That is, in the process of forming the passive film 16, a special apparatus such as a Chemical Vapor Deposition (Chemical Vapor Deposition) method is not required, and the manufacturing cost of the medical heater 13 can be reduced. Further, since the passive film 16 is formed by surface modification of the heat generating portion 153, the passive film 16 can be formed as a dense film, and the thickness of the passive film 16 can be made extremely small. Therefore, the passive coating 16 does not deteriorate the thermal conductivity from the heat generating portion 153 to the treatment member 12. That is, the treatment performance of the target region is not degraded.

In the medical heater 13 according to embodiment 1, the electric path portion 154 is provided so as to straddle the folded line Ln. That is, the circuit diameter portion 154 is folded back in a state where the substrate 14 is folded back with reference to the folding back line Ln. Here, the thickness of the circuit diameter portion 154 is larger than the thickness of the heat generating portion 153. Therefore, compared to the case where the heat generating portion 153 is folded back, disconnection of the conductive portion 15 can be suppressed, and durability of the conductive portion 15 can be sufficiently ensured.

In the medical heater 13 according to embodiment 1, the passive film 16 covers not only the surface of the heat generating portion 153 but also the surface of the heat generating side end portion 154a of the circuit diameter portion 154. Here, the heat-generating side end 154a is connected to the heat-generating portion 153, and thus tends to have a high temperature. That is, corrosion or oxidation of the heat-generating side end portion 154a and rust formation of the heat-generating side end portion 154a are likely to occur in accordance with use of the treatment instrument 2.

Therefore, by covering the surface of the heat-generating side end portion 154a with the passive film 16, corrosion or oxidation of the heat-generating side end portion 154a, which causes a change in resistance temperature characteristics measured in advance, and rusting of the heat-generating side end portion 154a can be suppressed. That is, even when the treatment instrument 2 is used for a long time, the heater temperature can be controlled to the target temperature by using the resistance temperature characteristics measured in advance.

In embodiment 1, the 1 st metal film 101 is formed on the 1 st plate surface 14a by electroless plating (step S1), and the pair of 2 nd metal films 102 are formed on the 1 st metal film 101 by electrolytic plating (step S3), thereby forming the conductive portions 15.

Therefore, the heat generating portions 153, the 1 st connecting portions 151, the 2 nd connecting portions 152, and the circuit diameter portions 154 having different thickness dimensions can be easily formed.

(embodiment mode 2)

Next, embodiment 2 will be described.

In the following description, the same components as those in embodiment 1 are denoted by the same reference numerals, and detailed description thereof will be omitted or simplified.

Fig. 10 is a diagram showing a medical heater 13A according to embodiment 2. Specifically, fig. 10 is a diagram corresponding to fig. 6.

As shown in fig. 10, a medical heater 13A according to embodiment 2 is different from the medical heater 13 described in embodiment 1 in that a cover member 18 is added.

The cover member 18 is provided on the 1 st plate surface 14a of the substrate 14 so as to straddle the folded line Ln. Specifically, the cover member 18 extends from a position where a predetermined gap is opened from the passive film 16 toward the 2 nd connection portion 152 side, and covers the surface of the circuit diameter portion 154. That is, the cover member 18 covers the region other than the heat-generating side end portion 154a in the circuit diameter portion 154.

The cover member 18 described above can be made of an electrically insulating material, for example, a cover layer, a sealing member, or a molten layer of polyimide.

According to embodiment 2 described above, the following effects are obtained in addition to the same effects as those of embodiment 1 described above.

The medical heater 13A according to embodiment 2 is provided with a cover member 18.

Therefore, the water tightness of the rear region Sp2 of the conductive part 15 can be improved by the cover member 18. Further, since the cover member 18 has electrical insulation, even when liquid penetrates into the recess 111, it is possible to prevent a short circuit from occurring between the treatment-side region Sp1 of the conductive portion 15 and the rear-side region Sp2 of the conductive portion 15.

Further, the cover member 18 covers the region other than the heat-generating side end portion 154a in the circuit diameter portion 154. That is, since the cover member 18 is provided at a position avoiding the heat-generating side end portion 154a which is likely to become high in temperature, the cover member 18 does not become high in temperature, and the cover member 18 can be prevented from being peeled off from the 1 st plate surface 14 a.

(other embodiments)

The present invention is not limited to the embodiments 1 and 2 described above, but the present invention is described above in detail.

In embodiments 1 and 2 described above, the target portion is given thermal energy, but the present invention is not limited to this, and high-frequency energy or ultrasonic energy may be given in addition to thermal energy. In addition, "applying high-frequency energy to the target region" means applying high-frequency current to the target region. The phrase "applying ultrasonic energy to a target region" means applying ultrasonic vibration to the target region.

In embodiments 1 and 2 described above, the medical heaters 13 and 13A according to the present invention are provided only on the 1 st gripping member 8, but the present invention is not limited to this, and the medical heaters 13 and 13A according to the present invention may be provided on both the 1 st gripping member 8 and the 2 nd gripping member 9.

In embodiments 1 and 2 described above, the material constituting the conductive portion 15 is exemplified by a material containing nickel, but the present invention is not limited thereto, and any one of stainless steel, nickel alloy, palladium, platinum, gold, and silver, or a combination thereof may be used as long as the material is other materials.

In embodiments 1 and 2 described above, the 1 st metal film 101 and the 2 nd metal film 102 are formed by electroless plating and electrolytic plating, respectively, but the present invention is not limited thereto, and the films may be formed by sputtering.

Description of the reference numerals

1. A disposal system; 2. a treatment instrument; 3. a control device; 4. a foot switch; 5. a handle; 6. a shaft; 7. a grip portion; 8. 1 st gripping member; 9. a2 nd holding member; 10. a support member; 11. a heat insulating member; 12. a disposal member; 13. 13A, a medical heater; 14. a substrate; 14a, the 1 st plate surface; 14b, 2 nd plate surface; 15. a conductive portion; 16. passive film covering; 17. an adhesive sheet; 18. a cover member; 51. an operation knob; 61. a movable member; 91. a holding surface; 101. 1 st metal film; 102. a2 nd metal film; 111. a recess; 121. disposing the surface; 122. arranging a surface; 123. a recess; 141. 1 st wide part; 142. the 2 nd wide part; 143. a narrow portion; 151. a1 st connecting part; 152. a2 nd connecting part; 153. a heat generating portion; 154. a circuit path section; 154a, heat-generating side end portion; a1, direction; ar1, tip side; ar2, base end side; ax, central axis; C. a cable; c1, conductive wires; ln, a fold line; MA1, zone 2; MA2, zone 3; MT1, MT2, masking tape; p1, P2, fulcrum; sp1, treatment side region; sp2, back side region; sp3, Sp4, region 1; y1, arrow.