TREATMENT TOOL, TREATMENT TOOL ASSEMBLING METHOD, AND TREATMENT TOOL DISASSEMBLING METHOD

A treatment tool includes: a sheath extending along a longitudinal axis; a fixed gripping piece protruding from a distal end of the sheath; a movable gripping piece that is movably attached to either the sheath or the fixed gripping piece, the movable gripping piece being configured to grip a living tissue between the movable gripping piece and the fixed gripping piece; and a movement restricting portion configured to allow movement of the movable gripping piece in a first range and restrict movement of the movable gripping piece in a second range different from the first range. The movable gripping piece is attachable to and detachable from either the sheath or the fixed gripping piece at a movement position within the second range.

BACKGROUND

1. Technical Field

The present disclosure relates to a treatment tool, a treatment tool assembling method, and a treatment tool disassembling method.

2. Related Art

In the related art, there is a treatment tool for treating a treatment target site in a living tissue (hereinafter, described as a target site.

The treatment tool includes an outer pipe being a tubular elongated member, and a jaw pivotably attached to the outer pipe at a distal end of the outer pipe. The jaw pivots with respect to the outer pipe to grip the target site between the jaw and a distal end portion of a blade inserted into the outer pipe to transmit ultrasound vibration from the proximal end toward the distal end.

SUMMARY

In some embodiments, a treatment tool includes: a sheath extending along a longitudinal axis; a fixed gripping piece protruding from a distal end of the sheath; a movable gripping piece that is movably attached to either the sheath or the fixed gripping piece, the movable gripping piece being configured to grip a living tissue between the movable gripping piece and the fixed gripping piece; and a movement restricting portion configured to allow movement of the movable gripping piece in a first range and restrict movement of the movable gripping piece in a second range different from the first range. The movable gripping piece is attachable to and detachable from either the sheath or the fixed gripping piece at a movement position within the second range.

In some embodiments, a treatment tool assembling method includes: attaching a movable gripping piece to a distal end of a sheath to be movable; and inserting a vibration transmitting portion into the sheath, the vibration transmitting portion being configured to transmit ultrasound vibration. The vibration transmitting portion is configured to allow movement of the movable gripping piece in a first range and restrict movement of the movable gripping piece in a second range different from the first range, the movable gripping piece is attachable to and detachable from the sheath at a movement position within the second range, and the attaching includes attaching the movable gripping piece to the distal end of the sheath in a posture of the movable gripping piece being located at a movement position within the second range.

In some embodiments, a treatment tool disassembling method includes: extracting a vibration transmitting portion from inside a sheath, the vibration transmitting portion being configured to transmit ultrasound vibration; and detaching a movable gripping piece from the sheath, the movable gripping piece having been movably attached to a distal end of the sheath. The vibration transmitting portion is configured to allow movement of the movable gripping piece in a first range and restrict movement of the movable gripping piece in a second range different from the first range, the movable gripping piece is attachable to and detachable from the sheath at a movement position within the second range, and the detaching is performed in a state where the movable gripping piece is located at a movement position within the second range after the restriction of the movement of the movable gripping piece in the second range by the vibration transmitting portion is released in the extracting.

DETAILED DESCRIPTION

Hereinafter, a mode (hereinafter, “embodiment”) for carrying out the disclosure will be described with reference to the accompanying drawings. Note that the disclosure is not limited to embodiments described below. In the drawings, same reference signs are attached to the same components.

Schematic Configuration of Treatment System

FIG. 1is a view illustrating a treatment system1according to an exemplary embodiment.

The treatment system1applies treatment energy to a site as a treatment target (hereinafter, referred to as a target site) in a living tissue, and thereby achieves treatment of the target site. In the present embodiment, thermal energy and high-frequency energy are employed as the treatment energy. In addition, the term treatment includes coagulation or incision of a target site. As illustrated inFIG. 1, the treatment system1includes a treatment tool2and a control device3.

Configuration of Treatment Tool

FIGS. 2 and 3are views illustrating a distal end portion of the treatment tool2. Specifically,FIG. 2is a perspective view illustrating a distal end portion of the treatment tool2.FIG. 3is a cross-sectional view of the distal end portion of the treatment tool2taken along a plane including a longitudinal axis Ax of a sheath6.

Hereinafter, for convenience of description, one side along the longitudinal axis (central axis) Ax of the sheath6is referred to as a distal end side Ar1, while the other side is referred to as a proximal end side Ar2.

As illustrated inFIGS. 1 to 3, the treatment tool2includes a housing4(FIG. 1), a movable handle5(FIG. 1), the sheath6, first and second gripping pieces7and8, and an open-close mechanism9(FIGS. 2 and 3).

The housing4supports the entire treatment tool2. As illustrated inFIG. 1, the housing4includes: a housing body41being a substantially cylindrical body coaxial with the longitudinal axis Ax; and a fixed handle42extending downward inFIG. 1from the housing body41and configured to be gripped by an operator.

As illustrated inFIG. 1, on a side surface of the housing4on the distal end side Ar1, there is provided a switch43in a state of being exposed to the outside. The switch43receives an output start operation by the operator. The output start operation is an operation of pressing the switch43, and is an operation of starting application of treatment energy to a target site. The switch43then outputs an operation signal corresponding to the output start operation to the control device3via an electric cable CA (FIG. 1).

The movable handle5is pivotally and pivotably supported to the housing4so as to be pivotable about a first pivot shaft Rx1orthogonal to the direction of the sheet surface ofFIG. 1. The movable handle5receives a closing operation and an opening operation by the operator. The closing operation is an operation of pivoting the movable handle5about the first pivot shaft Rx1in a direction approaching the fixed handle42. The opening operation is an operation of pivoting the movable handle5about the first pivot shaft Rx1in a direction away from the fixed handle42.

The sheath6has a substantially cylindrical shape as a whole. An end of the sheath6on the proximal end side Ar2is inserted into the housing4. As illustrated inFIGS. 1 to 3, the first and second gripping pieces7and8are provided at the end of the sheath6on the distal end side Ar1.

The first gripping piece7has an elongated shape extending along the longitudinal axis Ax. In addition, the end of the first gripping piece7on the proximal end side Ar2is fixed to the sheath6as illustrated inFIG. 2 or 3. That is, the first gripping piece7corresponds to a fixed gripping piece.

As illustrated inFIG. 3, the first gripping piece7includes a first electrode71and a heater72at an end on the distal end side Ar1facing the second gripping piece8.

The first electrode71is formed of a conductive material having high thermal conductivity such as copper, and has an elongated shape extending along the longitudinal axis Ax. The first electrode71provided in the first gripping piece7is in a state of being exposed to the outside.

The heater72provided in the first gripping piece7is in a state of being hidden inside by the first electrode71. When activated by electric power supply, the heater72generates heat and heats the first electrode71. Examples of the heater72include a sheet heater including a conductive pattern made on a substrate formed of polyimide or the like, a ceramic heater including a conductive pattern made on a ceramic substrate formed of aluminum nitride or the like, and other printed heaters.

The second gripping piece8has an elongated shape extending along the longitudinal axis Ax. An end of the second gripping piece8on the proximal end side Ar2is pivotally supported on the first gripping piece7so as to be pivotable about a second pivot shaft Rx2(FIGS. 2 and 3). Pivot movement of the second gripping piece8about the second pivot shaft Rx2allows the second gripping piece8to perform open-close operation with respect to the first gripping piece7, making it possible to grip the target site between the first and second gripping pieces7and8. That is, the second gripping piece8corresponds to a movable gripping piece.

The second gripping piece8includes a second electrode81(FIG. 3), which is formed of a conductive material and provided at a position facing the first electrode71, in a state of being exposed to the outside.

The attachment structure used to attach the second gripping piece8to the first gripping piece7will be described below in “Attachment structure used to attach second gripping piece to first gripping piece”.

The open-close mechanism9is a mechanism that opens and closes the second gripping piece8with respect to the first gripping piece7. As illustrated inFIG. 2 or 3, the open-close mechanism9includes a drive portion91.

The drive portion91is an elongated member extending along the longitudinal axis Ax, and configured to be inserted into the sheath6. Furthermore, an end of the drive portion91on the distal end side Ar1is engaged with the second gripping piece8.

The engagement structure between the second gripping piece8and the drive portion91will be described in “Engagement structure between second gripping piece and drive portion” described below.

The drive portion91operates as described below according to the operation of the movable handle5by the operator.

According to the closing operation of the movable handle5by the operator, the drive portion91receives a pressing force (driving force for gripping the target site between the first and second gripping pieces7and8) toward the distal end side Ar1. The pressing force allows the drive portion91to move toward the distal end side Ar1along the longitudinal axis Ax. The drive portion91then applies the driving force to the second gripping piece8. This allows the second gripping piece8to pivot about the second pivot shaft Rx2in a direction approaching the first gripping piece7(closing direction).

On the other hand, when the operator performs an opening operation on the movable handle5, the drive portion91operates in a direction opposite to the above direction. This allows the second gripping piece8to pivot about the second pivot shaft Rx2in a direction away from the first gripping piece7(opening direction).

As described above, the second gripping piece8opens and closes against the first gripping piece7according to the operation of the movable handle5by the operator.

Configuration of Control Device

The treatment tool2is detachably connected to the control device3by an electric cable CA. According to the operation signal input from the switch43via the electric cable CA, the control device3integrally controls the operation of the treatment tool2as described below.

The control device3supplies high-frequency power between the first and second electrodes71and81via the electric cable CA. This allows a high-frequency current to flow through the target site gripped between the first and second gripping pieces7and8(first and second electrodes71and81). In other words, high-frequency energy is applied from the first and second electrodes71and81to the target site.

The control device3supplies power to the heater72via the electric cable CA. This causes the heater72to generate heat. The heat of the heater72is transferred to the target site gripped between the first and second gripping pieces7and8(first and second electrodes71and81) through the first electrode71. In other words, thermal energy is applied from the first electrode71to the target site.

Attachment Structure Used to Attach Second Gripping Piece to First Gripping Piece

Next, an attachment structure used for attaching the second gripping piece8to the first gripping piece7will be described.

FIGS. 4 to 6are views illustrating an attachment structure used to attach the second gripping piece8to the first gripping piece7. Specifically,FIGS. 4 to 6are views of the first and second gripping pieces7and8along the second pivot shaft Rx2.

In the following, for convenience of description, in the direction in which the first and second gripping pieces7and8(first and second electrodes71and81) face each other, that is, a facing direction (or vertical direction inFIGS. 4 to 6), the upper side (side on which the second gripping piece8(second electrode81) is disposed) inFIGS. 4 to 6is referred to as an upper side Ar3. In the facing direction inFIGS. 4 to 6, a lower side (side on which the first gripping piece7(the first electrode71) is disposed) is referred to as a lower side Ar4.

The end of the second gripping piece8on the proximal end side Ar2includes a pair of second connectors82and a base83as illustrated inFIG. 2.

Each of the pair of second connectors82is formed of a plate member intersecting the second pivot shaft Rx2, and faces each other. The pair of second connectors82has shapes that are symmetrical to each other with respect to a plane parallel to the sheet surface ofFIGS. 4 to 6.

The base83is formed of a plate member substantially parallel to the second pivot shaft Rx2, and connects edges of the upper side Ar3of the pair of second connectors82.

The second gripping piece8is attached to the first gripping piece7in a state where a part of the first gripping piece7is housed inside a U-shaped cross section formed by the pair of second connectors82and the base83.

On an inner surface of the second connector82(surface facing the other second connector82), a pivot shaft821and a guide pin822are provided (FIGS. 4 to 6). The pivot shaft821has a cylindrical shape protruding along the second pivot shaft Rx2. The pivot shaft821functions as a pivot center of the second gripping piece8. That is, the second pivot shaft Rx2corresponds to a central axis.

The guide pin822is provided at a position close to the pivot shaft821and has the same shape as the pivot shaft821. The guide pin822guides the pivot operation of the second gripping piece8.

The first gripping piece7is provided with a pair of first connectors70(FIGS. 2 and 4 to 6) facing the pair of second connectors82.

Similarly to the second connector82, each of the pair of first connectors70is formed of a plate member intersecting the second pivot shaft Rx2, and faces each other. The pair of first connectors70has shapes that are symmetrical to each other with respect to a plane parallel to the sheet surface ofFIGS. 4 to 6.

An outer surface of first connector70(surface spaced apart from the other first connector70, surface facing the second connector82) is provided with a bearing73and an arc portion74(FIGS. 4 to 6).

The bearing73extends along a first straight line L1(FIGS. 4 to 6) intersecting the second pivot shaft Rx2from an outer edge of the first connector70(hereinafter, referred to as a starting end E1(FIGS. 4 to 6)) on the upper side Ar3. The bearing73allows the pivot shaft821and the guide pin822to be inserted along the first straight line L1from the starting end E1. In the present embodiment, the first straight line L1is a straight line inclined onto the distal end side Ar1toward the lower side Ar4when viewed from a direction along the second pivot shaft Rx2. In addition, the bearing73is constituted by a groove recessed in a thickness direction of the plate member in the first connector70on the outer surface of the first connector70. The bearing73pivotally and pivotably supports the pivot shaft821(second gripping piece8) at a terminating end E2(FIGS. 4 to 6) of the lower side Ar4.

The arc portion74is formed of a groove similarly to the bearing73, and communicates with the bearing73. In addition, the arc portion74extends from a communicating position with the bearing73toward the distal end side Ar1in an arc shape centered on the second pivot shaft Rx2located at the terminating end E2of the bearing73and having a radius of a distance between the pivot shaft821and the guide pin822. The guide pin822is inserted into the arc portion74in accordance with the pivot operation of the second gripping piece8.

Engagement Structure Between Second Gripping Piece and Drive Portion

Next, an engagement structure between the second gripping piece8and the drive portion91will be described.

FIG. 7is a view illustrating an engagement structure between the second gripping piece8and the drive portion91. Specifically,FIG. 7is a view illustrating the engagement structure between the second gripping piece8and the drive portion91as seen from the upper side Ar3.

The base83has a cutout portion831(FIGS. 2 and 7) cut out from the proximal end toward the distal end side Ar1at a central portion in the direction along the second pivot shaft Rx2.

As illustrated inFIG. 7, on inner wall surfaces of the cutout portion831facing each other along the second pivot shaft Rx2, engagement pins832are provided.

These engagement pins832each have a cylindrical shape protruding in directions approaching each other along the second pivot shaft Rx2.

On the other hand, an end of the drive portion91on the distal end side Ar1is provided with engagement grooves911(FIG. 7) respectively extending in directions (directions orthogonal to the sheet surface ofFIG. 7) orthogonal to each of the protruding direction of the engagement pin832and the longitudinal axis Ax, each of the engagement grooves911configured to be engaged with each of the engagement pins832.

When the drive portion91moves along the longitudinal axis Ax in a state where the engagement pin832and the engagement groove911are engaged with each other, the second gripping piece8performs open-close operation with respect to the first gripping piece7about the second pivot shaft Rx2.

Treatment Tool Assembling Method

Next, a method of assembling the treatment tool2will be described.

FIG. 8is a flowchart illustrating a method of assembling the treatment tool2.

First, as described below, a worker attaches the second gripping piece8to the first gripping piece7(step S1A).

That is, as illustrated inFIG. 4, when viewed in the direction along the second pivot shaft Rx2, the worker sets the second gripping piece8to be in a posture in which a straight line connecting the pivot shaft821and the guide pin822is parallel to the first straight line L1. Subsequently, as illustrated inFIGS. 4 and 5, the worker inserts the pivot shaft821and the guide pin822into the bearing73from the starting end E1of the bearing73while maintaining the posture. The posture of the second gripping piece8illustrated inFIGS. 4 and 5is a posture in which the distal end of the second gripping piece8is located on the upper side Ar3with respect to the second pivot shaft Rx2.

With the above step S1A, the second gripping piece8is attached to the first gripping piece7in a state where the pair of first connectors70is housed inside the U-shaped cross section formed by the pair of second connectors82and the base83.

After step S1A, the worker engages the drive portion91with the second gripping piece8as described below (step S1B).

That is, the worker positions the end of the drive portion91on the distal end side Ar1onto the upper side Ar3of the second gripping piece8. The worker then moves the end of the drive portion91on the distal end side Ar1to the lower side Ar4, and inserts the pair of engagement pins832into the pair of engagement grooves911. This allows the drive portion91to be engaged with the second gripping piece8as illustrated inFIG. 8.

After step S1B, the worker inserts the drive portion91into the sheath6from the proximal end side Ar2of the sheath6(step S1C).

After step S1C, the worker assembles the ends of the drive portion91and the sheath6on the proximal end side Ar2into the housing4(step S1D). This allows the drive portion91to be disposed at the position illustrated inFIG. 6. Specifically, the position illustrated inFIG. 6is a limit position that allows the drive portion91to move toward the proximal end side Ar2in a state where the operator has performed the opening operation on the movable handle5. In the state where the drive portion91is located at the limit position, the second gripping piece8pivots in the closing direction about the second pivot shaft Rx2from the state illustrated inFIG. 5, and the guide pin822is inserted into the arc portion74.

That is, the drive portion91allows the pivot operation in a first range R1(range illustrated inFIG. 6) in the closing direction of the second gripping piece8from the state illustrated inFIG. 6, and restricts the pivot operation in a second range R2(range illustrated inFIG. 6) in the opening direction of the second gripping piece8from the state illustrated inFIG. 6. Accordingly, the drive portion91corresponds to a movement restricting portion.

In addition, the second gripping piece8is attachable to and detachable from the first gripping piece7at a pivoting position (position illustrated inFIG. 5) within the second range R2.

Furthermore, when the second gripping piece8is located at the attachment-detachment position (the position illustrated inFIG. 5) which is a pivoting position where the second gripping piece8is attachable to and detachable from the first gripping piece7, the guide pin822is located in the bearing73and allows the movement of the pivot shaft821toward the starting end E1in the bearing73. That is, the second gripping piece8is detachable from the first gripping piece7.

In contrast, when the second gripping piece8is located at the pivoting position within the first range R1(the range illustrated inFIG. 6), the guide pin822is located in the arc portion74and restricts the movement of the pivot shaft821toward the starting end E1in the bearing73. That is, the second gripping piece8is not detachable from the first gripping piece7.

Treatment Tool Disassembling Method

Next, a method of disassembling the treatment tool2will be described.

FIG. 9is a flowchart illustrating a method of disassembling the treatment tool2.

Note that, the method of disassembling the treatment tool2performs reverse of individual steps of the above-described method of assembling the treatment tool2. Therefore, the method of disassembling the treatment tool2will be briefly described below.

First, the worker detaches the end of the drive portion91and the sheath6on the proximal end side Ar2from inside the housing4(step S2A).

After step S2A, the worker extracts the drive portion91from inside the sheath6(step S2B).

After step S2B, the worker releases the engagement between the second gripping piece8(engagement pin832) and the drive portion91(engagement groove911) (step S2C).

After step S2C, the worker positions the second gripping piece8at the attachment-detachment position (position illustrated inFIG. 5), and moves the pivot shaft821and the guide pin822toward the starting end E1in the bearing73, thereby detaching the second gripping piece8from the first gripping piece7(step S2D).

The treatment tool2described above may be disposed after each time of use, or may be repeatedly used a plurality of times. In the case of a plurality of times of use, for example, there is a need to perform remanufacturing by the reprocessing method illustrated inFIG. 10.

Reprocessing Method

First, the marketing authorization holder in charge of remanufacturing collects the used treatment tool2after being used for treatment and transports the used treatment tool2to a factory or the like (step S3A). At this time, the used treatment tool2is transported in a dedicated container in order to prevent contamination from the treatment tool2.

After step S3A, the marketing authorization holder cleans and sterilizes the collected and transported used treatment tool2(step S3B), and performs an acceptance inspection to determine whether the used treatment tool2can be remanufactured (step S3C). For example, in the acceptance inspection, the used treatment tool2having a significant defect or having been used the number of times exceeding a remanufacturable limit is determined to be not remanufacturable.

After step S3C, the marketing authorization holder disassembles the used treatment tool2by the method of disassembling the treatment tool2described above (FIG. 9) (step S3D).

After step S3D, the marketing authorization holder performs a component replacement step (step S3E). For example, in the component replacement step, the first and second gripping pieces7and8worn by the treatment or to which dirt adheres are replaced with new components.

After step S3E, the marketing authorization holder reassembles each component by the above-described method of assembling the treatment tool2(FIG. 8) (step S3F), and performs inspection and test on the newly formed treatment tool2(step S3G). Here, regarding the inspection and test, verification is performed to verify that the newly formed treatment tool2has the same effectiveness and safety as the original product.

After step S3G, the marketing authorization holder packages the newly formed treatment tool2, and then performs second sterilization (step S3H). For example, the sterilization uses a sterilization indicator such as a biological indicator (B.I.) to ensure the sterilization performance.

After step S3H, the marketing authorization holder ships the treatment tool2(step S3I).

Steps S3A to S3I described above are executed to achieve remanufacturing of the treatment tool2.

According to the present embodiment, the following effects are obtained.

In the treatment tool2according to the present embodiment, the drive portion91allows pivot operation of the second gripping piece8in the first range R1and restricts the pivot operation of the second gripping piece8in the second range R2. In addition, the second gripping piece8is attachable to and detachable from the first gripping piece7at a pivoting position (position illustrated inFIG. 5) within the second range R2.

Accordingly, since the treatment tool2of the present embodiment does not use the conventional welding in attaching the second gripping piece8to the first gripping piece7, it is possible to facilitate assembly and disassembly. In addition, after the assembly of the treatment tool2, the pivot operation of the second range R2in the second gripping piece8is restricted by the drive portion91, making it possible to use the treatment tool2reliably and safely. In particular, the second gripping piece8can be attached to and detached from the first gripping piece7only at the position illustrated inFIG. 5, which is the end of the second range R2. In other words, in the second range R2, there is a range (margin) that disables detachment of the second gripping piece8from the first gripping piece7. Therefore, even when elastic deformation occurs in the first and second gripping pieces7and8at the time of using the treatment tool2or even when dimensional variations occur in the first and second gripping pieces7and8, the assembled state can be stably maintained after the treatment tool2is assembled.

Furthermore, a conventionally used drive portion91is adopted as the movement restricting portion. This eliminates necessity to additionally provide the movement restricting portion, resulting in no increase in the number of parts.

In addition, the treatment tool2according to the present embodiment includes the guide pin822and the arc portion74in addition to the pivot shaft821and the bearing73. This makes it possible to smoothly perform open-close operation of the second gripping piece8with respect to the first gripping piece7while having a structure that facilitates assembly and disassembly of the treatment tool2.

Furthermore, in the treatment tool2according to the present embodiment, the bearing73is formed by a groove. Therefore, as compared with a case where the bearing73is formed as a through hole penetrating the front and back surfaces of the first connector70, it is possible to avoid opening of the starting end E1, making it possible to properly support the pivot shaft821by the bearing73. That is, it is possible to stably maintain the attached state of the second gripping piece8with respect to the first gripping piece7.

Furthermore, in the treatment tool2according to the present embodiment, the second gripping piece8and the drive portion91are engaged with each other by the engagement pin832and the engagement groove911. This eliminates necessity to use welding between the second gripping piece8and the drive portion91similarly to between the second gripping piece8and the first gripping piece7. This makes it possible to facilitate assembly and disassembly of the treatment tool2.

Next, another exemplary embodiment will be described.

In the following description, identical reference numerals are given to the components similar to those in the embodiment described above, and detailed description thereof will be omitted or simplified.

The present embodiment is different from the above-described embodiment in the structure of attaching the second gripping piece8to the first gripping piece7.

Hereinafter, for convenience of description, the treatment tool2according to the present embodiment is referred to as a treatment tool2A. In addition, the first gripping piece7according to the present embodiment will be referred to as a first gripping piece7A. Furthermore, the second gripping piece8according to the present embodiment will be referred to as a second gripping piece8A.

FIGS. 11 to 13are views illustrating an attachment structure used to attach the second gripping piece8A to the first gripping piece7A. Specifically,FIGS. 11 to 13are views of the first and second gripping pieces7A and8A along the second pivot shaft Rx2.

As compared with the first gripping piece7described in the above-described embodiment, the first gripping piece7A includes an engagement protrusion75instead of the arc portion74.

The engagement protrusion75is provided on an outer surface of the first connector70(a surface facing the second connector82). Note that, also in the present embodiment, the pair of first connectors70has shapes that are symmetrical to each other with respect to a plane parallel to the sheet surface ofFIGS. 11 to 13.

More specifically, on the outer surface of the first connector70, the engagement protrusion75protrudes in the thickness direction of the plate member in the first connector70. The bearing73is provided at the tip of the engagement protrusion75. In addition, on the outer surface of the engagement protrusion75, there is provided a first arc surface751having an arc shape and centered on the second pivot shaft Rx2positioned at the terminating end E2of the bearing73. The first arc surface751is located on the terminating end E2side and intersects the first straight line L1when viewed in the direction along the second pivot shaft Rx2.

As compared with the second gripping piece8described in the above-described embodiment, the second gripping piece8A includes an engagement recess823instead of the guide pin822.

The engagement recess823is provided on an inner surface of the second connector82(a surface facing the other second connector82). Note that, also in the present embodiment, the pair of second connectors82has shapes that are symmetrical to each other with respect to a plane parallel to the sheet surface ofFIGS. 11 to 13.

More specifically, on the inner surface of the second connector82, the engagement recess823is recessed in the thickness direction of the plate member in the second connector82so as to be capable of housing the engagement protrusion75. The pivot shaft821is provided on the bottom surface of the engagement recess823. In addition, on the inner side surface of the engagement recess823, there is provided a second arc surface8231having an arc shape centered on the second pivot shaft Rx2.

In the method of assembling the treatment tool2A according to the present embodiment, step S1A has a difference compared with step S1A in the method for assembling the treatment tool2described in the above embodiment (FIG. 8).

In step S1A according to the present embodiment, the worker attaches the second gripping piece8A to the first gripping piece7A as described below.

That is, as illustrated inFIG. 11, the worker sets the second gripping piece8A in a posture in which the second arc surface8231faces the lower side Ar4when viewed in a direction along the second pivot shaft Rx2. Subsequently, as illustrated inFIGS. 11 and 12, the worker inserts the pivot shaft821into the bearing73from the starting end E1of the bearing73while maintaining the posture. With this operation, the engagement protrusion75is housed in the engagement recess823. The posture of the second gripping piece8A illustrated inFIGS. 11 and 12is a posture in which the distal end of the second gripping piece8A is located on the upper side Ar3with respect to the second pivot shaft Rx2, similarly to the posture of the second gripping piece8described in the above embodiment illustrated inFIGS. 4 and 5.

With the above step S1A, the second gripping piece8A is attached to the first gripping piece7A in a state where the pair of first connectors70is housed inside the U-shaped cross section formed by the pair of second connectors82and the base83.

When step S1D is completed, the drive portion91is positioned at the position illustrated inFIG. 13. Specifically, the position illustrated inFIG. 13is a limit position that allows the drive portion91to move toward the proximal end side Ar2in a state where the operator has performed the opening operation on the movable handle5. In the state where the drive portion91is located at the limit position, the second gripping piece8A pivots in the closing direction about the second pivot shaft Rx2from the state illustrated inFIG. 12, and a part of the second arc surface8231faces a part of the first arc surface751.

That is, the drive portion91allows the pivot operation in a first range R1in the closing direction of the second gripping piece8A from the state illustrated inFIG. 13, and restricts the pivot operation in a second range R2in the opening direction of the second gripping piece8A from the state illustrated inFIG. 13.

In addition, the second gripping piece8A is attachable to and detachable from the first gripping piece7A at a pivoting position (position illustrated inFIG. 12) within the second range R2.

Furthermore, the first and second arc surfaces751and8231do not face each other when the second gripping piece8A is located at an attachment-detachment position (position illustrated inFIG. 12) being a pivoting position at which the second gripping piece8A is attachable to and detachable from the first gripping piece7A. Therefore, the engagement protrusion75and the engagement recess823allow the pivot shaft821to move toward the starting end E1in the bearing73. That is, the second gripping piece8A is detachable from the first gripping piece7A.

In contrast, when the second gripping piece8A is located at a pivoting position within the first range R1, the first and second arc surfaces751and8231partially face each other. Therefore, the engagement protrusion75and the engagement recess823restricts the movement of the pivot shaft821toward the starting end E1in the bearing73. That is, the second gripping piece8A is not detachable from the first gripping piece7A.

Note that, the method of disassembling the treatment tool2A performs reverse of individual steps of the above-described method of assembling the treatment tool2A, and thus, description will be omitted.

With the present embodiment, effects similar to the effects of the above-described embodiment can be achieved.

Next, another exemplary embodiment will be described.

In the following description, identical reference numerals are given to the components similar to those in the exemplary embodiments described above, and detailed description thereof will be omitted or simplified.

The present embodiment is different from the above embodiment shown inFIGS. 1-10in the structure for attaching the second gripping piece8to the first gripping piece7.

Hereinafter, for convenience of description, the treatment tool2according to the present embodiment is referred to as a treatment tool2B. In addition, the first gripping piece7according to the present embodiment will be referred to as a first gripping piece7B. Furthermore, the second gripping piece8according to the present embodiment will be referred to as a second gripping piece8B.

FIGS. 14 to 16are views illustrating an attachment structure used to attach the second gripping piece8B to the first gripping piece7B. Specifically,FIGS. 14 to 16are views of the first and second gripping pieces7B and8B along the second pivot shaft Rx2.

As compared with the first gripping piece7described in the above-described embodiment (FIGS. 1-10), the first gripping piece7B has no arc portion74and has a bearing73having a shape different from the bearing73in the above embodiment. Hereinafter, for convenience of description, the bearing73according to the present embodiment will be referred to as a bearing73B.

As compared with the second gripping piece8described in the above-described embodiment (FIGS. 1-10), the second gripping piece8B has no guide pin822and has a pivot shaft821having a shape different from the pivot shaft821in the above-described embodiment. Hereinafter, for convenience of description, the pivot shaft821according to the present embodiment will be referred to as a pivot shaft821B.

As illustrated inFIGS. 14 to 16, the bearing73B includes an insertion portion731and a bearing body732.

Similarly to the bearing73described in the above-described embodiment (FIGS. 1-10), the insertion portion731extends along the first straight line L1intersecting the second pivot shaft Rx2from the outer edge (hereinafter, it is described as a starting end E1) of the upper side Ar3in the first connector70. The insertion portion731allows the pivot shaft821B to be inserted along the first straight line L1from the starting end E1. In the present embodiment, similarly to the bearing73, the insertion portion731is constituted by a groove recessed in a thickness direction of the plate member in the first connector70on the outer surface of the first connector70.

Similarly to the insertion portion731, the bearing body732is formed of a groove, and communicates with a terminating end E2of the insertion portion731on the lower side Ar4. The bearing body732has a circular shape with a width dimension of the insertion portion731as a radius when viewed in a direction along the second pivot shaft Rx2. The bearing body732pivotally and pivotably supports the pivot shaft821B (the second gripping piece8B).

The pivot shaft821B protrudes along the second pivot shaft Rx2, and has a semicircular cross section taken along a plane orthogonal to the second pivot shaft Rx2. In the present embodiment, the radius of the semicircular shape of the pivot shaft821B is slightly smaller than the width dimension of the insertion portion731.

Here, the direction orthogonal to the semicircular chord in the pivot shaft821B corresponds to a first direction D1. That is, in the present embodiment, regarding the outer dimension of the pivot shaft821B in a direction orthogonal to the second pivot shaft Rx2, an outer dimension in the first direction D1(the radius of the semicircular shape in the pivot shaft821B) is the smallest.

In the method of assembling the treatment tool2B according to the present embodiment, step S1A has a difference compared with step S1A in the method for assembling the treatment tool2described in the above-described embodiment (seeFIG. 8).

In step S1A according to the present embodiment, the worker attaches the second gripping piece8B to the first gripping piece7B as described below.

That is, as illustrated inFIG. 14, when viewed in the direction along the second pivot shaft Rx2, the worker sets the second gripping piece8B in a posture in which the first direction D1is orthogonal to the first straight line L1, in other words, a posture in which the chord of the semicircular shape in the pivot shaft821B is parallel to the first straight line L1. Subsequently, as illustrated inFIGS. 14 and 15, the worker inserts the pivot shaft821B into the bearing73B from the starting end E1of the insertion portion731while maintaining the posture. The posture of the second gripping piece8B illustrated inFIGS. 14 and 15is a posture in which the distal end of the second gripping piece8B is located on the upper side Ar3with respect to the second pivot shaft Rx2, similarly to the posture of the second gripping piece8described in the above-described embodiment illustrated inFIGS. 4 and 5.

With the above step S1A, the second gripping piece8B is attached to the first gripping piece7B in a state where the pair of first connectors70is housed inside the U-shaped cross section formed by the pair of second connectors82and the base83.

When step S1D is completed, the drive portion91is positioned at the position illustrated inFIG. 16. Specifically, the position illustrated inFIG. 16is a limit position that allows the drive portion91to move toward the proximal end side Ar2in a state where the operator has performed the opening operation on the movable handle5. In the state where the drive portion91is located at the limit position, the second gripping piece8B pivots in the closing direction about the second pivot shaft Rx2from the state illustrated inFIG. 15, and the chord of the semicircular shape in the pivot shaft821B intersects the first straight line L1.

That is, the drive portion91allows the pivot operation in a first range R1in the closing direction of the second gripping piece8B from the state illustrated inFIG. 16, and restricts the pivot operation in a second range R2in the opening direction of the second gripping piece8B from the state illustrated inFIG. 16.

In addition, the second gripping piece8B is attachable to and detachable from the first gripping piece7B at a pivoting position (position illustrated inFIG. 15) within the second range R2.

Furthermore, when the second gripping piece8B is located at the attachment-detachment position (the position illustrated inFIG. 15) which is the pivoting position where the second gripping piece8B can be attached to and detached from the first gripping piece7B, the pivot shaft821B is allowed to move from the bearing body732to the insertion portion731. That is, the second gripping piece8B is detachable from the first gripping piece7B.

In contrast, when the second gripping piece8B is located at the pivoting position within the first range R1, because of interference with the inner wall surface of the insertion portion731, the pivot shaft821B is not allowed to move from the bearing body732to the insertion portion731. That is, the second gripping piece8B is not detachable from the first gripping piece7B.

Note that, the method of disassembling the treatment tool2B performs reverse of individual steps of the above-described method of assembling the treatment tool2B, and thus, description will be omitted.

With the present embodiment, effects similar to the effects of the above-described embodiment (FIGS. 1-10) can be achieved.

Next, another exemplary embodiment will be described.

In the following description, identical reference numerals are given to the components similar to those in embodiments described above, and detailed description thereof will be omitted or simplified.

In the above-described embodiment shown inFIGS. 14-16, the drive portion91is adopted as the movement restricting portion.

In contrast, in the present embodiment, the sheath6is adopted as the movement restricting portion.

Hereinafter, for convenience of description, the treatment tool2according to the present embodiment is referred to as a treatment tool2C. The sheath6according to the present embodiment is referred to as a sheath6C.

FIG. 17is a diagram illustrating a function of the sheath6C according to the present embodiment. Specifically,FIG. 17is a view that corresponds toFIG. 16.

The method of assembling the treatment tool2C according to the present embodiment is similar to the method of assembling the treatment tool2B described in the above embodiment (FIGS. 14-16).

In the present embodiment, after completion of step S1D, the sheath6C is disposed at the position illustrated inFIG. 17. In the state where the sheath6C is located at the position illustrated inFIG. 17, the second gripping piece8B pivots in the closing direction about the second pivot shaft Rx2from the state illustrated inFIG. 15, and the chord of the semicircular shape in the pivot shaft821B intersects the first straight line L1.

That is, the sheath6C allows the pivot operation in a first range R1in the closing direction of the second gripping piece8B from the state illustrated inFIG. 17, and restricts the pivot operation in a second range R2in the opening direction of the second gripping piece8B from the state illustrated inFIG. 17.

In addition, the second gripping piece8B is attachable to and detachable from the first gripping piece7B at a pivoting position (position illustrated inFIG. 15) within the second range R2.

With the present embodiment, effects similar to the effects of the above-described embodiments can be achieved.

Next, another exemplary embodiment will be described.

In the following description, identical reference numerals are given to the components similar to those in the embodiments described above, and detailed description thereof will be omitted or simplified.

The present embodiment is different from the above-described embodiment shown inFIGS. 14-16in the structure for attaching the second gripping piece8B to the first gripping piece7B.

Hereinafter, for convenience of description, the treatment tool2according to the present embodiment is referred to as a treatment tool2D. In addition, the second gripping piece8according to the present embodiment will be referred to as a second gripping piece8D.

FIGS. 18 to 20are views illustrating an attachment structure used to attach the second gripping piece8D to the first gripping piece7B. Specifically,FIGS. 18 to 20are views of the first and second gripping pieces7B and8D viewed along the second pivot shaft Rx2.

In the second gripping piece8D, the shape of the pivot shaft821B is different from that of the second gripping piece8B described in the above-described embodiment (FIGS. 14-16). Hereinafter, for convenience of description, the pivot shaft821B according to the present embodiment will be referred to as a pivot shaft821D.

The pivot shaft821D is formed by dividing a cylinder protruding along the second pivot shaft Rx2into two bodies at a boundary being a plane PL (FIGS. 18 to 20) that passes through a central axis (second pivot shaft Rx2) of the cylinder and is orthogonal to the first direction D1. Hereinafter, one of the two divided cylinders will be referred to as a first pivot shaft821D1, and the other will be referred to as a second pivot shaft821D2. The first and second pivot shafts821D1and821D2face each other in the first direction D1and are elastically deformable in the first direction D1. In the present embodiment, the diameter of the bottom surface of the cylinder constituting the entire pivot shaft821D is larger than the width dimension of the insertion portion731. In addition, the outer dimension in the first direction D1in a state where the first and second pivot shafts821D1and821D2are elastically deformed in a direction of approaching each other to the maximum is slightly smaller than the width dimension of the insertion portion731.

In the method of assembling the treatment tool2D according to the present embodiment, step S1A has a difference compared with step S1A in the method for assembling the treatment tool2B described in the above embodiment (FIGS. 14-16).

In step S1A according to the present embodiment, the worker attaches the second gripping piece8D to the first gripping piece7B as described below.

That is, as illustrated inFIG. 18, when viewed in the direction along the second pivot shaft Rx2, the worker sets the second gripping piece8D in a posture in which the first direction D1is orthogonal to the first straight line L1, in other words, a posture in which the plane PL is parallel to the first straight line L1. Subsequently, as illustrated inFIGS. 18 and 19, the worker presses the pivot shaft821D into the bearing73B from the starting end E1in the insertion portion731while maintaining the posture. With this operation, the first and second pivot shafts821D1and821D2are inserted into the insertion portion731while being elastically deformed in directions approaching each other by the inner wall surface of the insertion portion731. After have moved to the bearing body732, the first and second pivot shafts821D1and821D2no more interfere with the inner wall surface of the insertion portion731and thus return to the original shapes. The posture of the second gripping piece8D illustrated inFIGS. 18 and 19is a posture in which the distal end of the second gripping piece8D is located on the upper side Ar3with respect to the second pivot shaft Rx2, similarly to the posture of the second gripping piece8described in the above-described embodiment illustrated inFIGS. 4 and 5.

With the above step S1A, the second gripping piece8D is attached to the first gripping piece7B in a state where the pair of first connectors70is housed inside the U-shaped cross section formed by the pair of second connectors82and the base83.

When step S1D is completed, the drive portion91is positioned at the position illustrated inFIG. 20. Specifically, the position illustrated inFIG. 20is a limit position that allows the drive portion91to move toward the proximal end side Ar2in a state where the operator has performed the opening operation on the movable handle5. In the state where the drive portion91is located at the limit position, the second gripping piece8D pivots in the closing direction about the second pivot shaft Rx2from the state illustrated inFIG. 19, and the plane PL intersects the first straight line L1.

That is, the drive portion91allows the pivot operation in a first range R1in the closing direction of the second gripping piece8D from the state illustrated inFIG. 20, and restricts the pivot operation in a second range R2in the opening direction of the second gripping piece8D from the state illustrated inFIG. 20.

In addition, the second gripping piece8D is attachable to and detachable from the first gripping piece7B at a pivoting position (position illustrated inFIG. 19) within the second range R2.

Furthermore, when the second gripping piece8D is located at the attachment-detachment position (the position illustrated inFIG. 19) which is the pivoting position where the second gripping piece8D is attachable to and detachable from the first gripping piece7B, the pivot shaft821D is allowed to move from the bearing body732to the insertion portion731by elastic deformation of the first and second pivot shafts821D1and821D2in the direction of approaching each other. That is, the second gripping piece8D is detachable from the first gripping piece7B.

In contrast, when the second gripping piece8D is located at the pivoting position within the first range R1, because of interference with the inner wall surface of the insertion portion731, the pivot shaft821D is not allowed to move from the bearing body732to the insertion portion731. That is, the second gripping piece8D is not detachable from the first gripping piece7B.

Note that, the method of disassembling the treatment tool2D performs reverse of individual steps of the above-described method of assembling the treatment tool2D, and thus, description will be omitted.

With the present embodiment, effects similar to the effects of the above-described embodiments can be achieved.

Next, another exemplary embodiment will be described.

In the following description, identical reference numerals are given to the components similar to those in the embodiment described above (and shown inFIGS. 1-10), and detailed description thereof will be omitted or simplified.

The present embodiment is different from the above embodiment (FIGS. 1-10) in the structure for attaching the second gripping piece8to the first gripping piece7.

Hereinafter, for convenience of description, the treatment tool2according to the present embodiment is referred to as a treatment tool2E. In addition, the first gripping piece7according to the present embodiment will be referred to as a first gripping piece7E. Furthermore, the second gripping piece8according to the present embodiment will be referred to as a second gripping piece8E.

FIGS. 21 to 24are views illustrating an attachment structure used to attach the second gripping piece8E to the first gripping piece7E. Specifically,FIG. 21is an exploded perspective view illustrating the first and second gripping pieces7E and BE.FIGS. 22 and 23are views of the first and second gripping pieces7E and8E viewed along the second pivot shaft Rx2.

As compared with the first gripping piece7described in the above-described embodiment ofFIGS. 1-10, the first gripping piece7E has no arc portion74and has a bearing73having a shape different from the bearing73in the above embodiment. Hereinafter, for convenience of description, the bearing73according to the present embodiment will be referred to as a bearing73E.

As compared with the second gripping piece8described in the above-described embodiment ofFIGS. 1-10, the second gripping piece BE has no guide pin822and has a pivot shaft821having differences in shape and forming position from the pivot shaft821in the above embodiment. Hereinafter, for convenience of description, the pivot shaft821according to the present embodiment will be referred to as a pivot shaft821E.

A pair of pivot shafts821E is provided on each of surfaces of a pair of second connectors82on the front side of the sheet surface ofFIG. 21. The pair of second connectors82according to the present embodiment is shaped such that parallel displacement of one second connector82along the second pivot shaft Rx2forms the other second connector82. Hereinafter, for convenience of description, the second connector82on the front side on the sheet surface ofFIG. 21is referred to as a second connector82E1, while the second connector82on the back side on the sheet surface of the drawing ofFIG. 21is referred to as a second connector82E2.

As illustrated inFIG. 21, the pivot shaft821E includes a pivot shaft body821E1and a pair of protrusions821E2.

The pivot shaft body821E1has a cylindrical shape protruding along the second pivot shaft Rx2. The pivot shaft body821E1is a pivot center of the second gripping piece8E.

The pair of protrusions821E2protrudes in directions away from each other from the end on the tip side of the outer surface of the pivot shaft body821E1. When viewed in the direction along the second pivot shaft Rx2, the width dimension of the pair of protrusions821E2in a direction orthogonal to the protruding direction is smaller than the diameter of the pivot shaft body821E1.

The bearing73E, being a through hole that penetrates through the front-back of the first connector70, has an inner shape following the outer shape of the pivot shaft821E when viewed in the direction along the second pivot shaft Rx2, so as to be a through hole through which the pivot shaft821E can be inserted.

In the method of assembling the treatment tool2E according to the present embodiment, step S1A has a difference compared with step S1A in the method for assembling the treatment tool2described in the above embodiment (FIG. 8).

In step S1A according to the present embodiment, the worker attaches the second gripping piece8E to the first gripping piece7E as described below.

That is, as illustrated inFIG. 22, the worker inserts the second connector82E1between the pair of first connectors70, and sets the second gripping piece8E in a posture in which the pivot shaft821E matches the bearing73E when viewed in the direction along the second pivot shaft Rx2. Subsequently, the worker inserts the pivot shaft821E into the bearing73E while maintaining the posture. The posture of the second gripping piece8E illustrated inFIG. 22is a posture in which the distal end of the second gripping piece8E is located on the upper side Ar3with respect to the second pivot shaft Rx2, similarly to the posture of the second gripping piece8described in the above-described embodiment illustrated inFIGS. 4 and 5.

With the above step S1A, the second gripping piece BE is attached to the first gripping piece7E in a state where only the second connector82E1is housed between the pair of first connectors70.

When step S1D is completed, the drive portion91is positioned at the position illustrated inFIG. 23. Specifically, the position illustrated inFIG. 23is a limit position that allows the drive portion91to move toward the proximal end side Ar2in a state where the operator has performed the opening operation on the movable handle5. In the state where the drive portion91is located at the limit position, the second gripping piece8E pivots in the closing direction about the second pivot shaft Rx2from the state illustrated inFIG. 22, forming a state where the bearing73E and the pivot shaft821E do not match each other when viewed in the direction along the second pivot shaft Rx2.

That is, the drive portion91allows the pivot operation in a first range R1in the closing direction of the second gripping piece BE from the state illustrated inFIG. 23, and restricts the pivot operation in a second range R2in the opening direction of the second gripping piece BE from the state illustrated inFIG. 23.

In addition, the second gripping piece BE is attachable to and detachable from the first gripping piece7E at a pivoting position (position illustrated inFIG. 22) within the second range R2.

Furthermore, when the second gripping piece8E is located at the attachment-detachment position (the position illustrated inFIG. 22), which is the pivoting position where the second gripping piece8E can be attached to and detached from the first gripping piece7E, the bearing73E and the pivot shaft821E match each other as viewed in the direction along the second pivot shaft Rx2. That is, the second gripping piece8E is detachable from the first gripping piece7E.

On the other hand, when the second gripping piece8E is located at the pivoting position in the first range R1, the bearing73E and the pivot shaft821E do not match each other when viewed in the direction along the second pivot shaft Rx2. That is, because the protrusion821E2interferes with the first connector70, the second gripping piece8E is not detachable from the first gripping piece7E.

Note that, the method of disassembling the treatment tool2E performs reverse of individual steps of the above-described method of assembling the treatment tool2E, and thus, description will be omitted.

With the present embodiment, effects similar to the effects of the above-described embodiment ofFIGS. 1-10can be achieved.

Next, another exemplary embodiment will be described.

In the following description, identical reference numerals are given to the components similar to those in the embodiment described above and shown inFIGS. 1-10, and detailed description thereof will be omitted or simplified.

In the present embodiment, treatment energy applied to a target site is different from that in the embodiment described above.

Hereinafter, for convenience of description, the treatment system1according to the present embodiment will be referred to as a treatment system1F. In addition, the treatment tool2according to the present embodiment will be referred to as a treatment tool2F.

FIG. 24is a view illustrating the treatment system1F according to the present embodiment.

In the treatment system1F (treatment tool2F), ultrasound energy is adopted as treatment energy. As compared with the treatment tool2described in the above-described embodiment ofFIGS. 1-10, the treatment tool2F (FIG. 24) adopts a vibration transmitting portion7F, a movable gripping piece8F, a drive portion91F, and a sheath6F instead of the first and second gripping pieces7and8, the drive portion91, and the sheath6, respectively. Furthermore, the treatment tool2F further includes an ultrasound transducer10(FIG. 24).

The vibration transmitting portion7F has an elongated shape extending along the longitudinal axis Ax, and is inserted into the sheath6F in a state where the end portion of the member on the distal end side Ar1is exposed to the outside as illustrated inFIG. 24. The end portion on the distal end side Ar1is a portion that grips the target site together with the movable gripping piece8F, and corresponds to a fixed gripping piece76(FIG. 24). Furthermore, the end of the vibration transmitting portion7F on the proximal end side Ar2is connected to a bolt-tightened Langevin transducer (BLT)101included in the ultrasound transducer10(FIG. 24). Subsequently, the vibration transmitting portion7F transmits the ultrasound vibration generated by the BLT101from the end of the proximal end side Ar2to the fixed gripping piece76. In the present embodiment, the ultrasound vibration is a longitudinal vibration that vibrates in the direction along the longitudinal axis Ax.

The ultrasound transducer10is inserted into the housing body41from the proximal end side Ar2of the housing body41and is detachably connected to the housing body41. The ultrasound transducer10includes: a transducer (TD) case102constituting an exterior of the ultrasound transducer10; and a BLT101provided in the TD case102and configured to generate ultrasound vibration in accordance with AC power supply.

Here, the control device3is electrically connected to the BLT101via the electric cable CA. Subsequently, in response to the operation signal input from the switch43, the control device3supplies AC power to the BLT101via the electric cable CA. With this operation, ultrasound vibration is applied from the fixed gripping piece76to the target site gripped between the fixed gripping piece76and the movable gripping piece8F. In other words, ultrasound energy is applied from the fixed gripping piece76to the target site.

FIGS. 25 to 27are views illustrating an attachment structure used to attach the movable gripping piece8F to the sheath6F. Specifically,FIGS. 25 to 27are views of the end of the treatment tool2F on the distal end side Ar1along the second pivot shaft Rx2.

In the present embodiment, the movable gripping piece8F is attached to the sheath6F as illustrated inFIGS. 24 to 27.

As compared with the second gripping piece8described in the above-described embodiment ofFIGS. 1-10, the movable gripping piece8F has no second electrode81or guide pin822and has a pivot shaft821having a shape different from the pivot shaft821in the above embodiment. Hereinafter, for convenience of description, the pivot shaft821according to the present embodiment will be referred to as a pivot shaft821F.

Similarly to the pivot shaft821B described in the embodiment shown inFIGS. 14-16, the pivot shaft821F protrudes along the second pivot shaft Rx2, and has a semicircular cross section taken along a plane orthogonal to the second pivot shaft Rx2.

Here, the direction orthogonal to the semicircular chord in the pivot shaft821F corresponds to a first direction D1. That is, in the present embodiment, regarding the outer dimension of the pivot shaft821F in a direction orthogonal to the second pivot shaft Rx2, the outer dimension in the first direction D1(the radius of the semicircular shape in the pivot shaft821F) is the smallest.

At an end of the sheath6F on the distal end side Ar1, there is provided an extending portion61in which only a part of the lower side Ar4of the sheath6F is extended toward the distal end side Ar1.

As illustrated inFIGS. 25 to 27, the extending portion61has a pair of side walls62intersecting the second pivot shaft Rx2, and there is provided a bearing63on each of the side walls62. The pair of side walls62has a shape symmetrical to each other with respect to a plane parallel to the sheet surfaces ofFIGS. 25 to 27.

As illustrated inFIGS. 25 to 27, the bearing63includes an insertion portion631and a bearing body632.

The insertion portion631extends along a first straight line L1(FIGS. 25 to 27) intersecting the second pivot shaft Rx2from the outer edge (hereinafter, referred to as a starting end E1(FIGS. 25 to 27)) of the side wall62on the lower side Ar4. The insertion portion631allows the pivot shaft821F to be inserted along the first straight line L1from the starting end E1. In the present embodiment, the width dimension of the insertion portion631is slightly larger than the radius of the semicircular shape of the pivot shaft821F and smaller than the diameter of the semicircular shape. The first straight line L1is a straight line toward the upper side Ar3when viewed in the direction along the second pivot shaft Rx2. Furthermore, the insertion portion631is formed by a through hole penetrating the side wall62.

Similarly to the insertion portion631, the bearing body632is formed of a through hole, and communicates with the terminating end E2of insertion portion631on the upper side Ar3. The bearing body632has a circular shape with a width dimension of the insertion portion631as a radius when viewed in a direction along the second pivot shaft Rx2. The bearing body632pivotally and pivotably supports the pivot shaft821F (movable gripping piece8F).

FIG. 28is a view illustrating an engagement structure between the movable gripping piece8F and the drive portion91F. Specifically,FIG. 28is a view illustrating the engagement structure between the movable gripping piece8F and the drive portion91F as seen from the upper side Ar3.

The drive portion91F has a cylindrical shape extending along the longitudinal axis Ax. The vibration transmitting portion7F is inserted into the drive portion91F.

As illustrated inFIGS. 25 to 28, at an end of the drive portion91F on the distal end side Ar1, there is provided an arm912protruding from the upper side Ar3toward the distal end side Ar1.

The arm912is provided with engagement grooves911F (FIGS. 25 to 28) respectively extending in directions (directions orthogonal to the sheet surface ofFIG. 28) orthogonal to each of the protruding direction of the engagement pin832and the longitudinal axis Ax, each of the engagement grooves911F configured to be engaged with each of the engagement pins832.

When the drive portion91F moves along the longitudinal axis Ax in a state where the engagement pin832and the engagement groove911F are engaged with each other, the movable gripping piece8F performs open-close operation with respect to the fixed gripping piece76about the second pivot shaft Rx2.

Next, a method of assembling the treatment tool2F will be described.

FIG. 29is a flowchart illustrating a method of assembling the treatment tool2F.

First, the worker inserts the drive portion91F from the proximal end side Ar2of the sheath6F into the sheath6F (step S4A).

Next, as described below, the worker attaches the movable gripping piece8F to the sheath6F (step S4B).

That is, as illustrated inFIG. 25, when viewed in the direction along the second pivot shaft Rx2, the worker sets the movable gripping piece8F in a posture in which the first direction D1is orthogonal to the first straight line L1, in other words, a posture in which the chord of the semicircular shape in the pivot shaft821F is parallel to the first straight line L1. Subsequently, as illustrated inFIGS. 25 and 26, the worker inserts the pivot shaft821F into the bearing63from the starting end E1of the insertion portion631while maintaining the posture. The posture of the movable gripping piece8F illustrated inFIGS. 25 and 26is a posture in which the distal end of the movable gripping piece8F is located on the upper side Ar3with respect to the second pivot shaft Rx2, similarly to the posture of the second gripping piece8described in the above-described embodiment illustrated inFIGS. 4 and 5.

With the above step S4B, the movable gripping piece8F is attached to the sheath6F in a state where the extending portion61is housed inside the U-shaped cross section formed by the pair of second connectors82and the base83.

Together with step S4B, the worker engages the movable gripping piece8F with the drive portion91F as described below (step S4C).

That is, the worker inserts the pivot shaft821F into the bearing63(step S4B) and together with this, inserts the pair of engagement pins832into the pair of engagement grooves911F. This allows the movable gripping piece8F to be engaged with the drive portion91F as illustrated inFIG. 28.

After step S4C, the worker inserts the vibration transmitting portion7F into the drive portion91F as illustrated inFIG. 27(step S4D). With this operation, the vibration transmitting portion7F has a state where the fixed gripping piece76protrudes from the distal end of the sheath6F.

After step S4D, the worker assembles the ends of the drive portion91F and the sheath6F on the proximal end side Ar2into the housing4(step S4E). This allows the drive portion91F to be disposed at the position illustrated inFIG. 27. Specifically, the position illustrated inFIG. 27is a limit position that allows the drive portion91F to move toward the proximal end side Ar2in a state where the operator has performed the opening operation on the movable handle5. In the state where the drive portion91F is located at the limit position, the movable gripping piece8F pivots in the closing direction about the second pivot shaft Rx2from the state illustrated inFIG. 26, and the chord of the semicircular shape in the pivot shaft821F intersects the first straight line L1.

That is, the drive portion91F allows the pivot operation in the first range R1in the closing direction of the movable gripping piece8F from the state illustrated inFIG. 27, and restricts the pivot operation in a second range R2in the opening direction of the movable gripping piece8F from the state illustrated inFIG. 27. Therefore, the drive portion91F corresponds to the movement restricting portion.

In addition, the movable gripping piece8F is attachable to and detachable from the fixed gripping piece76at a pivoting position (a position illustrated inFIG. 26) within the second range R2.

Furthermore, when the movable gripping piece8F is located at an attachment-detachment position (a position illustrated inFIG. 26) which is a pivoting position where the movable gripping piece8F can be attached to and detached from the fixed gripping piece76, the pivot shaft821F is movable from the bearing body632to the insertion portion631. That is, the movable gripping piece8F is detachable from the sheath6F.

In contrast, when the movable gripping piece8F is located at the pivoting position within the first range R1, because of interference with the inner wall surface of the insertion portion631, the pivot shaft821F is not allowed to move from the bearing body632to the insertion portion631. That is, the movable gripping piece8F is not detachable from the sheath6F.

Next, a method of disassembling the treatment tool2F will be described.

FIG. 30is a flowchart illustrating a method of disassembling the treatment tool2F.

Note that, the method of disassembling the treatment tool2F performs reverse of individual steps of the above-described method of assembling the treatment tool2F. Therefore, the method of disassembling the treatment tool2F will be briefly described below.

First, the worker detaches the end of the drive portion91F and the sheath6F on the proximal end side Ar2from inside the housing4(step S5A).

After step S5A, the worker extracts the vibration transmitting portion7F from the inside of the drive portion91(step S5B).

After step S5B, the worker positions the movable gripping piece8F at the attachment-detachment position (the position illustrated inFIG. 26), and moves the movable gripping piece8F to the lower side Ar4while maintaining the posture of the movable gripping piece8F. Subsequently, the worker moves the engagement pin832to the lower side Ar4in the engagement groove911F to release the engagement between the engagement pin832and the engagement groove911F (step S5C).

Together with step S5C, the worker moves the pivot shaft821F toward the starting end E1in the bearing63, thereby detaching the movable gripping piece8F from the sheath6F (step S5D).

With the above-described present embodiment of the disclosure, effects similar to the effects of the above-described embodiment shown inFIGS. 1-10can be achieved.

Next, another exemplary embodiment will be described.

In the following description, identical reference numerals are given to the components similar to those in the embodiments described above, and detailed description thereof will be omitted or simplified.

The present embodiment is different from the above-described embodiment shown inFIGS. 24-30in the structure for attaching the movable gripping piece8F to the sheath6F.

Hereinafter, for convenience of description, the treatment tool2F according to the present embodiment is referred to as a treatment tool2G. In addition, the movable gripping piece8F according to the present embodiment will be referred to as a movable gripping piece8G.

FIGS. 31 to 33are views illustrating an attachment structure used to attach the movable gripping piece8G to the sheath6F. Specifically,FIGS. 31 to 33are views of the end of the treatment tool2G on the distal end side Ar1along the second pivot shaft Rx2.

The movable gripping piece8G is different from the movable gripping piece8F in the above-described embodiment ofFIGS. 24-30only in that the pivot shaft821F is rotated about the second pivot shaft Rx2by approximately 90°. Hereinafter, for convenience of description, the pivot shaft821F according to the present embodiment will be referred to as a pivot shaft821G.

In the method of assembling the treatment tool2G according to the present embodiment, step S4B has a difference compared with step S4B in the method for assembling the treatment tool2F described above (FIG. 29).

That is, as illustrated inFIG. 31, when viewed in the direction along the second pivot shaft Rx2, the worker sets the movable gripping piece8G in a posture in which the first direction D1is orthogonal to the first straight line L1, in other words, a posture in which the chord of the semicircular shape in the pivot shaft821G is parallel to the first straight line L1. Subsequently, as illustrated inFIGS. 31 and 32, the worker inserts the pivot shaft821G into the bearing63from the starting end E1of the insertion portion631while maintaining the posture. The posture of the movable gripping piece8G illustrated inFIGS. 31 and 32is a posture in which the distal end of the movable gripping piece8G is located on the lower side Ar4with respect to the second pivot shaft Rx2.

With the above step S4B, the movable gripping piece8G is attached to the sheath6F in a state where the extending portion61is housed inside the U-shaped cross section formed by the pair of second connectors82and the base83(FIG. 28).

In the present embodiment, after completion of step S4D, the movable gripping piece8G pivots in the opening direction about the second pivot shaft Rx2from the state illustrated inFIG. 32, and the semicircular chord of the pivot shaft821G intersects the first straight line L1.

That is, the vibration transmitting portion7F allows the pivot operation of the movable gripping piece8G in the first range R1in the opening direction of the movable gripping piece8G from the state of being in contact with the fixed gripping piece76, and restricts the pivot operation of the movable gripping piece8G in the second range R2in the closing direction of the movable gripping piece8G from the state of being in contact.

In addition, the movable gripping piece8G is attachable to and detachable from the sheath6F at a pivoting position (position illustrated inFIG. 32) within the second range R2.

With the present embodiment, effects similar to the effects of the above-described embodiments can be achieved.

OTHER EXEMPLARY EMBODIMENTS

Embodiments of the disclosure have been described hereinabove. However, the disclosure is not intended to be limited to the above-described embodiments.

In the above-described embodiments, the treatment energy obtained by combining the thermal energy and the high-frequency energy or the treatment energy of only the ultrasound energy is exemplified as the treatment energy applied to the target site, but the treatment energy is not limited thereto. As the treatment energy, other treatment energies may be adopted as long as the treatment energy is at least one of thermal energy, high-frequency energy, and ultrasound energy.

In the above-described embodiments, the movable gripping piece (second gripping pieces8,8A,8B,8D,8E, movable gripping pieces8F,8G) is pivotably attached to the sheath (sheath6,6C,6F) or the fixed gripping piece (first gripping piece7,7A,7B,7E, and fixed gripping piece76). However, the configuration is not limited thereto, and it is allowable to adopt a configuration in which the movable gripping piece is attached by a moving method other than pivoting.

According to the treatment tool, the treatment tool assembling method, and the treatment tool disassembling method of the disclosure, it is possible to facilitate assembly and disassembly.