Patent Publication Number: US-2018028254-A1

Title: Therapeutic energy applying structure and medical treatment device

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application is a continuation of International Application No. PCT/JP2015/065311, filed on May 27, 2015, the entire contents of which are incorporated herein by reference. 
    
    
     BACKGROUND 
     1. Technical Field 
     The disclosure relates to a therapeutic energy applying structure and a medical treatment device. 
     2. Related Art 
     Conventionally, medical treatment devices having a therapeutic energy applying structure to apply energy to body tissue for treatment (such as connection (or anastomosis) and dissection) have been known (see JP 2014-124491 A). 
     The therapeutic energy applying structure described in JP 2014-124491 A includes a flexible substrate and a heat transfer plate to be described below. 
     The flexible substrate functions as a sheet heater. On one surface of the flexible substrate, an electric resistance pattern for generating heat by applying current and a connection portion connected to the electric resistance pattern by conduction are formed. 
     The heat transfer plate is configured using a conductor such as copper. Further, the heat transfer plate is disposed to face one surface (the electric resistance pattern) of the flexible substrate, and transfers the heat from the resistance pattern to the body tissue (applies heat energy to the body tissue). 
     Here, the flexible substrate is longer than the heat transfer plate, and one end side (the side on which the connection portion is provided) thereof protrudes from the heat transfer plate when being assembled. Further, a lead wire to supply power to the electric resistance pattern is connected to the connection portion provided on the one end side. That is, reduction in thickness is acquired by positioning the lead wire on one surface (the side on which the heat transfer plate is disposed) of the flexible substrate in the therapeutic energy applying structure described in JP 2014-124491 A. 
     SUMMARY 
     In some embodiments, a therapeutic energy applying structure includes: an insulating substrate; an electric resistance pattern provided on one surface of the insulating substrate and configured to generate heat by applying current; a connection portion provided on the one surface of the insulating substrate and configured to be electrically connected to the electric resistance pattern, the connection portion having a lower electric resistance value than the electric resistance pattern; and a heat transfer plate disposed so as to face the one surface of the insulating substrate and configured to transfer the heat from the electric resistance pattern to a body tissue. Each of the insulating substrate and the heat transfer plate has an elongated shape extending in a same direction. The electric resistance pattern and the connection portion are arranged side by side in a longitudinal direction of the insulating substrate. The insulating substrate has a first region on which the connection portion is provided and has a second region on which the electric resistance pattern is provided. A width of the first region is larger than a width of the second region. The heat transfer plate covers an entire region of the electric resistance pattern when viewed from a thickness direction of the heat transfer plate. One end of the heat transfer plate in the longitudinal direction matches a boundary position between the electric resistance pattern and the connection portion, or the one end of the heat transfer plate is located on the connection portion deviating from the boundary position. 
     In some embodiments, a medical treatment device includes the therapeutic energy applying structure. 
     In some embodiments, a therapeutic energy applying structure includes: an insulating substrate; an electric resistance pattern provided on one surface of the insulating substrate and configured to generate heat by applying current; a connection portion provided on the one surface of the insulating substrate and configured to be electrically connected to the electric resistance pattern, the connection portion having a lower electric resistance value than the electric resistance pattern; and a heat transfer plate disposed so as to face the one surface of the insulating substrate and configured to transfer the heat from the electric resistance pattern to a body tissue. Each of the insulating substrate and the heat transfer plate has an elongated shape extending in a same direction. The electric resistance pattern and the connection portion are arranged side by side in a longitudinal direction of the insulating substrate. The insulating substrate has a first region on which the connection portion is provided and has a second region on which the electric resistance pattern is provided. A width of the first region is larger than a width of the second region. 
     The above and other features, advantages and technical and industrial significance of this invention will be better understood by reading the following detailed description of presently preferred embodiments of the invention, when considered in connection with the accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a schematic view illustrating a medical treatment system according to a first embodiment of the present invention; 
         FIG. 2  is an enlarged view of a distal end portion of the medical treatment device illustrated in  FIG. 1 ; 
         FIG. 3  is a schematic view illustrating the therapeutic energy applying structure illustrated in  FIG. 2 ; 
         FIG. 4  is a schematic view illustrating the therapeutic energy applying structure illustrated in  FIG. 2 ; 
         FIG. 5  is a schematic view illustrating a positional relationship between a heat transfer plate, a flexible substrate, and an adhesive sheet illustrated in  FIG. 3 or 4 ; 
         FIG. 6  is a schematic view illustrating a part of a therapeutic energy applying structure according to a second embodiment of the present invention; 
         FIG. 7  is a schematic view illustrating a part of a therapeutic energy applying structure according to a third embodiment of the present invention; 
         FIG. 8  is a schematic view illustrating a part of a therapeutic energy applying structure according to a fourth embodiment of the present invention; 
         FIG. 9  is a schematic view illustrating a part of a therapeutic energy applying structure according to a fifth embodiment of the present invention; 
         FIG. 10  is a side view illustrating a flexible substrate forming a therapeutic energy applying structure according to a sixth embodiment of the present invention; 
         FIG. 11  is a side view illustrating a flexible substrate forming a therapeutic energy applying structure according to a seventh embodiment of the present invention; 
         FIG. 12  is a side view illustrating a flexible substrate forming a therapeutic energy applying structure according to an eighth embodiment of the present invention; 
         FIG. 13  is a side view illustrating a therapeutic energy applying structure according to a ninth embodiment of the present invention; and 
         FIG. 14  is a schematic view illustrating a modified example of the ninth embodiment of the present invention. 
     
    
    
     DETAILED DESCRIPTION 
     Exemplary embodiments of the present invention will be described below with reference to the drawings. The present invention is not limited to the embodiments to be described below. The same reference signs are used to designate the same elements throughout the drawings. 
     First Embodiment 
     Schematic Configuration of Medical Treatment System 
       FIG. 1  is a schematic view illustrating a medical treatment system  1  according to a first embodiment of the present invention. 
     The medical treatment system  1  is configured to apply energy to a body tissue as a treatment target to perform treatment (such as connection (or anastomosis) and dissection) on the body tissue. As illustrated in  FIG. 1 , the medical treatment system  1  includes a medical treatment device  2 , a control device  3 , and a foot switch  4 . 
     Configuration of Medical Treatment Device 
     The medical treatment device  2  is, for example, a linear type surgical medical treatment tool for performing treatment on a body tissue through an abdominal wall. As illustrated in  FIG. 1 , the medical treatment device  2  includes a handle  5 , a shaft  6 , and a grasping portion  7 . 
     The handle  5  is a part to be gripped by an operator. As illustrated in  FIG. 1 , the handle  5  is provided with an operation knob  51 . 
     As illustrated in  FIG. 1 , the shaft  6  has a substantially cylindrical shape, and one end thereof is connected to the handle  5 . The grasping portion  7  is attached to the other end of the shaft  6 . Further, an opening and closing mechanism (not illustrated), which opens and closes holding members  8  and  8 ′ ( FIG. 1 ) forming the grasping portion  7  according to an operation of the operation knob  51  performed by the operator, is provided inside the shaft  6 . An electric cable C ( FIG. 1 ) connected to the control device  3  is disposed from one end side to the other end side via the handle  5  inside the shaft  6 . 
     Configuration of Grasping Portion 
       FIG. 2  is an enlarged view of a distal end portion of the medical treatment device  2 . 
     A pair of elements, which is denoted by the same reference numerals and distinguished by a prime mark (′) throughout the drawings, shares the same configuration. 
     The grasping portion  7  is a part for grasping a body tissue to treat the body tissue. As illustrated in  FIG. 1 or 2 , the grasping portion  7  includes the pair of holding members  8  and  8 ′. 
     The pair of holding members  8  and  8 ′ is pivotally supported at the other end of the shaft  6  so as to be capable of being opened and closed in a direction of an arrow R 1  ( FIG. 2 ), and enables grasping of the body tissue according to the operation of the operation knob  51  performed by the operator. 
     Therapeutic energy applying structures  9  and  9 ′ are provided on the pair of holding members  8  and  8 ′, respectively, as illustrated in  FIG. 2 . 
     Since the therapeutic energy applying structures  9  and  9 ′ have the same configuration, only the therapeutic energy applying structure  9  will be described hereinafter. 
     Configuration of Therapeutic Energy Applying Structure 
       FIGS. 3 and 4  are schematic views illustrating the therapeutic energy applying structure  9 . Specifically,  FIG. 3  is a perspective view of the therapeutic energy applying structure  9  viewed from an upper side in  FIG. 2 .  FIG. 4  is an exploded perspective view of  FIG. 3 . 
     The therapeutic energy applying structure  9  is attached to a surface of the holding member  8  on the upper side disposed on a lower side in  FIGS. 1 and 2 . The therapeutic energy applying structure  9  applies heat energy to the body tissue under control of the control device  3 . As illustrated in  FIG. 3 or 4 , the therapeutic energy applying structure  9  includes a heat transfer plate  91 , a flexible substrate  92 , an adhesive sheet (adhesive layer)  93 , and two lead wires  94 . 
     The heat transfer plate  91  is, for example, a thin plate having an elongated shape (an elongated shape extending in a right and left direction in  FIGS. 3 and 4 ) made of a material such as copper, and a treatment surface  911  as one plate surface faces the holding member  8 ′ side (the upper side in  FIGS. 1 and 2 ) when the therapeutic energy applying structure  9  is attached to the holding member  8 . The treatment surface  911  contacts the body tissue, and the heat transfer plate  91  transfers heat from the flexible substrate  92  to the body tissue (i.e., applies heat energy to the body tissue) when the body tissue is grasped by the holding members  8  and  8 ′. 
     The flexible substrate  92  partially generates heat, and functions as a sheet heater that heats the heat transfer plate  91  through such heat generation. As illustrated in  FIG. 3 or 4 , the flexible substrate  92  includes an insulating substrate  921  and a wiring pattern  922 . 
     The insulating substrate  921  is a sheet having an elongated shape (an elongated shape in the right and left direction in  FIGS. 3 and 4 ) made of polyimide which is an insulating material. 
     The material of the insulating substrate  921  is not limited to polyimide, and for example, a material having a high heat-resistant insulating property such as aluminum nitride, alumina, glass, and zirconia may be adopted. 
     Here, the insulating substrate  921  is formed such that a width W 1  (see  FIG. 5 ) on one end side in a longitudinal direction (the right side in  FIGS. 3 and 4 ) is larger than a width W 2  (see  FIG. 5 ) on the other end side (the left side in  FIGS. 3 and 4 ). Hereinafter, the one end side will be referred to as a wide region  9211 , and the other end side will be referred to as a narrow region  9212 . 
     The wide region  9211  is a region whose width gradually increases from a boundary position BP 1  against the narrow region  9212  (see  FIG. 5 ) toward the right side in  FIGS. 3 and 4 , and further extends to the right side in  FIGS. 3 and 4  with the width W 1  larger than the width of the heat transfer plate  91 . 
     The narrow region  9212  is a region that extends from the boundary position BP 1  against the wide region  9211  to the left side in  FIGS. 3 and 4  with the width W 2  smaller than the width of the heat transfer plate  91 . 
     The length of the insulating substrate  921  in the right and left direction in  FIGS. 3 and 4  is longer than the length of the heat transfer plate  91  in the right and left direction in  FIGS. 3 and 4 . 
     The wiring pattern  922  is obtained by processing stainless steel (SUS304), which is a conductive material, and includes a pair of lead wire connection portions  9221  and an electric resistance pattern  9222  ( FIG. 4 ) as illustrated in  FIG. 3 or 4 . Each thickness of the pair of lead wire connection portions  9221  and the electric resistance pattern  9222  is the same in the first embodiment. The wiring pattern  922  is bonded to one surface of the insulating substrate  921  by thermocompression bonding such that a boundary position BP 2  (see  FIG. 5 ) between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222  matches the boundary position BP 1  between the wide region  9211  and the narrow region  9212 . 
     The material of the wiring pattern  922  is not limited to stainless steel (SUS304), but may be another stainless material (for example, 400 series), or a conductive material such as platinum or tungsten may be adopted. The wiring pattern  922  may be formed on the one surface of the insulating substrate  921  by evaporation instead of the thermocompression bonding. 
     The pair of lead wire connection portions  9221  has a function as a connection portion, is provided on the wide region  9211 , and faces each other along a width direction of the insulating substrate  921 . 
     The pair of lead wire connection portions  9221  has an outer edge shape following an outer edge shape of the wide region  9211 . 
     Specifically, each of the pair of lead wire connection portions  9221  extends from the boundary position BP 2  (boundary position BP 1 ) against the electric resistance pattern  9222  to the right side in  FIGS. 3 and 4  with a length D 1  (a length along the width direction of the insulating substrate  921  (see  FIG. 5 )), then, gradually increases in the length toward the right side, and further extends to the right side in  FIGS. 3 and 4  with a length D 2  (see  FIG. 5 ) larger than the width of the heat transfer plate  91 . That is, each of the pair of lead wire connection portions  9221  has a substantially trapezoidal planar shape. 
     The two lead wires  94  ( FIGS. 3 and 4 ) forming the electric cable C are connected to the pair of lead wire connection portions  9221 , respectively. 
     The electric resistance pattern  9222  has one end that is connected (by conduction) to one of the lead wire connection portions  9221 , extends along a U shape following an outer edge shape of the narrow region  9212  while meandering in a wavy shape with a constant line width, and has the other end that is connected (by conduction) to the other of the lead wire connection portions  9221 . 
     Here, a length corresponding to an amplitude of the wavy shape of the electric resistance pattern  9222  is set to the length D 1  which is the same as the length D 1  in the vicinity of the boundary position BP 2  on the pair of lead wire connection portions  9221  ( FIG. 5 ). That is, the pair of lead wire connection portions  9221  has a lower electric resistance value than the electric resistance pattern  9222  since the length D 2  thereof is larger than the length D 1  of the electric resistance pattern  9222 . 
     The electric resistance pattern  9222  generates heat by applying voltage (by applying current) to the pair of lead wire connection portions  9221  by the control device  3  via the two lead wires  94 . 
     As illustrated in  FIGS. 3 and 4 , the adhesive sheet (adhesive layer)  93  is provided between the heat transfer plate  91  and the flexible substrate  92 , and causes a surface of the heat transfer plate  91  on the opposite side to the treatment surface  911  and one surface (a surface on the wiring pattern  922  side) of the flexible substrate  92  to be adhesively fixed to each other when a part of the flexible substrate  92  protrudes from the heat transfer plate  91 . The adhesive sheet  93  is a sheet with an elongated shape (an elongated sheet extending in the right and left direction in  FIGS. 3 and 4 ) that has favorable thermal conductivity and insulating property, is resistant to high temperature, and has an adhesive property, and is formed by, for example, mixing a high thermal conductivity filler (non-conductive material) such as alumina, boron nitride, graphite, and aluminum nitride with resin such as epoxy and polyurethane. 
     The width of the adhesive sheet  93  is substantially the same as the width W 2  of the narrow region  9212 . The length (a length in the right and left direction in  FIGS. 3 and 4 ) of the adhesive sheet  93  is longer than the length (the length in the right and left direction in  FIGS. 3 and 4 ) of the heat transfer plate  91  and to be shorter than the length (the length in the right and left direction in  FIGS. 3 and 4 ) of the insulating substrate  921 . 
     Positional Relationship among Heat Transfer Plate, Flexible Substrate, and Adhesive Sheet 
     Next, a positional relationship among the heat transfer plate  91 , the flexible substrate  92 , and the adhesive sheet  93  will be described with reference to  FIG. 5 . 
       FIG. 5  is a schematic view illustrating the positional relationship between the heat transfer plate  91 , the flexible substrate  92 , and the adhesive sheet  93 . Specifically,  FIG. 5  is a schematic view of a proximal end side (the right side in  FIGS. 3 and 4 ) of the therapeutic energy applying structure  9  viewed from the treatment surface  911  side (the upper side in  FIGS. 3 and 4  (in a thickness direction of the heat transfer plate  91 )). 
     The heat transfer plate  91  is indicated by a one-dot chain line and the adhesive sheet  93  is indicated by a two-dot chain line in  FIG. 5  for convenience of description. 
     As illustrated in  FIG. 5 , the heat transfer plate  91  covers the entire region of the electric resistance pattern  9222 , and one end of the heat transfer plate  91  in the longitudinal direction (a right end in  FIGS. 3 to 5 ) matches the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222 . 
     As illustrated in  FIG. 5 , the adhesive sheet  93  covers the entire region of the electric resistance pattern  9222 , and one end of the adhesive sheet  93  in the longitudinal direction (a right end in  FIGS. 3 to 5 ) is located on the wide region  9211  side and covers a part of the pair of lead wire connection portions  9221 . That is, one end side of the adhesive sheet  93  in the longitudinal direction straddles the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222  and protrudes to the right side in  FIG. 5  with respect to the heat transfer plate  91 . The two lead wires  94  ( FIGS. 3 and 4 ) are connected, respectively to regions (regions not covered by the adhesive sheet  93 ) exposed to the outside in the pair of lead wire connection portions  9221 . 
     Configurations of Control Device and Foot Switch 
     The foot switch  4  is a part that is operated by the operator with a foot. Switching between on and off states is performed to apply current to the medical treatment device  2  (to the electric resistance pattern  9222 ) from the control device  3  according to the operation using the foot switch  4 . 
     Means for switching between on and off states is not limited to the foot switch  4 , and other manually operated switches or the like may be adopted. 
     The control device  3  includes a central processing unit (CPU) and performs overall control of the medical treatment device  2  according to a predetermined control program. More specifically, the control device  3  applies a voltage to the electric resistance pattern  9222  via the electric cable C (the two lead wires  94 ) according to the operation of the foot switch  4  performed by the operator (turn-on operation), thereby heating the heat transfer plate  91 . 
     Operation of Medical Treatment Device 
     Next, an operation of the medical treatment system  1  described above will be described. 
     The operator grips the medical treatment device  2  and inserts the distal end portion (the grasping portion  7  and a part of the shaft  6 ) of the medical treatment device  2  into an abdominal cavity through the abdominal wall using, for example, a trocar or the like. The operator operates the operation knob  51  and grasps the body tissue as the treatment target with the holding members  8  and  8 ′. 
     Next, the operator operates the foot switch  4  to switch to the on state to apply current from the control device  3  to the medical treatment device  2 . When switching to the on state, the control device  3  applies the voltage to the wiring pattern  922  via the electric cable C (the two lead wires  94 ) to heat the heat transfer plate  91 . The body tissue in contact with the heat transfer plate  91  is treated by the heat of the heat transfer plate  91 . 
     In the therapeutic energy applying structure  9  according to the first embodiment described above, the width W 1  of the insulating substrate  921  on the one end side (the pair of lead wire connection portions  9221  side) is larger than the width W 2  thereof on the other end side (the electric resistance pattern  9222  side). The heat transfer plate  91  covers the entire region of the electric resistance pattern  9222  and is arranged such that the one end in the longitudinal direction matches the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222 . 
     When applying current to the wiring pattern  922  via the two lead wires  94 , there is a high possibility that the vicinity of the boundary position BP 2  on the pair of lead wire connection portions  9221  is turned into an overheated state. Thus, the heat around the boundary position BP 2  on the pair of lead wire connection portions  9221  can be dissipated to the heat transfer plate  91  via the adhesive sheet  93 , and further, to the lead wire connection portion  9221  and the insulating substrate  921  (the wide region  9211 ) by setting the shapes of the insulating substrate  921  and the lead wire connection portion  9221  and the positional relationship between the heat transfer plate  91  and the boundary position BP 2  as described above. 
     Electric resistance values of the pair of lead wire connection portions  9221  are lower than that of the electric resistance pattern  9222 . Therefore, it is possible to suppress the heat generation of the pair of lead wire connection portions  9221  itself. As a result, an effect of heat dissipation to the lead wire connection portion  9221  is further enhanced. 
     As described above, it is possible to avoid the overheated state of the pair of lead wire connection portions  9221  according to the therapeutic energy applying structure  9  of the first embodiment. 
     The length D 2  of the pair of lead wire connection portions  9221  is larger than the length D 1  of the electric resistance pattern  9222  in the therapeutic energy applying structure  9  according to the first embodiment. That is, it is possible to set the electric resistance values of the pair of lead wire connection portions  9221  to be low and to suppress the heat generation itself of the pair of lead wire connection portions  9221  by causing the outer edge shapes of the pair of lead wire connection portions  9221  and the electric resistance pattern  9222  to follow the outer edge shape of the insulating substrate  921  and setting the respective lengths D 1  and D 2 . 
     The adhesive sheet  93  covers the entire region of the electric resistance pattern  9222  and partly protrudes to the pair of lead wire connection portions  9221  side to cover a part of the pair of lead wire connection portions  9221  in the therapeutic energy applying structure  9  according to the first embodiment. That is, the adhesive sheet  93  is arranged so as to straddle the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222 . Thus, it is possible to dissipate the heat around the boundary position BP 2  on the pair of lead wire connection portions  9221  to the adhesive sheet  93 , and to effectively avoid the overheated state of the pair of lead wire connection portions  9221 . 
     Second Embodiment 
     Next, a second embodiment of the present invention will be described. 
     In the following description, the same reference signs are used to designate the same elements as those in the first embodiment, and detailed explanation thereof will be omitted or simplified. 
     A medical treatment system according to the second embodiment is different from the medical treatment system  1  described in the first embodiment in terms of configurations of the therapeutic energy applying structures  9  and  9 ′. Each therapeutic energy applying structure provided in each of the holding members  8  and  8 ′ has the same configuration in the second embodiment. Thus, only the therapeutic energy applying structure provided in the holding member  8  will be described hereinafter. 
     Configuration of Therapeutic Energy Applying Structure 
       FIG. 6  is a schematic view illustrating a part of a therapeutic energy applying structure  9 A according to the second embodiment of the present invention. Specifically,  FIG. 6  is the schematic view corresponding to  FIG. 5 . 
     As illustrated in  FIG. 6 , the therapeutic energy applying structure  9 A according to the second embodiment includes a flexible substrate  92 A having a wiring pattern  922 A with a different shape from that of the wiring pattern  922  of the therapeutic energy applying structure  9  ( FIGS. 3 to 5 ) described in the first embodiment. 
     Specifically, the wiring pattern  922 A includes a pair of lead wire connection portions  9221 A which is set such that a part with the length D 1  is longer than that of the pair of lead wire connection portions  9221  in the right and left direction in  FIG. 6 . Thus, the boundary position BP 2  between the pair of lead wire connection portions  9221 A and the electric resistance pattern  9222  is located on the narrow region  9212  in the therapeutic energy applying structure  9 A as illustrated in  FIG. 6 . 
     The length D 2  is larger than the length D 1  of the electric resistance pattern  9222  even in the above-described case of adopting the pair of lead wire connection portions  9221 A, and thus, the pair of lead wire connection portions  9221 A has a lower electric resistance value than the electric resistance pattern  9222 , which is similar to the first embodiment. 
     In the therapeutic energy applying structure  9 A illustrated in  FIG. 6 , the heat transfer plate  91  covers the entire region of the electric resistance pattern  9222 , and one end of the heat transfer plate  91  in the longitudinal direction (a right end in  FIG. 6 ) is located on the pair of lead wire connection portions  9221 A side within the narrow region  9212 . That is, the heat transfer plate  91  is arranged so as to straddle the boundary position BP 2  between the pair of lead wire connection portions  9221 A and the electric resistance pattern  9222 . 
     Even if the pair of lead wire connection portions  9221 A is adopted and the heat transfer plate  91  is arranged so as to straddle the boundary position BP 2  between the pair of lead wire connection portions  9221 A and the electric resistance pattern  9222  as in the second embodiment, it is possible to dissipate the heat around the boundary position BP 2  on the pair of lead wire connection portions  9221 A to the heat transfer plate  91  via the adhesive sheet  93  and further dissipate the heat to the lead wire connection portions  9221 A and the insulating substrate  921  (wide region  9211 ). Hence, the same advantageous effects as those of the first embodiment can be obtained. 
     Third Embodiment 
     Next, a third embodiment of the present invention will be described. 
     In the following description, the same reference signs are used to designate the same elements as those in the first embodiment, and detailed explanation thereof will be omitted or simplified. 
     A medical treatment system according to the third embodiment is different from the medical treatment system  1  described in the first embodiment in terms of configurations of the therapeutic energy applying structures  9  and  9 ′. Each therapeutic energy applying structure provided in each of the holding members  8  and  8 ′ has the same configuration in the third embodiment. Thus, only the therapeutic energy applying structure provided in the holding member  8  will be described hereinafter. 
     Configuration of Therapeutic Energy Applying Structure 
       FIG. 7  is a schematic view illustrating a part of a therapeutic energy applying structure  9 B according to the third embodiment of the present invention. Specifically,  FIG. 7  is a schematic view corresponding to  FIG. 5 . 
     As illustrated in  FIG. 7 , the therapeutic energy applying structure  9 B according to the third embodiment includes a heat transfer plate  91 B having a different length in the right and left direction in  FIG. 7  from that of the heat transfer plate  91  and includes an adhesive sheet  93 B having a different shape from that of the adhesive sheet  93 , compared to the therapeutic energy applying structure  9  ( FIGS. 3 to 5 ) described in the first embodiment. 
     Specifically, the heat transfer plate  91 B is set to have the length (the length in the right and left direction in  FIG. 7 ) that is longer than that of the heat transfer plate  91 . The heat transfer plate  91 B covers the entire region of the electric resistance pattern  9222 , and one end of the heat transfer plate  91 B in the longitudinal direction (a right end in  FIG. 7 ) is located on the wide region  9211  side and covers a part of the pair of lead wire connection portions  9221  as illustrated in  FIG. 7 . That is, the heat transfer plate  91 B is arranged so as to straddle the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222 . 
     In order to avoid electrical contact between the heat transfer plate  91 B and the wiring pattern  922 , the adhesive sheet  93 B is formed such that one end side (the right side in  FIG. 7 ) in the longitudinal direction has a wide width to cover the boundary position BP 2  side on the pair of lead wire connection portions  9221  as illustrated in  FIG. 7 . 
     Even if the heat transfer plate  91 B and the adhesive sheet  93 B are adopted and the heat transfer plate  91 B and the adhesive sheet  93 B are disposed so as to straddle the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222  as in the third embodiment, it is possible to dissipate the heat around the boundary position BP 2  on the pair of lead wire connection portions  9221  to the heat transfer plate  91 B via the adhesive sheet  93 B and further dissipate the heat to the lead wire connection portions  9221  and the insulating substrate  921  (wide region  9211 ). Hence, the same advantageous effects as those of the first embodiment can be obtained. 
     Fourth Embodiment 
     Next, a fourth embodiment of the present invention will be described. 
     In the following description, the same reference signs are used to designate the same elements as those in the first embodiment, and detailed explanation thereof will be omitted or simplified. 
     A medical treatment system according to the fourth embodiment is different from the medical treatment system  1  described in the first embodiment in terms of configurations of the therapeutic energy applying structures  9  and  9 ′. Each therapeutic energy applying structure provided in each of the holding members  8  and  8 ′ has the same configuration in the fourth embodiment. Thus, only the therapeutic energy applying structure provided in the holding member  8  will be described hereinafter. 
     Configuration of Therapeutic Energy Applying Structure 
       FIG. 8  is a schematic view illustrating a part of a therapeutic energy applying structure  9 C according to the fourth embodiment of the present invention. Specifically,  FIG. 8  is a schematic view corresponding to  FIG. 5 . 
     As illustrated in  FIG. 8 , the therapeutic energy applying structure  9 C according to the fourth embodiment includes a flexible substrate  92 C having an insulating substrate  921 C with a different shape from that of the insulating substrate  921  of the therapeutic energy applying structure  9  ( FIGS. 3 to 5 ) described in the first embodiment. 
     Specifically, the insulating substrate  921 C has a wide region  9211 C with a longer length in the right and left direction in  FIG. 8  than the wide region  9211  and a narrow region  9212 C with a shorter length in the right and left direction in  FIG. 8  than the narrow region  9212  while having the entire length (the length in the right and left direction in  FIG. 8 ) that is the same as that of the insulating substrate  921 . That is, the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222  is located on the right side of the boundary position BP 1  between the wide region  9211 C and the narrow region  9212 C, and located within the wide region  9211 C as illustrated in  FIG. 8 . 
     Even if the insulating substrate  921 C is adopted and the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222  is located within the wide region  9211 C as in the fourth embodiment, it is possible to dissipate the heat around the boundary position BP 2  on the pair of lead wire connection portions  9221  to the heat transfer plate  91  via the adhesive sheet  93  and further dissipate the heat to the lead wire connection portions  9221  and the insulating substrate  921  (wide region  9211 C). Hence, the same advantageous effects as those of the first embodiment can be obtained 
     Fifth Embodiment 
     Next, a fifth embodiment of the present invention will be described. 
     In the following description, the same reference signs are used to designate the same elements as those in the first embodiment, and detailed explanation thereof will be omitted or simplified. 
     A medical treatment system according to the fifth embodiment is different from the medical treatment system  1  described in the first embodiment in terms of configurations of the therapeutic energy applying structures  9  and  9 ′. Each therapeutic energy applying structure provided in each of the holding members  8  and  8 ′ has the same configuration in the fifth embodiment. Thus, only the therapeutic energy applying structure provided in the holding member  8  will be described hereinafter. 
     Configuration of Therapeutic Energy Applying Structure 
       FIG. 9  is a schematic view illustrating a part of a therapeutic energy applying structure  9 D according to the fifth embodiment of the present invention. Specifically,  FIG. 9  is a schematic view corresponding to  FIG. 5 . 
     As illustrated in  FIG. 9 , the therapeutic energy applying structure  9 D according to the fifth embodiment includes a flexible substrate  92 D having an insulating substrate  921 D and a wiring pattern  922 D with different shapes from those of the insulating substrate  921  and the wiring pattern  922 , and includes an adhesive sheet  93 D having a different shape from that of the adhesive sheet  93 , compared to the therapeutic energy applying structure  9  ( FIGS. 3 to 5 ) described in the first embodiment. 
     Specifically, the insulating substrate  921 D has the rectangular wide region  9211 D, which has the width W 1  at the boundary position BP 1  and extends to the right side in  FIG. 9  from the boundary position BP 1  with the width W 1  as illustrated in  FIG. 9 , which is different from the wide region  9211 . 
     As illustrated in  FIG. 9 , the wiring pattern  922 D has the pair of rectangular lead wire connection portions  9221 D each of which has the length D 2  at the boundary position BP 2  and extends to the right side in  FIG. 9  from the boundary position BP 2  with the length D 2 , which is different from the pair of lead wire connection portions  9221 . 
     The length D 2  is larger than the length D 1  of the electric resistance pattern  9222  even in the above-described case of adopting the pair of lead wire connection portions  9221 D, and thus, the pair of lead wire connection portions  9221 D has a lower electric resistance value than the electric resistance pattern  9222 , which is similar to the first embodiment. 
     Here, the wiring pattern  922 D is formed such that the boundary position BP 2  is located within the wide region  9211 D in the fifth embodiment. The heat transfer plate  91  covers the entire region of the electric resistance pattern  9222 , and one end of the heat transfer plate  91  in the longitudinal direction (a right end in  FIG. 9 ) matches the boundary position BP 2 . In  FIG. 9 , the one end of the heat transfer plate  91  in the longitudinal direction is shifted from the boundary position BP 2  for the purpose of illustration. 
     In order to avoid electrical contact between the heat transfer plate  91  and the wiring pattern  922 D, the adhesive sheet  93 D is formed such that one end side (the right side in  FIG. 9 ) in the longitudinal direction has a wide width to cover the boundary position BP 2  side on the pair of lead wire connection portions  9221 D as illustrated in  FIG. 9 . 
     Even if the flexible substrate  92 D (the insulating substrate  921 D and the wiring pattern  922 D) and the adhesive sheet  93 D are adopted as in the fifth embodiment, it is possible to dissipate the heat around the boundary position BP 2  on the pair of lead wire connection portions  9221 D to the heat transfer plate  91  via the adhesive sheet  93 D and further dissipate the heat to the lead wire connection portions  9221 D and the insulating substrate  921 D (wide region  9211 D). Hence, the same advantageous effects as those of the first embodiment can be obtained. 
     In particular, the heat capacities of the wide region  9211 D and the pair of lead wire connection portions  9221 D are increased, and thus, it is possible to further enhance the heat dissipation effect of the pair of lead wire connection portions  9221 D. 
     Sixth Embodiment 
     Next, a sixth embodiment of the present invention will be described. 
     In the following description, the same reference signs are used to designate the same elements as those in the first embodiment, and detailed explanation thereof will be omitted or simplified. 
     A medical treatment system according to the sixth embodiment is different from the medical treatment system  1  described in the first embodiment in terms of configurations of the therapeutic energy applying structures  9  and  9 ′. Each therapeutic energy applying structure provided in each of the holding members  8  and  8 ′ has the same configuration in the sixth embodiment. Thus, only the therapeutic energy applying structure provided in the holding member  8  will be described hereinafter. 
     Configuration of Therapeutic Energy Applying Structure 
       FIG. 10  is a side view illustrating a flexible substrate  92 E forming a therapeutic energy applying structure  9 E according to the sixth embodiment of the present invention. 
     As illustrated in  FIG. 10 , the therapeutic energy applying structure  9 E according to the sixth embodiment includes the flexible substrate  92 E having a wiring pattern  922 E with a different shape from that of the wiring pattern  922  of the therapeutic energy applying structure  9  ( FIGS. 3 to 5 ) described in the first embodiment. 
     Specifically, the wiring pattern  922 E includes a pair of lead wire connection portions  9221 E having a larger thickness than the pair of lead wire connection portions  9221 . In other words, the wiring pattern  922 E is formed such that the thickness of the pair of lead wire connection portions  9221 E is larger than that of the electric resistance pattern  9222 . That is, the length D 2  of the pair of lead wire connection portions  9221 E is larger than the length D 1  of the electric resistance pattern  9222  and the thickness thereof is larger than the thickness of the electric resistance pattern  9222 , and thus, the pair of lead wire connection portions  9221 E has an electric resistance value that is even lower than that of the electric resistance pattern  9222 . 
     This wiring pattern  922 E can be manufactured by, for example, uniformly forming the total thickness of the wiring pattern to be relatively large, and then, performing etching on a portion of the electric resistance pattern to reduce the thickness of the portion. 
     Although the total thickness of the pair of lead wire connection portions  9221 E is larger than the thickness of the electric resistance pattern  9222  in  FIG. 10 , the present invention is not limited thereto, and only a part of the pair of lead wire connection portions  9221 E may be configured to be larger than the thickness of the electric resistance pattern  9222 . 
     Although the heat transfer plate  91  and the adhesive sheet  93  are not illustrated in  FIG. 10 , the positional relationship between the heat transfer plate  91  and the adhesive sheet  93  with respect to the boundary position BP 1  between the wide region  9211  and the narrow region  9212  and the boundary position BP 2  between the pair of lead wire connection portions  9221 E and the electric resistance pattern  9222  is the same as that in the first embodiment. 
     According to the sixth embodiment, not only the same advantageous effects as those in the first embodiment but also the following advantageous effects can be obtained. 
     In the therapeutic energy applying structure  9 E according to the sixth embodiment, the thickness of the pair of lead wire connection portions  9221 E is larger than the thickness of the electric resistance pattern  9222 . Thus, it is possible to further lower the electric resistance value of the pair of lead wire connection portions  9221 E, and to further suppress heat generation itself of the pair of lead wire connection portions  9221 E. Further, a heat radiation effect of the lead wire connection portion  9221 E can be enhanced based on such a result. 
     Seventh Embodiment 
     Next, a seventh embodiment of the present invention will be described. 
     In the following description, the same reference signs are used to designate the same elements as those in the first embodiment, and detailed explanation thereof will be omitted or simplified. 
     A medical treatment system according to the seventh embodiment is different from the medical treatment system  1  described in the first embodiment in terms of configurations of the therapeutic energy applying structures  9  and  9 ′. Each therapeutic energy applying structure provided in each of the holding members  8  and  8 ′ has the same configuration in the seventh embodiment. Thus, only the therapeutic energy applying structure provided in the holding member  8  will be described hereinafter. 
     Configuration of Therapeutic Energy Applying Structure 
       FIG. 11  is a side view illustrating a flexible substrate  92 F forming a therapeutic energy applying structure  9 F according to the seventh embodiment of the present invention. 
     As illustrated in  FIG. 11 , the therapeutic energy applying structure  9 F according to the seventh embodiment includes the flexible substrate  92 F additionally having a pair of conductive layers  923 , compared to the therapeutic energy applying structure  9  ( FIGS. 3 to 5 ) described in the first embodiment. 
     Specifically, the pair of conductive layers  923  is a layer that is made of a conductive material such as gold, silver, copper, and nickel and formed by plating or electroforming on the entire surface on each of the pair of lead wire connection portions  9221 . The two lead wires  94  ( FIGS. 3 and 4 ) are connected to the pair of conductive layers  923 , respectively. 
     In the seventh embodiment, the pair of lead wire connection portions  9221  corresponds to a connection portion main body, and the pair of conductive layers  923  corresponds to a conductive portion. The pair of lead wire connection portions  9221  and the pair of conductive layers  923  constitute a connection portion. That is, the pair of lead wire connection portions  9221  and the pair of conductive layers  923  corresponding to the connection portion have the length D 2  larger than the length D 1  of the electric resistance pattern  9222  and have the larger thickness than the thickness of the electric resistance pattern  9222  by a thickness of the pair of conductive layers  923 , and thus, have an electric resistance value that is even lower than that of the electric resistance pattern  9222 . 
     Although the pair of conductive layers  923  is formed on the entire surface of the pair of lead wire connection portions  9221  in  FIG. 11 , the present invention is not limited thereto, and the pair of conductive layers  923  may be configured to be formed on only a part of each of the pair of lead wire connection portions  9221 . 
     The heat transfer plate  91  and the adhesive sheet  93  are not illustrated in  FIG. 11 , but a positional relationship between the heat transfer plate  91  and the adhesive sheet  93  with respect to the boundary position BP 1  between the wide region  9211  and the narrow region  9212  and the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222  is the same as that in the first embodiment. 
     Since the pair of conductive layers  923  is provided on the pair of lead wire connection portions  9221 , respectively, and the total thickness of the pair of lead wire connection portions  9221  and the pair of conductive layers  923  is made larger than the thickness of the electric resistance pattern  9222  in the therapeutic energy applying structure  9 F according to the seventh embodiment described above, the same advantageous effects as those of the sixth embodiment can be obtained. 
     Eighth Embodiment 
     Next, an eighth embodiment of the present invention will be described. 
     In the following description, the same reference signs are used to designate the same elements as those in the first embodiment, and detailed explanation thereof will be omitted or simplified. 
     A medical treatment system according to the eighth embodiment is different from the medical treatment system  1  described in the first embodiment in terms of configurations of the therapeutic energy applying structures  9  and  9 ′. Each therapeutic energy applying structure provided in each of the holding members  8  and  8 ′ has the same configuration in the eighth embodiment. Thus, only the therapeutic energy applying structure provided in the holding member  8  will be described hereinafter. 
     Configuration of Therapeutic Energy Applying Structure 
       FIG. 12  is a side view illustrating a flexible substrate  92 G forming a therapeutic energy applying structure  9 G according to the eighth embodiment of the present invention. 
     As illustrated in  FIG. 12 , the therapeutic energy applying structure  9 G according to the eighth embodiment includes the flexible substrate  92 G additionally having a pair of first conductive portions  924  and a pair of insulating portions  925 , compared to the therapeutic energy applying structure  9  ( FIGS. 3 to 5 ) described in the first embodiment. 
     Specifically, the pair of insulating portions  925  is a plate body made of an insulating material such as polyimide. The pair of first conductive portions  924  is a plate body made of a conductive material such as copper, and is attached to one plate surface of each of the pair of insulating portions  925 . 
     The pair of first conductive portions  924  and the pair of insulating portions  925  have substantially the same planar shape as the planar shape of the pair of lead wire connection portions  9221 , but a proximal end side (the right side in  FIG. 12 ) thereof is shorter than the pair of lead wire connection portions  9221  in order to secure a region to bond the two lead wires  94  to the pair of lead wire connection portions  9221 . 
     The pair of insulating portions  925  to which the pair of first conductive portions  924  is affixed, respectively, is bonded by diffusion bonding, ultrasonic welding, or resistance welding when the pair of first conductive portions  924  faces the pair of lead wire connection portions  9221 . The pair of conductive layers  923  described in the seventh embodiment may be provided between the pair of first conductive portions  924  and the pair of lead wire connection portions  9221 , respectively, as necessary at the time of bonding. Alternatively, solder, a conductive adhesive or the like may be employed to firmly bond the respective portions. 
     In the eighth embodiment, the pair of lead wire connection portions  9221  corresponds to the connection portion main body, and the pair of first conductive portions  924  corresponds to the conductive portion. The pair of lead wire connection portions  9221  and the pair of first conductive portions  924  constitute the connection portion. That is, the pair of lead wire connection portions  9221  and the pair of first conductive portions  924  corresponding to the connection portion have the length D 2  larger than the length D 1  of the electric resistance pattern  9222  and have the larger thickness than the thickness of the electric resistance pattern  9222  by a thickness of the pair of first conductive portions  924 , and thus, have an electric resistance value that is even lower than that of the electric resistance pattern  9222 . 
     The heat transfer plate  91  and the adhesive sheet  93  are not illustrated in  FIG. 12 , but a positional relationship between the heat transfer plate  91  and the adhesive sheet  93  with respect to the boundary position BP 1  between the wide region  9211  and the narrow region  9212  and the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222  is the same as that in the first embodiment. 
     Since the pair of first conductive portions  924  is provided on the pair of lead wire connection portions  9221 , respectively, and the total thickness of the pair of lead wire connection portions  9221  and the pair of first conductive portions  924  is made larger than the thickness of the electric resistance pattern  9222  in the therapeutic energy applying structure  9 G according to the eighth embodiment described above, the same advantageous effects as those of the sixth embodiment can be obtained. 
     In addition, since the pair of insulating portions  925  are affixed onto the pair of first conductive portions  924 , respectively, it is possible to omit insulating treatment of the pair of lead wire connection portions  9221  at the time of manufacturing the therapeutic energy applying structure  9 G. 
     Ninth Embodiment 
     Next, a ninth embodiment of the present invention will be described. 
     In the following description, the same reference signs are used to designate the same elements as those in the first embodiment, and detailed explanation thereof will be omitted or simplified. 
     A medical treatment system according to the ninth embodiment is different from the medical treatment system  1  described in the first embodiment in terms of configurations of the therapeutic energy applying structures  9  and  9 ′. Each therapeutic energy applying structure provided in each of the holding members  8  and  8 ′ has the same configuration in the ninth embodiment. Thus, only the therapeutic energy applying structure provided in the holding member  8  will be described hereinafter. 
     Configuration of Therapeutic Energy Applying Structure 
       FIG. 13  is a side view illustrating a therapeutic energy applying structure  9 H according to the ninth embodiment of the present invention. 
     As illustrated in  FIG. 13 , the therapeutic energy applying structure  9 H according to the ninth embodiment includes a flexible substrate  92 H additionally having a second conductive portion  926 , compared to the therapeutic energy applying structure  9  ( FIGS. 3 to 5 ) described in the first embodiment. 
     Specifically, the second conductive portion  926  is an adhesive sheet similar to the adhesive sheet  93 , and is affixed onto the pair of lead wire connection portions  9221  straddling the pair of lead wire connection portions  9221 . The two lead wires  94  ( FIGS. 3 and 4 ) are bonded to regions of the pair of lead wire connection portions  9221  exposed to the outside (the regions on a proximal end side (the right side in  FIG. 13 ) that are not covered by the second conductive portion  926 ). 
     In the ninth embodiment, the pair of lead wire connection portions  9221  corresponds to the connection portion main body, and the second conductive portion  926  corresponds to the conductive portion. The pair of lead wire connection portions  9221  and the second conductive portion  926  correspond to the connection portion. That is, the pair of lead wire connection portions  9221  and the second conductive portion  926  corresponding to the connection portion have the length D 2  larger than the length D 1  of the electric resistance pattern  9222  and have the larger thickness than the thickness of the electric resistance pattern  9222  by a thickness of the second conductive portion  926 , and thus, have an electric resistance value that is even lower than that of the electric resistance pattern  9222 . 
     As illustrated in  FIG. 13 , the positional relationship between the heat transfer plate  91  and the adhesive sheet  93  with respect to the boundary position BP 1  between the wide region  9211  and the narrow region  9212  and the boundary position BP 2  between the pair of lead wire connection portions  9221  and the electric resistance pattern  9222  is the same as that in the first embodiment. The adhesive sheet  93  is arranged such that one end in the longitudinal direction (a right end in  FIG. 13 ) is spaced apart from the second conductive portion  926  as illustrated in  FIG. 13 . 
     Since the second conductive portion  926  is provided on the pair of lead wire connection portions  9221 , and the total thickness of the pair of lead wire connection portions  9221  and the second conductive portion  926  is made larger than the thickness of the electric resistance pattern  9222  in the therapeutic energy applying structure  9 H according to the ninth embodiment described above, the same advantageous effects as those of the sixth embodiment can be obtained. 
     In addition, since the second conductive portion  926  is arranged so as to be separated from the adhesive sheet  93 , heat transferred from the wiring pattern  922  to the adhesive sheet  93  is not transferred to the second conductive portion  926 . That is, it is possible to effectively dissipate the heat of the pair of lead wire connection portions  9221  using the second conductive portion  926 . 
     Modified Example of Ninth Embodiment 
       FIG. 14  is a schematic view illustrating a modified example of the ninth embodiment of the present invention. Specifically,  FIG. 14  is a schematic view corresponding to  FIG. 13 . 
     A therapeutic energy applying structure  91  illustrated in  FIG. 14  may be adopted instead of the therapeutic energy applying structure  9 H described in the ninth embodiment. 
     Specifically, the therapeutic energy applying structure  91  has a structure in which a heat sink  95  made of metal such as aluminum, copper, and iron or ceramic having high heat conductivity such as aluminum nitride is bonded onto a top surface of the second conductive portion  926  as illustrated in  FIG. 14 . 
     Coating having a heat dissipation effect may be applied on the top surface of the second conductive portion  926  instead of forming the heat sink  95 . For example, it is possible to exemplify diamond-like carbon (DLC), alumina, and the like, or a coating material having a high emissivity, an alumite process, and the like as the coating. The second conductive portion  926  may be omitted, and the above-described coating may be applied on the pair of lead wire connection portions  9221 . 
     Other Embodiments 
     The present invention is not limited only to the first to ninth embodiments and the modified example of the ninth embodiment. 
     In the first to ninth embodiments and the modified example of the ninth embodiment, the therapeutic energy applying structures  9  ( 9 ′) and  9 A to  9 I are provided on both of the holding members  8  and  8 ′, respectively. Alternatively, the therapeutic energy applying structure may be provided only on one of the holding members  8  and  8 ′. 
     In the first to ninth embodiments and the modified example of the ninth embodiment, the therapeutic energy applying structures  9  ( 9 ′) and  9 A to  9 I are configured to apply heat energy to the body tissue. Besides the heat energy, applying high-frequency energy or ultrasound energy to the body tissue may be adopted. 
     According to the therapeutic energy applying structure and the medical treatment device of some embodiments, it is possible to avoid an overheated state of a connection portion. 
     Additional advantages and modifications will readily occur to those skilled in the art. Therefore, the invention in its broader aspects is not limited to the specific details and representative embodiments shown and described herein. Accordingly, various modifications may be made without departing from the spirit or scope of the general inventive concept as defined by the appended claims and their equivalents.