Abstract:
A control device having: one or more processors configured to: receive a first signal indicating one of a plurality of inputs of a first type received by a first input device; receive a second signal indicating one of a plurality of inputs of a second type received by a second input device; select a selected mode from one or more modes of a respective one or more treatment devices based on a combination of the first signal and the second signal; and output a control signal for controlling the one or more treatment devices in accordance with the selected mode.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a Continuation application of PCT International Application No. PCT/JP2016/061587, filed on Apr. 8, 2016, and claims the benefit of priority from prior Japanese Patent Application No. 2015-082021, filed on Apr. 13, 2015. The entire contents of PCT International Application No. PCT/JP2016/061587 and Japanese Patent Application No. 2015-082021 are incorporated herein by reference. 
     
    
     BACKGROUND 
       [0002]    Technical Field 
         [0003]    The present invention relates to a medical treatment system capable of controlling one or more treatment devices in accordance with a selected mode selected from a plurality of modes, and also relates to a control device that is provided in the medical treatment system. 
         [0004]    Background Art 
         [0005]    JP 2006-340839 A discloses a medical treatment device that includes a housing, a handle capable of opening and closing with respect to the housing, and an end effector with which treatment is given. In the medical treatment device, the handle is positioned near the base of a grip of the housing. Furthermore, a surface of a head of the housing (a portion near the head of the housing) is provided with a first operation button that is an operation member (a first input device), and a second operation button that is a selection member (a second input device). Inputting operation with the first operation button (pressing the first operation button) turns the first operation button into an ON state. This transmits ultrasonic vibration to the end effector (a treatment probe). With the second operation button, operation for switching the supply of high frequency energy to the end effector, or switching the intensity of electrical energy to be transmitted to an ultrasonic vibrator is performed. Thus, for example, when the supply of high frequency energy is switched with the second operation button and the first operation button is in the ON state, the medical treatment device can function in a first mode or a second mode; a first mode in which only ultrasonic vibration is transmitted to the end effector, and a second mode in which ultrasonic vibration is transmitted to the end effector and high frequency energy is also supplied to the end effector. When the first operation button (the operation member) is in the ON state, the first mode and the second mode are switched depending on the operating state input with the second operation button (the selection member). 
       SUMMARY 
       [0006]    When a medical treatment tool is provided with a handle near the base of the grip of the housing as described in JP 2006-340839 A, an operator holds using the operator&#39;s thumb put on the handle and the operator&#39;s middle finger, ring finger, and little finger put on the grip. Then, the operator rotates a rotating knob around the longitudinal axis and rotates the end effector around the longitudinal axis with the index finger while inputting operation with the operation member provided at a portion near the head of the housing using the index finger. When the housing is provided with the selection member in addition to the operation member at the portion near the head of the housing in the configuration described above, the operator needs to also use the index finger to input operation with the selection member. This reduces the operability of the operation member and selection member. 
         [0007]    In light of the foregoing, an objective of the present invention is to provide a medical treatment system that switches the modes in which the medical treatment tool functions in accordance with the operating state input with a selection member, and ensures the operability for operating the operation member and the selection member, and also to provide a control device and a medical treatment tool that are provided in the medical treatment system. 
         [0008]    To achieve the above objective, an aspect of the present invention is a medical treatment system comprising: one or more treatment devices, wherein the one or more treatment devices are configured to be controlled in one or more modes; a first input device configured to receive one of a plurality of inputs of a first type; a second input device configured to receive one of a plurality of inputs of a second type; a housing comprising: a distal portion; a proximal portion; and a grip, wherein the housing is configured to extend along a longitudinal axis extending from the distal portion to the proximal portion, wherein the grip is configured to extend along a direction crossing the longitudinal axis, wherein the first input device is arranged closer to the distal portion of the housing than the proximal portion of the housing, and wherein the second input device is arranged closer to the proximal portion of the housing than the first input device; and one or more processors configured to: select a selected mode from the one or more modes of the respective one or more treatment devices based on a combination of: the one of the plurality of inputs of the first type received by the first input device; and the one of the plurality of inputs of the second type received by the second input device; and control the one or more treatment devices in accordance with the selected mode. 
         [0009]    Another aspect of the present invention is a control device for controlling a medical treatment tool, wherein the medical treatment tool comprises: one or more treatment devices, wherein the one or more treatment devices are configured to be controlled in one or more modes; a first input device configured to receive one of a plurality of inputs of a first type; and a second input device configured to receive one of a plurality of inputs of a second type; wherein the control device comprises: one or more processors configured to: receive a first signal indicating the one of the plurality of inputs of the first type received by the first input device; receive a second signal indicating the one of the plurality of inputs of the second type received by the second input device; select a selected mode from the one or more modes of the respective one or more treatment devices based on a combination of: the first signal indicating the one of the plurality of inputs of the first type received by the first input device; and the second signal the one of the plurality of inputs of the second type received by the second input device; and output a control signal for controlling the one or more treatment devices in accordance with the selected mode. 
     
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
         [0010]      FIG. 1  illustrates a schematic diagram of a medical treatment device according to a first embodiment. 
           [0011]      FIG. 2  is an explanatory schematic diagram of an electrical connection between the medical treatment tool and control device according to the first embodiment, and a path of supply of energy used for treatment to an end effector. 
           [0012]      FIG. 3  is a flowchart of a process that a control unit performs in accordance with the operating state input with an operation button in the first embodiment. 
           [0013]      FIG. 4  is a schematic diagram of a state in which the housing and handle according to the first embodiment are held. 
           [0014]      FIG. 5  is a schematic diagram of patterns of the modes in which the medical treatment device functions in the first embodiment and its exemplary variations. The patterns are switched in accordance with the operating state input with the selection button. 
           [0015]      FIG. 6  is an explanatory schematic diagram of a plurality of modes in which the medical treatment device according to the first exemplary variation can function. 
           [0016]      FIG. 7  is a schematic diagram of a configuration to detect the operating states input with the operation button and the selection button in a second exemplary variation. 
           [0017]      FIG. 8  is a schematic diagram of a configuration to detect the operating states input with the operation buttons in a third exemplary variation. 
           [0018]      FIG. 9  is a schematic diagram of a medical treatment tool according to a fourth exemplary variation when a selection lever is in an OFF state. 
           [0019]      FIG. 10  is a schematic diagram of the medical treatment tool according to the fourth exemplary variation when the selection lever is in an ON state. 
           [0020]      FIG. 11  is a schematic cross-sectional view of the selection lever and structure around the selection lever according to the fourth exemplary variation. 
           [0021]      FIG. 12  is a schematic diagram of a medical treatment tool according to a fifth exemplary variation. 
           [0022]      FIG. 13  is a schematic diagram of the selection slider and structure around the selection slider according to the fifth exemplary variation when the selection slider is in an OFF state. 
           [0023]      FIG. 14  is a schematic diagram of the selection slider and structure around the selection slider according to the fifth exemplary variation when the selection slider is in an ON state. 
           [0024]      FIG. 15  is a schematic diagram of a medical treatment tool according to a sixth exemplary variation. 
           [0025]      FIG. 16  is a schematic diagram of a medical treatment tool according to a seventh exemplary variation when a selection switch is in an OFF state. 
           [0026]      FIG. 17  is a schematic diagram of the medical treatment tool according to the seventh exemplary variation when the selection switch is in an ON state. 
           [0027]      FIG. 18  is a schematic diagram of a medical treatment tool according to an eighth exemplary variation when a selection switch is in an OFF state. 
           [0028]      FIG. 19  is a schematic diagram of the medical treatment tool according to the eighth exemplary variation when the selection switch is in an ON state. 
           [0029]      FIG. 20  is a schematic diagram of a medical treatment tool according to a ninth exemplary variation when a selection switch is in an OFF state. 
           [0030]      FIG. 21  is a schematic diagram of the medical treatment tool according to the ninth exemplary variation when the selection switch is in an ON state. 
           [0031]      FIG. 22  is a schematic diagram of a medical treatment tool according to a tenth exemplary variation. 
           [0032]      FIG. 23  is a schematic diagram of a configuration to detect the operating states input with the operation button, the selection button, and the selection switch. 
           [0033]      FIG. 24  is a schematic diagram of a medical treatment tool according to an eleventh exemplary variation. 
           [0034]      FIG. 25  is a schematic diagram of a state in which the housing and handle according to the eleventh exemplary variation are held. 
           [0035]      FIG. 26  is a schematic diagram of a medical treatment tool according to a twelfth exemplary variation. 
           [0036]      FIG. 27  is a schematic diagram of a medical treatment tool according to a thirteenth exemplary variation. 
           [0037]      FIG. 28  is a schematic diagram of a state in which the housing and handle according to the thirteenth exemplary variation are held. 
           [0038]      FIG. 29  is a schematic diagram of a medical treatment tool according to a fourteenth exemplary variation. 
           [0039]      FIG. 30  is a schematic diagram of a medical treatment tool according to a fifteenth exemplary variation. 
           [0040]      FIG. 31A  is a schematic diagram of a state in which an external force does not act on a lever member according to the fifteenth exemplary variation. 
           [0041]      FIG. 31B  is a schematic diagram of a state in which an external force acts on a first lever extension portion in the lever member according to the fifteenth exemplary variation. 
           [0042]      FIG. 31C  is a schematic diagram of a state in which an external force acts on a second lever extension portion in the lever member according to the fifteenth exemplary variation. 
           [0043]      FIG. 31D  is a schematic diagram of a state in which an external force acts on a lever supporting shaft in the lever member according to the fifteenth exemplary variation. 
       
    
    
     DETAILED DESCRIPTION 
     First Embodiment 
       [0044]    The first embodiment of the present invention will be described with reference to  FIGS. 1 to 4 . 
         [0045]      FIG. 1  is a diagram of a medical treatment device (medical treatment system)  1  according to the present embodiment. As illustrated in  FIG. 1 , the medical treatment device  1  includes a medical treatment tool (hand-piece)  2 . The medical treatment tool  2  has a longitudinal axis C. In this example, a first side in the direction of the longitudinal axis C is on a head side near the head of the medical treatment tool  2  (a side of an arrow C 1  in  FIG. 1 ), and the side opposite to the side near the head is on a base side near the base of the medical treatment tool  2  (a side of an arrow C 2  in  FIG. 1 ). The medical treatment tool  2  is detachably connected to a control device  3  through a cable  5 . The control device  3  is an energy control device, for example, that controls the supply of energy used for treatment to (treatment energy) to the medical treatment tool  2 . 
         [0046]    The medical treatment tool  2  includes a housing  6  including a head and a base. The housing  6  includes a housing body  7  extending along the longitudinal axis C, and a grip (fixed handle)  8  extending from the housing body  7  in the direction crossing the longitudinal axis C. A first end of the cable  5  is connected to the base portion of the housing body  7 . A handle (movable handle)  11  is rotatably attached to the housing  6 . The handle  11  rotates around an attachment position at which the handle  11  is attached to the housing  6 . This rotation allows the handle  11  to open and close with respect to the grip  8  of the housing  6  (displaces the handle  11 ). In the present embodiment, the handle  11  is positioned on a head side near the head of the grip  8  so that the handle  11  opens and closes with respect to the grip  8  (moves from and toward the grip  8 ) in roughly parallel to the longitudinal axis C. 
         [0047]    A rotating knob  12  is coupled to the head side of the housing body  7 . The rotating knob  12  is rotatable around the longitudinal axis C of the housing  6 . A sheath  13  is coupled to the housing  6  while being inserted from the head side into the rotating knob  12  and housing body  7 . An extension member (probe)  15  extends from the inside of the housing body  7  through the inside of the sheath  13  toward the head side. The head of the extension member  15  is provided with a first grasp unit (treatment probe)  16 . The extension member  15  is inserted into and penetrates the sheath  13 . The first grasp unit  16  protrudes from the head of the sheath  13  toward the head side. In the present embodiment, the extension member  15  is made of a material having high vibration transferability and thus capable of transferring ultrasonic vibration. A second grasp unit (jaw)  17  is rotatably attached to the head of the sheath  13 . 
         [0048]    The handle  11  opens or closes with respect to the grip  8 . This moves a movable pipe (not illustrated) extending between the sheath  13  and the extension member  15  along the longitudinal axis C. This rotates the second grasp unit  17  so that the second grasp unit  17  opens or closes with respect to the first grasp unit  16 . In the present embodiment, the first grasp unit  16  and the second grasp unit  17  form an end effector  18  that treats an object to be treated such as body tissue. The end effector  18  grasps the object to be treated between a pair of the grasp units  16  and  17  so as to treat the object to be treated. 
         [0049]      FIG. 2  is an explanatory diagram of an electrical connection between the medical treatment tool  2  and the control device  3 , and a path of supply of energy used for treatment to the end effector  18 . As illustrated in  FIGS. 1 and 2 , a vibration generation unit  21  extends in the housing body  7  along the longitudinal axis C. The vibration generation unit  21  is connected to a base side near the base of the extension member  15  in the housing body  7 . The vibration generation unit  21  is provided with a piezoelectric device (not illustrated) that converts electrical energy (alternating current) into ultrasonic vibration. 
         [0050]    The control device  3  includes one or more processors such as an energy source  25  that generates energy for treatment, and a control unit  26  that controls the energy source  25 . The energy source  25  includes, for example, a drive circuit (not illustrated) that converts direct current power from a battery or electricity from an outlet into electrical energy used for treatment. The control unit  26  includes, for example, a processor or an integrated circuit including a Central Processing Unit (CPU) or an application specific integrated circuit (ASIC), and a storage medium such as a memory so as to control the whole medical treatment device  1 . Note that, in the control unit  26 , for example, a processor can work as a level setting unit  27  configured to set a level (energy level) on each type of energy output from the energy source  25 , or can work as a measurement unit  28  (a measurement circuit) that can measure a predetermined parameter. The level setting unit  27  and measurement unit  28  perform some of processes that, for example, the processor performs. The control device  3  is provided also with an alarm  29  electrically connected to the control unit  26 . The alarm  29  is, for example, a bell that warns by generating a sound, a lamp that warns by producing light, or a display screen that displays warning. In this example, the alarm  29  is not necessarily placed in the control device  3 , and can be placed, for example, in the housing  6  of the medical treatment tool  2 . Alternatively, warning can be displayed on the display screen of an endoscope (not illustrated) used together with the medical treatment device  1 . 
         [0051]    First ends of electrical lines  22 A and  22 B are connected to the vibration generation unit  21 . The electrical lines (energy lines)  22 A and  22 B extend through the insides of the housing  6 , cable  5 , and control device  3 . Second ends of the electrical lines  22 A and  22 B are connected to the energy source  25 . The control by the control unit  26  outputs the electrical energy (alternating current power) that is to be converted into ultrasonic vibration from the energy source  25  through the electrical lines  22 A and  22 B, and the electrical energy output through the electrical lines  22 A and  22 B is supplied to the vibration generation unit  21 . The supply of the electrical energy to the vibration generation unit  21  generates ultrasonic vibration. Then, the generated ultrasonic vibration is transmitted to the extension member  15 . The ultrasonic vibration is transmitted from the base side to head side of the extension member  15 . Subsequently, the ultrasonic vibration is transmitted to the first grasp unit  16  of the end effector  18 . 
         [0052]    First ends of energy lines  23 A and  23 B are also connected to the energy source  25 . The energy line  23 A extends through the insides of the control device  3 , cable  5 , and housing  6 . A second end of the energy line  23 A is connected to the first grasp unit  16 . The energy line  23 B extends through the insides of the cable  5 , and housing  6 . A second end of the energy line  23 B is connected to the second grasp unit  17 . The control by the control unit  26  outputs high frequency energy (high frequency electricity) from the energy source  25  through the energy lines  23 A and  23 B. Then, the high frequency energy is supplied through the energy line  23 A to the first grasp unit  16  and through the energy line  23 B to the second grasp unit  17 . The supply of the high frequency energy to the end effector  18  (the first grasp unit  16  and second grasp unit  17 ) causes the first grasp unit  16  and second grasp unit  17  to function as electrodes of the high frequency energies with different electrical potentials each other. 
         [0053]    As illustrated in  FIG. 1 , operation buttons  31 A and  31 B are attached as operation members to the housing  6 . In the present embodiment, the operation buttons  31 A and  31 B are attached to a surface of a head  32  of the grip  8 , and placed at a portion of the head side of the housing  6 . The operation buttons  31 A and  31 B are placed on the side on which the grip  8  is positioned when the longitudinal axis C is centered, and placed nearer to the longitudinal axis C than a force application unit (handle finger-put position)  33  to which operation force is applied by operation for opening or closing the handle  11  with respect to the housing  6 . With each of the operation buttons  31 A and  31 B, operation for causing the medical treatment device  1  to function (for example, to supply energy to the end effector  18 ) is input. In the present embodiment, the operation buttons  31 A and  31 B are momentary operation members and thus each of the operation buttons  31 A and  31 B is in the ON state only while the operation is input (only while the button is pressed). Thus, when the input of operation (pressing the button) is released, the operation buttons  31 A and  31 B is turned into an OFF state. 
         [0054]    As illustrated in  FIG. 2 , the inside of the housing  6  (the inside of the grip  8 ) is provided with switches  35 A and  35 B. Each of the switches  35 A and  35 B is switched between an opening state and a closing state in accordance with the operating state (namely, the ON state or OFF state) input with the operation button (one of  31 A and  31 B) corresponding to each of the switches  35 A and  35 B. First ends of the detection signal lines (first detection signal lines)  36 A 1  and  36 A 2  are connected to the switch  35 A. The detection signal lines  36 A 1  and  36 A 2  extend through the insides of the housing  6 , cable  5 , and control device  3 . Second ends of the detection signal lines  36 A 1  and  36 A 2  are connected to the control unit  26 . The detection signal lines  36 A 1  and  36 A 2  transmit a detection signal (first detection signal) indicating whether the switch  35 A opens or closes (namely, indicating the operating state input with the operation button  31 A) to the control unit  26 . Then, the control unit  26  detects the operating state input with the operation button  31 A (namely, whether the operation button  31 A is in the ON state or the OFF state) in accordance with the detection signal transmitted through the detection signal lines  36 A 1  and  36 A 2 . 
         [0055]    Similarly, the switch  35 B is connected to the control unit  26  through the detection signal lines (first detection signal lines)  36 B 1  and  36 B 2  so that the detection signal lines  36 B 1  and  36 B 2  transmit a detection signal (first detection signal) indicating whether the switch  35 B opens or closes (namely, the operating state input with the operation button  31 B) to the control unit  26 . The control unit  26  detects the operating state input with the operation button  31 B (namely, whether the operation button  31 B is in the ON state or the OFF state) in accordance with the detection signal transmitted through the detection signal lines  36 B 1  and  36 B 2 . 
         [0056]    As illustrated in  FIG. 1 , the housing  6  is provided with a selection button  41  as a selection member. In the present embodiment, the selection button  41  is placed on the grip  8  and exposed to the outside. The selection button  41  is placed at a portion facing an end of the width direction of the housing  6  (in the direction perpendicular to the drawing paper of  FIG. 1 ) on the external surface of the housing  6 . The selection button  41  is placed nearer to the base side than the operation buttons  31 A and  31 B, and placed nearer to the longitudinal axis C than the force application unit  33  of the handle  11 . In this example, the selection button  41  can be a momentary selection member or can be an alternate selection member. When the selection button  41  is a momentary one, the selection button  41  is in the ON state only while operation is input (only while the selection button  41  is pressed). On the other hand, when the selection button  41  is an alternate one, inputting operation input with the selection button  41  in the OFF state (pressing the selection button  41 ) switches the selection button  41  into the ON state. Inputting operation input with the selection button  41  in the ON state (pressing the selection button  41 ) switches the selection button  41  into the OFF state. Even when the input of operation (pressing the selection button  41 ) is released, the selection button  41  is maintained to be in the OFF state. Note that, when the selection button  41  is an alternate one, the housing  6  is provided with a state maintenance mechanism (not illustrated) that maintains the selection button  41  in the ON state and the selection button  41  in the OFF state. 
         [0057]    As illustrated in  FIG. 2 , the inside of the housing  6  (the inside of the grip  8 ) is provided with a switch  42 . The switch  42  is switched between the opening state and the closing state in accordance with the operating state input with the selection button  41  (namely, whether the selection button  41  is in the ON state or the OFF state). First ends of the detection signal lines (second detection signal lines)  43 A and  43 B are connected to the switch  42 . The detection signal lines  43 A and  43 B extend through the insides of the housing  6 , cable  5 , and control device  3 . Second ends of the detection signal lines  43 A and  43 B are connected to the control unit  26 . The detection signal lines  43 A and  43 B transmit a detection signal (second detection signal) indicating whether the switch  42  opens or closes (namely, the operating state input with the selection button  41 ) to the control unit  26 . The control unit  26  detects the operating state input with the selection button  41  (namely, whether the selection button  41  is in the ON state or the OFF state) in accordance with the detection signal transmitted through the detection signal lines  43 A and  43 B. 
         [0058]    Note that an exemplary embodiment can be provided with a foot switch  34  as an operation input apparatus (third input device). In this example, the foot switch  34  is placed separately from the medical treatment tool  2  (the housing  6  and end effector  18 ). With the foot switch  34  working as the operation input apparatus, operation for causing the medical treatment device  1  to function is input. The input of operation with the foot switch  34  is detected by the control unit  26 . 
         [0059]    Next, the mechanisms and effects of the medical treatment tool  2 , control device  3 , and medical treatment device  1  according to the present embodiment will be described.  FIG. 3  is a flowchart of a process that the control unit  26  (the control device  3 ) performs in accordance with the operating state input with the operation button (first operation button)  31 A. As illustrated in  FIG. 3 , while the control device  3  operates, the control unit  26  detects the operating state input with the selection button  41  (namely, whether the selection button  41  is in the ON state or the OFF state) in accordance with the detection signal transmitted through the detection signal lines (second detection signal lines)  43 A and  43 B (step S 101 ). When the selection button  41  is in the OFF state (step S 101 —Yes), the control unit  26  detects the operating state input with the operation button  31 A in accordance with the detection signal transmitted through the detection signal lines (first detection signal lines)  36 A 1  and  36 A 2 , and detects whether the operation button  31 A is switched from the OFF state to the ON state (step S 102 ). 
         [0060]    When the operation button  31 A is switched to the ON state (step S 102 —Yes), the control unit  26  detects whether the selection button  41  is maintained to be in the OFF state (step S 103 ), and detects whether a given period of time T 0  has elapsed since the operation button  31 A has been switched to the ON state (step S 104 ). In other words, the control unit  26  detects whether the selection button  41  is maintained to be in the OFF state until a given period of time T 0  has elapsed since the operation button  31 A has been switched to the ON state in steps S 103  and S 104 . In this example, the control unit  26  sets the given period of time T 0 , for example, within a range between 0.05 and 1 seconds. Note that, when the given period of time T 0  has not elapsed since the operation button  31 A has been switched to the ON state in step S 104  (step S 104 —No), the process goes back to step S 102 . 
         [0061]    When the selection button  41  is maintained to be in the OFF state (step S 103 —Yes and S 104 —Yes) during the given period of time T 0  after the operation button  31 A is switched to the ON state, the control unit  26  causes the medical treatment device  1  to function in the first mode (step S 105 ). This causes the medical treatment device  1  to function in the first mode when the given period of time T 0  has elapsed after the operation button  31 A is switched from the OFF state to the ON state while the selection button  41  is in the OFF state. In other words, the control unit  26  causes the medical treatment device  1  to function in the first mode in accordance with the fact that the operation button  31 A is in the ON state when the selection button  41  is in the OFF state. In the present embodiment, by causing the medical treatment device  1  to function in the first mode, the control unit  26  supplies the electrical energy (alternating current) from the energy source  25  to the vibration generation unit  21  so as to transmit the ultrasonic vibration (the first energy) generated by the vibration generation unit  21  to the first grasp unit  16  of the end effector  18 . 
         [0062]    The control unit  26  causes the medical treatment device  1  to function in the first mode (step S 105 ) as long as the operation button  31 A is maintained to be in the ON state (step S 106 —No). In such a case, the medical treatment device  1  is maintained to be in the first mode regardless of the operating state input with the operation button (second operation button)  31 B. In other words, unless the operation button  31 A is switched from the ON state to the OFF state, the medical treatment device  1  functions in the first mode even if the operation button  31 B is switched from the OFF state to the ON state. When the operation button  31 A is switched from the ON state to the OFF state (step S 106 —Yes), the control unit  26  stops the output of energy from the energy source  25  (step S 107 ) and thus the electrical energy is not supplied to the vibration generation unit  21 . The output of energy from the energy source  25  is stopped regardless of the operating state input with the operation button  31 B (namely, whether the operation button  31 B is in the ON state or the OFF state). This stops the transmission of the ultrasonic vibration to the end effector  18  and stops the medical treatment device  1  from functioning. 
         [0063]    When the selection button  41  is switched to the ON state (step S 103 —No) before the given period of time T 0  has elapsed since the operation button  31 A has been switched to the ON state in step S 102 , the control unit  26  causes the alarm  29  to warn an error (step S 108 ). Meanwhile, the control unit  26  maintains the state in which the output of energy from the energy source  25  stops (step S 109 ). This maintains the state in which the medical treatment device  1  is stopped from functioning. For example, the operator recognizes from the error warning of the alarm  29  that operation is not properly input with the operation button  31 A and the selection button  41 . 
         [0064]    When the selection button  41  is in the ON state in step S 101  (step S 101 —No), the control unit  26  detects the operating state input with the operation button  31 A in accordance with the detection signal transmitted through the detection signal lines (first detection signal lines)  36 A 1  and  36 A 2 , and detects whether the operation button  31 A is switched from the OFF state to the ON state (step S 111 ). When the operation button  31 A is maintained to be in the OFF state (step S 101 —No or step S 111 —No), the control unit  26  maintains the state in which the output of energy from the energy source  25  is stopped (step S 110 ) regardless of the operating state input with the selection button  41  (in other words, whether the selection button  41  is in the ON state or the OFF state). This maintains the state in which the medical treatment device  1  is stopped from functioning in the process performed in accordance with the operating state input with the operation button  31 A unless the operation button  31 A is switched to the ON state. When the selection button  41  is in the OFF state and the operation button  31 A is switched to the OFF state again before the given period of time T 0  has elapsed since the operation button  31 A has been switched to the ON state (step S 104 —No and S 102 —No), the control unit  26  maintains the state in which the output of energy from the energy source  25  is stopped (step S 110 ). 
         [0065]    When the selection button  41  is in the ON state and the operation button  31 A is switched from the OFF state to the ON state (step S 101 —No and step S 111 —Yes), the control unit  26  causes the medical treatment device  1  to function in a second mode different from the first mode (step S 112 ). Thus, when the selection button  41  is in the ON state and the operation button  31 A is switched from the OFF state to the ON state, the medical treatment device  1  functions in the second mode. In other words, the control unit  26  causes the medical treatment device  1  to function in the second mode in accordance with the fact that the selection button  41  is in the ON state and the operation button  31 A is in the ON state. In the present embodiment, by causing the medical treatment device  1  to function in the second mode, the control unit  26  supplies the electrical energy (alternating current) from the energy source  25  to the vibration generation unit  21  and transmits the ultrasonic vibration (first energy) generated by the vibration generation unit  21  to the first grasp unit  16  of the end effector  18 , and transmits the high frequency energy (second energy) different from the ultrasonic vibration to the end effector  18 . 
         [0066]    As long as the operation button  31 A is maintained to be in the ON state (step S 113 —No) and the selection button  41  is maintained to be in the ON state (step S 114 —No), the control unit  26  causes the medical treatment device  1  to function in the second mode (step S 112 ). In such a case, the medical treatment device  1  is maintained to be in the second mode regardless of the operating state of the operation button (second operation button)  31 B. In other words, as long as the operation button  31 A is not switched from the ON state to the OFF state and the selection button  41  is not switched from the ON state to the OFF state, the medical treatment device  1  functions in the second mode even if the operation button  31 B is switched from the OFF state to the ON state. 
         [0067]    When the operation button  31 A is switched from the ON state to the OFF state (step S 113 —Yes), or when the selection button  41  is switched from the ON state to the OFF state (step S 114 —Yes), the control unit  26  stops the output of energy from the energy source  25  (step S 115 ). This stops the supply of the electrical energy to the vibration generation unit  21  and thus stops the transmission of the ultrasonic vibration to the end effector  18 . This also stops the supply of the high frequency energy to the end effector  18 . In such a case, the output of energy from the energy source  25  is stopped regardless of the operating state input with the operation button  31 B (in other words, whether the operation button  31 B is in the ON state or the OFF state). This stops the supply of energy to the end effector  18 , and stops the medical treatment device  1  from functioning. 
         [0068]    A process that the control unit  26  performs in accordance with the operating state input with the operation button (second operation button)  31 B is performed in a similar manner to the process performed in accordance with the operating state on the operation button (first operation button)  31 A (see  FIG. 3 ). In other words, when the selection button  41  is in the OFF state and the operation button  31 B is switched from the OFF state to the ON state, the control unit  26  detects whether the selection button  41  is maintained to be in the OFF state until the given period of time T 0  has elapsed since the operation button  31 B has been switched to the ON state. When the selection button  41  is maintained to be in the OFF state until the given period of time T 0  has elapsed since the operation button  31 B has been switched to the ON state, the control unit  26  causes the medical treatment device  1  to function in a third mode different from the first mode and the second mode. In other words, the control unit  26  causes the medical treatment device  1  to function in the third mode in accordance with the fact the selection button  41  is in the OFF state and the operation button  31 B is in the ON state. In the present embodiment, by causing the medical treatment device  1  to function in the third mode, the control unit  26  supplies the high frequency energy to the end effector  18 . In this example, the high frequency energy is supplied in an appropriate amount, for an appropriate length of time, at an appropriate frequency for solidification. 
         [0069]    As long as the operation button  31 B is in the ON state when the medical treatment device  1  functions in the third mode, the control unit  26  maintains the medical treatment device  1  in the third mode regardless of the operating state input with the operation button  31 A. When the operation button  31 B is switched to the OFF state, the control unit  26  stops the output of energy from the energy source  25  and stops the medical treatment device  1  from functioning regardless of the operation input with the operation button  31 A (in other words, whether the operation button  31 A is in the ON state or the OFF state). When the selection button  41  is in the OFF state and the operation button  31 B is switched to the ON state and the selection button  41  is switched from the OFF state to the ON state before the given period of time T 0  has elapsed since the operation button  31 B has been switched to the ON state, the control unit  26  warns an error and maintains the state in which the medical treatment device  1  is stopped from functioning. 
         [0070]    When the selection button  41  is in the ON state and the operation button  31 B is switched from the OFF state to the ON state, the control unit  26  causes the medical treatment device  1  to function in a fourth mode different from the first to third modes. In other words, the control unit  26  causes the medical treatment device  1  to function in the fourth mode in accordance with the fact that the selection button  41  is in the ON state and the operation button  31 B is in the ON state. In the present embodiment, by causing the medical treatment device  1  to function in the fourth mode, the control unit  26  supplies the same type of high frequency energy as the high frequency energy supplied in the third mode to the end effector  18  in a state in which the high frequency energy is supplied while at least one of the amount of the supplied high frequency energy, the length of time to supply the high frequency energy, and the frequency at which the high frequency energy is supplied is different from that in the third mode. At that time, the high frequency energy is supplied in an appropriate amount, for an appropriate length of time, at an appropriate frequency for sealing of a blood vessel. 
         [0071]    When the medical treatment device  1  functions in the fourth mode, the control unit  26  maintains the medical treatment device  1  in the fourth mode regardless of the operating state input with the operation button  31 A as long as the operation button  31 B is maintained to be in the ON state and the selection button  41  is maintained to be in the ON state. When the operation button  31 B is switched to the OFF state, or the selection button  41  is switched to OFF state, the control unit  26  stops the output of energy from the energy source  25  and stops the medical treatment device  1  from functioning regardless of the operating state input with the operation button  31 A (in other words, whether the operation button  31 A is the ON state or the OFF state). 
         [0072]    As described above, when the operation button  31 A is in the ON state, the detection signal (the first detection signal) indicating the operating state input with the operation button  31 A is transmitted through the detection signal lines  36 A 1  and  36 A 2  to the control unit  26 . This enables the control unit  26  to cause the medical treatment device  1  to function in a plurality of modes (in the first mode or the second mode). When the operation button  31 A is the ON state, the detection signal (the second detection signal) indicating the operating state input with the selection button  41  (whether the selection button  41  is in the ON state or the OFF state) is transmitted through the detection signal lines  43 A and  43 B to the control unit  26 . Then, the control unit  26  selects (determines) a mode in which the medical treatment device  1  functions (the first mode or the second mode) from the modes in accordance with the transmitted detection signal (the second detection signal). Similarly, when the operation button  31 B is in the ON state, the detection signal (the first detection signal) indicating the operating state input with the operation button  31 B is transmitted through the detection signal lines  36 B 1  and  36 B 2  to the control unit  26 . This enables the control unit  26  to cause the medical treatment device  1  to function in a plurality of modes (the third mode or the fourth mode). When the operation button  31 B is the ON state, the detection signal (the second detection signal) indicating the operating state input with the selection button  41  (whether the selection button  41  is in the ON state or the OFF state) is transmitted through the detection signal lines  43 A and  43 B to the control unit  26 . Then, the control unit  26  selects (determines) a mode in which the medical treatment device  1  functions (the third mode or the fourth mode) from the modes in accordance with the transmitted detection signal (the second detection signal). 
         [0073]    Thus, in the present embodiment, only providing a selection button (selection member)  41  enables the control unit  26  to cause the medical treatment device  1  to function in a plurality of modes when each of the operation buttons (the operation members)  31 A and  31 B is in the ON state by performing the process in accordance with the operating state input with the operation button  31 A illustrated in  FIG. 3 , and the process in a similar manner to the process illustrated in  FIG. 3  in accordance with the operating state input with the operation button  31 B. This enables the medical treatment device  1  to function in many modes even when the number of the operation buttons  31 A and  31 B is reduced. 
         [0074]    In the detection of the operating states input with the operation buttons  31 A and  31 B, and the selection button  41 , for example, when the selection button  41  is switched from the OFF state to the ON state before the given period of time T 0  has elapsed since the operation button ( 31 A or  31 B) has been switched to the ON state, it is sometimes difficult to determine whether the operation button ( 31 A or  31 B) and the selection button  41  are simultaneously in the ON state. In the present embodiment, the process in accordance with the operating state input with the operation button  31 A illustrated in  FIG. 3 , and the process in a similar manner to the process illustrated in  FIG. 3  in accordance with the operating state input with the operation button  31 B are processed. By performing the processes, the control unit  26  warns an error when it is difficult to determine whether the operation button ( 31 A or  31 B) and the selection button  41  are simultaneously in the ON state. This warning effectively prevents the medical treatment device  1  from functioning in a mode that the operator does not intend. 
         [0075]    To treat an object to be treated using the medical treatment device  1 , the operator holds the housing  6  and the handle  11  and inserts the head of the sheath  13  and the end effector  18 , for example, into an abdominal cavity. The operator opens or closes the handle  11  with respect to the grip  8  while inserting the sheath  13  and the end effector  18  in a body cavity in order to open or close the grasp units  16  and  17 , rotate the rotating knob  12  around the longitudinal axis C in order to adjust the angle of the position of the end effector  18  around the longitudinal axis C. 
         [0076]      FIG. 4  is a diagram of a state in which the operator holds the housing  6  and the handle  11 . As illustrated in  FIG. 4 , for example, when the operator holds the housing  6  and the handle  11  with the operator&#39;s right hand H, the operator puts the grip  8  of the housing  6  between the operator&#39;s thumb F 1  and palm P. The operator puts the operator&#39;s ring finger F 4  and little finger F 5  (or middle finger F 3 , ring finger F 4 , and little finger F 5  depending on the operator) on the force application unit  33  of the handle  11  so as to apply operation force on the handle  11  using the operator&#39;s ring finger F 4  and little finger F 5  (or middle finger F 3 , ring finger F 4 , and little finger F 5  depending on the operator) in order to close the handle  11  with respect to the grip  8 . The operator uses the operator&#39;s index finger F 2  or middle finger F 3  to rotate the rotating knob  12  and input operation with each of the operation buttons  31 A and  31 B (press each of the operation buttons  31 A and  31 B). 
         [0077]    In the present embodiment, the selection button (selection member)  41  is placed nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B on the outer surface of the housing  6 . This placement enables the operator to input operation with the selection button  41  (to press the selection button  41 ) using the thumb F 1  while grasping the grip  8  between the thumb F 1  and the palm P. Thus, the operator can switch the selection button  41  between ON state and OFF state using the thumb F 1 . Thus, the operator does not use the operator&#39;s index finger F 2 , middle finger F 3 , ring finger F 4 , and little finger F 5 , which are used for at least one of operations for opening and closing the handle  11 , rotating the rotating knob  12 , and inputting operation with the operation buttons  31 A and  31 B, in order to input operation with the selection button  41 . Thus, the operator does not need to change the positions and postures of the operator&#39;s index finger F 2 , middle finger F 3 , ring finger F 4  and little finger F 5  in order to switch the selection button  41  between the ON state and the OFF state in treatment, and does not need also to hold the housing  6  and the handle  11  again with the operator&#39;s right hand H. This secures the operability for opening and closing the handle  11 , rotating the rotating knob  12 , and inputting operation with the operation buttons  31 A and  31 B, and secures also the operability for inputting operation with the selection button  41 . 
         [0078]    As described above, the present embodiment can provide the medical treatment device ( 1 ) that switches the modes in which the medical treatment device ( 1 ) functions in accordance with the operating state input with the selection member ( 41 ), and secures the operability of the operation members ( 31 A and  31 B), and the selection member ( 41 ). 
       Exemplary Variation 
       [0079]    Note that, when the operation button  31 A is in the ON state in the first embodiment, the medical treatment device  1  can function in the mode in which ultrasonic vibration is transmitted to the end effector  18  (the first mode) and in the mode in which ultrasonic vibration is transmitted and the high frequency energy is also supplied to the end effector  18  (the second mode) in accordance with the operating state input with the selection button  41 . However, the mode is not limited to the modes according to the first embodiment. Similarly, when the operation button  31 B is in the ON state, the medical treatment device  1  can function in the mode in which high frequency energy is supplied to the end effector  18  in an amount appropriate for solidification (the third mode) and in the mode in which high frequency energy is supplied to the end effector  18  in an amount appropriate for sealing of a blood vessel (the fourth mode) in accordance with the operating state input with the selection button  41 . However, the mode is not limited to the modes according to the first embodiment. 
         [0080]      FIG. 5  is a diagram (table) of patterns of switching of the modes in which the medical treatment device  1  functions in accordance with the operating state input with the selection button  41 . When the operation button  31 A is in the ON state in the first embodiment, the medical treatment device  1  functions in a pattern X 1  illustrated in  FIG. 5  in accordance with the operating state input with the selection button  41 . When the operation button  31 B is in the ON state, the medical treatment device  1  functions in a pattern X 2  illustrated in  FIG. 5  in accordance with the operating state input with the selection button  41 . However, in an exemplary variation, the medical treatment device  1  functions in the pattern X 2  when the operation button  31 A is in the ON state and the medical treatment device  1  functions in the pattern X 1  when the operation button  31 B is in the ON state. In other words, the control unit  26  causes the medical treatment device  1  to function, for example, in one of patterns X 1  to X 16 , Xa 1  to Xa 6 , Xa 9 , Xa 11  to Xc 11 , and Xa 12  to Xc 12  illustrated in  FIG. 5  in accordance with the operating state input with the selection button  41 . 
         [0081]    The first embodiment is provided with two operation buttons  31 A and  31 B. However, the number of the operation buttons can be one, or three or more. In other word, at least an operation button ( 31 A or  31 B) needs being provided. When one operation button is provided, the control unit  26  causes the medical treatment device  1  to function in one of the patterns X 1  to X 16 , Xa 1  to Xa 6 , Xa 9 , Xa 11  to Xc 11 , and Xa 12  to Xc 12  illustrated in  FIG. 5  in accordance with the operating state input with the selection button  41 . 
         [0082]    Hereinafter, each of the patterns X 1  to X 16 , Xa 1  to Xa 6 , Xa 9 , Xa 11  to Xc 11 , and Xa 12  to Xc 12  illustrated in  FIG. 5  will be described. Note that the patterns X 1  and X 2  have already described in the first embodiment, and thus the description will be omitted. In the pattern Xa 1 , the medical treatment device  1  functions in a mode in which ultrasonic vibration is transmitted to the end effector  18  in accordance with the fact the selection button  41  is in the OFF state and the operation button ( 31 A or  31 B) is in the ON state. The medical treatment device  1  functions in a mode in which the ultrasonic vibration and heat are transmitted to the end effector  18  in accordance with the fact the selection button  41  is in the ON state and the operation button ( 31 A or  31 B) is in the ON state. In this pattern, the end effector  18  is provided with a heating element (not illustrated) so that the electrical energy (direct current power or alternating current power) is supplied from the energy source  25  to the heating element. Then, the heat generated by the heating element is transmitted to the end effector  18 . 
         [0083]    In the pattern Xa 2 , the medical treatment device  1  functions in a mode in which high frequency energy is transmitted to the end effector  18  in accordance with the fact the selection button  41  is in the OFF state and the operation button ( 31 A or  31 B) is in the ON state. The medical treatment device  1  functions in a mode in which heat is transmitted to the end effector  18  in accordance with the fact the selection button  41  is in the ON state and the operation button ( 31 A or  31 B) is in the ON state. 
         [0084]    In the pattern X 3 , the medical treatment device  1  functions in a mode in which high frequency energy is transmitted to the end effector  18  in accordance with the fact the selection button  41  is in the OFF state and the operation button ( 31 A or  31 B) is in the ON state. The medical treatment device  1  functions in a mode in which ultrasonic vibration is transmitted to the end effector  18  and water is conveyed near the end effector  18  through a water convey path (not illustrated) in accordance with the fact the selection button  41  is in the ON state and the operation button ( 31 A or  31 B) is in the ON state. In this pattern, a water convey source (not illustrated) that supplies water (liquid) through the water convey path is provided, and the control unit  26  controls the operation, for example, of a water convey pump of the water convey source. In each mode described in the pattern Xa 3 , the function to supply high frequency energy to the end effector  18  is added to the functions of the mode corresponding to the pattern X 3 . 
         [0085]    Alternatively, in the pattern X 4 , the medical treatment device  1  functions in a mode in which ultrasonic vibration is transmitted to the end effector  18  in accordance with the fact the selection button  41  is in the OFF state and the operation button ( 31 A or  31 B) is in the ON state. The medical treatment device  1  functions in a mode in which ultrasonic vibration is transmitted to the end effector  18  and suction is performed from the periphery of the end effector  18  through a suction path (not illustrated) in accordance with the fact the selection button  41  is in the ON state and the operation button ( 31 A or  31 B) is in the ON state. In this pattern, a suction source (not illustrated) that perform suction through the suction path, and the control unit  26  controls the operation, for example, of a suction pump of the suction source. In each mode in the pattern Xa 4 , the function to supply high frequency energy to the end effector  18  is added to the functions of the mode corresponding to the pattern X 4 . 
         [0086]    Alternatively, in the pattern X 5 , the medical treatment device  1  functions in a mode in which ultrasonic vibration is transmitted to the end effector  18  in accordance with the fact the selection button  41  is in the OFF state and the operation button ( 31 A or  31 B) is in the ON state. The medical treatment device  1  functions in a mode in which a different type of high frequency energy (the second energy) from the ultrasonic vibration (the first energy) is transmitted to the end effector  18  in accordance with the fact the selection button  41  is in the ON state and the operation button ( 31 A or  31 B) is in the ON state. Instead of the supply of high frequency energy in the pattern X 5 , heat is transmitted to the end effector  18  in the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in the pattern Xa 5 . 
         [0087]    The mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state in the pattern X 5  is switched to the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in the pattern X 6 . The mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in the pattern X 5  is switched to the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state in the pattern X 6 . Similarly, the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state in the pattern Xa 5  is switched to the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in the pattern Xa 6 . The mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in the pattern Xa 5  is switched to the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state in the pattern Xa 6 . 
         [0088]    High frequency energy is supplied to the end effector  18  in each mode of the pattern X 7  instead of the transmission of ultrasonic vibration in the mode corresponding to the pattern X 3 . Similarly, high frequency energy is supplied to the end effector  18  in each mode of the pattern X 8  instead of the transmission of ultrasonic vibration in the mode corresponding to the pattern X 4 . 
         [0089]    In a mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state in the pattern X 9 , the output of energy from the energy source  25  is maintained as long as operation is input with the operation button ( 31 A or  31 B). In other words, in a mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state, the supply of energy to the end effector  18  is maintained as long as the operation button ( 31 A or  31 B) is maintained to be in the ON state. When the mode is switched to a mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state, the output of energy is automatically stopped in accordance with the fact that a predetermined period of time T′ 0  has elapsed since the start of the output of energy from the energy source  25 . In other words, in a mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state, the supply of energy to the end effector  18  is stopped when the predetermined period of time T′ 0  has elapsed since the start of the output of energy even while the operation button ( 31 A or  31 B) is maintained to be in the ON state. Even in such a case, however, the output of energy is started in accordance with the fact that the selection button  41  is in the ON state and the operation button ( 31 A or  31 B) is in the ON state. Note that, when ultrasonic vibration is transmitted as energy to the end effector  18  and the mode is switched to the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state, the output of energy can automatically be stopped in accordance with the fact that a predetermined period of time T′ 1  has elapsed since the start of a phase locked loop control (PLL control). 
         [0090]    An incision is detected based on a sound impedance Z in a mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in the pattern Xa 9  instead of stopping the output of energy after the predetermined period of time T′ 0  has elapsed in the pattern X 9 . In this pattern, ultrasonic vibration is transmitted as energy to the end effector  18  so that the object to be treated that is grasped between the grasp units  16  and  17  is sectioned with the ultrasonic vibration. The control unit  26  chronologically detects, in the vibration generation unit  21 , the sound impedance Z of the electrical energy (alternating current power) supplied to the vibration generation unit  21 . When the sound impedance Z exceeds a set threshold Zth, it is determined that the incision of the object to be treated is completed. When it is determined that the incision is completed, the control unit  26  notifies the operator of the completion of incision or the output of energy from the energy source  25  is automatically stopped. This prevents the ultrasonic vibration from wearing the end effector  18  after the completion of incision. 
         [0091]    In the pattern X 10 , the detection of an incision described in the pattern Xa 9  is performed both in a mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state and in a mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state. However, in the pattern X 10 , the threshold Zth is set at a high value in the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state, and the threshold Zth is set at a low value in the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in comparison to the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state. 
         [0092]    In the pattern X 11 , energy (electrical energy) to be supplied from the energy source  25  to the vibration generation unit  21  at a normal level is output so that ultrasonic vibration is transmitted to the end effector  18  in a mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state. The level at which the energy is output is lowered in the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in comparison with the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state so that the amplitude of the ultrasonic vibration is reduced in the end effector  18 . In each of the patterns Xa 11  to Xc 11 , high frequency energy is output at a normal level from the energy source  25  in the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state so that the high frequency energy is supplied to the end effector  18 . In each of the patterns Xa 11  to Xc 11 , the level at which the high frequency energy is output is lowered in the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in comparison to the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state. This causes the reduction in the high frequency electricity as the pattern Xa 11 , or the reduction in the maximum value (wave height) of the high frequency voltage as the pattern Xb 11 , or the reduction in the maximum value (wave height) of the high frequency current as the pattern Xc 11 . 
         [0093]    In contrast to the pattern X 11 , the level at which the high frequency energy is output is increased in the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in comparison to the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state so that the amplitude of the ultrasonic vibration in the end effector  18  is increased in the pattern X 12 . In contrast to the patterns Xa 11  to Xc 11 , the level at which the high frequency energy is output is increased in the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state in comparison to the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state in each of the patterns Xa 12  to Xc 12 . This causes the increase in the high frequency electricity as the pattern Xa 12 , the increase in the maximum value (wave height) of the high frequency voltage as the pattern Xb 12 , or the increase in the maximum value (wave height) of the high frequency current as the pattern Xc 12 . 
         [0094]    In the pattern X 13 , energy (for example, high frequency energy, or the electrical energy to the vibration generation unit  21 ) is output from the energy source  25  at a level used for treatment in the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state (the first mode) so that the energy to be used for treatment (for example, high frequency energy or ultrasonic vibration) is supplied to the end effector  18 . In the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state (the second mode), the measurement unit  28  measures a predetermined parameter. When high frequency energy is supplied to the end effector  18 , the predetermined parameter to be measured can be, for example, the phase difference between the high frequency current and the high frequency voltage, the value of the high frequency current, the value of the high frequency voltage, or the chronological variations thereof. When the ultrasonic vibration is transmitted to the end effector  18 , the predetermined parameter to be measured can be, for example, the phase difference between the current and voltage of the electrical energy supplied to the vibration generation unit  21 , the value of current, the value of voltage, or the chronological variations thereof. When high frequency energy is supplied to the end effector  18 , an impedance Z′ of the object to be treated that is grasped between the grasp units  16  and  17  can be measured as the predetermined parameter. When the impedance Z′ of the object to be treated is measured as the predetermined parameter the object to be treated, the high frequency energy is output from the energy source  25  at a lower level than the level used for the treatment and the high frequency energy is supplied to the end effector  18 . 
         [0095]    In the first exemplary variation, the mode in which the medical treatment device  1  functions is switched as the illustrated pattern X 14  in accordance with the operating state input with the selection button  41 .  FIG. 6  is an explanatory diagram of a plurality of modes in which the medical treatment device  1  according to the present exemplary variation can function. As illustrated in  FIGS. 5 and 6 , in the pattern X 14 , energy (for example, high frequency energy, or the electrical energy to the vibration generation unit  21 ) is output at a set level from the energy source  25  so that energy used for treatment (for example, high frequency energy or ultrasonic vibration) is supplied to the end effector  18  in the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state (the first mode). In the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state (the second mode), the process performed by the level setting unit  27  of the control unit  26  changes the set level of the energy output from the energy source  25 . 
         [0096]    For example, in an exemplary embodiment illustrated in  FIG. 6 , ultrasonic vibration is transmitted to the end effector  18  when the mode is switched to a mode in which the medical treatment device  1  functions in accordance with the fact that the selection button  41  is in the OFF state and the operation button  31 A is in the ON state. In this example, the energy source  25  supplies the electrical energy at a set level among the levels Y 1  to Y 3  of to the vibration generation unit  21 . In a mode in which the medical treatment device  1  functions in accordance with that fact that the selection button  41  is in the ON state and the operation button  31 A is the ON state, the control unit  26  changes the set level of the electrical energy supplied to the vibration generation unit  21  (arrow A 1 , A 2 , or A 3  in  FIG. 6 ). In this example, only the level of the electrical energy is changed. The electrical energy is not output from the energy source  25  to the vibration generation unit  21 . 
         [0097]    In the exemplary embodiment illustrated in  FIG. 6 , high frequency energy is supplied to the end effector  18  when the mode is switched to the mode in which the medical treatment device  1  functions in accordance with the fact the selection button  41  is in the OFF state and the operation button  31 B is in the ON state. In this example, the energy source  25  supplies the high frequency energy at a set level among the levels Y′ 1  to Y′ 3  to the end effector  18 . In a mode in which the medical treatment device  1  functions in accordance with the fact that the selection button  41  is in the ON state and the operation button  31 B is the ON state, the control unit  26  changes the set level of the high frequency energy supplied to the end effector (arrow A′ 1 , A′ 2 , or A′ 3  in  FIG. 6 ). In this example, only the set level of the high frequency energy is changed. The high frequency energy is not output from the energy source  25  to the end effector  18 . 
         [0098]    When the mode is switched in the pattern X 15  in an exemplary variation, energy (for example, high frequency energy or the electrical energy to the vibration generation unit  21 ) is output at a level used for treatment from the energy source  25  so that the energy used for treatment (for example, high frequency energy or ultrasonic vibration) is supplied to the end effector  18  in the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state (the first mode). The energy is supplied to the end effector  18  in a similar manner to the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state, and the handle  11  is electrically operated and closed in the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state (the second mode). In this example, the inside of the housing  6  is provided with an electric motor (not illustrated) so that electrical energy (drive electricity) is supplied from the energy source  25  to the electric motor. This electricity drives the electric motor. Driving the electric motor makes driving force act on the handle  11  so that the handle  11  is closed. 
         [0099]    The process in accordance with the operating state input with the operation button ( 31 A or  31 B) is not limited to the process illustrated in  FIG. 3  and the process performed in a similar manner to  FIG. 3 . For example, when the selection button  41  is in the OFF state and the operation button ( 31 A or  31 B) is switched to the ON state (step S 101 —Yes and S 102 —Yes in  FIG. 3 ) and the selection button  41  is switched from the OFF state to the ON state before the given period of time T 0  has elapsed since the operation button ( 31 A or  31 B) has been switched to the ON state (step S 103 —No in  FIG. 3 ), an error is warned and a state in which the medical treatment device  1  is stopped from functioning is maintained in the first embodiment. However, when the selection button  41  is switched from the OFF state to the ON state before the given period of time T 0  has elapsed since the operation button ( 31 A or  31 B) has been switched to the ON state, it is determined in an exemplary variation that the operation button ( 31  A or  31 B) and the selection button  41  are simultaneously in the ON state. Then, the control unit  26  causes the medical treatment device  1  to function in a mode in which the medical treatment device  1  functions in accordance with the fact that the operation button ( 31  A or  31 B) and the selection button  41  are simultaneously in the ON state (for example, the second mode). 
         [0100]    In an exemplary variation, as long as the control by the control unit  26  maintains the operation button ( 31 A or  31 B) in the ON state, the mode in which the medical treatment device  1  functions is not changed even when the operating state is switched with the selection button  41  (the selection button  41  is switched between the ON state and the OFF state). To switch the mode in which the medical treatment device  1  functions in this example, it is necessary to switch the operation button ( 31 A or  31 B) from the OFF state to the ON state after the operating state input with the selection button  41  is switched while the operation button ( 31 A or  31 B) is in the OFF state. In contrast, in another exemplary variation, the control by the control unit  26  switches the operating state input with the selection button  41  (switches the selection button  41  between the ON state and the OFF state). This switching changes the mode in which the medical treatment device  1  functions even while the operation button ( 31 A or  31 B) is in the ON state. 
         [0101]    In the second exemplary variation, the mode in which the medical treatment device  1  functions is switched to the mode as the pattern X 16  illustrated in  FIG. 5  in accordance with the operating state input with the selection button  41 . In the pattern X 16 , the medical treatment device  1  operates in accordance with the operation input with the foot switch (the operation input apparatus)  34  in the mode in which the medical treatment device  1  functions when the selection button  41  is in the OFF state (the first mode). In other words, when the selection button  41  is in the OFF state, the medical treatment device  1  operates in accordance with the operation input with the foot switch  34  regardless of the operation input with the operation button ( 31 A or  31 B) (whether the operation button ( 31 A or  31 B) is in the ON state or the OFF state). For example, when operation is input with the foot switch  34 , energy (for example, high frequency energy, or the electrical energy to the vibration generation unit  21 ) is output from the energy source  25  so that the energy used for treatment (for example, high frequency energy or ultrasonic vibration) is supplied to the end effector  18 . 
         [0102]    On the other hand, in the pattern X 16 , the medical treatment device  1  operates in accordance with the operation input with the operation button (the operation member)  31 A or  31 B in the mode in which the medical treatment device  1  functions when the selection button  41  is in the ON state (the second mode). In other words, when the selection button  41  is in the ON state, the medical treatment device  1  operates in accordance with the operation input with the operation button ( 31 A or  31 B) regardless of the operation input with the foot switch  34 . For example, when operation is input with the operation button  31 A, energy (for example, high frequency energy, or the electrical energy to the vibration generation unit  21 ) is output from the energy source  25  so that the energy used for treatment (for example, high frequency energy or ultrasonic vibration) is supplied to the end effector  18 . 
         [0103]      FIG. 7  is a diagram of the configuration to detect the operating state input with each of the operation buttons  31 A and  31 B, and the selection button  41  in the present exemplary variation. In the present exemplary variation, the operating state input with the operation button corresponding to each of the switches  35 A and  35 B (the operation button  31 A or  31 B) is detected in accordance with whether each of the switches  35 A and  35 B opens or closes, and the operating state input with the selection button  41  is detected in accordance with whether the switch  42  opens or closes. As illustrated in  FIG. 7 , in the present exemplary variation, the control unit  26  is connected to the switch  35 A through the detection signal line  45 A, and the control unit  26  is connected to the switch  35 B through the detection signal line  45 B. Similarly, the control unit  26  is connected to the switch  42  through the detection signal line  45 C. In the present exemplary variation, the switches  35 A and  42  are electrically arranged in series each other and the switches  35 B and  42  are electrically arranged each other. The detection signal lines  45 A to  45 C are a first detection signal line that transmits a detection signal (first detection signal) indicating the operating state input with each of the operation buttons  31 A and  31 B to the control unit  26 , and are a second detection signal line that transmits a detection signal (second detection signal) indicating the operating state input with the selection button  41  to the control unit  26 . 
         [0104]    In the present exemplary variation, when both the operation button  31 A and the selection button  41  are in the ON states, both the switches  35 A and  42  are closed and thus the detection current flows through the detection signal lines  45 A and  45 C. The flow of the detection current through the detection signal lines  45 A and  45 C switches the mode to a mode in which the medical treatment device  1  operates in accordance with the operation input with the operation button  31 A and, for example, energy used for treatment is transmitted to the end effector  18  in accordance with the operation input with the operation button  31 A. When the selection button  41  is in the OFF state, the detection current does not flow through the detection signal lines  45 A and  45 C even when the operation button  31 A is in the ON state. Thus, when the selection button  41  is in the OFF state, the medical treatment device  1  operates in accordance with the operation input with the foot switch  34  even when the operation button  31 A in the ON state. Accordingly, when the operation button  31 A and the selection button  41  are momentary ones, the medical treatment device  1  operates in accordance with the operation input with the foot switch  34  unless operation is simultaneously input with the operation button  31 A and the selection button  41  (unless the operation button  31 A and the selection button  41  are simultaneously pressed) even when the operation is input with the operation button  31 A (the operation button  31 A is pressed). 
         [0105]    In the present exemplary variation, when both the operation button  31 B and the selection button  41  are in the ON states, both the switches  35 B and  42  are closed and thus the detection current flows through the detection signal lines  45 B and  45 C. The flow of the detection current through the detection signal lines  45 B and  45 C switches the mode to a mode in which the medical treatment device  1  operates in accordance with the operation input with the operation button  31 B and, for example, energy used for treatment is transmitted to the end effector  18  in accordance with the operation input with the operation button  31 B. When the selection button  41  is in the OFF state, the detection current does not flow through the detection signal lines  45 B and  45 C even when the operation button  31 B is in the ON state. Thus, when the selection button  41  is in the OFF state, the medical treatment device  1  operates in accordance with the operation input with the foot switch  34  even when the operation button  31 B is the ON state. Accordingly, when the operation button  31 B and the selection button  41  are momentary ones, the medical treatment device  1  operates in in accordance with the operation input with the foot switch  34  unless the operation is simultaneously input with the operation button  31 B and the selection button  41  (unless the operation button  31 B and the selection button  41  are simultaneously pressed) even when operation is input with the operation button  31 B (even when the operation button  31 B is pressed). 
         [0106]      FIG. 8  is a diagram of the configuration to detect the operating state input with each of the operation buttons  31 A and  31 B in a third exemplary variation. In the present exemplary variation, the operating state input with the operation button corresponding to each of the switches  35 A and  35 B (the operation button  31 A or  31 B) is also detected in accordance with whether each of the switches  35 A and  35 B opens or closes. As illustrated in  FIG. 8 , in the present exemplary variation, the control unit  26  is connected to the switch  35 A through the detection signal line  46 A, and the control unit  26  is connected to the switch  35 B through the detection signal line  46 B. Similarly, the control unit  26  is connected to the switches  35 A and  35 B through the detection signal line  46 C. The detection signal lines (first detection signal lines)  46 A to  46 C transmits a detection signal (first detection signal) indicating the operating state input with each of the operation buttons  31 A and  31 B to the control unit  26 . 
         [0107]    In the present exemplary variation, when the operation button  31 A is in the ON state and the operation button  31 B is in the OFF state, the detection current flows through the detection signal lines  46 A and  46 B. When the operation button  31 A is in the OFF state and the operation button  31 B is in the ON state, the detection current flows through the detection signal lines  46 B and  46 C. When both the operation buttons  31 A and  31 B are in the ON states, the detection current flows through the detection signal lines  46 A and  46 B. Thus, both when the selection button  41  is in the OFF state and when the selection button  41  is in the ON state in the present exemplary variation, the medical treatment device  1  can function in three modes; a mode in which only the operation button  31 A is in the ON state, a mode in which only the operation button  31 B is in the ON state, and a mode in which both the operation buttons  31 A and  31 B are in the ON states. In other words, both when the selection button  41  is in the OFF state and when the selection button  41  is in the ON state, the medical treatment device  1  can function in a larger number of modes than the number of the operation buttons  31 A and  31 B that are the operation members. 
         [0108]    In an exemplary embodiment, when the selection button  41  is in the ON state and only the operation button  31 A is in the ON state, ultrasonic vibration is supplied to the end effector  18 . Alternatively, when the selection button  41  is in the ON state and only the operation button  31 B is in the ON state, high frequency energy is supplied to both the grasp units  16  and  17  of the end effector  18  so that a bipolar treatment by the high frequency energy is performed. Alternatively, when the selection button  41  is in the ON state and both the operation buttons  31 A and  31 B are in the ON states, high frequency energy is supplied to only one of the grasp units  16  and  17  of the end effector  18  so that a mono-polar treatment by the high frequency energy is performed. 
         [0109]    In the embodiments, when the selection button  41  that is a selection member is an alternate button, the selection button  41  is maintained to be in both the ON state and the OFF state. However, the selection member is not limited to the alternate button. For example, the external surface of the housing  6  is provided with a selection lever  41 A as the selection member in a fourth exemplary variation illustrated in  FIGS. 9 to 11 . The selection lever  41 A is placed at a portion facing a first end of the housing  6  in the width direction of the housing  6  (the direction perpendicular to the drawing papers of  FIG. 9  and  FIG. 10 ) on the external surface of the housing  6 . The external surface of the housing  6  is provided with a concavity  47  in the present exemplary variation so that the selection lever  41 A can rotate around a rotation shaft R 1  in the concavity  47 . The selection lever  41 A can rotate between an OFF state position (the position illustrated in  FIG. 9 ) and an ON state position (the position illustrated in  FIG. 10 ). 
         [0110]    In the present exemplary variation, the selection lever  41 A is also placed nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B. Thus, the thumb F 1  can input operation with the selection lever  41 A (can rotate the selection button  41 A) while the grip  8  is grasped between the thumb F 1  and the palm P. The thumb F 1  switches the selection lever  41 A between the ON state and the OFF state. 
         [0111]    In the present exemplary variation, the external surface of the housing  6  is provided with engagement protrusions  48 A and  48 B in the concavity  47 . An engagement groove  49 , which can be engaged with the engagement protrusions  48 A and  48 B, is formed on the selection lever  41 A. The engagement of the engagement groove  49  with the engagement protrusion  48 A fixes the selection lever  41 A on the OFF state position with respect to the housing  6  so that the selection lever  41 A that is the selection member is maintained to be in the OFF state. In other words, the engagement protrusion  48 A and the engagement groove  49  work as a state maintenance mechanism that maintains the selection lever  41 A in the OFF state. The engagement of the engagement groove  49  with the engagement protrusion  48 B fixes the selection lever  41 A on the ON state position with respect to the housing  6  so that the selection lever  41 A that is the selection member is maintained to be in the ON state. In other words, the engagement protrusion  48 B and the engagement groove  49  work as a state maintenance mechanism that maintains the selection lever  41 A in the ON state. 
         [0112]    In a fifth exemplary variation illustrated in  FIGS. 12 to 14 , the external surface of the housing  6  is provided with a selection slider  41 B as the selection member. The selection slider  41 B is placed at a portion facing a side opposite to the side on which the force application unit  33  is placed with respect to the longitudinal axis C (the upper side of  FIG. 12 ) on the external surface of the housing  6 . In the present exemplary variation, the selection slider  41 B can move in the direction along the longitudinal axis C with respect to the housing  6 . Moving the selection slider  41 B switches the selection slider  41 B between the OFF state (the state illustrated in  FIG. 13 ) and the ON state (the state illustrated in  FIG. 14 ). 
         [0113]    In the present exemplary variation, the selection slider  41 B is placed nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B. Thus, the thumb F 1  can input operation with the selection slider  41 B (can move the selection slider  41 B) while the grip  8  is grasped between the thumb F 1  and the palm P. The thumb F 1  switches the selection slider  41 B between the ON state and the OFF state. 
         [0114]    In the present exemplary variation, the internal surface of the selection slider  41 B is provided with a groove  58  and a pressure unit  59 . As illustrated in  FIG. 13 , moving the selection slider  41 B to a position at which the switch  42  is inserted into the groove  58  prevents the selection slider  41 B from pressing the switch  42 . Thus, the switch  42  is maintained to be in an opening state and the selection slider  41 B is maintained to be in the OFF state. In other words, the groove  58  works as a state maintenance mechanism that maintains the selection slider  41 B in the OFF state. When the selection slider  41 B is moved to a position at which the pressure unit  59  presses the switch  42 , the pressure by the pressure unit  59  maintains the switch  42  in a closing state. This maintains the selection slider  41 B in the ON state. In other words, the pressure unit  59  works as a state maintenance mechanism that maintains the selection slider  41 B in the ON state. 
         [0115]    In the embodiments described above, the selection member ( 41 ,  41 A, or  41 B) is placed on the external surface of the housing  6 . However, the placement is not limited to the embodiments. For example, in a sixth exemplary variation illustrated in  FIG. 15 , the inside of the housing  6  is provided with a selection switch  41 C including a switch  42  as the selection member. In the present exemplary variation, the selection switch  41 C is placed nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B. In the present exemplary variation, the selection switch  41 C is placed on a position at which the handle  11  can press the selection switch  41 C so that the handle  11  opens or closes with respect to the housing  6 . This opening or closing varies the pressure from the handle  11  on the selection switch  41 C. The variation in the pressure from the handle  11  on the selection switch  41 C switches the selection switch  41 C between the ON state and the OFF state (in other words, the variation switches the operating states input with the selection switch  41 C). Note that switching the operating states input with the selection switch  41 C switches the switch  42  between the opening and closing states. 
         [0116]    For example, when the selection switch  41 C is a momentary one, closing the handle  11  with respect to the grip  8  causes the handle  11  to press the selection switch  41 C so that the selection switch  41 C is switched to the ON state. Opening the handle  11  with respect to the grip  8  prevents the handle  11  from having contact with the selection switch  41 C so that the selection switch  41 C is switched to in the OFF state. In the present exemplary variation, the control unit  26  also causes the medical treatment device  1  to function, for example, in one of the patterns X 1  to X 16 , Xa 1  to Xa 6 , Xa 9 , Xa 11  to Xc 11 , and Xa 12  to Xc 12  illustrated in  FIG. 5  in accordance with the operating state input with the selection switch  41 C. 
         [0117]    In the present exemplary variation, the selection switch (the selection member)  41 C is placed nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B in the housing  6 . Thus, opening or closing the handle  11  with respect to the housing  6  can vary the pressure from the handle  11  on the selection switch  41 C. In other words, in the present exemplary variation, opening or closing the handle  11  simultaneously switches the selection switch  41 C between the ON state and the OFF state. In the present exemplary variation, the housing  6  and the handle  11  are held as described in the first embodiment (see  FIG. 4 ). Thus, it is unnecessary in the present exemplary variation to change the positions and postures of the operator&#39;s index finger F 2 , middle finger F 3 , ring finger F 4 , and little finger F 5  and to hold the housing  6  and the handle  11  again with the operator&#39;s right hand H during the input of operation with the selection switch  41 C because opening or closing the handle  11  switches the operating states input with the selection switch  41 C. Thus, in the present exemplary variation, the operability for opening and closing the handle  11 , rotating the rotating knob  12 , inputting operation with the operation buttons  31 A and  31 B is secured and the operability for inputting operation with the selection switch  41 C is also secured. 
         [0118]    In a seventh exemplary variation illustrated in  FIGS. 16 and 17 , opening and closing the handle  11  with respect to the housing  6  varies the pressure from the handle  11  on the selection switch  41 C. The variation in pressure from the handle  11  on the selection switch  41 C switches the selection switch  41 C between the OFF state (the state illustrated in  FIG. 16 ) and the ON state (the state illustrated in  FIG. 17 ). 
         [0119]    In the present exemplary variation, a movable tube  71  extends along the longitudinal axis C in the housing body  7 . The movable tube  71  moves together with a movable pipe (not illustrated) along the longitudinal axis C in response to the opening or closing of the handle  11 . A ring-shaped sliding member  72  is placed on the outer peripheral surface of the movable tube  71 . The handle  11  is coupled with the sliding member  72  in the housing body  7 . The sliding member  72  can move along the longitudinal axis C with respect to the movable tube  71 . A tube-shaped elastic member (coil spring)  73  is also placed on the outer peripheral surface of the movable tube  71 . A first end (the head) of the elastic member  73  is connected to the movable tube  71  and a second end (the base) of the elastic member  73  is connected to the sliding member  72 . 
         [0120]    In the present exemplary variation, closing the handle  11  with respect to the grip  8  when the selection switch  41 C that is the selection member is in the OFF state moves the movable tube  71  and the movable pipe toward the head side so that the grasp units  16  and  17  are closed. Thus, the object to be treated is grasped between the grasp units  16  and  17  so that the object to be treated is compressed. When the object to be treated is compressed to some extent, the motion of the movable tube  71  and the movable pipe stops. Further closing the handle  11  from that state moves the sliding member  72  toward the head side with respect to the movable tube  71 . This causes the elastic member  73  to contract. This contraction of the elastic member  73  increases the holding force between the grasp units  16  and  17 . 
         [0121]    In the present exemplary variation, the elastic member  73  contracts by a predetermined contraction amount (a predetermined stroke) or more. This contraction causes the handle  11  to press the selection switch  41 C (the switch  42 ) and thus the selection switch  41 C is switched from the OFF state to the ON state. Thus, even when the handle  11  is closed, the selection switch  41 C is maintained to be in the OFF state unless the application of operation force in an amount more than or equal to a predetermined amount causes the elastic member  73  to contract by a predetermined contraction amount or more. Thus, in the present exemplary variation, the selection switch  41 C is switched to the ON state only when the object to be treated is grasped between the grasp units  16  and  17  and the force application unit  33  applies the operation force more than or equal to a predetermined amount of force and the handle  11  is closed. 
         [0122]    In an eighth exemplary variation illustrated in  FIGS. 18 and 19 , opening or closing the handle  11  with respect to the housing  6  varies the pressure from the handle  11  on the selection switch  41 C. The variation in pressure from the handle  11  on the selection switch  41 C switches the selection switch  41 C between the OFF state (the state illustrated in  FIG. 18 ) and the ON state (the state illustrated in  FIG. 19 ). In the present exemplary variation, the inside of the housing  6  is provided with a stopper  75 . The stopper  75  is fixed with respect to the housing  6 . 
         [0123]    In the present exemplary variation, closing the handle  11  with respect to the grip  8  when the selection switch  41 C that is the selection member is in the OFF state causes the handle  11  to have contact with the stopper  75 . Further closing the handle  11  from that state causes the handle  11  to warp on the contact position with the stopper  75  as a fulcrum. 
         [0124]    In the present exemplary variation, the handle  11  warps by a predetermined warping amount or more after the handle  11  comes into contact with the stopper  75 . This warping causes the handle  11  to press the selection switch  41 C (the switch  42 ), and thus switches the selection switch  41 C from the OFF state to the ON state. Thus, even when the handle  11  is closed, the selection switch  41 C is maintained to be in the OFF state unless the application of operation force in an amount more than or equal to a predetermined amount causes the handle  11  to warp by a predetermined warping amount or more. Thus, similarly to the seventh exemplary variation, the selection switch  41 C is switched to the ON state only when the object to be treated is grasped between the grasp units  16  and  17  and the force application unit  33  applies the operation force in an amount more than or equal to a predetermined amount and the handle  11  is closed in the present exemplary variation. 
         [0125]    In a ninth exemplary variation illustrated in  FIGS. 20 and 21 , opening or closing the handle  11  with respect to the housing  6  varies the pressure from the handle  11  on the selection switch  41 C. The variation in pressure from the handle  11  on the selection switch  41 C switches the selection switch  41 C between the OFF state (the state illustrated in  FIG. 20 ) and the ON state (the state illustrated in  FIG. 21 ). In the present exemplary variation, the inside of the housing  6  is provided with an elastic member  76 . The selection switch  41 C is attached on the elastic member  76 . 
         [0126]    In the present exemplary variation, closing the handle  11  with respect to the grip  8  when the selection switch  41 C that is the selection member is in the OFF state causes the handle  11  to have contact with the elastic member  76 . Further closing the handle  11  from that state causes the elastic member  76  to contract. 
         [0127]    In the present exemplary variation, when the elastic member  76  contracts by a predetermined contraction amount or more, this contraction causes the handle  11  to press the selection switch  41 C (the switch  42 ) and thus switches the selection switch  41 C from the OFF state to the ON state. Thus, even when the handle  11  is closed, the selection switch  41 C is maintained to be in the OFF state unless the application of operation force in an amount more than or equal to a predetermined amount causes the elastic member  76  to contract by a predetermined contraction amount or more. Thus, similarly to the seventh exemplary variation and the eighth exemplary variation, the selection switch  41 C is switched to the ON state only when the object to be treated is grasped between the grasp units  16  and  17  and the force application unit  33  applies the operation force in an amount more than or equal to a predetermined amount and the handle  11  is closed in the present exemplary variation. 
         [0128]    The tenth exemplary variation illustrated in  FIGS. 22 and 23  is provided with a selection button  41  and a selection switch  41 C as selection members. In the present exemplary variation, the selection button  41  is provided nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B. Thus, the thumb F 1  can input operation with the selection button  41  (can press the selection button  41 ) while the grip  8  is grasped between the thumb F 1  and the palm P. The thumb F 1  switches the selection button  41  between the ON state and the OFF state. In the present exemplary variation, the selection switch  41 C is provided nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B. Opening or closing the handle  11  with respect to the housing  6  varies the pressure from the handle  11  on the selection switch  41 C. The variation in pressure from the handle  11  to the selection switch  41 C switches the selection switch  41 C between the OFF state and the ON state. 
         [0129]      FIG. 23  is a diagram of the configuration to detect the operating state of each of the operation buttons  31 A and  31 B, the selection button  41 , and the selection switch  41 C in the present exemplary variation. In the present exemplary variation, the operating state input with the operation button corresponding to each of the switches  35 A and  35 B (the operation button  31 A or  31 B) is detected in accordance with whether each of the switches  35 A and  35 B opens or closes. Furthermore, the operating state input with the selection button  41  is detected in accordance with whether the switch  42 A opens or closes and the operating state input with the selection switch  41 C is detected in accordance with whether the switch  42 B placed on the selection switch  41 C opens or closes in the present exemplary variation. As illustrated in  FIG. 23 , in the present exemplary variation, the control unit  26  is connected to the switches  35 A,  35 B, and  42 A through the detection signal line  77 A. The control unit  26  is connected to the switch  35 A through the detection signal line  77 B, and connected to the switch  35 B through the detection signal line  77 B. The control unit  26  is also connected to the switch  42 B through the detection signal line  77 C. In the present exemplary variation, the switches  42 A and  42 B are electrically arranged in series each other. The detection signal lines  77 A to  77 D are a first detection signal line that transmits a detection signal (a first detection signal) indicating the operating state input with each of the operation buttons  31 A and  31 B to the control unit  26 , and are a second detection signal line that transmits a detection signal (a second detection signal) indicating the operating state input with each of the selection button  41  and the selection switch  41 C to the control unit  26 . 
         [0130]    In the present exemplary variation, when both the selection button  41  and the selection switch  41 C are in the ON states, both the switches  42 A and  42 B are closed so that the detection current flows through the detection signal lines  77 A and  77 D. The flow of the detection current through the detection signal lines  77 A and  77 D switches the mode from the mode in which both the selection buttons  41  and the selection switch  41 C in the OFF states. Thus, even when both the selection button  41  and the selection switch  41 C are in the OFF states and one of the selection button  41  and the selection switch  41 C is switched to the ON state (even when one of the switch  42 A and  42 B is closed), the detection current does not flow through the detection signal lines  77 A and  77 D and thus the mode is not switched. 
         [0131]    For example, in an exemplary embodiment, the mode is switched so that the medical treatment device  1  functions as the pattern X 16  illustrated in  FIG. 5  in accordance with the operating state input with each of the selection button  41  and the selection switch  41 C. In this example, when at least one of the selection button  41  and the selection switch  41 C is in the OFF state, the detection current does not flow through the detection signal lines  77 A and  77 D. Thus, the medical treatment device  1  operates in accordance with the operation input with the foot switch  34 . For example, even when closing the handle  11  switches the selection switch  41 C to the ON state, the medical treatment device  1  operates in accordance with the operation input with the foot switch  34  unless operation is simultaneously input with both the selection button  41  and the selection switch  41 C (unless both the selection button  41  and the selection switch  41 C are simultaneously pressed). Thus, even when the selection switch  41 C is switched to the ON state, the energy used for treatment (for example, high frequency energy or ultrasonic vibration) is not supplied to the end effector  18  in accordance with the operation input with the operation button ( 31 A or  31 B) unless both the selection button  41  and the selection switch  41 C are in the ON states. In the present exemplary variation, for example, when closing the handle  11  switches the selection switch  41 C to the ON state, and operation is simultaneously input with both the selection button  41  and the selection switch  41 C (both the selection button  41  and the selection switch  41 C are simultaneously pressed), the mode is switched to the mode in which the medical treatment device  1  operates in accordance with the operation input with the operation buttons  31 A and  31 B. 
         [0132]    In the embodiments and variations, the handle  11  is placed on the head side of the grip  8 . However, as an eleventh exemplary variation illustrated in  FIGS. 24 and 25 , the handle  11  can be placed on the base side of the grip  8 . In the present exemplary variation, the handle  11  also opens and closes in roughly parallel to the longitudinal axis C. The grip  8  includes a grip grasp unit (grip finger-put position)  51 . In the present exemplary variation, the operation buttons (the operation members)  31 A and  31 B are placed on the surface of the head  32  of the grip  8  and the operation buttons  31 A and  31 B are placed nearer to the longitudinal axis C than the grip grasp unit  51 . Thus, the operation buttons  31 A and  31 B are placed at a portion on the head side of the housing  6 . 
         [0133]    In the present exemplary variation, the grip grasp unit  51  of the grip  8  is provided with a selection button (the selection member)  41 . In the present exemplary variation, the selection button  41  is exposed to the outside of the external surface of the housing  6 , and placed nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B. In the present exemplary variation, the control unit  26  causes the medical treatment device  1  to function, for example, in one of the patterns X 1  to X 16 , Xa 1  to Xa 6 , Xa 9 , Xa 11  to Xc 11 , and Xa 12  to Xc 12  illustrated in  FIG. 5  in accordance with the operating state input with the selection button  41 . 
         [0134]    As illustrated in  FIG. 25 , for example, in a state in which an operator holds the housing  6  and the handle  11  with the operator&#39;s right hand H, the operator&#39;s middle finger F 3 , ring finger F 4  and little finger F 5  are put on the grip grasp unit  51  so that the grip  8  of the housing  6  is held. Then, the thumb F 1  is put on the force application unit  33  of the handle  11  so that the thumb F 1  applies operation force on the handle  11  to close the handle  11  with respect to the grip  8 . The index finger F 2  performs the operation for rotating the rotating knob  12  and inputting operation with the operation buttons  31 A and  31 B (pressing the operation buttons  31 A and  31 B). 
         [0135]    In the present exemplary variation, the selection button (the selection member)  41  is placed nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B on the external surface of the housing  6 , and is positioned on the grip grasp unit  51 . This enables the operator to input operation with the selection button  41  (to press the selection button  41 ) using any one of the middle finger F 3 , ring finger F 4 , and little finger F 5  put on the grip grasp unit  51  of the grip  8 . The middle finger F 3 , ring finger F 4 , or little finger F 5  switches the selection button  41  between the ON state and the OFF state. Thus, the thumb F 1  and index finger F 2  used for at least one of the operations for opening or closing the handle  11 , for rotating the rotating knob  12 , and for inputting operation with the operation buttons  31 A and  31 B are not used for inputting operation with the selection button  41 . Thus, it is unnecessary to change the positions and postures of the thumb F 1  and index finger F 2  and to hold the housing  6  and the handle  11  again with the right hand H in order to switch the selection button  41  between the ON state and the OFF state. Thus, in the present exemplary variation, the operability for opening or closing the handle  11 , for rotating the rotating knob  12 , and for inputting operation with the operation buttons  31 A and  31 B is secured and the operability for inputting operation with the selection button  41  is also secured. 
         [0136]    In a twelfth exemplary variation illustrated in  FIG. 26 , the base side of the grip  8  is provided with the handle  11  and the base surface  52  of the grip  8  is provided with the selection switch  41 C (the switch  42 ). In the present exemplary variation, the selection switch  41 C is placed nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B. Then, the selection switch  41 C is exposed to the outside of the external surface of the housing  6 . In the present exemplary variation, the selection switch  41 C is placed at a position at which the handle  11  can press the selection switch  41 C so that opening or closing the handle  11  with respect to the housing  6  varies the pressure from the handle  11  on the selection switch  41 C. The variation in pressure from the handle  11  on the selection switch  41 C switches the selection switch  41 C between the ON state and the OFF state (in other words, the operating state input with the selection switch  41 C is switched). In the present exemplary variation, the control unit  26  causes the medical treatment device  1  to function, for example, in one of the patterns X 1  to X 16 , Xa 1  to Xa 6 , Xa 9 , Xa 11  to Xc 11 , and Xa 12  to Xc 12  illustrated in  FIG. 5  in accordance with the operating state input with the selection switch  41 C. 
         [0137]    In the present exemplary variation, the selection switch (the selection member)  41 C is placed nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B on the housing  6 , and placed on the base surface  52  of the grip  8 . Thus, opening or closing the handle  11  with respect to the housing  6  can vary the pressure from the handle  11  on the selection switch  41 C. In other words, in the present exemplary variation, opening or closing the handle  11  immediately switches the selection switch  41 C between the ON state and the OFF state. In the present exemplary variation, the housing  6  and the handle  11  are held as described in the eleventh exemplary variation (see  FIG. 25 ). Thus, it is unnecessary to change the positions and postures of the thumb F 1  and index finger F 2  and to hold the housing  6  and the handle  11  again with the right hand H in order to input operation with the selection switch  41 C because opening or closing the handle  11  immediately switches the selection switch  41 C between the ON state and the OFF state. Thus, in the present exemplary variation, the operability for opening and closing the handle  11 , for rotating the rotating knob  12 , and for inputting operation with the operation buttons  31 A and  31 B is secured and the operability for inputting operation with the selection switch  41 C is also secured. 
         [0138]    In the embodiments and variations, the handle  11  opens or closes in roughly parallel to the longitudinal axis C. For example, in a thirteenth exemplary variation as illustrated in  FIGS. 27 and 28 , the handle  11  can open or close in a direction crossing (roughly perpendicular to) the longitudinal axis C. In the present exemplary variation, the housing  6  includes a housing body  7  extending along the longitudinal axis C, and a grip  8  extending from the housing body  7  in a direction crossing the longitudinal axis C. The handle  11  is placed opposite to the grip  8  while the longitudinal axis C is centered. The grip  8  includes a grip grasp unit (the grip finger-put position)  55 , and an inclined surface  56  placed nearer to the head side of the grip  8  than the grip grasp unit  55 . The inclined surface  56  faces the head side of the grip  8 . In the present exemplary variation, the operation buttons (the operation members)  31 A and  31 B are provided on the inclined surface  56  of the grip  8 . The operation buttons  31 A and  31 B are placed nearer to the head side of the grip  8  than the grip grasp unit  55 . Thus, the operation buttons  31 A and  31 B are placed at a portion on the head side of the housing  6 . 
         [0139]    In the present exemplary variation, the grip grasp unit  55  of the grip  8  is provided with the selection button (the selection member)  41 . In the present exemplary variation, the selection button  41  is exposed to the outside of the external surface of the housing  6  and is placed nearer to the base side of the grip  8  than the operation buttons  31 A and  31 B. In the present exemplary variation, the control unit  26  causes the medical treatment device  1  to function, for example, in one of the patterns X 1  to X 16 , Xa 1  to Xa 6 , Xa 9 , Xa 11  to Xc 11 , and Xa 12  to Xc 12  illustrated in  FIG. 5  in accordance with the operating state input with the selection button  41 . 
         [0140]    As illustrated in  FIG. 28 , for example, in the state in which the right hand H holds the housing  6  and the handle  11 , the middle finger F 3 , ring finger F 4 , and little finger F 5  are put on the grip grasp unit  55  so that the grip  8  of the housing  6  are held. The thumb F 1  is put on the force application unit  33  of the handle  11  so that the thumb F 1  applies operation force on the handle  11  to close the handle  11  with respect to the grip  8 . The index finger F 2  performs the operation for rotating the rotating knob  12 , or inputting operation with the operation buttons  31 A or  31 B (pressing operation the operation buttons  31 A or  31 B). 
         [0141]    In the present exemplary variation, the selection button (the selection member)  41  is placed near to the base side of the housing  6  than the operation buttons  31 A and  31 B on the external surface of the housing  6 , and placed on the grip grasp unit  55 . This enables the operator to input operation with the selection button  41  (to press the selection button  41 ) using any one of the middle finger F 3 , ring finger F 4 , and little finger F 5  put on the grip grasp unit  55  of the grip  8 . The middle finger F 3 , ring finger F 4  and little finger F 5  switch the selection button  41  between the ON state and the OFF state. Thus, the thumb F 1  and index finger F 2  used for at least one of the operations for opening and closing the handle  11 , for rotating the rotating knob  12 , and for inputting operation with the operation buttons  31 A and  31 B are not used for inputting operation with the selection button  41 . Thus, it is unnecessary to change the positions and postures of the thumb F 1  and index finger F 2  and to hold the housing  6  and the handle  11  again with the right hand H in order to switch the selection button  41  between the ON state and OFF state in treatment. Thus, in the present exemplary variation, the operability for opening and closing the handle  11 , for rotating the rotating knob  12 , and for inputting operation with the operation buttons  31 A and  31 B is secured and the operability for inputting operation with the selection button  41  is also secured. 
         [0142]    In a fourteenth exemplary variation illustrated in  FIG. 29 , the handle  11  opens and closes in a direction crossing (roughly perpendicular to) the longitudinal axis C, and a portion  57  facing the handle  11  on the external surface of the housing  6  is provided with the selection switch  41 C (the switch  42 ). In the present exemplary variation, the selection switch  41 C is placed nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B (the inclined surface  56 ). The selection switch  41 C is exposed to the outside of the external surface of the housing  6 . In the present exemplary variation, the selection switch  41 C is placed at a position at which the handle  11  can press the selection switch  41 C so that opening or closing the handle  11  with respect to the housing  6  varies the pressure from the handle  11  on the selection switch  41 C. The variation in the pressure from the handle  11  on the selection switch  41 C switches the selection switch  41 C between the ON state and the OFF state (in other words, the variation switches the operating states input with the selection switch  41 C). In this exemplary variation, the control unit  26  causes the medical treatment device  1  to function, for example, in one of the patterns X 1  to X 16 , Xa 1  to Xa 6 , Xa 9 , Xa 11  to Xc 11 , and Xa 12  to Xc 12  illustrated in  FIG. 5  in accordance with the operating state on the selection switch  41 C. 
         [0143]    In the present exemplary variation, the selection switch (the selection member)  41 C is placed near to the base side of the housing  6  than the operation buttons  31 A and  31 B on the housing  6 , and placed at a portion  57  facing the handle  11  on the external surface of the housing  6 . Opening or closing the handle  11  with respect to the housing  6  can vary the pressure from the handle  11  on the selection switch  41 C. In other words, in the present exemplary variation, opening or closing the handle  11  immediately switches the selection switch  41 C between the ON state and the OFF state. In the present exemplary variation, the housing  6  and the handle are held as described in the thirteenth exemplary variation (see  FIG. 28 ). Thus, because opening or closing the handle  11  immediately switches the selection switch  41 C between the ON state and the OFF state in the present exemplary variation, it is unnecessary to change the positions and postures of the thumb F 1  and index finger F 2  and to hold the housing  6  and the handle  11  again with the right hand H in order to input operation with the selection switch  41 C. Accordingly, in the present exemplary variation, the operability for opening and closing the handle  11 , rotating the rotating knob  12 , and inputting the operation buttons  31 A and  31 B is secured and the operability for inputting operation with the selection switch  41 C is also secured. 
         [0144]    In a fifteenth exemplary variation illustrated in  FIGS. 30 to 31D , a lever  60  is rotatably attached to the housing  6 . Similarly to the first embodiment, the handle  11  is placed nearer to the head side of the housing  6  than the grip  8  in the present exemplary variation. The handle  11  moves in roughly parallel to the longitudinal axis C. Similarly to the first embodiment, the housing  6  is provided with the operation buttons (the operation members)  31 A and  31 B and the selection button (the selection member)  41 . In the present exemplary variation, the lever  60  rotates around a rotation axis R 2  that is roughly parallel to the width direction of the housing  6  (the direction perpendicular to the drawing paper of  FIG. 30 ). The lever  60  rotates between a position at which the lever  60  can press the operation button  31 A (the position indicated with a solid line in  FIG. 30 ) and a position at which the lever  60  can press the operation button  31 B (the position indicated in a dashed line in  FIG. 30 ). Note that the rotation axis R 2  of the lever  60  passes through a position nearer to the base side of the housing  6  than the operation buttons  31 A and  31 B and nearer to the head side of the housing  6  than the selection button  41 . 
         [0145]    The lever  60  includes a lever supporting shaft  61  through which the rotation axis R 2  passes, a first lever extension portion  62  extending from the lever supporting shaft  61  toward the head side of the housing  6  (the side on which the operation buttons  31 A and  31 B are positioned), and a second lever extension portion  63  extending from the lever supporting shaft  61  toward the base side of the housing  6  (the side on which the selection button  41  is positioned). In order to input operation with the operation button  31 A, rotating the lever  60  moves the first lever extension portion  62  to a position at which the first lever extension portion  62  can have contact with the operation button  31 A. Meanwhile, the second lever extension portion  63  is positioned at a position at which the second lever extension portion  63  can have contact with the selection button  41 . In order to input operation with the operation button  31 B, rotating the lever  60  moves the first lever extension portion  62  to a position at which the first lever extension portion  62  can have contact with the operation button  31 B. Meanwhile, the second lever extension portion  63  is positioned at a position at which the second lever extension portion  63  can have contact with the selection button  41 . 
         [0146]    As illustrated in  FIG. 31A , even when the lever  60  is positioned at a position at which the lever  60  can have contact with the operation button ( 31 A or  31 B) and the selection button  41 , the first lever extension portion  62  does not have contact with the operation button ( 31 A or  31 B) and the second lever extension portion  63  does not have contact with the selection button  41  unless an external force (the pressing force from the operator) acts on the lever  60 . Thus, in the state illustrated in FIG.  31 A, operation is not input with the operation button ( 31 A or  31 B) and the selection button  41 . For example, when the operation button ( 31 A or  31 B) and the selection button  41  are momentary ones, the operation button ( 31 A or  31 B) and the selection button  41  are in the OFF states. 
         [0147]    As illustrated in  FIG. 31B , when the lever  60  is positioned at a position in which the lever  60  can have contact with the operation button ( 31 A or  31 B) and the selection button  41  and an external force (the pressing force from the operator) acts on the first lever extension portion  62  (the arrow τ 1  in  FIG. 31B ), the first lever extension portion  62  has contact with the operation button ( 31 A or  31 B). Meanwhile, the second lever extension portion  63  does not have contact with the selection button  41 . Thus, in the state illustrated in  FIG. 31B , operation is input with the operation button ( 31 A or  31 B) while operation is not input with the selection button  41 . Thus, for example, when the operation button ( 31 A or  31 B) and the selection button  41  are momentary ones, the operation button ( 31 A or  31 B) is in the ON state and the selection button  41  is in the OFF state. 
         [0148]    On the other hand, when an external force (the pressing force from the operator) acts on the second lever extension portion  63  (the arrow τ 2  in  FIG. 31C ) in a state in which the lever  60  is positioned at a position in which the lever  60  can have contact with the operation button ( 31 A or  31 B) and the selection button  41  as illustrated in  FIG. 31C , the second lever extension portion  63  has contact with the selection button  41 . Meanwhile, the first lever extension portion  62  does not have contact with the operation button ( 31 A or  31 B). Thus, in the state as illustrated in  FIG. 31C , operation is input with the selection button  41  and operation is not input with the operation button ( 31 A or  31 B). Thus, for example, when the operation button ( 31 A or  31 B) and the selection button  41  are momentary ones, the selection button  41  is in the ON state and the operation button selection button  41  is in the OFF state. 
         [0149]    When an external force (the pressing force from the operator) acts on the lever supporting shaft  61  (the arrow T 3  in  FIG. 31D ) in a state in which the lever  60  is positioned at a position at which the lever  60  can have contact with the operation button ( 31 A or  31 B) and the selection button  41  as illustrated in  FIG. 31D , the first lever extension portion  62  has contact with the operation button ( 31 A or  31 B) and the second lever extension portion  63  has contact with the selection button  41 . Thus, in the state illustrated in  FIG. 31D , operation is input with the operation button ( 31 A or  31 B) and operation is input with the selection button  31 . Thus, for example, when the operation button ( 31 A or  31 B) and the selection button  41  are momentary ones, the operation button ( 31 A or  31 B) and the selection button  41  are in the ON states. 
         [0150]    As described above, in the present exemplary variation, the provision of the lever  60  can makes it easy to simultaneously input operation with both the operation button ( 31 A or  31 B) and the selection button  41 . 
         [0151]    An indicator (not illustrated) that indicates to the operator whether the selection member ( 41 ,  41 A,  41 B, or  41 C) is in the ON state or the OFF state can be provided in an exemplary variation. The indicator can be provided on the medical treatment tool  2  (for example, on the housing  6 ) or on the control device  3 . Alternatively, the indicator can be provided separately from the medical treatment tool  2  and the control device  3 . The operation of the indicator is controlled, for example, by the control unit  26 . 
         [0152]    In an embodiment, the indicator is a light generation member such as an LED that generates light when the selection member ( 41 ,  41 A,  41 B, or  41 C) in one of the ON state or the OFF state. In another exemplary embodiment, the indicator is, for example, a protrusion or lever provided on the housing. In this example, the switching of the selection member ( 41 ,  41 A,  41 B, or  41 C) between the ON state and the OFF state varies the protrusion amount of the protrusion or the orientation of the lever. In other words, the shape of the indicator varies. In another exemplary embodiment, a member that changes, for example, the texture when the selection member ( 41 ,  41 A,  41 B, or  41 C) is clicked, the stroke when the selection member ( 41 ,  41 A,  41 B, or  41 C) is switched, or the amount of force necessary to switch the selection member ( 41 ,  41 A,  41 B, or  41 C) is provided as the indicator. In this example, the switching of the selection member ( 41 ,  41 A,  41 B, or  41 C) between the ON state and the OFF state varies the texture, stroke, or the amount of force. 
         [0153]    In the embodiments and variations, the medical treatment device ( 1 ) is provided with the housing ( 6 ) that includes the base and head and includes the housing body ( 7 ) extending along the longitudinal axis (C), the handle ( 11 ) capable of opening and closing with respect to the housing ( 6 ), the end effector ( 18 ) placed nearer to the head side of the medical treatment device ( 1 ) than the housing ( 6 ) and used to treat an object to be treated. A portion on the head side of the housing ( 6 ) is provided with the operation member ( 31 A or  31 B), a portion nearer to the base side of the housing ( 6 ) than the operation member ( 31 A or  31 B) is provided with the selection member ( 41 ,  41 A,  41 B,  41 C, or  41  and  41 C). Operation for causing the medical treatment device ( 1 ) to function is input with the operation member ( 31 A or  31 B). The operating state input with selection member ( 41 ,  41 A,  41 B,  41 C, or  41  and  41 C) is switched. The control unit ( 26 ) can cause the medical treatment device ( 1 ) to function in a plurality of modes and the control unit ( 26 ) detects the operating state input with the selection member ( 41 ,  41 A,  41 B,  41 C, or  41  and  41 C). Then, the control unit ( 26 ) selects a mode in which the medical treatment device ( 1 ) functions from the modes in accordance with the result of detection of the operating state input with the selection member ( 41 ,  41 A,  41 B,  41 C, or  41  and  41 C). The configurations of the embodiments and variations can properly be changed or partially combined as long as the configuration includes the components described above. 
         [0154]    The embodiments and variations of the present invention have been described above. Needless to say, the present invention is not limited to the embodiments and variations and can variously be changed without departing from the scope of the invention.