JP2005193061A - Endoscopic biopsy forceps device with selective bipolar cauter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscopic biopsy forceps device equipped with a pair of jaw parts as bipolar electrodes. <P>SOLUTION: An endoscopic bipolar cautery biopsy forceps device has a conduit, a pair of opposed jaws disposed in a hinge type and located at the distal end of the conduit. The jaw part has a proximal end part with a conductive part and a distal end part with conductivity. The conductive parts of the proximal end part and the distal end part of each special jaw part are electrically and mutually connected. The conductive parts of opposed jaw parts are mutually insulated when the opposed jaw parts are in an open position. The conductive parts have a pair of conductive pull wires respectively with the proximal end and the distal end. The pull wires are extended through the conduit and mutually insulated in the conduit. The distal ends of the pull wires are mechanically and electrically connected. The proximal ends of the pull wires are connectable with an electric cautery supply source. The endoscopic biopsy forceps device is located at the proximal end of the conduit and connected to the pull wires to operate the pull wires to mutually open/close the jaw parts. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to an endoscopic biopsy forceps medical device. More particularly, the present invention relates to an endoscopic biopsy forceps device having bipolar cautery capability.

  No. 07 / 837,046, filed on Feb. 18, 1992 (filed May 10, 1990, now published as US Pat. No. 5,133,727). Serial application No. 07 / 521,766), serial application No. 07 / 865,913 filed on April 9, 1992, and serial application filed on October 9, 1992. Application No. 07 / 959,247, a continuation-in-part application, all of which are incorporated herein by reference in their entirety.

  Many different types of endoscopic biopsy forceps devices are commonly used. Typically, these devices have a complex structure, require the manufacture and machining of precision small parts and are therefore generally very expensive. Such devices often include opposing jaws to grasp and tear tissue for biopsy. An example of one early endoscopic biopsy forceps instrument is shown in Schmidt US Pat. No. 3,895,636 (1975), which engages a sharp trocar and hub. A pair of cup-shaped jaws with an annular rim is disclosed. However, Schmidt's device does not disclose the ability to perform a cautery operation. On the other hand, recently, US Pat. No. 4,763,668 by Macek et al., 4,721,116 by Sintogen et al., 4,815,476 by Crothic, 4,817,630 by Sintogen et al., Neilman Numerous improvements have been made to endoscopic biopsy forceps instruments, such as disclosed in US Pat. No. 4,880,015, Esser et al. Does not disclose a device with ablation ability.

  Clearly, when traumatic procedures such as taking biopsy material are performed, the ability to perform endoscopic cauterization procedures to stop bleeding is desired. Both monopolar and bipolar endoscopic ablation devices are known (such as those disclosed in U.S. Pat. No. 4,418,692 by Guei), but bipolar ablation due to low trauma to the patient Is preferred. In a bipolar ablation instrument, the current path passes from one electrode through the tissue to be ablated and then through the other electrode and exits the instrument. Thus, only the tissue between the two electrodes is cauterized. On the other hand, in a unipolar device, the patient effectively becomes the second electrode, and the current must be dissipated through the patient. Thus, the control of the ablation position becomes inaccurate and the tissue surrounding the tissue to be ablated also undergoes different degrees of ablation.

  In US Pat. No. 4,763,660 to Jaeger, a bipolar endoscopic microelectrocautery device is shown. Jaeger's device also discloses a device for obtaining biopsy material. However, the device disclosed in Jaeger requires a number of different single function “instrument heads” and is always the only one of the instrument heads to perform a specific function such as grasping, excision, or cauterization. Only one is attached to the appliance. Thus, the biopsy forceps “head” does not have the ability to cauterize, while the cautery “head” does not have the ability to obtain biopsy material. Even with these devices, the surgeon cannot cauterize the biopsy site at the same time that the biopsy material is collected.

  Therefore, an object of the present invention is to provide an endoscopic biopsy forceps having a pair of jaws that function as bipolar electrodes.

  It is also an object of the present invention to provide an endoscopic biopsy forceps in which only a selected portion of the biopsy jaw surface is conductive.

  Another object of the present invention is that the jaw of the biopsy forceps can be operated by a pair of pull wires included in the coil shaft, and the pull wire also has a function of making an electrical connection to the jaw. Another object of the present invention is to provide an endoscopic biopsy forceps capable of bipolar cauterization.

  A further object of the present invention is a method of manufacturing a biopsy forceps jaw capable of cauterization and assembling the jaw on a clevis so that only a portion of the jaw is conductive. It is to provide a manufacturing and assembly method.

  Yet another object of the present invention is to provide an endoscopic biopsy forceps mechanism capable of bipolar cauterization that facilitates the connection between the endoscopic device and a power source.

  For these purposes described in detail below, the bipolar ablation biopsy forceps of the present invention generally comprises: a conduit; pivotally mounted on the distal end of the conduit, and a conductive distal portion; A pair of jaws with a conductive proximal portion, said jaws being electrically isolated from each other when relatively open; a portion extending through a conduit A pair of electrically conductive pulling wires that are electrically and mechanically in contact with the jaw at its conductive proximal end; and coupled to the puller wire to open and close the jaw Energizing means for doing this. Typically, the proximal end of the conductive puller wire is not insulated and terminates with a contact or coupling means that couples with the electrocautery power source. The electrocautery power source can be activated by stepping or manually, and / or the bipolar cautery biopsy forceps may include an electrical switch for activating the ablation function.

  The jaws of the bipolar cautery biopsy forceps preferably include a proximal conductive non-insulating tongue, a distal conductive cutting surface, and a proximal tongue and a distal cutting surface to which the distal end of the pull wire is coupled The jaw part pivots around this pivot point and opens and closes. In the open position, the jaws are insulated from one another. A clevis, which is insulated from the jaw, is preferably placed at the distal end of the conduit to provide an insulating pivot pin with which the jaw pivots. The cutting surface at the distal end of the jaw preferably includes metal cutting teeth. Some or all of the teeth may be insulated, but at least a portion of one tooth of each jaw is not insulated, providing a bipolar electrode.

  Several different jaw embodiments are provided. According to one embodiment, the jaws are formed via a cast-out precision casting or MIM (metal injection molding) and then coated with an insulating polymer or ceramic material. Alternatively, the jaws are formed by insert molding metal teeth and tongue elements formed by casting, stamping, photochemical processing or photochemical machining (PCM) into a non-conductive polymer material. . A third embodiment of the jaw includes molding the jaw from ceramic (CIM) and selectively plating the tooth and tongue areas with a suitable metal (eg, gold).

  In a preferred aspect of the invention: an insulating composite sleeve-washer for insulating the jaw and clevis pin from each other, or an integrated insulating clevis pin-washer for insulating the jaw; forming the conduit as a flexible coil; Placing the jaws on a clevis connected to the distal end of the flexible coil; forming the proximal end of each jaw as a tongue, and pulling the pull wire by Z-bending in the wire; Coupling to the tongue; and securing the handle to the proximal end of the main coil. The handle includes a central grooving shaft, and a removable spool is disposed around the shaft. In this preferred embodiment, when the spool is moved proximally with respect to the central shaft, the pull wire is pulled and the tongue at the proximal end of the jaw pivots, thereby closing the jaw. As the spool is moved distally with respect to the central shaft, the puller wire is compressed, thus moving the tongue and thereby opening the jaws.

  In another aspect of the invention: one or more cross blocks are attached and the cross blocks are engaged in slots across the proximal end of the spool; the proximal end of the pull wire is coupled to the cross block And providing a connection in the spool for electrocautery power.

  Additional objects and advantages of the present invention will become apparent to those skilled in the art upon reference to the detailed description taken in conjunction with the provided drawings.

  Referring to the drawings in detail, and in particular to FIGS. 1 and 2, a biopsy forceps assembly 10 is shown, which includes a distal end 12 with a jaw assembly 14 and a handle for operating the assembly. 17, a spool 19, and a proximal end 16 with a thumb ring 21. The handle 17 is provided with a longitudinal slot 112 that communicates with the axial bore 92. Crossing block 110 (or other pull wire retaining means) is slidable within slot 112 and is carried in diametrical slot 116 at the proximal end of spool 19. The intersection block 110 is coupled to the pull wire 60 as will be described in more detail below with reference to FIGS. 5-1A and FIGS. 5-2A to 5-4A. The pull wire extends through the axial hole 92 into the main coil 50, and both the main coil 50 and the pull wire 60 extend to the distal end 12 of the biopsy forceps 10.

  The jaw assembly 14 includes a pair of jaws 18, preferably each of which is a duplicate of the other. Each jaw 18 is a generally elongated, somewhat hemispherical structure, as shown in FIGS. 2, 3c, 3e, and 6, and has a distal end and a proximal end. On the distal end of each jaw 18, there is a row of teeth 20 oriented generally radially about point R as shown in FIG. 3c. Each jaw 18 has a generally longitudinal centerline, as shown in FIGS. 3c and 3e. The teeth 20 on one side of the longitudinal centerline of each jaw 18 are offset by a half pitch from the corresponding teeth 20 on the other side of the longitudinal centerline. The teeth on one side of the jaw 18 are offset by a half pitch with respect to the corresponding teeth on the other longitudinal side of the jaw 18 so that the upper and lower jaws of the jaw assembly 14 The same template can be used for both. As best shown in FIGS. 3c and 6, the teeth 20 are arranged radially, so that when the jaws are closed together, the jaws 18 automatically mesh and the teeth 20 are Can be properly aligned.

  2 and 3a-3e, the proximal end of each jaw 18 includes a tongue 24 having a generally semicircular recess 26 on the outer surface. A hole 30 extends laterally through the middle section of the jaw 18 between the distal and proximal ends of each jaw 18 and a clevis pin 28 extends through the hole 30 in each jaw 18. Each jaw 18 has an annular boss 33 disposed around the outer surface of the hole 30 as shown in FIGS. 3c and 3e. The boss 33 acts as a bearing surface and reduces the friction typically found in prior art endoscopic biopsy forceps devices. The clevis pin 28 (FIG. 3b) is received in the hole 32 of the clevis 34, as shown in FIG. 3a. The clevis 34 extends proximally into the hub 40 and includes an inner thread 35 for receiving the main tubular coil 50, as shown in FIG. As described in more detail below, the selectively conductive jaws 18 are integrated non-conductive combination washers that are insulated from each other and are preferably about 0.005 to 0.015 inch thick polymer. / Also insulated from the stainless steel clevis 28 by the sleeve 29 (FIG. 3d). The washer / sleeve 29 has a washer portion 129 and a sleeve portion 229. The washer portion 129 prevents the proximal portion of the jaw portion 18 and the opposing surfaces of the pivot portion from contacting each other, and the sleeve portion 229 prevents the conductive clevis pin from being electrically connected to the jaw portion 18. It will be appreciated that the clevis 34 is preferably non-conductive. A preferred material for forming clevis is the VECTRA polymer available from Hoechst-Celanese or equivalent. The clevis pin 28 (FIG. 3b) may be made of a polymer, in which case the washer / sleeve 29 need only have a washer portion 129.

  In a preferred embodiment of the invention, the main coil 50 comprises a stainless steel rod having a diameter of about 0.021 inches, which is tightly wound and has a main coil having an outer diameter of about 0.09 inches and a length of about 7 feet. Is formed in advance. As shown in FIG. 2, at least a portion of the coil 50 and a portion of the clevis hub 40 are covered by a reinforcing mechanism 300. Although the coil is reinforced more than when it is not covered, the shrinkable covering material is lubricious and smooth, so that it is possible to avoid damage to the endoscope in which the biopsy forceps device is inserted. A polyethylene (PE) sheath 54 also extends approximately the entire length of the interior of the coil 50, as shown in FIGS. The pull wire 60 extends through the sheath 54, which acts as a bearing between the pull wire 60 and the lumen of the main coil 50.

  The distal end of each puller wire 60 has a non-insulating Z-shaped bend. The Z-shaped bend of each puller wire 60 extends into a recess 66 in the tongue 24 of each cutter jaw 18 in a hole 66 near the proximal end of the tongue 24, as best shown in FIGS. 2 and 3c. By extending through, it has a portion 62 that is pivotally arranged. Each puller wire 60 has a bend 70 that extends between its distal end and the distal end of the main coil 50, as shown in FIG. Anti-bend 70 assists in opening cutter jaw 18 as spool 19 on handle 17 is moved distally. The remaining portion of each puller wire is covered with an insulating sheath 61 to its proximal end as will be described in more detail below.

  With reference to FIGS. 1 and 4, the crimp ferrule 102 is shown extending outwardly from within the axial bore 92 of the handle, and the crimp ferrule 102 extends slightly distally from the distal end of the handle 17. The crimp ferrule 102 is fixed to the inner wall of the hole 92 by a barb 104. The crimp ferrule is disposed around the main coil 50, and the coil 50 is fixed in the crimp ferrule 102 by one or more crimps 106. A strain relief sheath (not shown) surrounds the distal end of the handle and the proximal end of the coil and limits the twisting and movement of the main coil 50 relative to the hole 92 while the coil 50 at the distal end of the handle 17. Prevents refracting at an acute angle.

  With reference to FIGS. 1, 5-1A and 5-1B, the proximal end of pull wire 60 extends through the proximal end of main coil 50 and metal anti-twist tube 109 (FIGS. 5-4B); Locked within the non-conductive T-block 110 carried by the spool 19 within the slot 116 as shown in FIG. In this embodiment, the anti-twist tube 109 of the puller wire 60 is bent at 71 as shown to form a Y-shape, and the puller wire proximal electrical connection 64 is the securing screw 114 and button screw 214. Made by. The fixing screw 114 fixes the proximal electrical connection 64 of the pull wire 60 to the T-shaped block 110, and the button screw 214 is used to fix the conductor connection 39, which is connected to the power supply 39. Connect to a wire 39a extending from 100 (FIG. 1) to the button screw 214. Typically, as shown in FIG. 5B, the conductor connecting portion 39 is positioned between the button screw 214 and the T-shaped block 110, and an electrical connection is established between the conductor and the T-shaped block. The button screw is tightened to result. The non-conductive T-shaped block 110 passes through a slot 112 in the handle 17 that communicates with the axial bore 92 (FIG. 1) and is held in place. The proximal end 64 of the puller wire 60 is not insulated and passes through the T block 110. The pull wire 60 is fixed to the T-shaped block 110 by a fixing screw 114. Movement of the spool 19 disposed around the central shaft of the handle 17 initiates movement of the puller wire 60 disposed within the main coil, the distal end of the puller wire 60 being shown in FIGS. Is attached to the tongue 24 on the cutter jaw 18.

  As described above, the pull wire is electrically conductive and has its entire length except for the distal Z-shaped bend connection 62 connected to the tongue 24 of the jaw 18 and its proximal connection connected at 64 to the power source. Insulated across. Thus, the pull wire 60 is separated at the T-block 110 and secured by a separate securing screw 114 as shown in FIG. 5A, where it is electrically connected to a contact (described in detail below) 100. An insulating cover (not shown) is provided in the recess 119 of the spool 19. The power supply 100 can be operated by hand or foot and, if desired, an electrical switch (not shown) may be provided on the spool to provide additional control.

  5-2A and 5-2B show another form of the T-shaped block 110. FIG. As shown in FIGS. 5-2A and 5-2B, in particular, the puller wire 60 is bent at 71 and within an ABS or other plastic sheath 209 as described below with reference to FIGS. 5-4A. Insert molding. The sheath 209 is provided with a flare 113a or 113b, and this flare engages with the gap 111a or 111b between the pair of T-shaped blocks 110a or 110b. As shown in FIGS. 5-2A and 5-2B, respectively, the flare may be stepped (113a) or inclined (113b). As shown in FIG. 5A, electrical contact is made by a fixing screw.

  Yet another embodiment of a pull wire retention or engagement mechanism is shown in FIGS. 5-2C and 5-2D. Here, the pull wire engaging mechanism 110c includes a pair of conductive plates that are substantially parallel and spaced apart from each other. This plate is provided with a hole 107 for receiving the non-insulated proximal end 64 of the puller wire 60. In this embodiment, the non-insulated end 64 of the puller wire 60 is provided with a Z-shaped bend similar to the distal end. The Z-shaped bend engages the hole 107 in the plate 110c at 64 as shown in FIG. 5-2C. As shown in FIG. 5-2D, the substantially parallel conductive plates 1110c are supported by the recesses in the spool and terminate on the spool 19 side by an electrical socket 139 for receiving the blade 239 of the male cautery plug. The plate may also terminate with a male prong for connection to a female cautery plug. For example, as shown in FIG. 5E, the prong 339 is placed in the spool 19. Electrical contact between the prong 339 and the metal plate 110d is provided by deflecting the bent end 348 of the metal plate 110d relative to a ball contact 349 integral with the prong 339. A collar 359 integral with the spool 19 surrounds the prong 339 and assists in fixing the female cautery plug 101 connected to the power source 100 to the spool 19.

  Instead of the T-shaped block or metal plate embodiment of FIGS. 5-1A and FIGS. 5-2A-5-2E, the non-conductive cross block 120 shown in FIG. Used for. Non-conductive cross block 120 passes through slot 112 of handle 17 that communicates with axial bore 92 (FIG. 1). The proximal end 64 of the puller wire 60 is not insulated and passes through the cross block 120. The pull wire 60 is fixed in the cross block 120 by a fixing screw 114. At both ends of the cross block 120, electrical contact is made by a fixing screw 114 screwed into a metal anchor block 114 a located in the spool 19. An insulating cover (not shown) is provided in the recess 119 in the spool 19.

  Instead of the fixation screw 114 and anchor block 114a, a fixture 210 is used to secure and electrically connect the pull wire 60, as shown in FIG. 5-3B. In this embodiment, pull wire 60 and anti-twist tube 109 are corrugated by mold 310 as shown in FIGS. 5-4A. The crimp tube 109 with the pull wire 60 is then fitted into the corresponding recess 210 of the spool 19.

  It will be appreciated that some means must be provided to accept the ablation wire regardless of the particular pull wire retention mechanism used. Thus, the wire may be soldered or otherwise connected to a bipolar cautery forceps instrument, and a plug or receptacle for the corresponding plug or receptacle on the instrument may be provided at the end of the wire. .

  FIG. 5-4B shows the arrangement of inner and outer sheaths that protect and insulate the puller wire 60. As described above, a metal anti-twist tube 109 is preferably used around the insulator 61 of the pull wire 60 to prevent the pull wire 60 from twisting. An insulating sheath 208 is preferably disposed around one anti-twist tube 109 of the pull wire 60 to prevent the metal anti-twist tube 109 from contacting. Both the inner sheath 208 and the other anti-twisted tube 109 of the other puller wire 60 are preferably coated with an outer sheath 209 that holds the tube 109 in close proximity so that it can be easily passed through the instrument.

  While the apparatus described above with reference to FIGS. 1-5-4A provides a bipolar cautery biopsy forceps device that can be used to perform a biopsy and also perform a cautery operation, It will be appreciated that the entire surface of jaw 18 forms an electrode. However, in many applications it is desirable to control a specific ablation point, so such large electrodes are not desirable.

  Referring to FIG. 6, a jaw 18 having a limited or selective conductive (electrode) surface is shown. The jaw 18 is preferably cast from a conductive metal and then the jaw is made of an emergency such as PARYLENE made by Union Carbide, as described in the parent application US patent application Ser. No. 07 / 837,046. By coating with a thin highly insulating polymer. Preferably, PARYLENE is uniformly applied to the jaw surface by rolling or other method under vacuum at room temperature. The proximal portion of jaw 18 must be in contact with the non-insulated distal portion of pull wire 60 and at least a portion of the distal portion of the jaw must be uninsulated to act as an electrode. As such, the connection 66 of the tooth 20 and tongue 24 is preferably masked prior to coating so that the conductivity of these surfaces is maintained. Alternatively, if the tooth and tongue are not masked, after applying the polymer coating, it is removed from the connection 66 of the tooth 20 and tongue 24 by turning, grit blasting, or other methods. It will be appreciated that instead of removing the polymer from connection 66, a hole 66 may be drilled after coating to provide a non-insulating surface. It will also be appreciated that in this embodiment of the jaw, the insulating washer / sleeve 29 is not absolutely necessary since the clevis hole is covered with an insulator. However, it is still preferred to use an insulating washer / sleeve to prevent current from flowing through the intimately insulating portion of the jaw. Furthermore, it is desirable to use the sleeve 29 because the coating gradually wears from the inner diameter of the hole 30.

  Another mechanism for creating a selectively conductive jaw is shown in FIG. Here, the jaw 18 is formed by injection molding a ceramic 218 such as alumina or zirconia. Thereafter, conductive plating traces 318 are provided on the formed jaws, and the traces are provided on the ceramic surface or in the ceramic, as well as on the teeth 20 and the pull wire connection 66. In this way, the tooth portion 20 is electrically connected to the pull wire connecting portion 66. The plating can be applied by sputtering or other suitable method.

  Yet another mechanism for constructing a selectively conductive jaw is shown in FIGS. 8a-8c. Here, the conductive skeleton 418 of the jaw is formed by casting, punching, or photochemical cutting or turning, and the skeleton 418 is preferably provided with a staking hole 419. The scaffold is then used as a fill in an insert injection mold filled with plastic 518. While in the mold, the plastic flows through the staking holes 419 and mechanically secures the conductive framework 418. This mold is designed so that at least the conductive teeth 20 are exposed and the rest of the skeleton 418 is covered in plastic 518. As indicated by the phantom line (PP) in FIG. 8a, if desired, the pull wire connection region 66 of the skeleton 418 is also exposed during insert molding to ensure electrical contact with the pull wire. Therefore, it is not necessary to drill holes 66. It is also understood that because of the way the jaws are formed, the plastic 518 may completely cover some of the teeth, or may cover some or all of the teeth. .

  9-1A, 9-1B, 9-2A, and 9-2B illustrate another embodiment of a jaw 918 according to another feature of the present invention. These jaws are similar to the jaws 18 shown in FIGS. 2, 3 c, and 3 e, and each jaw is pulled through a clevis pin hole 930, a tongue 924, and a pull wire hole 966 with an annular boss 933. A recess 926 is provided for receiving a wire (not shown). However, unlike the jaw portion 18 described above, the jaw portion 918 is provided with a tooth portion 920 that extends over the entire circumference of the jaw portion. As best shown in FIG. 9-1B, the teeth 920 are arranged in a distal row 921, a proximal row 922, and two side rows 923. The proximal row and the distal row are oriented radially about points e1 and e2 that are located somewhat proximal and somewhat distal to the center point R on the center line CL, respectively. The straight side row 923 is arranged to connect the proximal curve row and the distal curve row. The tooth part 920 is shifted by a half pitch with respect to the center line, like the tooth part 20 of the jaw part 18.

  FIG. 9-2C shows yet another embodiment of the jaw 918a. This jaw is the same as the above-described jaw 918 except for the tongue 924. In this embodiment, the tongue 924 includes a lateral extension 924a across the center line CL. The lateral extension 924 a is provided with an internal recess 926 a that communicates with the recess 926 through the pull wire hole 966. It will be noted that the recess 926a is slightly offset from the recess 926. Due to this offset, the Z-shaped bent portion of the pulling wire 60 is better accommodated. However, it should be noted that in the arrangement of FIGS. 9-2C, the jaws of the biopsy forceps device cannot be identical. Additional details of similar tongue placement can be obtained by reference to co-pending US patent application Ser. No. 07 / 680,392, which is incorporated herein by reference.

  10A, 10B, and 10C show another embodiment of the insulating washer / sleeve and clevis pin described above with reference to FIGS. 3b and 3d. In this embodiment of FIGS. 10A, 10B, and 10 C, the washer, sleeve, and clevis pin are a single non-conductive unit 929. The non-conductive unit 929 includes a substantially flat washer portion 912 positioned between the jaw portions 18 (or 918), a substantially cylindrical (solid) sleeve portion 932 positioned in the hole 30 (or 930), And a generally cylindrical (solid) clevis pin portion 922 that engages with the hole 32 of the clevis 34 (FIG. 3a). Forming the sleeve, the washer and clevis pin as a single unit 929 has the advantage of preventing fluids and other biological materials from entering the gap between the jaws. Further, since the clevis pin cannot be removed from the clevis, the structure is more reliable. To assemble the jaw and clevis using this embodiment, the non-conductive clevis 34 (FIG. 3a) has its arms 34a, 34b widened and the jaw with the non-conductive clevis pin / washer / sleeve unit 929. It must be flexible enough to be inserted between them. The clevis 34 is sufficiently elastic so that after the jaw and washer / sleeve / clevis pin 929 are aligned between the arms 34a, 34b, the arm grips the clevis pin of the unit within the hole 32 in the clevis arm. Must have. Although the non-conductive unit 929 need not have a stepped sleeve portion 932, it should be understood that such a step is desirable in order to provide a bearing or stop surface for the clevis. Thus, several embodiments of bipolar cautery biopsy forceps have been described and illustrated. Although specific embodiments of the invention have been described, the invention is not limited to these and is to be understood as broadly as permitted by the art and the specification should be read as such. is there. Thus, although specific shapes of handles and spools have been disclosed, it is understood that other shapes can be used without sacrificing the selective bipolar cautery feature of the present invention. In practice, the various features of the described embodiments may be mixed and combined to achieve the desired result. Other handle configurations can also be used as long as the puller wire is moved relative to the coil and an electrical connection for the puller wire is provided. Also, while specific shapes have been disclosed for the selectively conductive surfaces of the jaws, it is understood that other shapes can be used as well. Furthermore, while several embodiments of electrical contact to a power source have been shown, it will be apparent to those skilled in the art that other types of electrical connections can be adapted for use in the present invention. Further, although a main coil is shown, the main coil need not be a coil, and may be any other type of flexible or rigid conductor that meets the requirements of the present invention. Accordingly, one of ordinary skill in the art appreciates that other modifications can be made to the provided invention without departing from the spirit and scope of the claims.

FIG. 1 is a partial cross-sectional side elevational view of the bipolar cautery biopsy forceps assembly of the present invention. FIG. 2 is an enlarged side elevation view of the distal end of the selective bipolar cautery biopsy forceps instrument of FIG. 3a is an enlarged top plan view of the clevis of FIG. 3b is an enlarged top plan view of the clevis pin of FIG. 3c is an enlarged top plan view of the lower jaw of FIG. 3d is an enlarged top plan view of the insulating sleeve and washer of FIG. 3e is an enlarged top plan view of the upper jaw of FIG. 4 is a cross-sectional view showing the coupling of the coil to the handle of the bipolar cautery biopsy forceps instrument of FIG. 5A is a cross-sectional view of the spool of FIG. 1 used in the T-shaped pull wire support block of the first embodiment of the present invention. FIG. 5-1B is a partial cross-sectional top view of the spool of FIG. 5-1A. FIG. 5-2A is a cross-sectional view of the T-shaped pull wire support block of the second embodiment. FIG. 5-2B is a diagram of a third embodiment of the T-shaped pull wire support block similar to FIG. 5-2A. FIG. 5-2C is a cross-sectional view of the pulling wire support plate. FIG. 5-2D is a top plan view of the support plate of the embodiment of FIG. 5-2C showing the connection of the cautery plug. FIG. 5-2E shows another embodiment of the cautery plug connection similar to FIG. 5-2D. FIG. 5-3A is similar to FIG. 5-1A, but has crossed blocks instead of T blocks. FIG. 5-3B is a view similar to FIG. 5-3A but having another pull wire grasping part. FIG. 5-4A is a cross-sectional view of a die and a sheath for corrugating the pull wire used in FIG. 5-3B. FIG. 5-4B is a cross-sectional view of one embodiment of a sheath sheath for a puller wire. FIG. 6 is a side elevational view of a conductive jaw having a selective polymer coating. FIG. 7 is a side elevational view of an injection molded plastic jaw where the teeth are made conductive by external conductive traces. FIG. 8a is a side elevational view of a selectively conductive insert injection molded jaw. FIG. 8b is a side elevational view of the conductive insert of FIG. 8a. FIG. 8c is an enlarged top plan view of the conductive insert of FIG. 8b. FIG. 9-1A is a view similar to FIG. 2 showing a jaw portion of another embodiment. FIG. 9-1B is an enlarged plan view of one of the jaws of FIG. 9-1A. 9-2A is a side elevational view of one of the jaws of FIG. 9-1A. 9-2B is a front view of the jaw portion of FIG. 9-2A. 9-2C is a view of another second embodiment of the jaw but similar to FIG. 9-1B. FIG. 10A is a view similar to FIG. 3d showing another embodiment of the washer, sleeve, and clevis pin. 10B is a cross-sectional view taken along line AA of FIG. 10A. 10C is a cross-sectional view taken along line BB in FIG. 10A.

Claims (30)

An endoscopic bipolar cautery biopsy forceps for use with an electrocautery source, the forceps comprising:
a) a conduit having a proximal end and a distal end;
b) a pair of opposing jaws hingedly disposed at the distal end of the conduit, each of the jaws having a proximal end portion having a conductive portion and a distal portion having a conductive portion. And the conductive portions of the proximal end portion and the distal end portion of each particular jaw are electrically connected to each other, and the conductive portion of the opposing jaw is the opposing jaw portion Are insulated from each other when in the open position, the forceps further
c) having a pair of electrically conductive pull wires each having a proximal end and a distal end, the pull wires extending through the conduit and insulated from each other within the conduit, the distal end of each pull wire Is mechanically and electrically connected to the proximal end portion of each of the opposing jaws, the proximal end of the pull wire is connectable to an electrical cautery source, and the forceps further comprises:
d) For use with an electrocautery source comprising biasing means disposed at the proximal end of the conduit and coupled to the puller wire to actuate the puller wire to open and close the jaws relative to each other Endoscopic bipolar cautery biopsy forceps.   The inner power of claim 1, further comprising a power connection means electrically connected to the proximal end of the puller wire to connect an electrocautery source to the puller wire. Visual bipolar cautery biopsy forceps.   The inner of claim 1, wherein the jaws each have an electrically non-conductive outer surface except for a cutting surface of the distal end portion and a conductive portion of the proximal end portion. Visual bipolar cautery biopsy forceps.   The endoscopic bipolar ablation biopsy forceps according to claim 1, wherein each jaw includes a conductive skeleton insert-molded in a non-conductive body.   Each of the jaws comprises a non-conductive body having a conductive tooth on the distal portion of the jaw and a conductive tongue on the proximal portion of the jaw, the conductive tooth The endoscopic bipolar cautery biopsy forceps according to claim 1, wherein the conductive tongue is electrically connected.   The endoscopic bipolar ablation biopsy of claim 1, further comprising e) a clevis coupled to the distal end of the conduit, wherein the jaw is hingedly disposed on the clevis. forceps.   The endoscopic bipolar cautery biopsy forceps according to claim 6, wherein the clevis is non-conductive.   The endoscopic bipolar cautery biopsy forceps according to claim 7, wherein the clevis includes a clevis pin that is hingedly engaged with the jaw.   The endoscopic bipolar cautery biopsy forceps according to claim 8, wherein the clevis pin is non-conductive.   9. The endoscopic bipolar cautery biopsy forceps of claim 8, further comprising non-conductive sleeve means for covering the clevis pin and electrically insulating the clevis pin from the jaw. .   11. An endoscopic bipolar cautery biopsy forceps according to claim 10, wherein the non-conductive sleeve means includes non-conductive washer means for electrically insulating the jaws from each other.   3. An endoscopic bipolar ablation according to claim 2, wherein said biasing means includes a shaft with a longitudinal slot and a sliding member coaxial with said shaft with a member extending into said slot. Forceps.   The endoscopic bipolar ablation biopsy forceps according to claim 12, wherein the power connection means includes a conductive portion of the member.   The member includes a pair of conductive plates each having a pull wire hole and the proximal end of each of the pull wires includes a Z-shaped bend that engages each of the pull wire holes. The endoscopic bipolar cautery biopsy forceps according to item 13.   The endoscopic bipolar cautery biopsy forceps according to claim 1, wherein the conduit comprises a flexible coil.   f) further comprising a non-conductive unit having a solid clevis pin integral with a non-conductive washer means for electrically insulating the jaws from each other, the end connecting the solid clevis pin with the clevis The endoscopic bipolar ablation biopsy forceps according to claim 7, further comprising a portion.   17. The endoscopic bipolar cautery biopsy forceps according to claim 16, wherein the solid clevis pin is stepped to form a seat on which the non-conductive clevis is placed. An endoscopic bipolar cautery biopsy forceps for use with an electrocautery source, the forceps comprising:
a) a tightly wound flexible coil having a proximal end and a distal end;
b) a clevis coupled to the distal end of the flexible coil, the clevis having a clevis pin, and the forceps further comprising:
c) a pair of opposed substantially hollow jaws hinged about the clevis pin, each jaw having a proximal end portion with a conductive portion and a conductive surface portion; A distal end portion comprising: the electrically conductive portion of the proximal end portion and the electrically conductive surface portion of the distal end portion are electrically connected to each other; Conductive portions are insulated from each other when the opposing jaws are in an open position, and the conductive surface portion of the opposing jaws is a relatively substantially smaller portion of the outer surface of the distal end portion. The forceps further comprises:
d) comprising a pair of electrically conductive pull wires each having a proximal end and a distal end, the pull wires extending into the coil and insulated from each other within the coil, the distal end of each pull wire comprising: Mechanically and electrically connected to the conductive proximal end portion of each of the opposing jaws, the forceps further comprising:
e) biasing means disposed at the proximal end of the coil and coupled to the puller wire to actuate the puller wire to open and close the jaws relative to each other;
f) Endoscopic for use with an electrocautery source having a power coupling means electrically coupled to the proximal end of the puller wire for coupling an electrocautery source to the puller wire Bipolar cautery biopsy forceps.   The distal end portion of the jaw has a cutting edge, the edge has a plurality of teeth extending from the edge, and the relatively substantially small conductive surface portion is the plurality of the plurality of teeth. 19. An endoscopic bipolar cautery biopsy forceps according to claim 18 disposed on at least one of the teeth.   20. The endoscopic bipolar cautery biopsy forceps of claim 19 further comprising non-conductive sleeve means for covering the clevis pin and electrically insulating the clevis pin from the jaw. .   21. An endoscopic bipolar cautery biopsy forceps according to claim 20, wherein the non-conductive sleeve means comprises non-conductive washer means for electrically insulating the jaws from each other.   The endoscopic bipolar ablation biopsy forceps according to claim 21, wherein the jaw is a metallic jaw covered with a thin layer of insulating polymer.   The clevis pin is a solid non-conductive clevis pin integral with a non-conductive washer means for electrically insulating the jaws from each other, the solid clevis pin having an end connected to the clevis The endoscopic bipolar cautery biopsy forceps according to claim 18.   24. The endoscopic bipolar ablation biopsy forceps according to claim 23, wherein the solid clevis pin is stepped to form a seat on which the non-conductive clevis is placed. A bipolar cautery forceps for use with an electrocautery feeder having a bipolar electrical connection,
a) a conduit having a proximal end and a distal end;
b) a pair of articulating opposing jaws located at the distal end of the conduit, each jaw having at least a portion that is electrically conductive; When the jaws are in the open position, they are electrically insulated from each other, the forceps further
c) having a pair of electrically conductive pull wires each having a proximal end and a distal end, the pull wires extending into the conduit and insulated from each other within the conduit, the distal end of each pull wire being A conductive portion of the jaw is mechanically and electrically connected to each of the jaws, the proximal end of the pull wire is connectable to an electrocautery supply, and the forceps further includes:
d) A bipolar electrical connection disposed at the proximal end of the conduit and including biasing means coupled to the pull wire to move the pull wire to open and close the jaws relative to each other Bipolar cautery forceps for use with an electrocautery supply having   26. The forceps according to claim 25, wherein the conduit is formed of a non-conductive material.   26. The forceps according to claim 25, wherein the puller wire is insulated from the conduit.   26. The scope of claim 25, wherein each of the opposing jaws has a conductive inner core and a non-conductive outer surface that covers all but a portion of the distal ends of the jaws directly opposite each other. Forceps.   29. The forceps according to claim 28, wherein the non-conductive outer surface is a non-conductive body molded, and the inner core is a conductive skeleton insert-molded in the non-conductive body.   Each opposing jaw has an injection molded non-conductive body with a conductive plated tooth at a distal portion of the jaw, and the teeth are electrically connected to the conductive portion of the jaw. The forceps according to claim 25, which are connected.

Images