CN100421629C - 用于凝结组织的装置 - Google Patents

用于凝结组织的装置 Download PDF

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CN100421629C
CN100421629C CNB2004800310106A CN200480031010A CN100421629C CN 100421629 C CN100421629 C CN 100421629C CN B2004800310106 A CNB2004800310106 A CN B2004800310106A CN 200480031010 A CN200480031010 A CN 200480031010A CN 100421629 C CN100421629 C CN 100421629C
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CN1870945A (zh
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U·施尼茨勒
D·舍勒
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Erbe Elecktromedizin GmbH
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/042Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating using additional gas becoming plasma
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/16Indifferent or passive electrodes for grounding
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00589Coagulation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601Cutting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00607Coagulation and cutting with the same instrument
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature

Abstract

已有用于凝结组织的装置,特别是探针,用于向探针所在的电极和组织之间的空间输送氩气。在一些情况下,需要凝结靠近探针排气口处的组织。这里提出了一种装置,其中电极的末端伸出到输气装置或探针之外。在所述电极的末端设置有引导装置以引导气体或等离子体,从而使至少部分流动气体或等离子体偏转到预先设定的方向。

Description

用于凝结组织的装置
技术领域
本发明涉及用于凝结组织的装置,该装置包括连接到产生高频电流的高频发电机的电极以及管子、管状探针或类似的输气装置,该输气装置以预定流向驱动氩气或类似惰性气体从输气装置的排气口进入电极和组织之间的空间。
背景技术
此类装置已经为公众所知,例如DE 4139029A1中所公开的。在此装置中,气流沿轴向从输气装置的流出口流到电极,且电极位于流出口前面,因此等离子体易于沿输气装置的轴线方向产生。特别是当在体腔内做内窥镜检查操作时,也就是在狭窄的(confined)情况下,很难相对于流出口沿径向凝结位于侧面的组织部位。
DE 19820240C2公开了一种组织凝结装置,其中,电极完全置入管状探针之内,该管状探针具有围绕探针的圆周面螺旋走向的缝状开口,因此输送的气体还有等离子体将形成于探针的径向方向。考虑到狭窄的空间关系,在制造这样的探针过程中存在问题。另一个问题是探针材料能相对容易地被等离子体的高温损坏。
发明内容
本发明的目的是研制一种开始提及的装置,通过这样的一种方式,利用简单的方法,可以使可靠确定偏离轴向的等离子体束的方向成为可能。
此目的是通过开始提及的装置来实现的,其中电极的末端突出于输气装置之外,而且在所述的电极末端设置有用于引导气体和/或等离子体的引导装置,通过这样一种方式,可以使至少部分流动气体/等离子体偏转到预先设定的方向。
本发明的实质特点在于,电极本身在结构上包括于装置总体的机械结构之内,其在一定程度上起到输气装置的作用,即引导装置。这样气体或等离子体的优选方向由引导装置确定。这里需要指出的是,在一个几乎完全充满惰性气体的空间内,产生等离子体的方向不受气体流向的影响。然而,因为等离子体总是沿最小总阻抗的路径产生,而且,即便是在体腔内,将空间完全均匀地充满实际上也是不可能的,所以一方面可以通过引导装置确定气流,从而进一步确定空间内的气体集中,另一方面可以通过延伸等离子体从电极到组织必须经过的路径来实现所需的方向改变。
优选地,引导装置由电绝缘材料构成,因此上述路径的改变容易实现。
此外,引导装置优选由热稳定材料制造,以便在操作过程中,即便引导装置长时间与等离子体接触,也不会产生材料的损坏变化。特别合适的材料是陶瓷,它可以通过例如喷涂或浸泡应用于实例中。
就本身已知,电极优选构造为杆或导线形状,同时引导装置优选围绕电极轴向对称布置,通过这样一种方式,气体/等离子体流将相对于输气装置排气口沿大体径向方向流到周边空间。这种布置不需要在进行内窥镜检查操作过程中,为了凝结位于排气口径向方向的组织部分,而在体腔内转动装置。因为等离子体(如上所解释的)寻找最近因此阻抗也最小的路径,所以只需将装置放在需要凝结的组织部位附近即可。等离子流不会改变方向直到等离子路径被延长,当处理的组织部位变干时,因此阻抗就更大。
引导装置优选在面向排气口的一面制为凹面,因此用特别简单的方式就可以实现满足气体流动的气流的分导。
为了避免接触组织而引起的医疗损伤,引导装置的远离排气口且与之面对的侧面为圆形。这样引导装置同时具有保护措施,以免电极和组织的直接接触,公知的这会造成致命的后果。
在本发明的一个优选实施方式中,电极制造成相对于排气口为可移动的,通过这样一种方式,当电极处于回缩状态时,引导装置将以充分防漏的方式关闭排气口。这样可以确保在伸出探针过程中,体液或其他污染物不会进入输气装置。
附图说明
下面,参考附图,对本发明的优选实施方式进行更加详细的说明,其中:
图1图示具有示意表示的外围设备的本发明第一种优选实施方式的透视图,
图2与图1类似,图示本发明第二种优选实施方式,以及
图3与图2对应,图示本发明第三种优选实施方式。
附图标记数字说明
1高频发电机、2导线、3电极、4末端、5组织表面10输气装置、11导管、12气源、13排气口、20引导装置21内凹部分、22圆形轮廓
具体实施方式
在下面的描述中,相同的参考数字用于表示相同的部分或具有相同作用的部分。
图1表示探针的末端部分,包括管状的输气装置10,该输气装置的内腔通过导管11与气源12连通。电极3(一般由钨制成)置于输气装置10之内,与输气装置大致同轴,电极3通过导线2连接到高频发电机。电极3的末端4从输气装置的排气口13向外伸出。
在图1所示的本发明实施方式中,球状陶瓷件连接在探针3的末端4上,以构成引导装置20。该装置使由气源12提供并从排气口13流出的惰性气体流转向箭头P所指的方向。如果该装置靠近并平行于组织表面5,则由引导装置20结合输气装置10的末端部分(在输气装置排气口13处)所界定的空间被充分地限定,这样当输送的惰性气体被来自发电机1的高频电流电离时,在电极3和组织表面5之间形成的等离子体的最短路径相对于电极3沿径向定位。因此,引导装置20不但用于确定提供的惰性气体流的方向,还用于“引导”等离子体。
图2中本发明的实施方式与图1中本发明的实施方式的不同之处在于,引导装置20不是球形,而是类似用于内燃机的阀门的形状,该引导装置包括位于输气装置10的排气口13对面区域的内凹部分21。远离输气装置10并与其面对的引导装置的末端变平。在平的末端部分和内凹部分21之间的过渡部分具有圆形轮廓22,因此和组织表面5的接触不会引起对组织的医疗伤害。
图3中本发明的实施方式和图2中实施方式的不同之处在于,引导装置20的末端是半球形的而不是平的,而且作为整体具有同样降低损伤危险的圆形轮廓22。
电极3可以制成能缩进排气孔13且/或能够向前推到排气口13之外,这样当电极3处于回缩状态时,引导装置20置于排气口13处。这样的布置在将输气装置10或对应设计的探针伸入过程中,避免了体液或类似物进入输气装置10内腔的危险,因为此状态下排气口13是关闭的。

Claims (8)

1. 用于凝结组织的装置,包括:
电极(3),该电极连接到产生高频电流的高频发电机(1),和
管状的输气装置(10),用于将惰性气体从输气装置(10)的排气口(13)输送到电极(3)和组织(5)之间的空间中,通过这种方式在电极(3)和组织(5)之间产生等离子体,
其特征在于:
电极(3)的末端(4)伸出到输气装置(10)之外,且在所述末端(4)设置有引导装置(20)用于引导气体和/或等离子体,通过这种方式使至少部分流动气体和/或等离子体偏转到预先设定的方向。
2. 根据权利要求1所述的装置,其特征在于,引导装置由电绝缘材料制成。
3. 根据权利要求1所述的装置,其特征在于,引导装置由热稳定材料制成。
4. 根据权利要求2或3所述的装置,其特征在于,所述材料是陶瓷。
5. 根据权利要求1所述的装置,其特征在于,电极(3)的形状是杆状或导线状,且引导装置(20)围绕电极(3)轴向对称布置,以便气体相对于输气装置(10)的排气口(13)以径向的方向流到周围空间。
6. 根据权利要求1所述的装置,其特征在于,引导装置(20)的面对排气口(13)的侧面(21)具有凹面结构。
7. 根据权利要求1所述的装置,其特征在于,引导装置(20)是圆形,以避免和组织(5)接触而造成医疗伤害。
8. 根据权利要求1所述的装置,其特征在于,电极(3)被构造成可以相对于排气口(13)移动的结构,通过这种方式,当引导装置(20)处于回缩状态时,引导装置能够以充分防漏的方式将排气口(13)关闭。
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DE10350709.4 2003-10-30
DE10350709A DE10350709A1 (de) 2003-10-30 2003-10-30 Vorrichtung zur Koagulation von Gewebe

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US9603653B2 (en) 2017-03-28
DE502004010500D1 (de) 2010-01-21
WO2005041800A8 (de) 2005-07-14
DE10350709A1 (de) 2005-08-18
EP1682023A1 (de) 2006-07-26
US10524860B2 (en) 2020-01-07
JP2007509664A (ja) 2007-04-19
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WO2005041800A1 (de) 2005-05-12
EP1682023B1 (de) 2009-12-09
US20140336644A1 (en) 2014-11-13

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