CN105578980A - 在双极型电外科仪器中使用的电极 - Google Patents
在双极型电外科仪器中使用的电极 Download PDFInfo
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Abstract
一种端部效应器配件包括相对的第一钳口配件和第二钳口配件,第一配件和第二配件中的至少一个能够相对于另一个从第一位置至少移动至彼此更接近的第二位置,其中在第一位置中钳口配件相对于彼此设置成隔开关系,在第二位置中钳口配件合作以将组织抓在钳口配件之间。第一钳口配件包括第一壳体以及与第一壳体的至少一部分相关联的第一导电的组织接合结构。第二钳口配件包括第二壳体以及与第二壳体的至少一部分相关联的第二导电的组织接合结构。端部效应器配件包括沿着第一壳体或第二壳体的任一个的侧面部分的至少一部分而耦合的解剖器电极。解剖器电极与第一导电的组织接合结构和第二导电的组织接合结构电隔离。
Description
背景
1.技术领域
本公开涉及电外科仪器。更具体地,本公开涉及诸如例如血管闭合设备这样的双极型电外科仪器,包括钳口配件,钳口配件包括适合于组织解剖和凝固的电极。
2.背景技术
电外科仪器已经变得由外科医生广泛使用。电外科手术涉及外科程序期间电能和/或电磁能的应用以切割、解剖、烧蚀、凝固、烧灼、闭合或另外处理生物组织。电外科手术典型地使用可操作以输出能量的电外科发生器和包括适合于在电外科程序期间将能量传输到组织部位外科仪器(例如,端部效应器)的手持件来执行。电外科手术可以使用单极型或双极型仪器来执行。
单极型和双极型电外科手术的基本目的在于产生热量以实现期望的组织/临床效果。在单极型电外科手术中,设备使用具有单个、有源电极的仪器将来自电外科发生器的能量递送到组织。在单极型电外科手术中,患者返回电极(也称作接地垫、电烧灼器垫、中性电极或患者板)外部地连接到患者(例如,位于患者大腿或背部上的板),作为完成电外科发生器与患者之间的电气电路的手段。当电外科能量被应用时,能量从有源电极行进到外科部位、通过患者并且到达返回电极。在双极型电外科手术中,有源电极和返回电极功能都在外科部位处执行。双极型电外科设备包括具有相反极性的两个电极,它们为了它们表面之间的电流的应用而彼此位置接近。双极型电外科电流从一个电极行进通过介于中间的组织到达另一个电极以完成电气电路,由此消除对于位于远处的电流返回的需要。双极型仪器通常包括诸如夹持器、切割器、钳子、解剖器等的端部效应器。
钳子利用机械动作来束紧、抓、解剖和/或夹组织。通过利用电外科钳子,外科医生可以利用机械夹紧动作和电外科能量通过加热组织和血管来烧灼、凝固/干燥、闭合和/或分割组织来达到止血目的。双极型电外科钳子利用两个通常相对的电极,电极与端部效应器的内部相对表面可操作地关联并且都电耦合到电外科发生器。在双极型钳子中,端部效应器配件通常包括相对于彼此能够旋转地安装的相对的钳口配件。在双极型配置中,仅被抓在钳口配件之间的组织包括在电气电路中。
通过利用电外科钳子,外科医生可以通过控制经由钳口配件应用到组织的电外科能量的强度、频率和持续时间来烧灼、凝固/干燥和/或闭合组织和/或仅仅减少或减慢出血。在闭合处理期间,诸如应用在相对的钳口配件之间的压力以及钳口配件的导电的组织接触表面(电极)之间的间隙距离这样的机械因素在确定被闭合组织的结果厚度和闭合的有效性时发挥作用。
各种类型的端部效应器配件已经用于使用各种类型的单极型和双极型电外科仪器的各种类型的电外科手术。
发明内容
对于这样的钳口配件组件存在连续的需求,它可以容易地集成到用于生产在电外科仪器中(诸如电外科钳子)使用的端部效应器配件的制造配件过程中。
根据本公开的方面,提供一种端部效应器配件。端部效应器配件包括相对的第一钳口配件和第二钳口配件,第一配件和第二配件中至少一个能够相对于另一个从第一位置至少移动至彼此更接近的第二位置,其中在第一位置中钳口配件相对于彼此设置成隔开关系,在第二位置中钳口配件合作以将组织抓在钳口配件之间。第一钳口配件包括第一壳体以及与第一壳体的至少一部分相关联的第一导电的组织接合结构。第二钳口配件包括第二壳体以及与第二壳体的至少一部分相关联的第二导电的组织接合结构。端部效应器配件也包括沿着第一壳体或第二壳体的任一个壳体的侧面部分的至少一部分而耦合的解剖器电极。解剖器电极与第一导电的组织接合结构和第二导电的组织接合结构电隔离。
根据本公开的另一个方面,提供一种双极型钳子。双极型钳子包括具有附于其上的杆的壳体。杆包括附接到杆的远端的相对的钳口配件。钳口配件的至少一个能够相对于另一个从第一位置至少移动至彼此更接近的第二位置,其中在第一位置中钳口配件相对于彼此设置成隔开关系,在第二位置中钳口配件合作以将组织抓在钳口配件之间。每个钳口配件包括外部壳体以及与外部壳体的至少一部分相关联的导电的组织接合结构。双极型钳子也包括沿着壳体中的任一个壳体的侧面部分的至少一部分而耦合的一个或多个解剖器电极。一个或多个解剖器电极与导电的组织接合结构电隔离。在至少一个解剖器电极的激活期间的电流返回路径包括导电的组织接合结构的任一个。
根据本公开的另一个方面,提供一种双极型钳子,包括具有附于其上的杆的壳体。杆包括附接到杆的远端的第一钳口配件和第二钳口配件。第一钳口配件和第二钳口配件中的至少一个能够相对于另一个从第一位置至少移动至彼此更接近的第二位置,其中在第一位置中钳口配件相对于彼此设置成隔开关系,在第二位置中钳口配件合作以将组织抓在钳口配件之间。第一钳口配件包括第一外部壳体以及被设置成与第一外部壳体的至少一部分相关联的第一导电的组织接合结构。第二钳口配件包括第二外部壳体以及被设置成与第二外部壳体的至少一部分相关联的第二导电的组织接合结构。双极型钳子还包括第一解剖器电极和第二解剖器电极。第一解剖器电极沿着第一外部壳体的第一侧面的至少一部分而耦合,其中第一解剖器电极与第一导电的组织接合结构电隔离。第二解剖器电极沿着第二外部壳体的第二侧面的至少一部分而耦合,其中第二解剖器电极与第二导电的组织接合结构电隔离。双极型钳子适合于允许第一解剖器电极和第二解剖器电极的每一个被个体地激活。
附图说明
包括适合于在电外科仪器中使用用于组织解剖和凝固的电极的本公开的钳口配件的目标和特征,当结合附随附图阅读其各种实施例的描述时,将对于本领域普通技术人员变得明白,其中:
图1是根据本公开的实施例的内窥镜双极型钳子的右侧视图,示出壳体、能够旋转的元件、杆和端部效应器配件;
图2是根据本公开的实施例的开放双极型钳子的透视图;
图3是根据本公开的实施例的图1的双极型钳子的端部效应器配件的钳口配件的透视图,所示具有适合于组织解剖和凝固的电极;
图4是根据本公开与图3的钳口配件相类似的钳口配件的另一个实施例的放大端视图,所示具有适合于组织解剖和凝固的电极;
图5是图4中所示的钳口配件的左侧视图;
图6是根据本公开的包括适合于组织解剖和凝固的电极的钳口配件的再另一个实施例的放大端视图;
图7是图6中所示的钳口配件的左侧视图;
图8是根据本公开的实施例的钳口配件的放大端视图,该钳口配件包括适合于组织解剖和凝固的两个电极;以及
图8是根据本公开的钳口配件的另一个实施例的放大端视图,该钳口配件包括适合于组织解剖和凝固的两个电极。
具体实施方式
在下文,参考随附附图描述本公开的用于在电外科仪器中使用的钳口配件的实施例。相同的附图标记贯穿图的描述可以指类似或相同的元件。如附图中所示并且如该描述中所使用的,并且如在指物体上的相对定位时传统的,术语“近端”指更接近用户的装置或其组件的那部分,而术语“远端”指距离用户较远的装置或其组件的那部分。
该描述可以使用短语“在一个实施例中”、“在实施例中”、“在一些实施例中”或者“在其他实施例中”,这每个可以指根据本公开的相同或不同实施例的一个或多个。
本公开的各种实施例提供适合于闭合、烧灼、凝固/干燥、切割和/或解剖血管和血管组织的电外科仪器。本公开的各种实施例提供具有端部效应器配件的电外科钳子,端部效应器配件包括相对于彼此以相对关系设置的两个钳口配件。本公开的钳口配件的各种实施例包括适合于组织解剖和凝固的一个或多个解剖器电极。本公开的端部效应器配件的实施例可以包括以单侧或双侧配置排列的钳口配件。
包括解剖器电极的本公开的电外科钳子的实施例可以适合于在内窥镜外科程序中使用和/或适合于在开放手术应用中使用。本公开的电外科仪器的实施例可以通过适当的双极型线缆连接到发生器和/或其他适当的电源。虽然下面的描述描述了内窥镜双极型钳子的使用,但是本公开的教导也可以应用于包括钳口配件的各种电外科设备。
这里公开的各种实施例也可以被配置为与机器人外科系统一起工作并且通常称作“远程外科”。这种系统使用各种机器人元件在手术室中帮助外科医生并且允许外科仪器仪表的远程操作(或者部分远程操作)。各种机器人臂、齿轮、凸轮、滑轮、电动和机械马达等可以为此目的而使用并且可以与机器人外科系统一起设计以在手术或治疗的过程期间帮助外科医生。这种机器人系统可以包括远程可操纵系统、自动灵活外科系统、远程灵活外科系统、远程关节连接外科系统、无线外科系统、模块化或选择性可配置的远程操作的外科系统等。
可以使用挨着手术室或者位于远程位置的一个或多个控制台来使用机器人外科系统。在该实例中,外科医生或护士的一个团队可以准备患者进行外科手术并且配置具有这里公开的仪器中的一个或多个仪器的机器人外科系统,而另一个外科医师(或者一组外科医生)经由机器人外科系统远程地控制仪器。如可以领会,技艺精湛的外科医生可以在多个位置执行多个手术而不离开他/她的远程控制台,这会在经济上是有利的并且会对于患者或者一系列患者是有益的。
外科系统的机器人臂通常由控制器耦合到一对主柄。柄可以由外科医生移动以产生任何类型的外科仪器(例如,端部效应器、抓器、刀、剪刀等)的工作端的相应移动,这可以补充这里描述的实施例中国的一个或多个实施例的使用。主柄的移动可以被缩放,使得工作端具有与由外科医生的操作手执行的移动不同的、更小或更大的相应移动。缩放因子或杠杆比率可以是可调节的,使得操作者可以控制一个或多个外科仪器的工作端的分辨率。
主柄可以包括各种传感器以向外科医生提供关于各种组织参数或条件(例如因操控、切割或另外的处理而引起的组织电阻、由仪器施加到组织上的压力、组织温度、组织阻抗等)的反馈。如可以领会的,这种传感器向外科医生提供模拟实际手术条件的增强触觉反馈。主柄也可以包括各种不同的致动器,用于精密的组织操控或治疗,进一步增强外科医生模仿实际手术条件的能力。
图1中,示出与各种外科程序一起使用的内窥镜双极型钳子10的实施例,通常包括壳体20、柄配件30、能够旋转的配件80、触发器配件70和端部效应器配件100。端部效应器配件100通常包括相对于彼此以相对关系设置的两个钳口配件110和120。根据本公开的端部效应器配件100的实施例在图3中更详细地示出。然而,应当理解,也可以使用其他的端部效应器实施例。双极型钳子10的一个或多个组件,例如,壳体20、柄配件30、能够旋转的配件80、触发器配件70和/或端部效应器配件100,可以适合于相互合作以抓、闭合和/或分割组织,例如管状血管和血管组织(未示出)。取决于特定的目的或者实现期望的结果,钳子10可以包括另外的、更少或者与图1中所示不同的组件。
端部效应器100包括适合于组织解剖和凝固的解剖器电极160。解剖器电极160(随后将在该说明中更详细地描述)可以包括任何适当的导电材料,包括但不限于,金属、金属合金、导电聚合物和复合材料。解剖器电极160可以形成为材料的多层配置。在一些实施例中,解剖器电极160的一个或多个部分,例如其面向内部的一个或多个表面,可以包括不导电或者基本上不导电的材料,被配置为提供解剖器电极160的导电元件(例如,尖端部分169和/或肩部分168)与一个或多个钳口配件组件之间的电隔离,例如,为了减少激活期间使得钳口配件110和120短路的机会,和/或为了便于装配和/或为了满足恰当的钳口对齐、热电阻、强度和刚度的具体容忍要求,这在确定电外科仪器的可靠性和有效性时发挥作用。
在一些实施例中,如图1中所示,端部效应器配件100包括以单侧配置的钳口配件110和120,并且解剖器电极160被设置成与能够移动的钳口配件110相关联。在替换的实施例中,适合于组织解剖和凝固的解剖器电极(例如,图6和图7中所示的解剖器电极660)可以被设置成与固定的钳口配件(例如图6和图7中所示的620)相关联。在替换的实施例中,其中相对于彼此以相对关系设置的两个钳口配件以双侧配置排列,根据本公开的解剖器电极可以被设置成与双侧钳口配件的任一个相关联。
虽然图1描绘了与内窥镜外科程序有关地使用的双极型钳子10,本公开的教导也可以应用于更多传统开放外科程序。为了这里的目的,钳子10依据内窥镜仪器来描述;然而,钳子(例如,图2中所示的双极型钳子200)的开放版本也可以包括如下面描述的相同或类似的操作组件和特征。
钳子10包括杆12,杆具有被配置为机械地接合端部效应器配件100的远端14和被配置为机械地接合壳体20的近端16。在一些实施例中,杆12具有从柄配件30的近侧到钳子10的远侧在大约7厘米至大约44厘米范围内的长度。端部效应器配件100可以能够选择性地并且能够释放地与杆12的远端14接合,和/或杆12的近端16可以能够选择性地并且能够释放地与壳体20和柄配件30接合。
杆12的近端16容纳在壳体20内,并且与其相关的连接在标题为“METHODOFMANUFACTURINGJAWASSEMBLYFORVESSELSEALERANDDIVIDER”的共同转让的美国专利No.7,150,097、标题为“VESSELSEALERANDDIVIDERFORUSEWITHSMALLTROCARSANDCANNULAS”的共同转让的美国专利No.7,156,846、标题为“VESSELSEALERANDDIVIDERFORUSEWITHSMALLTROCARSANDCANNULAS”的共同转让的美国专利No.7,597,693以及标题为“VESSELSEALERANDDIVIDERHAVINGAVARIABLEJAWCLAMPINGMECHANISM”的共同转让的美国专利No.7,771,425中公开。
在一些实施例中,如图1中所示,钳子10包括电外科线缆15。电外科线缆15可以由适当的柔性的、半刚性或刚性的线缆形成,并且可以直接连接到电外科电力生成源28。在一些实施例中,电外科线缆15将钳子10连接到连接器17,连接器17进一步将仪器10可操作地连接到电外科电力生成源28。线缆15可以在内部分割成一个或多个线缆引线,每个线缆引线将能量通过它们各自的馈送路径传输给端部效应器配件100。
电外科电力生成源28可以是适合于与电外科设备一起使用的任何发生器,并且可以被配置为提供各种频率的电磁能量。可以适合于用作电外科能量源的电外科发生器的示例在由博尔德柯惠外科解决方案公司出售的商标FORCEEZTM、FORCEFXTM和FORCETRIADTM下市售。钳子10可以作为替换地被配置为电池供电的无线仪器。
端部效应器配件100可以被配置为单侧配件,即端部效应器配件100可以包括关于杆12固定安装的稳定或固定的钳口配件,例如120,以及围绕耦合到固定钳口配件的枢销(pivotpin)103安装的能够移动的钳口配件,例如110。作为替换,钳子10可以包括双侧配件,即钳口配件110和120都相对于彼此是能够移动的。钳口配件110和120可以以各种角度弯曲,以便于组织的操控和/或提供用于接近目标组织的增强的视线。
如图1中所示,端部效应器配件100通过能够旋转的配件80的手动或者其他方式的旋转而能够围绕纵轴“X-X”旋转。能够旋转的配件80通常包括两半(未示出),当围绕杆12的管子装配时,该两半形成通常圆形的能够旋转的元件82。能够旋转的配件80,或者其一部分,可以被配置为覆盖驱动配件(未示出)和/或刀配件(未示出)或者其组件。往复套筒(未示出)滑动地设置在杆12内并且能够由驱动配件(未示出)远程操作。钳子10的能够旋转的配件实施例、驱动配件实施例和刀配件实施例的示例在上述共同转让的美国专利No.7,150,097、No.7,156,846、No.7,597,693和No.7,771,425中描述。
柄配件30包括固定柄50和能够移动的柄40。在一些实施例中,固定柄50整体地与壳体20相关联,并且能够移动的柄40选择性地相对于固定柄50是能够移动的。柄配件30的能够移动的柄40最终连接到驱动配件(未示出)。如可以领会的,施加力以朝向固定柄50移动能够移动的柄40近端地拉动驱动套筒(未示出),以将移动传递到钳口配件110和120,从钳口配件110和120相对于彼此以隔开关系设置的开放位置到达钳口配件110和120合作以将组织抓在其间的夹住或关闭位置。钳子10的柄配件实施例的示例在上述共同转让的美国专利No.7,150,097、No.7,156,846、No.7,597,693和No.7,771,425中描述。
钳子10包括开关90,开关90被配置为允许用户选择性地在各种不同的取向上激活钳子10,即多取向激活。如可以领会的,这简化激活。当开关90被按下时,电外科能量通过一个或多个电气引线(未示出)传送到钳口配件110和120。虽然图1描绘开关90设置在壳体配件20的近端,但是开关200可以设置在钳子10的另一个部分(例如,固定柄50、能够旋转的元件82等)上或者壳体配件20上的另一个位置上。
如图1和图3中所示,钳口配件110和120包括分别地相对于彼此以相对的关系排列并且被设置成分别与外部壳体111和121(图3)相关联的导电的组织接合表面或闭合板112和122。在一些实施例中,外部壳体111和121定义其中的空腔,空腔分别被配置为至少部分地封装和/或牢固地接合闭合板112和122,和/或其他钳口配件组件。
在一些实施例中,外部壳体111和121可以至少部分地由不导电或基本上不导电的材料形成。外部壳体111和/或外部壳体121包括相对于解剖器电极160适当设置的一个或多个导电部分以提供电流返回路径。在一些实施例中,如图3中所示,外部壳体111包括被配置为提供电流返回路径的两个导电部分114和115。导电部分114和115的形状、大小以及例如相对于解剖器电极160的相对位置可以与图3中描绘的配置不同。另外,或者作为替换,外部壳体121可以包括适当地设置以提供电流返回路径的一个或多个导电部分。
解剖器电极160包括尖端部分169和肩部分168。在一些实施例中,尖端部分169可以在远端延伸超出外部壳体111的远端113。尖端部分169可以被配置为提供期望的功能,并且可以包括各种角度的弯曲以便于与目标组织接触。在一些实施例中,尖端部分169被配置用于解剖,并且可以包括尖刀缘、钝尖、钝缘、桨叶、挂钩、球形部分或另一种形状。肩部分168沿着外部壳体111的侧面部分的至少一部分延伸。在一些实施例中,肩部分168被配置用于凝固。例如,取决于特定的目的,肩部分168的形状和大小可以与图1和3中所描绘的配置不同。
闭合板112和122可以适合于彼此独立地连接到电外科能量源(例如,图1中所示的28),使得取决于特定的目的,闭合板112和122的任一个或者两个都可以被选择性地通电。在一些实施例中,钳口配件110连接到第一电气引线(未示出)并且钳口配件120连接到第二电气引线(未示出),第一电气引线和第二电气引线又与电外科能量源(例如,图1中所示的28)电气耦合。在一些实施例中,第一电气引线和第二电气引线分别在外部壳体111和121内终止,例如,分别电动机械地耦合到闭合板112和122,并且可以允许用户在外科手术期间根据需要选择性地将双极型或单极型电外科能量供给到钳口配件110和120。激活开关90(图1)能够被选择性地致动,以控制能量到闭合板112和122的供给。激活开关90可以包括一个或多个开关组件以便于闭合板112和122的任一个或二者的选择性激活。
钳口配件110和120的一个或两个包括纵向取向的插槽或刀通道,被配置为允许刀片(未示出)的往复。在一些实施例中,如图3中所示,取决于特定的目的,刀通道125可以完全设置在两个钳口配件的一个(例如钳口配件120)中。
闭合板112、122,外部壳体111、121以及刀片实施例的示例在于2001年4月6日提交的、标题为“ELECTROSURGICALINSTRUMENTWHICHREDUCESCOLLATERALDAMAGETOADJACENTTISSUE”的共同转让的国际申请序列No.PCT/US01/11412,以及于2001年4月6日提交的、标题为“ELECTROSURGICALINSTRUMENTREDUCINGFLASHOVER”的共同转让的国际申请序列No.PCT/US01/11411中公开。
在图2中,示出与各种外科程序一起使用的开放钳子200的实施例,通常包括端部效应器配件230,端部效应器配件230与一对相对的杆212a和212b可操作地相关联并且被设置成分别与其末端216a和216b相关联。端部效应器配件230包括第一钳口元件232和第二钳口元件234,第一钳口元件232和第二钳口元件234相对于彼此以相对关系设置并且围绕枢销245能够枢转地连接并且相对于彼此能够移动以抓握组织。
杆212a包括被设置与杆的近端214a相关联的柄215。杆212b包括被设置与杆的近端214b相关联的柄217。柄215和217分别定义手指和/或拇指孔215a和217a,通过它们来容纳用户的手指或拇指。手指和/或拇指孔215a和217a便于杆212a和212b相对于彼此的移动以将第一钳口元件232和第二钳口元件234从第一钳口元件232和第二钳口元件234相对于彼此以隔开关系设置的开放位置枢转到第一钳口元件232和第二钳口元件234合作以将组织抓在第一钳口元件232和第二钳口元件23之间的夹住或关闭位置。
端部效应器配件230包括适合于组织解剖和凝固的解剖器电极260。解剖器电极260包括肩部分268。例如,取决于特定的目的,肩部分268的形状和大小可以与图2中描绘的配置不同。解剖器电极260可以包括尖端部分269。
在一些实施例中,如图2中所示,解剖器电极260被设置成与第一钳口元件232相关联。在替换的实施例中,解剖器电极260可以被设置成与第二钳口元件234相关联。解剖器电极260包括任何适当的导电材料,并且可以形成为材料的多层配置。在一些实施例中,解剖器电极260的一个或多个部分可以包括不导电或者基本上不导电的材料。图2中所示的解剖器电极260与图1和图3中所示的解剖器电极160相类似,并且为了简洁而省略对相同元件的进一步描述。
图4和图5示出根据本公开的实施例的端部效应器配件400,其包括适合于组织解剖和凝固的解剖器电极460。如在图5中最佳示出的,解剖器电极460包括尖端部分469和肩部分468。
端部效应器配件400通常包括相对于彼此以相对关系设置的两个钳口配件410和420。钳口配件410和420每个分别包括相对于彼此以相对关系设置并且被设置与分别外部壳体411和421相关联的导电的组织接合表面或闭合板412和422。
外部壳体411和421通常分别包括远端413和423,以及两个侧面部分(例如,图4中所示的壳体411的第一侧面部分“S1”和第二侧面部分“S2”)。在一些实施例中,外部壳体411和421可以至少部分地由不导电或者基本上不导电的材料形成。外部壳体411和/或外部壳体421可以包括具有适当导电性的一个或多个导电部分并且关于解剖器电极460的一个或多个特征部(例如,尖端部分469和/或肩部分468)如此设置以提供电流返回路径。在一些实施例中,如图5中所示,外部壳体411包括被配置为提供电流返回路径的两个导电部分414和415。导电部分414和415的形状、大小以及例如相对于解剖器电极460的相对位置可以与图5中描绘的配置不同。
在一些实施例中,解剖器电极460的尖端部分469可以在远端延伸超出外部壳体411的远端413。尖端部分469可以被配置为提供期望的功能,并且可以包括各种角度的弯曲以便于与目标组织接触。尖端部分469可以包括尖刀缘、钝尖、钝缘、桨叶、挂钩、球形部分或另一种形状。肩部分468沿着外部壳体411的第一侧面部分“S1”的至少一部分延伸。肩部分468可以具有任何适当的维度,例如长度、宽度和高度。肩部分468的形状和大小可以与图5中所描绘的配置不同。在一些实施例中,尖端部分469被配置用于解剖,并且肩部分468被配置用于凝固。
解剖器电极460可以包括任何适当的导电材料,包括但不限于,金属、金属合金、导电聚合物和复合材料。在一些实施例中,解剖器电极460的一个或多个部分,例如其面向内部的一个或多个表面,可以包括不导电或者基本上不导电的材料,被配置为提供解剖器电极460的导电元件(例如,尖端部分469和/或肩部分468)与一个或多个钳口配件组件之间的电隔离,例如,为了减少激活期间使得钳口配件410和420短路的机会,和/或为了便于装配和/或为了满足恰当的钳口对齐、热电阻、强度和刚度的具体容忍要求,这在确定电外科仪器的可靠性和有效性时发挥作用。
在一些实施例中,解剖器电极460的一个或多个部分,例如其面向内部的一个或多个表面,可以包括不导电或者基本上不导电的材料,导电或者基本上不导电的材料被适当地配置为提供解剖器电极460的导电元件(例如,尖端部分469和/或肩部分468)与一个或多个钳口配件组件之间的电隔离,例如,为了便于装配和/或为了满足恰当的钳口对齐、热电阻、强度和刚度的具体容忍要求。
图6和图7示出根据本公开的实施例的端部效应器配件600,其包括适合于组织解剖和凝固的解剖器电极660。端部效应器配件600通常包括相对于彼此以相对关系设置的两个钳口配件610和620。钳口配件610和620每个分别包括被设置成分别与外部壳体611和621相关联并且相对于彼此以相对关系排列的组织接合表面或闭合板612和622。解剖器电极660通常与闭合板612和622绝缘。解剖器电极660可以至少部分地与外部壳体611和/或外部壳体621的一个或多个导电部分绝缘。
外部壳体611和621分别包括远端613和623,并且被配置为定义两个侧面部分(例如,如图6中所示,远端地从壳体621的远端613延伸的第一侧面部分“S1”和第二侧面部分“S3”)。外部壳体611和621可以至少部分地由电绝缘材料形成。在一些实施例中,外部壳体611和/或外部壳体621包括一个或多个导电部分的配置件,该配置件相对于解剖器电极600适当地设置以提供电流返回路径。在一些实施例中,如图7中所示,外部壳体611包括被配置为提供电流返回路径的两个导电部分614和615。导电部分614和615的形状、大小以及例如相对于解剖器电极660的相对位置可以与图7中描绘的配置不同。
解剖器电极660可以包括任何适当的导电材料,包括但不限于,金属、金属合金、聚合物和复合材料。解剖器电极660可以形成为材料的多层配置。在一些实施例中,解剖器电极660的一个或多个部分,例如其面向内部的一个或多个表面,可以包括不导电或者基本上不导电的材料,不导电或者基本上不导电的材料被适当地配置为提供解剖器电极660的导电元件(例如,尖端部分669和/或肩部分668)与钳口配件610和620的一个或多个导电部分的配置件之间的电隔离,例如,为了便于装配,和/或为了确保与用来将相对的钳口配件610和620彼此电隔离的电绝缘套管的配置件电隔离的连接,或者与用来将相对的钳口配件610和620彼此电隔离的电绝缘套管的配置件电隔离的独立。
在替换的实施例中,解剖器电极,和/或其组件,例如肩部分,可以被设置成与外部壳体621的第二侧面部分“S4”相关联。在一些实施例中,端部效应器配件600可以配置有两个解剖器电极,两个解剖器电极例如被设置成分别与第一侧面部分“S3”和第二侧面部分“S4”的每个相关联,例如,以允许端部效应器配件600使用时的用户灵活性以便于组织解剖和凝固。
图8示出根据本公开的实施例的端部效应器配件800,包括例如适合于组织解剖和凝固的第一解剖器电极861和第二解剖器电极862。端部效应器配件800通常包括相对于彼此以相对关系设置的两个钳口配件810和820。钳口配件810和820每个分别包括相对于彼此以相对关系排列并且被设置成分别与外部壳体811和821相关联的导电的组织接合表面或闭合板812和822。图8中所示的钳口配件810和820与图6和图7中分别所示的钳口配件610和620相类似,并且为了简洁而省略对其进一步的描述。
第一解剖器电极861沿着外部壳体821的侧面部分“S5”的至少一部分而耦合,并且第二解剖器电极862沿着外部壳体821的侧面部分“S6”的至少一部分而耦合,使得第一解剖器电极861和第二解剖器电极862分别设置在钳口配件820的相对的侧上。第一解剖器电极861和第二解剖器电极862分别与图6和图7中所示的解剖器电极660相类似,并且为了简洁而省略对其进一步的描述。
图9示出根据本公开的实施例的端部效应器配件900,包括例如适合于组织解剖和凝固的第一解剖器电极961和第二解剖器电极962。端部效应器配件900通常包括相对于彼此以相对关系设置的两个钳口配件910和920。钳口配件910和920每个分别包括相对于彼此以相对关系排列并且被设置成分别与外部壳体911和921相关联的导电的组织接合表面或闭合板912和922。外部壳体921包括侧面部分“S7”和侧面部分“S8”,并且外部壳体911包括侧面部分“S9”和侧面部分“S10”。
在一些实施例中,如图9中所示,第一解剖器电极961沿着外部壳体921的侧面部分“S7”的至少一部分而耦合,并且第二解剖器电极962沿着外部壳体811的侧面部分“S10”的至少一部分而耦合,使得第一解剖器电极961和第二解剖器电极962各自分别设置在钳口配件920和910的相对的侧上。第一解剖器电极961和第二解剖器电极962分别与图6和图7中所示的解剖器电极660相类似,并且为了简洁而省略对其进一步的描述。在上述实施例的任何一个中,具有多个解剖器电极的端部效应器配件可以适合于例如取决于特定的目的,允许解剖器电极被个体地激活。
在与装配到钳口配件配置中的解剖器电极的上面实施例的任何一个相兼容的替换的实施例中,电绝缘套管可以用来将相对的钳口元件彼此电隔离,其中一个或多个电绝缘套管的配置可以与钳口配件的任一个或二者相关联。
在一些实施例中,一个或多个电绝缘套管的配置可以另外地,或者作为替换地,与一个或多个解剖器电极相关联。在一些实施例中,电绝缘套管可以包括陶瓷或者诸如聚合物材料(例如塑料)的各种适当的不导电材料的任何一种,和/或其他绝缘材料。在其他实施例中,具有适当的重量、强度、成本和/或其他特性的其他不导电的合成和/或天然材料可以用于一个或多个电绝缘套管。
包括适合于组织解剖和凝固的解剖器电极的上述双极型钳子实施例能够将能量引导到组织中,并且可以适合于在多种程序和手术中使用。上述端部效应器实施例可以利用机械夹住动作和电能通过加热组织和血管来凝固、烧灼、切割和/或闭合组织来达到止血目的。钳口配件可以是单侧或双侧的。包括适合于组织解剖和凝固的解剖器电极的上述双极型钳子实施例可以适合于与内窥镜外科程序和/或手助、内窥镜和腹腔镜外科程序一起使用。包括适合于组织解剖和凝固的解剖器电极的上述双极型钳子实施例可以适合于在开放外科应用中使用。
例如,取决于专业电外科仪器的设计,上述端部效应器实施例可以与具有变化的几何形状(例如长度和曲率)钳口配件的闭合板和支撑底座结合使用,使得各种配置的钳口配件可以被制造并装配到包括适合于组织解剖和凝固的解剖器电极的各种端部效应器配置中。
虽然为了例示和描述的目的参考附图详细描述了实施例,但是应当理解,本发明的处理和装置不解释为由此所限制。可以对前述实施例进行各种修改而不背离本公开的范围,这对于本领域中那些普通技术人员将是明显的。
Claims (14)
1.一种端部效应器配件,包括:
相对的第一钳口配件和第二钳口配件,第一配件和第二配件中的至少一个能够相对于另一个从第一位置至少移动至彼此更接近的第二位置,其中在第一位置中钳口配件相对于彼此设置成隔开关系,在第二位置中钳口配件合作以将组织抓在钳口配件之间;
第一钳口配件包括:
第一壳体;以及
第一导电的组织接合结构,第一导电的组织接合结构与第一壳体的至少一部分相关联;
第二钳口配件包括:
第二壳体;以及
第二导电的组织接合结构,第二导电的组织接合结构与第二壳体的至少一部分相关联;以及
解剖器电极,解剖器电极沿着第一壳体或第二壳体中的任一个壳体的侧面部分的至少一部分而耦合,其中解剖器电极与第一导电的组织接合结构和第二导电的组织接合结构电隔离。
2.根据权利要求1所述的端部效应器配件,其中解剖器电极的激活期间的电流返回路径包括第一导电的组织接合结构和第二导电的组织接合结构的任一个。
3.根据权利要求2所述的端部效应器配件,还包括:
导电区域的配置件,导电区域的配置件设置在第一壳体或第二壳体的任一个上,其中导电区域的配置件相对于解剖器电极而设置,以在解剖器电极的激活期间提供另一个电流返回路径。
4.根据权利要求1所述的端部效应器配件,其中钳口配件包括一个稳定的钳口配件以及围绕耦合到所述稳定的钳口配件的枢销而安装的一个能够移动的钳口配件。
5.根据权利要求1所述的端部效应器配件,其中解剖器电极适合于组织解剖和凝固。
6.根据权利要求1所述的端部效应器配件,其中解剖器电极还包括第一壳体或第二壳体中的任一个壳体的侧面部分的向外延伸的肩部分,肩部分被配置用于凝固。
7.根据权利要求6所述的端部效应器配件,其中解剖器电极还包括第一壳体或第二壳体中的任一个壳体的远端的向外延伸的尖端部分,尖端部分被配置用于解剖。
8.一种双极型钳子,包括:
壳体,壳体具有附于壳体的杆,杆包括附接到杆的远端的相对的钳口配件,钳口配件的至少一个能够相对于另一个从第一位置至少移动至彼此更接近的第二位置,其中在第一位置中钳口配件相对于彼此设置成隔开关系,在第二位置中钳口配件合作以将组织抓在钳口配件之间,每个钳口配件包括外部壳体以及与外部壳体的至少一部分相关联的导电的组织接合结构;以及
至少一个解剖器电极,所述至少一个解剖器电极沿着外部壳体中的任一个外部壳体的侧面部分的至少一部分而耦合,其中所述至少一个解剖器电极与导电的组织接合结构电隔离,其中在所述至少一个解剖器电极的激活期间的电流返回路径包括导电的组织接合结构的任一个。
9.根据权利要求8所述的双极型钳子,还包括连接到每个钳口配件的电外科能量源,使得钳口配件能够将双极型能量传导通过保持在钳口配件之间的组织以实现组织闭合。
10.根据权利要求8所述的双极型钳子,还包括:
导电区域的配置件,导电区域的配置件设置在壳体的任一个上,其中导电区域的配置件相对于所述至少一个解剖器电极而设置,以在所述至少一个解剖器电极的激活期间提供另一个电流返回路径。
11.根据权利要求8所述的双极型钳子,其中双极型钳子适合于允许所述至少一个解剖器电极被个体地激活。
12.一种双极型钳子,包括:
壳体,壳体具有附于壳体的杆,杆包括附接到杆的远端的第一钳口配件和第二钳口配件,第一配件和第二配件中的至少一个能够相对于另一个从第一位置至少移动至彼此更接近的第二位置,其中在第一位置中钳口配件相对于彼此设置成隔开关系,在第二位置中钳口配件合作以将组织抓在钳口配件之间;
第一钳口配件包括:
第一外部壳体;以及
第一导电的组织接合结构,第一导电的组织接合结构被设置成与第一外部壳体的至少一部分相关联,
第二钳口配件包括:
第二外部壳体;以及
第二导电的组织接合结构,第二导电的组织接合结构被设置成与第二外部壳体的至少一部分相关联;以及
第一解剖器电极,第一解剖器电极沿着第一外部壳体的第一侧面的至少一部分而耦合,其中第一解剖器电极与第一导电的组织接合结构电隔离;以及
第二解剖器电极,第二解剖器电极沿着第二外部壳体的第二侧面的至少一部分而耦合,其中第二解剖器电极与第二导电的组织接合结构电隔离;
其中双极型钳子适合于允许第一解剖器电极和第二解剖器电极的每一个被个体地激活。
13.根据权利要求12所述的双极型钳子,还包括:
导电区域的配置件,导电区域的配置件设置在第一壳体和第二壳体的至少一个上,其中导电区域的配置件相对于第一解剖器电极和第二解剖器电极的至少一个而设置,以在第一解剖器电极和第二解剖器电极中的至少一个解剖器电极的激活期间提供电流返回路径。
14.根据权利要求12所述的双极型钳子,其中第一外部壳体的第一侧面和第二外部壳体的第二侧面设置在第一钳口配件和第二钳口配件的相对的侧上。
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US20120253344A1 (en) * | 2011-03-28 | 2012-10-04 | Tyco Healthcare Group Lp | Surgical Forceps with External Cutter |
Cited By (3)
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CN108926383A (zh) * | 2017-05-24 | 2018-12-04 | 厄比电子医学有限责任公司 | 具有销电极的凝固和解剖器具 |
US11129668B2 (en) | 2017-05-24 | 2021-09-28 | Erbe Elektromedizin Gmbh | Coagulation and dissection instrument with pin electrodes |
CN108926383B (zh) * | 2017-05-24 | 2022-04-01 | 厄比电子医学有限责任公司 | 具有销电极的凝固和解剖器具 |
Also Published As
Publication number | Publication date |
---|---|
EP3434216A1 (en) | 2019-01-30 |
EP3049006B1 (en) | 2018-10-10 |
WO2015047611A1 (en) | 2015-04-02 |
US9717548B2 (en) | 2017-08-01 |
US20150088128A1 (en) | 2015-03-26 |
EP3049006A1 (en) | 2016-08-03 |
EP3049006A4 (en) | 2017-07-05 |
CN105578980B (zh) | 2018-12-11 |
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