CN1976642A - 电外科器械 - Google Patents
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Abstract
本发明公开一种电外科器械，其具有两个相结合的分支，其能以挤压工具的方式被驱动。该器械还包含在分支末端的电极部件，其用于夹持组织和用于传导凝结电流通过组织以引起其凝结，以及用于从H.F.发生器提供凝结电流给电极部件的电流供应装置。布置至少一个预防短路的装置并设计成电极部件不能相互接触的方式。开发这种电外科器械以使电极部件间的距离能够更可靠的被调节以匹配所需H.F.电压。为此目的，用于防止短路的装置被设计在电极部件上。
Description
技术领域
本发明涉及一种根据专利权利要求1前述部分的电外科器械。
电外科器械在用来凝结或切割生物组织的高频外科手术中已经被使用了一些年。伴随着凝结，高频电流通过被治疗的组织，由于蛋白质凝结和脱水而引起其变化。在此，组织以血管阻塞和血流停滞的方式收缩。切割过程需要高电流密度，组织液被爆发性蒸发和细胞膜被完全撕裂的作用使组织一分为二。
双极器械的应用正变得越来越重要，因为其比单极器械需要更低的电流强度。特别有利的是双极器械电极部件之间电流的方向能够被计算并且不继续通过患者身体的任何距离。
双极器械关键地具有两个相结合的挤压部，由此在其近端提供夹持装置用于操作挤压部。在挤压部的远端，有用来夹持组织和传导凝结电流通过组织的电极部件。由HF发生器产生的电压，和由其提供的HF电流经电流供应装置被传导到双极器械的电极部件。为防止因两电极部件接触的短路，已知器械具有位于分支上用来防止短路的装置，由此当器械被闭合时电极部件总是被间隔分开。
用于防止短路的已知装置的问题是它们仅间接限定了电极部件之间的间隔，因为它们与电极部件是分开的。因此，例如分支的纵横比需要被考虑以确定合适的间隔。这使得调节间隔和所需的HF电压是相当的困难。
因此本发明的目的是进一步构建一种本文开始时所指出类型的电外科器械，使得其能调节电极部件之间的间隔至所需的HF电压。
通过根据专利权利要求1的电外科器械实现此目的。
具体的说，通过由两个相结合的分支组成的电外科器械来实现此目的，其以挤压工具的方式被驱动。该器械还包括位于分支远端的电极部件用于夹持组织和用于传导凝结电流通过组织以引起其凝结，以及电流供应装置，用于从HF发生器供给凝结电流到电极部件。至少一个用于防止短路的装置被安置并配置成电极不能接触的方式，由此用于防止短路的装置被配置在电极部件上。
本发明的关键点在于，用于防止短路的装置被直接安置在电极部件之间必须具有有效间隔的位置。与此同时，没有妨碍凝结，因为由于热传导在组织和装置之间接触点处组织也能被凝结。至此程度，电极部件间的任何火花放电都可以用凝结操作被可靠地避免。
本发明的优选改进在从属权利要求中具体说明。
在一个优选实施方案中，用于防止短路的装置在至少一个电极部件上具有作为绝缘部的距离元件。因此，即使它们接触，电极部件间的短路也能通过距离元件被防止。
在另一个优选实施方案中，邻接绝缘部，在至少一个电极部件上安排至少一个初始切割部，尤其是配置成与相对于所述凝结电极的相反电极具有降低的间隔，其安排方式使得用于切割入组织的电弧从起始切割部随着凝结电流电压的任何增加而被产生。切割部优选被安排在电极部件上，作为相对于电极部件逐渐变细的区域并从电极部件突出。除了切割部以外，电极部件随后还具有明显的凝结部。在凝结操作期间，形成凝结部和切割部的电极部件在其整个表面区域上，即在凝结部的表面区域和切割部的表面区域，可以作为凝结电极操作，然而逐渐变细的切割部单独可用于随后的切割操作。
切割部保证电弧只在此产生，然而作为电极部件之间间隔太大的结果，至相反电极的破坏性放电不能在电极部件的其余部分发生。因此同一个器械既能用于凝结又能用于切割，和能够避免改变器械从而带来不间断操作的好处。
距离元件可以被配置为线形和点状。例如，线形距离元件随后将在分支扩展的方向上延伸，共心安排在整个电极部件上，并由此形成边缘。有利的是，以此方式有可能形成稳定的电弧并且可以保证均匀切割。点状距离元件很容易制造，其可靠地防止在电极部件间发生短路和，作为热传导的结果，也保证了在组织和距离元件之间接触点处的安全凝结。安排在相应电极部件上，例如在电极部件的各自端，的几个点状距离元件，可靠地防止了短路并且既不影响凝结又不影响切割操作。
优选的是，第二切割部将被配置在电极部件上，面向具有绝缘部的电极部件。如果面对第二切割部的绝缘部被直接安排在电极部件上，使得电极部件没有明显的初始切割部，这是特别有利的。在这个实施方案中，绝缘部优选比相对的切割部更小，使得在朝向相对切割部的绝缘部的外周区域周围可以形成电弧。这使得可以实现精确的切割。
作为替代，可以在两个相对的电极部件上都配置切割部。因此电弧形成和切割扩展区域被极其准确的确定。
优选的是，用于防止短路的装置具有至少一个绝缘部，其在电极部件之内形成。被提供作为切割部的距离元件随后被配置在面对绝缘部的电极部件上。当分支被带到一起时，切割部被以只接触绝缘部的方式安排。有利的是，在此也提供了精确的切割，因为在被整合部和切割部之间形成电弧。该实施方案中绝缘部免受震动或相似的机械应力并关键地也免受电弧影响。
在此实施方案中绝缘部分可以如此配置，使得具有绝缘部的电极部件的电极表面被盈满。这允许电极部件在治疗后被简便和安全的清洁。
作为替代，能够安排绝缘部使它沉在相应的电极部件中，因此电极部件具有凹部。被配置在相对电极部件上的切割部因此可以至少部分的被嵌入凹部中，使得在切割操作期间能够凹部内朝向切割部形成电弧。因此周围组织被保护免受灼烧，与此同时可以精确确定切割线。
在一个优选实施方案中，绝缘部可以相对于在各自的电极部件上的初始切割部和/或第二切割部以对称方式被安排。共操作部的对称安排保证在距离元件的外周区域上均匀形成电弧，其有助于进行均匀的切割。
一个可能的实施方案提供了以可以实施机械切割的方式配置的距离元件。优选的是，随后距离元件将具有致使自身机械切割的切割边缘。随着外科医生适宜的运用，随后组织可以在凝结步骤之后被完全切入并且不必要改变器械。这允许实现对组织特别软的治疗。
在一个优选实施方案中，在至少一个电极部件上，切割部被配置成具有基本三角形截面的边缘。三角形截面允许从电极部件的一个大表面区域连续过度至它的刃形锥形。平滑过度特别适合于在有足够组织厚度的地方使用整个电极部件作为凝结电极，因为整个表面区域和组织可以互相接触。
有利的是，在至少一个电极部件上切割部被配置为具有基本圆或圆形截面的刃边。在明显凝结部和切割部之间的一个过度上，优选的是以截短的方式配置切割部，以保证切割部牢固地固定于相应电极部件。在此实施方案中，有相对大的电极表面可用于凝结操作，然而被配置为刃边的切割部几乎不能用于在有足够组织厚度的地方。另一方面，在操作的高级阶段，以及电外科器械的相对电极部件足够靠近时，切割部的刃形配置允许电流密度以可以切割操作的方式增加。
优选的是，绝缘部从对电弧腐蚀具有抗性的材料构建。因此，提供了对电弧磨损的可靠抗性。
在一个优选实施方案中，绝缘部由陶瓷材料组成。有利的是，陶瓷对高度的抗腐蚀性和对电弧磨损以及机械应力也具有高度的抗性。
下面，从实施方案的实例来描述本发明，其从举例说明中被更详细描述。它们描述了
图1a示意性描绘的在第一实施方案中在凝结阶段期间的电极安排；
图1b在凝结阶段结束时根据图1a的电极安排；
图1c在切割阶段期间根据图1a的电极安排；
图2示意性描绘的在第二实施方案中电极安排；
图3示意性描绘的在第三实施方案中电极安排；
图4示意性描绘的在第四实施方案中电极安排；
图5示意性描绘的在第五实施方案中电极安排；
图6示意性描绘的在第六实施方案中电极安排；
图7示意性描绘的根据本发明具有电极安排的电外科器械。
在以下描述中，相同的附图标记被用于相同和相似的工作部件。
图1a描绘了在第一实施方案中凝结阶段期间根据本发明的电极安排的截面的前视图。在此表示的是两个相对的电极部件18、19，其中一个电极部件18具有切割部18a和绝缘部21作为距离元件。在这个实施方案中，距离元件形成用于防止短路的装置20。被治疗的组织30被夹持在电极间。
当分支11、12被带到一起时绝缘部21防止电极部件18、19间不希望的短路，并且其可以被配置为线形和点状。例如，线形距离元件随后将在分支扩展方向延伸，共心排列在整个电极部件上并由此形成边缘。有利的是，因此有可能形成稳定的电弧并保证平稳的切割。点状距离元件很容易制造，其可靠的防止电极部件之间出现短路，作为热传导的结果，也保证了在组织和距离元件之间接触点上安全的凝结。安排在相应的电极部件例如在电极部件各自末端的几个点状距离元件可靠的防止短路并且既不影响凝结也不影响切割操作。而切割部18a在任何情况下被配置为线形。
除了防止短路以外，部21定义了在凝结阶段后仍保留的组织30的厚度，因为它防止由于电极部件18、19之间的太小间隔因任何预置的凝结电压而过早形成电弧。
图1b描绘了根据图1a的电极安排，尽管在此表示的是凝结的结束。根据图1a和1b凝结电流流过电极部件18、18a、19的整个表面，置于其间的组织30被凝结。作为热传导的结果，绝缘部21下的组织30被凝结。
图1c描绘了在切割阶段上述电极的排列。在凝结阶段的结尾，用于电外科治疗所需的HF电压被轻微增加，结果在切割部18a和相对电极部件19之间形成电弧23，其现在切割已经凝结的组织30。
切割部18a优先安排在电极部件18上作为相对于电极部件18渐细的区域并从此突出。除了切割部18a以外，电极部件18随后将由明显的凝结部组成。在凝结操作期间，形成凝结部和切割部18a的电极部件18可以在它的整个表面区域上作为凝结电极操作，即在凝结部的表面区域上和切割部18a表面区域上，而渐细的切割部18a单独可用于随后的切割操作。
绝缘部21的高，和由此自切割部18a和相对电极部件19的间隔，和用于切割所需的HF电压被相互调节。因此避免在切割部18a以外，即在电极部件18的剩余区域，形成电弧23。
因为正如所述的电极安排，同一器械既能用来凝结又能用来切割，能够避免改变器械从而带来不间断操作的好处。
在图2a中表示的是在第二实施方案中作为电极安排的截面的前视图。为了更好阐明，在治疗期间夹持在电极部件间的组织在这个实施方案中没有表示出。此外，这同样适用于图3-6。所述安排不同于图1a-1c中所示的安排，切割部18a被配置为具三角形截面的边缘。因为从电极部件18的一个大表面区域连续过度到它的刃形锥体，这个方案特别适合于在有足够组织厚度的地方使用整个电极部件18作为凝结电极，因为整个表面区域和组织可以相互接触。用合适的HF电压，在切割部18a和相对电极部件19之间形成电弧23。
绝缘部21在这种情况下具有渐细的形状，必要时这有助于机械切割，也就是说，距离元件具有明显的切割边缘22。随着外科医生适宜的运用，随后组织可以在凝结步骤之后被完全切入并且不必要改变器械。这使得可以对组织进行特别轻柔的处理而不使用电弧。
图3描绘了在第三实施方案中电极安排截面的前视图。在此，切割部18a被配置在电极部件18上和切割部19a被配置在电极部件19上。绝缘部21被直接安排在切割部18a的下面并相对于切割部18a、19a对称。共操作部18a、21、19a的对称安排保证在绝缘部21的外周区域均匀产生弧23，有利于进行均匀的切割。作为发挥距离元件功能的绝缘部21比切割部18a、19a更小，以至于不妨碍形成电弧23。因为窄的切割部18a、19a被容纳于电极部件18、19，切割进程能够被极其准确的确定。
一种电极安排的非常简单的实施方案被描绘于图4。在此，电极部件19仅有切割部19a，而在面对电极部件19的电极部件18上，只配置绝缘部21。因为电弧23在切割部19a的方向形成，该实施方案允许以特别容易的方式确定准确的切割线。
图5描绘了在电极部件18之内配置绝缘部21的电极部件18时电极安排的截面的前视图，其中绝缘部21与电极表面18b平齐。在相对电极部件19上的第二切割部19a被提供作为距离元件。绝缘部21和切割部19a在该实施方案中操作作为用于防止短路的装置20。有利的是，于此也提供准确的切割，因为在整合的部21和切割部19a之间形成电弧23。该实施方案使绝缘部21免受震动或相似的机械应力并基本上也免受电弧影响。
图6描绘了与图5所示相似的电极安排的配置。然而，在此配置的绝缘部21沉入相应的电极部件18，以至于在电极部件18上形成凹部18c。配置在相对电极部件19上的切割部19a可以至少部分的降入凹部18c，以至于在切割操作期间能够朝向切割部19a在凹部18c内形成电弧23。周围组织因此被保护免受灼烧，与此同时准确的切割线可以被确定。
也是在这个实施方案中，切割部19a可以被配置明显的切割边缘，其允许对组织进行机械切割。
图7描述了一个充分说明的电外科器械10，其具有根据本发明的电极安排。在示例中，附图标记11和12表示电外科器械10的两个分支。这两个分支11、12具有安装有电极部件18、19的末端13、14，其中电极部件18、19互相面对。例如，借助于电极部件18、19，它可以抓住脉管，并通过供给高频电流凝结或切割该脉管。此外，提供夹持部11a、12a，其被连接至分支11、12各自的近端15、16。挤压部11、12的近端15、16结束于电流供应装置17的连接元件17a。电流供应装置17使电外科器械10连接至HF发生器(未示出)，其产生HF电压，使得通过例如电导线(未示出)穿过器械10，HF电流可以被供给至电极部件18、19。
刃形切割部18a被配置在电极部件18上。其配置有两个绝缘部21、21’作为两个点状距离元件。被安排在电极部件18各自末端或切割部18a上的距离元件可靠的防止短路并且既不影响凝结也不影响切割操作。
为获得绝缘部对电弧的高度抗性，该部优选用抗电弧腐蚀的材料制成。尤其是通过应用陶瓷材料提供了对磨损的高度抗性。
在此应指出，作为本发明的本质，所有上述部件已经对其自身及其任何组合都要求了保护，尤其是在附图中示出的细节。对其的修改对于本领域的技术人员是熟悉的。
附图标记
10 电外科器械
11 挤压部，分支
11a 夹持部
12 挤压部，分支
12a 夹持部
13 远端
14 远端
15 近端
16 近端
17 电流供应装置
17a 连接元件
18 电极部件
18a 切割部
18b 电极表面
18c 凹部
19 电极部件
19a 切割部
20 防止短路装置
21、21’ 绝缘部
22 切割边缘
23 电弧
30 组织
Claims (11)
1.电外科器械，其包括
-两个相结合的分支(11、12)，其能以挤压工具的方式被驱动，
-在分支(11、12)远端(13、14)的电极部件(18、19)，其用于夹持组织(30)和用于传导凝结电流通过组织(30)以引起其凝结，
-电流供应装置(17)，其用于从H.F.发生器提供凝结电流给电极部件(18、19)和
-至少一个用于防止短路的装置(20)，其以电极部件(18、19)不能接触的方式被安排和配置，
其特征在于
用于防止短路的装置(20)被配置在电极部件(18、19)上。
2.根据权利要求1的电外科器械，
其特征在于
用于防止短路的装置(20)在至少一个电极部件(18、19)上提供作为绝缘部(21)的距离元件。
3.根据前述任一项权利要求特别是根据权利要求2所述的电外科器械，
其特征在于，
邻接绝缘部(21)，在至少一个电极部件(18)上，以这样的方式安排至少一个初始切割部(18a)，使得随着凝结电流电压的任何增加，从初始切割部(18a)产生用于切入组织的电弧。
4.根据前述任一项权利要求特别是根据权利要求2或3所述的电外科器械，
其特征在于，
第二切割部(19a)被配置在面对具有绝缘部(21)的电极部件(18)的电极部件(19)上。
5.根据前述任一项权利要求特别是根据权利要求1所述的电外科器械，
其特征在于，
用于防止短路的装置(20)具有以下特征：
-至少一个绝缘部(21)，其被配置在电极部件(18)内，
-被提供作为切割部(19a)的距离元件，其被配置在面对绝缘部(21)的电极部件(19)上，
其中以如此方式安排切割部(19a)，使得当分支(11、12)被带到一起时，切割部(19a)仅接触绝缘部(21)。
6.根据前述任一项权利要求特别是根据权利要求2-5任一项所述的电外科器械，
其特征在于，
绝缘部(21)相对于在各自电极部件(18、19)上的初始切割部(18a)和/或第二切割部(19a)以对称方式被安排。
7.根据前述任一项权利要求特别是根据权利要求2-6任一项所述的电外科器械，
其特征在于，
距离元件以能实施机械切割的方式被配置。
8.根据前述任一项权利要求特别是根据权利要求3-7任一项所述的电外科器械，
其特征在于，
在至少一个电极部件(18、19)上切割部(18a、19a)被配置为具有基本为三角形截面的刃边。
9.根据前述任一项权利要求特别是根据权利要求3-7任一项所述的电外科器械，
其特征在于，
在至少一个电极部件(18、19)上切割部(18a、19a)被配置为具有圆形截面的刃边。
10.根据前述任一项权利要求特别是根据权利要求2-9任一项所述的电外科器械，
其特征在于，
用抗电弧腐蚀的材料配置绝缘部(21)。
11.根据前述任一项权利要求特别是根据权利要求2-10任一项所述的电外科器械，
其特征在于，
用陶瓷材料配置绝缘部(21)。
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE102004031141A DE102004031141A1 (de) | 2004-06-28 | 2004-06-28 | Elektrochirurgisches Instrument |
| DE102004031141.2 | 2004-06-28 |
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| CN1976642A true CN1976642A (zh) | 2007-06-06 |
| CN100544681C CN100544681C (zh) | 2009-09-30 |
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| US (1) | US8623016B2 (zh) |
| EP (1) | EP1778112B1 (zh) |
| JP (1) | JP4652405B2 (zh) |
| CN (1) | CN100544681C (zh) |
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-
2004
- 2004-06-28 DE DE102004031141A patent/DE102004031141A1/de not_active Ceased
-
2005
- 2005-05-25 CN CNB2005800213469A patent/CN100544681C/zh active Active
- 2005-05-25 US US11/631,042 patent/US8623016B2/en active Active
- 2005-05-25 EP EP05745726A patent/EP1778112B1/de active Active
- 2005-05-25 JP JP2007518472A patent/JP4652405B2/ja active Active
- 2005-05-25 WO PCT/EP2005/005680 patent/WO2006000280A1/de active Application Filing
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8623016B2 (en) | 2004-06-28 | 2014-01-07 | Erbe Elektromedizin Gmbh | Electrosurgical instrument |
Also Published As
| Publication number | Publication date |
|---|---|
| JP2008504084A (ja) | 2008-02-14 |
| WO2006000280A1 (de) | 2006-01-05 |
| EP1778112B1 (de) | 2012-08-29 |
| US20080045944A1 (en) | 2008-02-21 |
| DE102004031141A1 (de) | 2006-01-26 |
| CN100544681C (zh) | 2009-09-30 |
| EP1778112A1 (de) | 2007-05-02 |
| JP4652405B2 (ja) | 2011-03-16 |
| US8623016B2 (en) | 2014-01-07 |
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