EP1199999A1 - Electrode permettant de couper un tissu biologique - Google Patents

Electrode permettant de couper un tissu biologique

Info

Publication number
EP1199999A1
EP1199999A1 EP00958307A EP00958307A EP1199999A1 EP 1199999 A1 EP1199999 A1 EP 1199999A1 EP 00958307 A EP00958307 A EP 00958307A EP 00958307 A EP00958307 A EP 00958307A EP 1199999 A1 EP1199999 A1 EP 1199999A1
Authority
EP
European Patent Office
Prior art keywords
electrode
tissue
individual surfaces
cutting
active electrode
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
EP00958307A
Other languages
German (de)
English (en)
Inventor
Klaus Fischer
Martin Hagg
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Erbe Elecktromedizin GmbH
Original Assignee
Erbe Elecktromedizin GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from DE1999141105 external-priority patent/DE19941105C2/de
Application filed by Erbe Elecktromedizin GmbH filed Critical Erbe Elecktromedizin GmbH
Publication of EP1199999A1 publication Critical patent/EP1199999A1/fr
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical 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
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical 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
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical 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
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop

Definitions

  • the invention relates to an electrode for cutting a biological tissue according to the preamble of patent claim
  • WO 96/20652 also discloses an electrode whose rough surface is partially provided with a metallic coating which makes the surface smoother and thereby reduces tissue sticking to the electrode during cutting and enables the electrode to be cleaned more easily.
  • an electrosurgical electrode is known, the metallic surface of which is coated with a polymer coating which acts as an electrical and thermal insulator.
  • the tip of the electrode remains free and the polymer layer has holes through which the gie penetrates from the electrode into the biological tissue to be cut.
  • No. 5,549,604 describes an electrode and a method for producing the electrode, the electrode being provided with an electrically conductive, pure amorphous silicone coating which is applied by means of a PECVD (plasma enhanced chemical vapor deposition) method.
  • PECVD plasma enhanced chemical vapor deposition
  • the silicone coating prevents biological tissue from sticking or sticking to the tip of the electrode during the cutting process.
  • WO 97/11649 also discloses an electrosurgical electrode with a silicone coating and a method for producing the electrode.
  • the silicone coating has a different thickness.
  • the silicone coating on the cutting edges of the electrode is particularly thin in order to allow an HF current to flow from the electrode into the biological tissue.
  • the silicone coating on the flat areas of the electrode is particularly thick and acts as an insulator. The silicone coating prevents the biological tissue from sticking or sticking to the electrode during cutting.
  • a high-frequency surgical unit in which the HF current flow is not generated continuously, but in one or more time intervals in order to cut the electrode too deeply into the tissue due to an excessive HF current flow to avoid.
  • the HF current flow is not generated continuously, but in one or more time intervals in order to cut the electrode too deeply into the tissue due to an excessive HF current flow to avoid.
  • it can, under certain circumstances, take a very long time to produce arcing-like discharges. During this time, an excessive HF current flowing into the tissue can damage it.
  • the active electrode area comprises, at least after the beginning of a cutting process, a multiplicity of individual areas which are accessible for the formation of the discharges and which are separated from one another by isolated areas, the individual areas being dimensioned very small relative to a total area of the active electrode area.
  • An essential point of the invention lies in the small number and the small size of electrically active, ie conductive surfaces or individual surfaces which are present for the formation of arc-like discharges or arcs.
  • the contact resistance between the electrode and the tissue to be cut is so great that only a very small amount of HF current flows into the tissue. Especially when cutting the tissue, too deep, unintentional coagulation of the tissue is avoided (even before arcing occurs).
  • the individual surfaces are preferably dimensioned so small that the HF current dries out the tissue sections touching the individual surfaces without substantial heating of the tissue to form essentially insulating tissue sections.
  • the RF current is therefore so small due to the dimensioning of the individual surfaces that no damage to the underlying tissue layers can occur due to an excessive RF current.
  • the individual surfaces are preferably formed by (spark) breakdown of an insulation layer on the active electrode area. Essentially, an HF current flow into the tissue only comes about through a (spark) breakdown of the insulation layer. Before a breakdown, the active electrode area is isolated due to the insulation layer, as a result of which there is no substantial HF current flow in the tissue. ) In a preferred embodiment, the insulation layer is designed to be so completely penetrable that it covers the active electrode area essentially completely so that it is penetrated by the HF current when the tissue is touched before the electrode is used for the first time. A small number of individual surfaces is preferably formed in the insulation layer before the electrode is used for the first time.
  • the individual surfaces are formed by targeted spark breakdowns before the electrode is used for the first time, while the insulation layer cannot be penetrated by the HF current during use.
  • the electrode can be prepared during manufacture.
  • the individual surfaces are formed via channels in a porous layer, which isolates the active electrode area from direct contact with the tissue.
  • a porous layer which isolates the active electrode area from direct contact with the tissue.
  • the insulation layer or the porous layer can be formed in such a way that tissue does not stick or stick during cutting.
  • the active electrode area is formed from a large number of individual elements.
  • the individual elements preferably comprise wires or electrically conductive fibers.
  • the effective conductive area of the electrode is determined by the number of wires or electrically conductive fibers. By reducing the wires or the electrically conductive fibers under the individual elements, for example, the contact resistance between the electrode and the tissue can be increased.
  • the electrode is particularly preferably designed in the form of a cord or ribbon.
  • the electrode is preferably designed as a polypectomy tube. A rough or roughened surface of the electrode is particularly advantageous in order to prevent the polypectomy slurry from slipping when it is placed against the tissue to be cut, ie when wrapping the polyp around it.
  • the invention relates to a method for producing an electrode for cutting biological tissue by means of an HF current, wherein arc-like discharges occur during the cutting between an electrically conductive active electrode region and the tissue.
  • the active electrode area is covered with an insulation layer.
  • a large number of individual surfaces are produced in the insulation layer and are accessible for the formation of the discharges.
  • the individual surfaces are preferably formed by (spark) breakdown of the insulation layer on the active electrode region.
  • the individual surfaces are particularly preferably formed by targeted spark breakdowns before the electrode is used for the first time.
  • the active electrode region is formed from a large number of individual elements in a preferred embodiment of the method.
  • the individual elements preferably comprise wires or electrically conductive fibers which are interwoven, interwoven, sewn or twisted with non-conductive wires.
  • the invention relates to the use of the electrode in endoscopy for the removal of polyps.
  • the electrode is preferably used in an applicator for gas enterology.
  • the electrode can also be used under water. The contact resistance between the electrode and the tissue is reduced by the water, so that there is a risk of an excessive HF current is particularly large and the electrode according to the invention can be used particularly advantageously here.
  • FIG. 10 shows an embodiment of an electrode for polypectomy and the basic arrangement when performing the polypectomy
  • FIG. 3 is a plan view of the electrode according to the first embodiment of the invention.
  • Fig. 5 is a plan view of an electrode according to a third embodiment of the invention.
  • Fig. 6 shows an embodiment of the electrode for use in an endoscope for gastroenterology.
  • FIG. 1 shows an electrode 11 for polypectomy, which is connected to an active connection 14 of a high-frequency generator 10 (HF generator).
  • HF generator high-frequency generator
  • a high-frequency alternating voltage is present at the active connection 14 of the HF generator 10.
  • the HF generator 10 has control elements
  • the electrode has an active electrode region 12, which comprises a wire-shaped loop (polypectomy tube).
  • the wire-shaped loop is placed around a polyp 42 that includes biological tissue 40.
  • the biological tissue 40 that is to say the patient, is electrically connected to a neutral connection 15 of the high-frequency generator 10, for example earth.
  • a high-frequency AC voltage for cutting the tissue is present between the active electrode area 12 of the electrode 11, in particular the wire-shaped loop, and the tissue 40 of the polyp 42.
  • the high-frequency alternating voltage depends on the voltage of the HF generator 10 and, if applicable, a voltage drop within the tissue 40.
  • the polypectomy slurry can be surrounded in particular by argon gas, which is supplied by means of a gas supply 13.
  • the argon gas favors the formation of arc-like discharges between the polypectomy slurry and the polyp 42 and prevents the generation of smoke.
  • arc-like discharges occur between the loop and the tissue 40.
  • a high-frequency current flow occurs over the active electrode area 12 m, the tissue 40.
  • the conductive material 20 of the electrode in particular a metal, is coated with an insulation layer 21.
  • the insulation layer 21 has a multiplicity of openings 22 which define conductive areas of the electrode surface, namely individual surfaces 26.
  • HF current high-frequency current
  • the K cell surfaces 26 so limited that damage to deeper tissue sections cannot occur due to excessive current flow.
  • the individual surfaces 26 of the electrode surface are made relatively small in relation to the total surface of the electrode.
  • the HF current flowing over these small individual surfaces 26 does have a very high current density at certain points, but the sum of the HF currents flowing over all individual surfaces 26 of the insulating coating 21 results in an overall low total current.
  • the openings 22 can arise when the electrode is used for the first time when the insulation layer is broken through. They can also be generated in a targeted manner (in particular by generating electrical breakdowns) before they are used for the first time.
  • the insulating coating 21 is therefore made from a biocompatible material, in particular from organic substances, which do not result in any harmful residues when burned.
  • the insulating coating 21 has openings 22 which define the individual surfaces S.
  • the RF current flow from the electrode to the tissue can essentially be determined by the diameter of these openings 22.
  • the insulating coating 21 or insulation layer which covers the metallic surface 20 of the electrode, has grains 25.
  • the grains 25 bring about a porosity of the insulating coating 21, as a result of which these air channels are formed.
  • the air channels cause an arc-like discharge to occur even at a low voltage between the active electrode region 12 and the tissue 40.
  • the insulating coating 21, which envelops the entire electrically active region of the electrode, at the same time prevents an HF current flow from the electrode from occurring into the tissue without arc-like discharges. It is only the arc-like discharges that cause an HF current to flow, which, however, is limited between the electrode and the tissue due to the high contact resistance formed by the relatively small air channels
  • the electrode again shows the top view of a section of the active electrode region 12 of another embodiment of the electrode.
  • the electrode has conductive wires 23 and non-conductive wires 24 (shown obliquely), which are intertwined, twisted, woven or sewn together.
  • E HF current flow from the electrode into the tissue occurs exclusively via the conductive wires 23.
  • the total HF current that can flow from the electrode into the tissue can essentially be determined via the number of conductive wires 23.
  • a combination with the options described above (insulating coating, etc.) is very possible.
  • 6 shows the use of the electrode in an endoscope for gastroenterology, that is, for mirroring the gastrointestinal area.
  • An applicator 30 for gastroenterology has an endoscope for mirroring an intestine 41. Furthermore, the applicator 30 has an opening for gas supply for the supply of argon gas in particular, which prevents smoke formation during an electrosurgical cutting process. In addition, an extraction opening is provided for extracting argon gas and smoke or vapor pressure levels. Furthermore, a polypectomy tube 31, which can be controlled by an operator via the applicator 30, is provided for the removal of polyps 42 in the intestine 41. The polypectomy loop 31 is movably attached to the applicator 30 in such a way that the surgeon can extend the polypectomy loop 31 out of the applicator 30 and retract it into the applicator so as not to disturb the view, for example during endoscopy ,
  • the electrode according to the invention essentially has the advantage that an excessively high HF current flow from the electrode into tissue to be cut is avoided before arcing-like discharges occur between the electrode and the tissue, and in particular a possibly too deep coagulation.
  • the insulating coating can in particular be designed in such a way that sticking or sticking of the cut biological tissue to the electrode is avoided.
  • a rough or roughened surface of the electrode is very advantageous in order to prevent the electrode, which is designed as a polypectomy slurry, from slipping when it is placed against the tissue to be cut, ie the polyp. LIST OF REFERENCE NUMBERS

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne une électrode permettant de couper un tissu biologique au moyen d'un courant haute fréquence. Lors de la coupe, des décharges de type arc électrique apparaissent entre une zone d'électrode qui est active et électroconductrice et le tissu. L'objectif de cette invention est d'éviter un flux de courant trop élevé dans le tissu, notamment lors de la découpe. Afin d'atteindre cet objectif, la zone d'électrode active comprend, au moins après le début du processus de coupe, plusieurs surfaces individuelles qui sont accessibles pour la formation de la décharge et sont séparées les unes des autres par des zones d'isolation, lesdites surfaces individuelles étant de dimensions très petites par rapport à une surface totale de la zone d'électrode active.
EP00958307A 1999-07-30 2000-07-27 Electrode permettant de couper un tissu biologique Ceased EP1199999A1 (fr)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
DE19935879 1999-07-30
DE19935879 1999-07-30
DE1999141105 DE19941105C2 (de) 1999-08-30 1999-08-30 Elektrode zum Schneiden eines biologischen Gewebes sowie Verfahren zur Herstellung einer solchen
DE19941105 1999-08-30
PCT/EP2000/007256 WO2001008577A1 (fr) 1999-07-30 2000-07-27 Electrode permettant de couper un tissu biologique

Publications (1)

Publication Number Publication Date
EP1199999A1 true EP1199999A1 (fr) 2002-05-02

Family

ID=26054414

Family Applications (1)

Application Number Title Priority Date Filing Date
EP00958307A Ceased EP1199999A1 (fr) 1999-07-30 2000-07-27 Electrode permettant de couper un tissu biologique

Country Status (2)

Country Link
EP (1) EP1199999A1 (fr)
WO (1) WO2001008577A1 (fr)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AU4246001A (en) * 2000-03-14 2001-09-24 Herbert Maslanka Electrosurgical instrument comprising a reduced electrode surface area
US20080004620A1 (en) * 2002-12-20 2008-01-03 Cithara Endoscopy, Inc., A California Corporation Device for resection of tissue
DE10334562B4 (de) * 2003-07-29 2005-06-09 Erbe Elektromedizin Gmbh Chirurgisches Instrument
CN104161584B (zh) * 2014-08-05 2017-08-08 中国人民解放军总医院 新型的低温等离子手术装置

Family Cites Families (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2946728A1 (de) 1979-11-20 1981-05-27 Erbe Elektromedizin GmbH & Co KG, 7400 Tübingen Hochfrequenz-chirurgiegeraet
AU4945490A (en) * 1989-01-06 1990-08-01 Angioplasty Systems Inc. Electrosurgical catheter for resolving atherosclerotic plaque
US5080660A (en) * 1990-05-11 1992-01-14 Applied Urology, Inc. Electrosurgical electrode
US5207675A (en) * 1991-07-15 1993-05-04 Jerome Canady Surgical coagulation device
DE4212053C1 (de) 1992-04-10 1996-01-11 Erbe Elektromedizin Chirurgisches Instrument
US5382247A (en) 1994-01-21 1995-01-17 Valleylab Inc. Technique for electrosurgical tips and method of manufacture and use
US5549604A (en) 1994-12-06 1996-08-27 Conmed Corporation Non-Stick electroconductive amorphous silica coating
US5713895A (en) 1994-12-30 1998-02-03 Valleylab Inc Partially coated electrodes
US5702387A (en) 1995-09-27 1997-12-30 Valleylab Inc Coated electrosurgical electrode
ATE262837T1 (de) * 1997-11-25 2004-04-15 Arthrocare Corp System zur elektrochirurgischen hautbehandlung

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO0108577A1 *

Also Published As

Publication number Publication date
WO2001008577A1 (fr) 2001-02-08

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