EP1296606A1 - Systeme d'electrodes d'un instrument chirurgical - Google Patents

Systeme d'electrodes d'un instrument chirurgical

Info

Publication number
EP1296606A1
EP1296606A1 EP01960235A EP01960235A EP1296606A1 EP 1296606 A1 EP1296606 A1 EP 1296606A1 EP 01960235 A EP01960235 A EP 01960235A EP 01960235 A EP01960235 A EP 01960235A EP 1296606 A1 EP1296606 A1 EP 1296606A1
Authority
EP
European Patent Office
Prior art keywords
arrangement according
profiles
rod
carrier
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.)
Withdrawn
Application number
EP01960235A
Other languages
German (de)
English (en)
Inventor
Kai Desinger
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.)
Celon AG Medical Instruments
Original Assignee
Celon AG Medical Instruments
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
Application filed by Celon AG Medical Instruments filed Critical Celon AG Medical Instruments
Publication of EP1296606A1 publication Critical patent/EP1296606A1/fr
Withdrawn legal-status Critical Current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
    • A61B18/148—Probes or electrodes therefor having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
    • 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
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/306—Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres

Definitions

  • the invention relates to an electrode arrangement for a surgical instrument for the electrothermal coagulation of human or animal tissue, with an elongated carrier, at least two electrodes running in the longitudinal direction of the carrier, which can be connected to an external AC voltage, with a plurality of self-supporting metallic rod profiles running in the longitudinal direction of the carrier , which are connected to one another by means of one or more insulating spacer elements and form the electrodes.
  • alternating currents for example in the frequency range from 300 KHz to 2 MHz
  • so-called mono-polar electrode arrangements or bipolar electrode arrangements are used to introduce the HF current into the tissue.
  • an electrode - also referred to as a neutral electrode - is placed on the patient's skin as a large-area electrode in the vicinity of the treatment site and is fixed and grounded there or connected to ground.
  • a second electrode handled by the surgeon - also referred to as an active electrode - is connected to the AC voltage source.
  • the shape of the electrode is adapted to the particular application, in particular to the size of the tissue area to be treated, so that both the duration of the operation and the thermal stress on the affected organ or body area are acceptable and only coagulate the desired tissue area.
  • both electrodes are connected to an HF generator and arranged in mutually fixed dimensions, for example on an insulating elongated support, and are placed by the surgeon in the immediate vicinity of the treatment parts and are usually also actively guided.
  • a bipolar electrode arrangement with a liquid channel is known from WO 97/17009, via which rinsing liquid can be introduced into the engagement area.
  • Two or three electrodes are arranged as a conical section on a conical distal tip of the instrument, which can be inserted into the tissue, the electromagnetic RF field being formed between the electrodes and intended to coagulate the surrounding tissue.
  • the advantages of the invention lie in the fact that simple manufacture of the electrodes is achieved by using standard profiles made of conductive metal, in the form of a hollow profile or solid profile, at least one rod profile being designed as a hollow profile, and therefore increasing the strength of the support on the one hand and Allows access to the treatment site for light guides, treatment fluids etc. or for suctioning off body fluids.
  • appropriate rod profiles which are part of the support and each form an electrode with a bare circumferential section, various advantageous functions of the electrode arrangement are realized.
  • the rod profiles are an integral part of the carrier, each also have an electrode in the longitudinal direction and can also be used - if they are designed as a hollow profile - to enable material to be transported from the distal end of the carrier to the outside in a simple manner.
  • all the rod profiles are designed as hollow profiles and can have any cross-section, for example, also have a circular cross section. If three or more hollow profiles are used, several hollow channels are advantageously realized, which enable material to be transported from the tip of the electrode arrangement to the outside.
  • Each rod profile preferably has a bare, metallic outer section as an electrode. If three or more rod profiles form the carrier, the overall diameter of the carrier is increased, but the electromagnetic HF field that forms when the HF alternating voltage is applied between the electrodes running in the longitudinal direction also becomes uniform on the outer circumference — in the circumferential direction distributed.
  • two adjacent rod profiles are closed at their distal front end and have through openings which connect the two hollow channels of the rod profiles to one another for the circulation of fluids, for example cooling liquid or liquids at a predetermined temperature.
  • the hollow channel of a hollow rod profile can be used, on the one hand to position an optical waveguide in a displaceable or fixed manner from the proximal side of the electrode arrangement for position control of the distal end of the electrodes.
  • the hollow channel is open at the distal end, and the optical waveguide emits light at the distal end or takes up reflected light and leads it back to the proximal end.
  • Laser or high-power diodes for the visible wavelength range serve as light sources, which can preferably be installed in the surgical instrument to which the electrode arrangement is detachably or firmly coupled.
  • the spacer element is uniform over the entire length of the rod profiles and has at least one hollow channel which extends over the entire length of the electrode arrangement and at the distal end of the electrode attachment Order is open or closed.
  • a temperature sensor can be arranged, which measures the tissue temperature at the distal end of the electrode arrangement and outputs corresponding measured values via lines to the proximal end of the electrode arrangement.
  • Each rod profile preferably forms an electrode running in the longitudinal direction of the carrier with a predetermined, metallic exposed peripheral section.
  • a spacer element between the rod profile uniformly fills the space between the opposite circumferential sections of the rod profiles.
  • the spacer element is realized either by an adhesive or a plastic casting material and holds the rod profiles together in a living manner, the free electrodes being free of insulation material and directed towards the outside of the fabric.
  • Carrier can be either bipolar or tripolar or quadropolar, i.e. be constructed with two, three or four electrodes which are electrically insulated from one another, run in the longitudinal direction of the carrier and can be supplied with a high-frequency AC voltage.
  • all the rod profiles are designed as solid profiles and are held together by an insulating spacer element.
  • Show it: 1 shows a longitudinal section through a first embodiment of a bipolar electrode arrangement.
  • FIG. 2 shows a cross section through the arrangement according to FIG. 1;
  • FIG. 3 shows a longitudinal section through a second bipolar embodiment of the electrode arrangement
  • FIG. 5 shows a cross section through a quadrupolar embodiment of the electrode arrangement
  • FIG. 6 shows a cross section through a third bipolar embodiment of the electrode arrangement
  • FIG. 7 shows a cross section through a fourth bipolar embodiment of the electrode arrangement
  • FIG. 8 shows a cross section through a fifth bipolar embodiment of the electrode arrangement
  • FIG. 10 shows a cross section through the electrode arrangement according to FIG. 9.
  • FIG. 1 and 2 show a first embodiment of a bipolar electrode arrangement in longitudinal section and in cross section.
  • two circular hollow profiles 4 made of metal are arranged at a short distance above one another and, together with a spacer element 10 present between the hollow profiles 4, form a carrier which has an electrode 14 running in the longitudinal direction of the carrier on each hollow profile 4 at the proximal end, at which the electrode arrangement is coupled to a corresponding surgical instrument, can be connected.
  • the hollow profiles 4 each have a hollow channel 6, which is open at the distal end 3 of the electrode arrangement, that is to say each has an opening 8.
  • the two hollow profiles 4 converge to a tip 9 at the distal end 3.
  • the two hollow profiles 4 are connected to one another by means of an insulating spacer element 10, for example by means of a plastic profile that runs uniformly over the entire length of the electrode.
  • Treatment fluids can be supplied to the treatment site in the hollow channels 6 or body fluids can be drawn off from the treatment site or optical waveguides can be used which can illuminate the treatment site.
  • the optical waveguide can be provided in a hollow channel 6 either fixed or longitudinally displaceable.
  • FIG. 3 shows a second embodiment of a bipolar electrode arrangement, which largely corresponds to the embodiment according to FIGS. 1 and 2, but the two hollow channels 6 of the hollow profiles are closed at the distal end 3 by means of closure pieces. In contrast, there are through openings 7 between the hollow channels 6 of the two hollow profiles 4 and allow countercurrent circulation of a tempered liquid from the proximal end of the electrode arrangement to the distal end 3 and back again to the proximal end.
  • FIG. 4 shows a tripolar embodiment of the electrode arrangement, in which three hollow profiles - lying in cross section with their longitudinal axes on a triangle - run in the longitudinal direction of the carrier and form the electrode arrangement.
  • the hollow profiles 4 each have a hollow channel 6, which can be open or closed at the distal end of the electrode arrangement.
  • the hollow profiles 4 are made of metal and have an exposed metallic circumferential section which forms the electrodes 14 running in the longitudinal direction.
  • One electrode 14 is provided for each hollow profile 4, so the arrangement overall forms three electrodes 14 running in the longitudinal direction, to which the HF alternating voltage can be applied proximally, two of the hollow profiles also being able to be electrically connected to one another, but alternatively being at different alternating voltages.
  • the three hollow profiles 4 are connected to one another by means of an insulating spacer element 10.
  • the spacer element 10 extends on the adjacent circumferential sections of the hollow profiles 4, whereas the exposed metallic circumferential sections 14 are not covered with insulation material of the spacer 10.
  • 5 shows a cross section through a quadrupolar embodiment of the electrode arrangement, in which four metallic hollow profiles 4 with a circular cross section in the longitudinal direction are connected to one another in an insulating manner and fastened to one another by means of one or more spacing elements 10 located one behind the other.
  • Outer exposed metallic peripheral sections of the hollow profiles 4 each form an electrode 14, that is to say a total of four electrodes 14 running in the longitudinal direction, which come into contact with the human or animal body tissue when the electrode arrangement is used, and between which there is the electromagnetic field required for electrothermal coagulation develops when an HF AC voltage is applied proximally.
  • 6 to 10 show further embodiments of the bipolar electrode arrangement, which are characterized in that the circumferential contour of the cross section of the electrode arrangement is circular.
  • two hollow profiles 4 with a polygonal cross section or a semicircular cross section are provided as rod profiles, which are isolated from one another by means of a uniform spacer element 10.
  • the hollow channels 6 serve to receive sensors or optical fibers or as channels for treatment or bath fluid.
  • the bare metallic peripheral sections on the outside serve as electrodes and run in the longitudinal direction of the arrangement.
  • FIGS. 9 and 10 also show bipolar electrode arrangements, in which, however, two full profiles run in the longitudinal direction of the carrier, which therefore have no hollow channels.
  • a spacing element 10 made of insulating material is interposed, which firmly connects the two full profiles 4 to one another and - in the embodiment according to FIG. 8 - has two hollow channels 16 which extend in the longitudinal direction from the proximal end to the distal end of the electrode arrangement extend.
  • the exposed metallic peripheral sections 14 form the two electrodes, which run in the form of a strip in the longitudinal direction and come into metallic contact with the body tissue when the electrode arrangement is put into use.
  • the embodiment shown in FIGS. 9 and 10 contains two in cross section circular full profiles 4, which are firmly connected to one another via the spacer element 10.
  • the outer contour of the electrode arrangement is approximately circular, the distal end 3 has a tip 9.

Abstract

L'invention concerne un système d'électrodes d'un instrument chirurgical de coagulation électrothermique de tissus humains ou animaux. Ce système comprend un long support, au moins deux électrodes qui s'étendent dans le sens longitudinal du support et peuvent être raccordées à une tension alternative externe et plusieurs profilés métalliques autoporteurs en forme de barres s'étendant dans le sens longitudinal. Les profilés métalliques sont reliés par au moins une entretoise isolante et constituent les électrodes. Au moins un profilé est conçu sous forme de profilé creux ou de profilé plein.
EP01960235A 2000-05-26 2001-05-22 Systeme d'electrodes d'un instrument chirurgical Withdrawn EP1296606A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE20009426U DE20009426U1 (de) 2000-05-26 2000-05-26 Chirurgisches Instrument
DE20009426U 2000-05-26
PCT/EP2001/005879 WO2001089403A1 (fr) 2000-05-26 2001-05-22 Systeme d'electrodes d'un instrument chirurgical

Publications (1)

Publication Number Publication Date
EP1296606A1 true EP1296606A1 (fr) 2003-04-02

Family

ID=7942027

Family Applications (1)

Application Number Title Priority Date Filing Date
EP01960235A Withdrawn EP1296606A1 (fr) 2000-05-26 2001-05-22 Systeme d'electrodes d'un instrument chirurgical

Country Status (7)

Country Link
US (1) US7666183B2 (fr)
EP (1) EP1296606A1 (fr)
JP (1) JP2003533331A (fr)
CN (1) CN100522093C (fr)
AU (1) AU2001281783A1 (fr)
DE (1) DE20009426U1 (fr)
WO (1) WO2001089403A1 (fr)

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Also Published As

Publication number Publication date
AU2001281783A1 (en) 2001-12-03
DE20009426U1 (de) 2001-10-31
WO2001089403A8 (fr) 2002-02-21
US7666183B2 (en) 2010-02-23
US20040116923A1 (en) 2004-06-17
CN1430488A (zh) 2003-07-16
WO2001089403A1 (fr) 2001-11-29
JP2003533331A (ja) 2003-11-11
CN100522093C (zh) 2009-08-05

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