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
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/0042—Surgical instruments, devices or methods, e.g. tourniquets with special provisions for gripping
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/00477—Coupling
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/00982—General structural features
  • A61B2017/00991—Telescopic means
• • 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
  • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
  • A61B2018/00589—Coagulation
• • 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
  • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
  • A61B2018/00601—Cutting
• • 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
  • A61B2018/141—Snare

Definitions

• the invention relates to a loop electrode according to the preamble of claim 1.
• loop electrodes are known and commonly used in the prior art. These are primarily two different types of loop electrodes. It is, for example, a Schiingenelektrode known in which the two wire ends of the loop firmly, so are integrally connected to an inner shaft. The disadvantage here is that the instrument can only be used in the closed state. In unfavorable anatomical conditions, this can lead to complications. In addition, a loop electrode is known from the prior art, in which both wire ends are detachable on the inner shaft. This is again disadvantageous that inexperienced users this type of Schiingenelektroden can cause problems, since the handling has proved to be complicated.
• Object of the invention is to provide a Schiingenelektrode available that addresses the disadvantages of the prior art, while offering the most user-friendly and quickly applicable solution.
• An inventive Schiingenelektrode consists of a shaft and an associated handle.
• the shaft in turn consists of an inner shaft and an outer shaft.
• the inner shaft is firmly connected to the handle.
• the outer shaft is slidably mounted on the inner shaft. This displaceability results primarily from the fact that the outer shaft has a larger diameter than the inner shaft.
• the outer shaft is not connected to the inner shaft.
• the inner shaft has a loop. This loop is used, for example, the coagulation of human tissue.
• the loop electrode according to the invention is preferably used in the field of hysterectomy and applied with monopolar or bipolar technique.
• the tissue is severed by pulling the inner shaft through the outer shaft in the direction of the proximal end.
• the sling is contracted at the distal end, until it is partially to almost completely in the outer shaft and the tissue is severed.
• the looping electrode according to the invention is designed in such a way that the loop comprises precisely a first loop head which can be decoupled from the inner shaft.
• This first ski head may be formed in one embodiment as a ball. In principle, however, it is also possible for the first ski head to be in the form of a cube, pyramid, cylinder, oval ball, or any other shape which exceeds the diameter of the wire.
• the second ski head is firmly connected. This means that the second ski head can not be detached from the inner shaft, as is the case for example with the first loop head. This also means that a decoupling and coupling is not possible. Rather, the second ski head remains connected to the inner shaft even if the outer shaft has not been mounted on the inner shaft.
• the loop can only be decoupled from the inner shaft at one end, the user of the loop electrode is advantageously given a hand that he can also take into account unfavorable anatomical conditions during the surgical procedure.
• the outer shaft can be positioned in two positions with the sling pushed out to the inner shaft. This serves to operate the loop on the one hand as a closed system to the other as a semi-open system. This gives the user greater flexibility.
• the user selects depending on the anatomical conditions and the amount of tissue, whether a capture of the tissue or the looping of the tissue is advantageous. For example, it decouples the ski head of the inner shaft with a large amount of tissue and puts the loop around the body tissue, which is to be removed.
• the user of the Schiingenelektrode can advantageously control with the inner shaft, where the Schiingenelektrode is guided. Then he can re-pair the first ski head with the inner shaft.
• Special protection of this advantageous solution is also the coupling itself, which can be performed as a kind of catching pot.
• a loop according to the invention is designed such that it can be retracted and pushed out into the outer shaft.
• the loop electrode according to the invention can be used in two operating modes. First, it can be used as a semi-open system. In this semi-open system, the loop is firmly connected at one end to the inner shaft and the second end can be connected by means of an auxiliary instrument, such as a forceps, with the inner shaft. At the second loose end, for example, a ball is mounted on the wire, which is inserted into the inner shaft to close the loop. Due to the spring action of the wire, the ball automatically locks in the inner shaft. As soon as the outer shaft closes the area into which the ball is inserted, the ball is secured and can no longer come loose.
• the second mode is a closed system.
• the outer shaft can not be raised over the area of the catch pot of the inner shaft. This ensures that the ball can not come loose from the inner shaft.
• a backup which may be, for example, a bracket, wherein the bracket can be clipped onto the inner shaft and / or clipped off in a preferred embodiment.
• the securing in the form of the bracket can also be clipped and / or clipped directly to the proximal end of the outer shaft. In this way, the loop electrode is secured at any time of use.
• the outer shaft has a finger recess.
• This finger recess serves the better operation of the Schiingenelektrode, as in the interaction a relative movement of the outer shaft to the inner shaft can be carried out with the finger recess attached to the outer shaft and the handle firmly attached to the inner shaft.
• the inner shaft has a coupling. This coupling is suitable for receiving and releasing the first ski head.
• the shape of the coupling is based on the shape of the first ski head.
• the coupling is intended to produce a non-positive connection between the first ski head and the inner shaft, which, however, should also be easily detachable. Particularly preferred is the execution of the coupling as a catching pot.
• the advantage here is ease of use for the user, since the first ski head can be connected without major work and special training with the inner shaft. Due to the special form of the coupling, the ski head can be easily removed, being caught when re-hooking the ski head in the catching pot and thus is self-holding.
• the self-holding is achieved in that the ball wrapped in the catching pot and pulled by the spring action of the wire forward into the catch pot and thus automatically held.
• the loop is partially enclosed in plastic. This ensures that only defined areas can be coagulated or cut. Therefore, not the entire loop is enclosed in plastic, but only the part that should not serve for cutting.
• the loop is formed for example as a quadrilateral, wherein one of the corner regions is designed as a distal end, for example, without a plastic envelope.
• the opposite end of the proximal side is directly connected to the inner shaft or coupled.
• the loop may also be hexagonal.
• Advantage of this design is that the open loop has a larger area and thereby entwine a larger amount of tissue can be.
• Another advantage is that when removing small tissues, such as stalked polyps, the loop can be pulled to the first corners and then forms a small loop. Adjustments to the shape and length are left to the skilled person, as long as the usability of the hexagonal loop is guaranteed.
• proximal and distal are to be understood in the context of the application from the point of view of the user.
• the term half-open position implies that the first ski head has been removed from the catching pot.
• the closed position of the sling means that the first ski head is in the catching pot and the outer shaft has been pulled over the catching pot for securing purposes.
• the coupling on the catch pot wherein the catching pot forms a conical recess.
• the catching pot is designed in such a way that with the help of the wire the ski head is latched into the catching pot in a self-retaining manner.
• the coupling is tubular, wherein the catching pot is formed by two distally located tabs.
• FIG. 1 shows a side view of a loop electrode according to the invention in the ready-to-use state
• FIG 2 is a side view of the Schiingenelektrode of Figure 1, in the non-usable state.
• Figure 3 is an enlarged view of the inventive Schiingenelektrode of Figure 1 or 2;
• Figure 5 is a hexagonal loop
• Fig. 5.1 shows the loop of Fig. 5 with the hexagonal loop shown drawn in by about one-half;
• FIG. 6 shows a coupling according to the invention with catching pot
• FIG. 1 shows how a loop electrode 1 has a loop 6 at its distal end 7.
• the loop 6 consists of a wire 10, which is formed quadrangular in Figure 1.
• a securing bracket 4 is shown, which is clipped onto the inner shaft 2.
• an outer shaft 3 shown, which includes a finger recess 15.
• a handle not shown in detail is attachable. The handle is then firmly connected to the inner shaft 2, which means that the handle dictates the movements of the inner shaft 2.
• FIG. 3 shows an enlarged detail view of part of the loop electrode 1 from FIG.
• the wire 10 of the loop 6 forms a first ski head 8 in the form of a ball 9.
• a coupling 1 1 is shown, which allows easy insertion of the ball 9, since the coupling is designed in the form of a conical head 16. Ie. the ball 9 can be easily placed in the provided hole of the coupling 1 1, wherein the wire 10 is guided by a channel connected to the hole to set the ball 9 in the coupling 1 1.
• FIG. 5 shows a hexagonal wire 12 with the central corners 13, the corners 13 being arranged on the proximal side and the front corners 14 being arranged distally.
• the hexagonal wire 12 is shown, which has been retracted by about half, in which case a retraction in the proximal direction is meant.
• the front corners 14 now form a small loop.
• the inner shaft 3 is shown with the clutch 1 1 in an enlarged form.
• a recess 16 (conical head) for receiving the ball 9 and the retracted tabs 17 is shown as a depth stop for the ball 9.
• the catching pot 18 is used to fix and hold the ball 9. Dashed lines indicated is the ball 9 which is held in the catching pot 18.

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• 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)

Applications Claiming Priority (3)

Publications (1)

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Family Applications (1)

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• 2012
  • 2012-12-03 DE DE102012111736.5A patent/DE102012111736A1/de not_active Ceased
• 2013
  • 2013-11-07 JP JP2015541141A patent/JP2015533595A/ja active Pending
  • 2013-11-07 WO PCT/EP2013/073313 patent/WO2014075991A1/de active Application Filing
  • 2013-11-07 US US14/442,136 patent/US20160262824A1/en not_active Abandoned
  • 2013-11-07 EP EP13805280.8A patent/EP2919695A1/de not_active Withdrawn

Non-Patent Citations (1)

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