EP3164094A1 - Dispositif pour realiser la resection d'un organe - Google Patents
Dispositif pour realiser la resection d'un organeInfo
- Publication number
- EP3164094A1 EP3164094A1 EP15742049.8A EP15742049A EP3164094A1 EP 3164094 A1 EP3164094 A1 EP 3164094A1 EP 15742049 A EP15742049 A EP 15742049A EP 3164094 A1 EP3164094 A1 EP 3164094A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- loop
- state
- branches
- conduit
- branch
- 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- Withdrawn
Links
- 210000000056 organ Anatomy 0.000 title claims abstract description 17
- 238000002271 resection Methods 0.000 title claims abstract description 9
- 239000004020 conductor Substances 0.000 claims abstract description 43
- 230000000694 effects Effects 0.000 claims abstract description 5
- 239000000463 material Substances 0.000 abstract description 4
- 238000002679 ablation Methods 0.000 description 5
- 206010028980 Neoplasm Diseases 0.000 description 2
- 208000037062 Polyps Diseases 0.000 description 2
- 239000012530 fluid Substances 0.000 description 2
- 230000036244 malformation Effects 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 229910001260 Pt alloy Inorganic materials 0.000 description 1
- 238000007664 blowing Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 230000010339 dilation Effects 0.000 description 1
- 230000005489 elastic deformation Effects 0.000 description 1
- 239000012777 electrically insulating material Substances 0.000 description 1
- 239000011810 insulating material Substances 0.000 description 1
- 229910052741 iridium Inorganic materials 0.000 description 1
- GKOZUEZYRPOHIO-UHFFFAOYSA-N iridium atom Chemical compound [Ir] GKOZUEZYRPOHIO-UHFFFAOYSA-N 0.000 description 1
- 229910052703 rhodium Inorganic materials 0.000 description 1
- 239000010948 rhodium Substances 0.000 description 1
- MHOVAHRLVXNVSD-UHFFFAOYSA-N rhodium atom Chemical compound [Rh] MHOVAHRLVXNVSD-UHFFFAOYSA-N 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 210000004291 uterus Anatomy 0.000 description 1
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
- A61B18/149—Probes or electrodes therefor bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
-
- 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
- A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
- A61B18/082—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
- A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
- A61B18/10—Power sources 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00071—Electrical conductivity
- A61B2018/00077—Electrical conductivity high, i.e. electrically conducting
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00172—Connectors and adapters therefor
- A61B2018/00178—Electrical connectors
-
- 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
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00559—Female reproductive organs
-
- 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
- A61B2018/00577—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
- 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
- A61B2018/00595—Cauterization
-
- 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
-
- 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
- A61B2018/1475—Electrodes retractable in or deployable from a housing
Definitions
- the present invention relates to devices for performing the resection of all or part of an organ located in a cavity of a living body, in particular of a human being, whatever the nature of this organ, whether it is healthy or no, and more particularly the devices known in the field under the terminology "resectoscopes".
- Such a known device essentially comprises: a guide defined between a proximal end and a distal end, this guide comprising a through duct opening at its two ends; two electrically conductive son, insulated and slidably mounted in the conduit, these two son each having first and second ends able to emerge, during their translation in the conduit, respectively of the two proximal and distal ends of the conduit, the first two ends of the two wires having means for a two-pole connection of a source of electrical energy; an open loop defined between two free terminals and made of an electrically conductive resistant material to produce heat by Joule effect and thus allow, by burning, ablation of all or part of the determined organ; and means for electrically connecting the two free terminals of the open loop respectively to the two second ends of the two conductive wires.
- the known prior art resectoscopes comprise a loop whose overall section, even outside the duct, is at most equal to the overall internal section of the duct, so that it is relatively easily translated into the duct and she comes in and comes in just as easily.
- Such resectoscopes are known such as those described in US2009 / 182324, JP2008 206994, WO2013 / 064577.
- the US2009 / 82324 describes a resectoscope comprising, at the output, two electrical conductors mechanically joined by a die of an insulating material that does not allow them to be traversed by the same electrical current.
- the present invention aims to provide a device for performing the resection of all or part of an organ, as defined above, in a cavity of a living body, including a human being which largely overcomes the aforementioned drawbacks of known prior art resectoscopes.
- the present invention relates to a device for the resection of an organ in a cavity of a living body, including 'of a human being, comprising at least:
- a guide defined between a proximal end and a distal end, said guide defining a duct opening at its two ends, two electrical conductors, each conductor being defined along a longitudinal axis and slidably mounted in said duct, the two said longitudinal axes being substantially parallel, each conductor having a first end and a second end both able to emerge respectively from the proximal and distal ends of said conduit, the first ends respectively of the two conductors comprising means for connection to at least one pole of a source of electrical energy,
- An open loop terminated by two free terminals, said loop being made of an electrically conductive and resistant material to be able to produce heat by Joule effect, and
- said open loop is arranged to be able to assume two states, namely:
- FIG. 1 is a general and perspective diagrammatic view of a device for performing the resection of all or part of an organ in a cavity of a living body, in particular of a human being,
- FIG. 2 is an end view of an embodiment of the device according to the invention.
- FIGS. 3 and 4 show a perspective view of two embodiments of the "loop" part of the device according to the invention
- FIG. 5 represents a perspective view of a principal embodiment of a detail of a portion of the "loop" portion of the device according to the invention.
- Figure 6 is a block diagram of the device according to the invention. It is first of all specified that, in the present description, if the adverb "substantially" is associated with a qualifier of a given means, this qualifier must be understood in the strict sense or approached.
- the present invention relates to a device for performing the resection, by burning, of an organ in a cavity of a living body, in particular of a human being, which finds a particularly advantageous application in the field of hysteroscopy for intrauterine surgery.
- a device known to practitioners under the term "resectoscope” allows the realization of intrauterine interventions to achieve the removal of all or part of an organ, for example a polyp, a tumor, a synechia, a uterine malformation or similar.
- the device comprises at least one guide 10 defined between a proximal end 11 and a distal end 12, this guide defining a through conduit 13 opening at its two ends, two electrical conductors 21, 22, each conductor being defined according to a longitudinal axis and slidably mounted in the conduit 13, the conductors being further arranged so that their longitudinal axes are or remain substantially parallel to each other. In known manner, these conductors are further covered with an electrically insulating material.
- Each conductor comprises a first end 21-1, 22-1 and a second end 21-2, 22-2 both able to emerge respectively from the proximal end 1 and distal 12 of the conduit 13 when it is translated in this conduit.
- the first ends 21-1, 22-1 respectively of the two conductors comprise means for connection to at least one pole of a source of electrical energy 100, according to the case of direct or alternating current whose frequency can be adjusted, if necessary, to achieve ablation of the organ and cauterization of the wound.
- an open loop 40 terminated by two free terminals 41, 42 and means 30 for electrically connecting the two free terminals 41, 42 of the open loop respectively to the second ends 21-2, 22-2 of the two conductors 21, 22
- This open loop 40 is made of an electrically conductive material and resistant to be able to produce heat by the Joule effect up to a suitable temperature, for example 1000 degrees, so as to allow, in a known manner in itself, ablation by burning of the determined organ, then possibly the cauterization of the wound.
- the open loop is open loop
- E1 E2 is arranged to be able to take two states E1, E2, namely a first state E1, FIGS. 3 and 6, in which the orthogonal projection of its overall section in a plane perpendicular to the longitudinal axes of the conductors is included in FIG. the inner section of the duct 13 defined in the same plane, and a second state E2, FIG. 4, in which its overall section is greater than the internal section of the duct 13.
- section is used to define essentially the area of a surface.
- this term can be taken exceptionally to define one of the linear dimensions of this surface, for example the diameter of a circle, or the small or long axis of an ellipse.
- the loop 40 comprises at least two branches 40-1, 40-2, each branch being defined between a first end and a second end 43, 44, the first ends respectively of the two branches constituting the two free terminals. 41, 42, and means for cooperating the portions of the two branches having the second ends 43, 44 so that these portions of branches move relative to each other always being in contact in at least one point to ensure electrical continuity.
- the means for cooperatively mounting the portions of the two branches comprising the second ends 43, 44 consist of two rings 53, 54 respectively integral with these two second ends, these two portions of branches slidably passing respectively in the two rings.
- the means for cooperatively mounting the portions of the two branches comprising the second ends 43, 44 consist of a ring 53 secured to the second end of one of the two branches, the portion the other branch having the second end of the other branch being slidably mounted in this ring and the second end of this other branch having a stop 54 against which the ring 53 is adapted to abut.
- the ring 53 is formed of a fold of the portion of one of the two branches carrying the second end of this branch and the stop 54 consists of a curvature of the portion of the other branch having the second end of this other branch.
- the device further comprises means for passing the loop 40 as described above, its state E1 ( Figure 3) to its state E2 ( Figure 4), and vice versa.
- These means can be realized in different ways.
- they may be of automatic type, such as those illustrated schematically functionally in FIG. 5.
- they comprise elastic means 60 mounted in cooperation between a conductor and the branch which is connected to this conductor, so as to make it pivot about an axis substantially coincident with the longitudinal axis of the driver.
- these resilient means 60 are constituted, FIG. 5, by a spring 160 surrounding, by a first of its ends, the first end 41 of the branch 40-1 which is connected to the conductor 21 and bearing, by its other end, on this same branch 40-1.
- the spring 160 When the loop 40 is inside the conduit, the spring 160 is in a compressed state. On the other hand, when the loop 40 is out of the conduit 13, the spring 160 relaxes and the branch 40-1 is driven elastically in a dextrorsum rotation, this rotation being obtained by elastic deformation of the branch, or possibly by a pivot or the like between the branch and the conductor 21.
- the passage of the loop 40 from its state E1 to its state E2 makes it possible to obtain a length and / or a larger surgical operating area than when the loop is in its state E1, thus facilitating the practitioner's work.
- the practitioner pulls on the two conductors 21, 22 relative to the guide 10 to retract the loop 40 in the conduit 13.
- the two branches are closed on one another by compressing the spring (s) 160, the loop returning to its state E1 in the conduit. The practitioner can then without difficulty remove the guide out of the cavity.
- the means for passing the loop 40, when it is formed of two branches as described above, from its state E1 to its state E2, and vice versa, can be realized in another way.
- they may be constituted by means, shown schematically at 200 in Figure 6, to rotate each conductor about its respective longitudinal axis.
- the loop 40 when the loop 40 is outside the conduit 13, to change it from its state E1 to its state E2, it is sufficient for the practitioner to rotate the two conductors in opposite directions relative to each other , for example manually.
- the Practitioner rotates the two conductors in the opposite direction.
- the Practitioner can make it enter the conduit 13 by pulling the conductors relative to the guide 10, before leaving the guide of the cavity.
- the open loop 40 comprises two branches sliding one on the other.
- this open loop can be made in one piece.
- the means for passing loop 40 from its state E1 to its state E2, and vice versa comprise means, schematically illustrated at 300 in FIG. 6, for translating the two conductors 21, 22 substantially along their respective longitudinal axis, independently of one another.
- Such an embodiment is advantageous, especially when the duct 13 is of cylindrical shape of revolution and when the loop 40 affects the shape of an ellipse whose minor axis is at most equal to the diameter of the duct 13 and the large axis much larger .
- the means for passing the loop 40 from its state E1 to its state E2, and reciprocally comprise means, schematically illustrated at 400 in FIG. 6, for moving the two conductors 21, 22 relative to one another in a direction substantially perpendicular to their respective longitudinal axis, so as to move them apart or bring them closer to each other.
- the loop goes from one of its two states to another by deformation.
- the loop 40 has a substantially circular shape whose diameter is at most equal to the internal diameter of the duct 13, or a substantially elliptical shape whose minor axis is at most equal to diameter of the duct 13, as described above, the means 200 and 400 described above being able to combine.
- the loop 40 is made of an electrically conductive and resistive material, for example a platinum alloy, iridium, rhodium or stainless steel, and shaped so as to be both relatively flexible and rigid to be able to undergo elastic and / or plastic deformations.
- an electrically conductive and resistive material for example a platinum alloy, iridium, rhodium or stainless steel, and shaped so as to be both relatively flexible and rigid to be able to undergo elastic and / or plastic deformations.
- the skilled person will choose the appropriate solution to the surgical problem.
- the structure of the device according to the invention as described above greatly facilitates the work of the practitioner especially, but not exclusively, in the case where the cavity in which, as explained in the preamble of the present description, the device must be used for the removal of an organ by burning, for example in a uterine cavity, has a part having a much larger section for whatever reason than that of its entry.
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
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR1401514A FR3023157B1 (fr) | 2014-07-06 | 2014-07-06 | Dispositif pour realiser la resection d'un organe dans une cavite d'un corps vivant |
PCT/FR2015/000124 WO2016005666A1 (fr) | 2014-07-06 | 2015-06-24 | Dispositif pour realiser la resection d'un organe |
Publications (1)
Publication Number | Publication Date |
---|---|
EP3164094A1 true EP3164094A1 (fr) | 2017-05-10 |
Family
ID=51726556
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP15742049.8A Withdrawn EP3164094A1 (fr) | 2014-07-06 | 2015-06-24 | Dispositif pour realiser la resection d'un organe |
Country Status (8)
Country | Link |
---|---|
US (1) | US20170164993A1 (fr) |
EP (1) | EP3164094A1 (fr) |
JP (1) | JP2017521211A (fr) |
AU (1) | AU2015287530A1 (fr) |
CA (1) | CA2953869A1 (fr) |
FR (1) | FR3023157B1 (fr) |
RU (1) | RU2017100026A (fr) |
WO (1) | WO2016005666A1 (fr) |
Family Cites Families (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5078716A (en) * | 1990-05-11 | 1992-01-07 | Doll Larry F | Electrosurgical apparatus for resecting abnormal protruding growth |
US5437665A (en) * | 1993-10-12 | 1995-08-01 | Munro; Malcolm G. | Electrosurgical loop electrode instrument for laparoscopic surgery |
US5569244A (en) * | 1995-04-20 | 1996-10-29 | Symbiosis Corporation | Loop electrodes for electrocautery probes for use with a resectoscope |
US6283988B1 (en) * | 1997-04-07 | 2001-09-04 | Broncus Technologies, Inc. | Bronchial stenter having expandable electrodes |
US6093185A (en) * | 1998-03-05 | 2000-07-25 | Scimed Life Systems, Inc. | Expandable PMR device and method |
US6190382B1 (en) * | 1998-12-14 | 2001-02-20 | Medwaves, Inc. | Radio-frequency based catheter system for ablation of body tissues |
JP4653136B2 (ja) * | 2007-03-30 | 2011-03-16 | オリンパスメディカルシステムズ株式会社 | 剥離用処置具とレゼクトスコープ |
US20090182324A1 (en) * | 2008-01-16 | 2009-07-16 | Mel Kurtulus | Laproscopic electronic surgical instruments |
DE102011085721A1 (de) * | 2011-11-03 | 2013-05-08 | Günter Farin | HF-chirurgisches Resektionsinstrument mit einer Resektionsschlinge zur Entfernung pathologischer Gewebe |
-
2014
- 2014-07-06 FR FR1401514A patent/FR3023157B1/fr not_active Expired - Fee Related
-
2015
- 2015-06-24 JP JP2017521616A patent/JP2017521211A/ja not_active Abandoned
- 2015-06-24 AU AU2015287530A patent/AU2015287530A1/en not_active Abandoned
- 2015-06-24 WO PCT/FR2015/000124 patent/WO2016005666A1/fr active Application Filing
- 2015-06-24 CA CA2953869A patent/CA2953869A1/fr not_active Abandoned
- 2015-06-24 US US15/323,244 patent/US20170164993A1/en not_active Abandoned
- 2015-06-24 RU RU2017100026A patent/RU2017100026A/ru not_active Application Discontinuation
- 2015-06-24 EP EP15742049.8A patent/EP3164094A1/fr not_active Withdrawn
Non-Patent Citations (2)
Title |
---|
None * |
See also references of WO2016005666A1 * |
Also Published As
Publication number | Publication date |
---|---|
CA2953869A1 (fr) | 2016-01-14 |
US20170164993A1 (en) | 2017-06-15 |
FR3023157A1 (fr) | 2016-01-08 |
AU2015287530A1 (en) | 2016-12-22 |
RU2017100026A (ru) | 2018-08-06 |
WO2016005666A1 (fr) | 2016-01-14 |
RU2017100026A3 (fr) | 2019-02-12 |
FR3023157B1 (fr) | 2019-01-25 |
JP2017521211A (ja) | 2017-08-03 |
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