ES2537227T3 - Instrumento electro-quirúrgico con mordazas y con un electrodo - Google Patents
Instrumento electro-quirúrgico con mordazas y con un electrodo Download PDFInfo
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- ES2537227T3 ES2537227T3 ES11774133.0T ES11774133T ES2537227T3 ES 2537227 T3 ES2537227 T3 ES 2537227T3 ES 11774133 T ES11774133 T ES 11774133T ES 2537227 T3 ES2537227 T3 ES 2537227T3
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- 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
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
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- 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
- A61B18/1206—Generators therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2902—Details of shaft characterized by features of the actuating rod
- A61B2017/2903—Details of shaft characterized by features of the actuating rod transferring rotary motion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
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- 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
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- 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
- A61B2018/00184—Moving parts
- A61B2018/00196—Moving parts reciprocating lengthwise
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- 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
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- 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
- A61B2018/00607—Coagulation and cutting with the same instrument
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- 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
- A61B2018/0063—Sealing
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- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
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- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00702—Power or energy
- A61B2018/00708—Power or energy switching the power on or off
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- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00827—Current
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- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00869—Phase
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- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00892—Voltage
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- 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
- A61B2018/1412—Blade
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- 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
- A61B2018/1425—Needle
- A61B2018/1432—Needle curved
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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)
Abstract
Un instrumento electro-quirúrgico (10) que comprende: una primera mordaza (102); una segunda mordaza (104) opuesta a la primera mordaza y acoplada a la primera mordaza para aprisionar tejido entre la primera y segunda mordazas; un primer electrodo (103a) conectado a la primera mordaza; y un accionador (14) que tiene: un vástago alargado rotativo (16) conectado al accionador y a las mordazas primera y segunda; al menos una conexión conductora (24a); y al menos un contacto estacionario (26a) dispuesto dentro del accionador y conectable eléctricamente al menos a una conexión conductora, caracterizado porque la conexión conductora rodea una posición del vástago alargado rotativo dentro del accionador y comprende al menos un anillo conductor conectado eléctricamente al primer electrodo.
Description
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de obturación. Por ejemplo, el primer electrodo 205 incluye trayectorias de obturación primera y segunda 217a, 217b. Las trayectorias de obturación primera y segunda rodean y están adyacentes a la cuchilla o canal de corte de la mordaza a través de la cual se sitúa o atraviesa la cuchilla o electrodo de corte. En el caso ilustrado, la superficie de obturación monolítica puede incluir también espacios o cavidades 215a, 215b y una tercera y una cuarta trayectorias de obturación 219a, 219b situadas cerca, pero separadas, de las trayectorias de obturación primera y segunda. Las trayectorias de obturación primera y segunda son, en un caso, trayectorias interiores con respecto a las trayectorias exteriores de las tercera y cuarta trayectorias de obturación. Las trayectorias de obturación múltiples interrumpidas o separadas proporcionan zonas o partes de obturación redundante del tejido que está siendo obturado, separadas por una parte del tejido no tratada o manipulada eléctricamente o de otro modo por las mordazas. Como tal, situando un tejido separado o no afectado entre las trayectorias de obturación, se mejora la obturación global del tejido y se reducen la extensión térmica a lo largo del tejido y los efectos de la misma. En el caso ilustrado, el tejido entre la primera trayectoria de obturación y la cuarta trayectoria de obturación permanece sin afectar por la energía que está siendo transmitida al electrodo mientras que el tejido a lo largo de la primera y tercera trayectorias de obturación es obturado eléctricamente. De igual modo, el tejido entre la segunda trayectoria de obturación y la cuarta trayectoria de obturación es eléctricamente obturado y el tejido entre las trayectorias o dentro
- o a lo largo de las cavidades permanece sin afectar. El tejido a lo largo de las cavidades no es tampoco comprimido
- o mecánicamente manipulado en comparación con el tejido a lo largo de las trayectorias de obturación.
En un caso, el primer electrodo 205 puede ser activado por el usuario para cortar, coagular, fundir o soldar tejido en contacto con o entre el primer electrodo 205 y la primera mordaza 202 y/o el segundo electrodo 206. En un caso, el segundo electrodo 206 y la primera mordaza 202 comparten un contacto eléctrico común y/o polaridad común, de tal manera que la energía de RF puede ser transmitida entre el primer electrodo 205 y la primera mordaza 202 y/o entre el primer electrodo 205, el segundo electrodo 206 y la primera mordaza 202.
En un caso, cuando las mordazas no están completamente abiertas o cerradas, es decir, en un estado o condición entre estar abiertas o estar cerradas, se puede fundir el tejido situado entre las mordazas 202, 204. Sin embargo, en un caso, la interrupción automática de la energía de RF no es utilizada, no es activada o es desactivada cuando no se satisfacen o no se pueden garantizar las condiciones apropiadas para la interrupción automática de energía de RF. También se puede evitar el corte (mecánica y/o eléctricamente). Se puede determinar la identificación del estado intermedio en base a la activación o falta de la misma de un conmutador y/o mordazas o mediante la detección de la posición del gatillo o de las mordazas uno con respecto a otras.
En realizaciones, la energía electro-quirúrgica de RF para cortar y/o coagular tejido de una manera bipolar utiliza tanto un electrodo activo como uno de retorno y se puede utilizar por ejemplo en general y en operaciones laparoscópicas ginecológicas. En tales configuraciones, el efecto quirúrgico deseado (por ejemplo, corte, coagulación) está basado en la relación de densidad de corriente entre los electrodos, en la geometría de los electrodos y en la corriente y voltaje suministrados a los electrodos. En un caso, el corte del tejido utiliza una salida de voltaje mayor que 200 V y la coagulación utiliza un voltaje inferior a 200 V. La densidad de corriente se mide como la (Corriente Suministrada)/(Área Superficial del Electrodo). Como tales, los electrodos activo y de retorno pueden ser valorados por la siguiente relación de densidad de corriente: Electrodo Activo/Electrodo de Retorno = (Densidad de Corriente Grande)/(Densidad de Corriente Pequeña). Se ha de apreciar que un electrodo puede adoptar o conmutar entre roles como un electrodo activo o un electrodo de retorno con respecto a otro electrodo sobre la base de la densidad de corriente, de la geometría del electrodo y/o de la corriente y voltaje suministrados a los electrodos. En general, los electrodos activo y de retorno están eléctricamente aislados o aislados entre sí.
En las figuras 30-38 se muestran varias configuraciones de las mordazas del instrumento electro-quirúrgico. En varios casos, se sitúa al menos uno o sólo un electrodo en una de las mordazas. Por ejemplo, el electrodo está, en un caso, situado en la mordaza superior y orientado horizontalmente con relación a la mordaza. Se ha de apreciar que el electrodo puede estar en una mordaza opuesta a la ilustrada y que las mordazas superior e inferior son relativas entre sí.
En las figuras 30a-30B, una mordaza movible 602 incluye un electrodo vertical exterior 605. Esta configuración de electrodo proporciona corte en la punta de una mordaza de articulación o movible y/o a lo largo de la longitud de la mordaza. En un caso, el corte sigue en una manera de articulación y/o trayectoria relativa al vástago y al accionador del instrumento. Por ejemplo, el tejido puede ser cortado cuando se abre la mordaza superior, cuando el electrodo situado en la mordaza es paralelo o está en línea con la trayectoria que recorre la mordaza (por ejemplo, la trayectoria 601 y/o 603 (en ambas direcciones o en una)). En el caso ilustrado, el electrodo 605 en combinación con una parte conductora mayor 606 que rodea al electrodo sobre la mordaza o un segundo electrodo 607 conducen energía de RF entre ellos para efectuar la trayectoria de corte.
En un caso, una mordaza estacionaria 704 incluye un electrodo vertical exterior 705 como se muestra en la figura
31. Esta configuración de electrodo proporciona corte en la punta de una mordaza estacionaria 704 y/o a lo largo de la longitud de la parte exterior de la mordaza. En un caso, el electrodo 705 opera ya sea en combinación con un electrodo interior o uno exterior que actúa como otro electrodo para conducir energía de RF entre ellos. En un caso, una mordaza movible 702 no incluye un electrodo o está de otro modo separada o aislada del electrodo 705. En
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Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US38901210P | 2010-10-01 | 2010-10-01 | |
US389012P | 2010-10-01 | ||
PCT/US2011/054661 WO2012045095A1 (en) | 2010-10-01 | 2011-10-03 | Electrosurgical instruments with jaws and/or an electrode and amplifiers for electrosurgery |
Publications (1)
Publication Number | Publication Date |
---|---|
ES2537227T3 true ES2537227T3 (es) | 2015-06-03 |
Family
ID=44860516
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES11774133.0T Active ES2537227T3 (es) | 2010-10-01 | 2011-10-03 | Instrumento electro-quirúrgico con mordazas y con un electrodo |
ES15151398.3T Active ES2664081T3 (es) | 2010-10-01 | 2011-10-03 | Sistema electro-quirúrgico con un amplificador de radio frecuencia y con medios para la adaptación a la separación entre electrodos |
ES17207793T Active ES2912092T3 (es) | 2010-10-01 | 2011-10-03 | Instrumentos electroquirúrgicos y conexiones a los mismos |
Family Applications After (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES15151398.3T Active ES2664081T3 (es) | 2010-10-01 | 2011-10-03 | Sistema electro-quirúrgico con un amplificador de radio frecuencia y con medios para la adaptación a la separación entre electrodos |
ES17207793T Active ES2912092T3 (es) | 2010-10-01 | 2011-10-03 | Instrumentos electroquirúrgicos y conexiones a los mismos |
Country Status (6)
Country | Link |
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US (5) | US9320563B2 (es) |
EP (4) | EP2898846B1 (es) |
JP (5) | JP6143362B2 (es) |
AU (1) | AU2011308509B8 (es) |
ES (3) | ES2537227T3 (es) |
WO (1) | WO2012045095A1 (es) |
Families Citing this family (213)
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