FR2573301A1 - Surgical forceps and its control and monitoring apparatus - Google Patents

Surgical forceps and its control and monitoring apparatus Download PDF

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Publication number
FR2573301A1
FR2573301A1 FR8417545A FR8417545A FR2573301A1 FR 2573301 A1 FR2573301 A1 FR 2573301A1 FR 8417545 A FR8417545 A FR 8417545A FR 8417545 A FR8417545 A FR 8417545A FR 2573301 A1 FR2573301 A1 FR 2573301A1
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FR
France
Prior art keywords
thermocouple
control means
thermocouples
clamp according
rods
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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.)
Granted
Application number
FR8417545A
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French (fr)
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FR2573301B3 (en
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LAMIDEY GILLES
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LAMIDEY GILLES
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Publication date
Application filed by LAMIDEY GILLES filed Critical LAMIDEY GILLES
Priority to FR8417545A priority Critical patent/FR2573301B3/en
Publication of FR2573301A1 publication Critical patent/FR2573301A1/en
Application granted granted Critical
Publication of FR2573301B3 publication Critical patent/FR2573301B3/en
Expired legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30—Surgical pincettes without pivotal connections
    • 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
    • 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
    • A61B18/1402—Probes for open surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00084—Temperature
    • A61B2017/00092—Temperature using thermocouples
    • A61B2017/00097—Temperature using thermocouples one of the thermometric elements being an electrode or the heating element

Abstract

The invention relates to a high-frequency current surgical forceps - monopolar and bipolar - including two metal branches with active extremities and to its monitoring apparatus. According to the invention at least one of the two active extremities includes a thermocouple (1C-2C) connected to an apparatus which interrupts or regulates the high-frequency current. Each branch 1-2 consists of two rods 1A-1B 2A-2B welded at the active extremity of the branch in order to form the thermocouple 1C-2C there. The invention applies generally to surgical instruments.

Description

La présente invention se rapporte à une pince chirurgicale et à son appareillage de commande et de con trôle, considérés en soi, sans implication d'aucune méthode de traitement chirurgical du corps humain ou animal. The present invention relates to a surgical clip and its control and monitoring equipment, considered in themselves, without the implication of any method of surgical treatment of the human or animal body.

L'utilisation des courants de haute-fréquence pour coaguler les vaisseaux sanguins sectionnés au cours d'opération chirurgicale. s'effectue généralement à l'aide de pinces agissant soit en mode monopolaire (voir la figure 1 du dessin annexé), soit en mode bipolaire si l'instrument est approprié, cest-à-dire avec les deux branches électriquement isolées l'une de l'autre (voir la figure 2 du dessin annexe). L'effet de coagulation est contrôle par le chirurgien qui décide. lui-même, d'interrompre le passage du courant H.F. au moment qu'il juge opportun. The use of high-frequency currents to coagulate the severed blood vessels during surgery. is generally carried out using pliers acting either in monopolar mode (see Figure 1 of the appended drawing), or in bipolar mode if the instrument is suitable, that is to say with the two electrically isolated branches one on the other (see Figure 2 of the attached drawing). The coagulation effect is checked by the surgeon who decides. itself, to interrupt the passage of the H.F. current at the time it deems appropriate.

En prolongeant l'action au-delà de ce qui est nécessaire pour bloquer le courant sanguin et assurer l'hémostase, les tissus déshydratés se nécrosent et, par parcelles, viennent adhérer aux pinces qu'il est alors nécessaire de nettoyer en cours d'opération. By prolonging the action beyond what is necessary to block the blood flow and ensure hemostasis, the dehydrated tissues become necrotized and, by pieces, adhere to the forceps which it is then necessary to clean during surgery.

La présente invention entend empêcher le phénomène d'adhérence sur les extrémités actives de la pince et notamment éviter ainsi, à l'utilisateur, de devoir nettoyer fréquemment celle-ci. The present invention intends to prevent the phenomenon of adhesion to the active ends of the clamp and in particular thus avoid, the user, having to frequently clean the latter.

L'invention vise une pince dont une ou les deux extrémités actives comportent un thermocouple relié à un appareillage électromécanique ou électronique interrompant ou régulant le courant de Haute-Fréquence pour une température maximale choisie. The invention relates to a clamp of which one or both active ends comprise a thermocouple connected to an electromechanical or electronic apparatus interrupting or regulating the high-frequency current for a selected maximum temperature.

Les moyens de mesure, de contact ou de régulation sont en principe placés en série avec un interrupteur manuel ou à pédale. commandé par le chirurgien ou son aide. Avec une pince selon l'invention les coagulations sont assurées d'être régulières et non nécrosantes par l'arrêt automatique du courant H.F. lorsque la température affichée est atteinte au point de préhension.  The measuring, contact or regulation means are in principle placed in series with a manual or pedal switch. ordered by the surgeon or his assistant. With forceps according to the invention, the coagulations are ensured to be regular and non-necrotizing by the automatic stopping of the HF current when the displayed temperature is reached at the point of gripping.

Une autre possibilité offerte par l'invention est de permetttre la mise sous tension Haute-Fréquence de la pince sous condition que ses extrémités actives soient à environ 37-C (température des tissus du patient quand il s'agit d'un être humain?, la pince étant alors électriquement inerte lorsqu'elle reste à la température ambiante (de 20 à 25@C par exemple) même si l'opérateur appuie sur la pédale ou l'interrupteur de commande. Another possibility offered by the invention is to allow the High-Frequency tensioning of the clamp provided that its active ends are at about 37-C (temperature of the patient's tissues when it is a human being? , the clamp is then electrically inert when it remains at room temperature (from 20 to 25 @ C for example) even if the operator presses the pedal or the control switch.

Cet avantage protège le générateur H.F. contre les risques de fonctionnement inutilement prolongé si l'opérateur continue à appuyer sur la pédale alors qu'il n'utilise plus l'instrument pour coaguler. This advantage protects the HF generator against the risks of unnecessarily prolonged operation if the operator continues to press the pedal while he is no longer using the instrument to coagulate.

Le ou les moyens de contrôle électromécaniques ou électroniques, appropriés et jumelés avec la pince, sont bien entendu réalisés pour la sécurité du patient et du chirurgien, en assurant les isolements et la limitation des courants de fuite B.F. et H.F. conformément aux normes de construction des appareils électro-chirurgicaux. The electromechanical or electronic control means or means, suitable and paired with the clamp, are of course made for the safety of the patient and the surgeon, by ensuring the isolations and the limitation of the BF and HF leakage currents in accordance with the construction standards of the electro-surgical devices.

D'autres caractéristiques et avantages de la présente invention ressortiront de la description qui va suivre faite en regard du dessin annexé sur lequel
- Les figures 1 et 2 sont des schémas expliquant la coagulation monopolaire et la coagulation bipolaire;
t -la figure 3 est une vue schématique en pers pective d'une pince chirurgicale selon l'invention;
- la figure 4 représente l'appareillage de commande et de contrôle selon l'invention;
Les pinces électro-chirurgicales classiques - mono ou bipolaires - comportent deux branches métalliques de section rectangulaire ou similaire venant en contact à leurs extrémités sous la pression des doigts.Other characteristics and advantages of the present invention will emerge from the description which follows, given with reference to the appended drawing in which
- Figures 1 and 2 are diagrams explaining monopolar coagulation and bipolar coagulation;
FIG. 3 is a schematic perspective view of a surgical clip according to the invention;
- Figure 4 shows the command and control apparatus according to the invention;
The classic electrosurgical forceps - mono or bipolar - comprise two metal branches of rectangular or similar section coming into contact at their ends under the pressure of the fingers.

Dans la forme de réalisation représentée une pince selon l'invention comprend deux branches (1 et 2) constituées chacune de deux tiges (1A - 18) (2A - 2B) de section ronde (ou d'une autre section ou profil) s'amincissant vers l'extrémité active de la branche où ils se rejoignent.  In the embodiment shown a clamp according to the invention comprises two branches (1 and 2) each consisting of two rods (1A - 18) (2A - 2B) of round section (or another section or profile) s' slimming towards the active end of the branch where they meet.

Ces deux tiges de métaux différents (Acier, Inox,
Nickel, Maillechort ou Constantan par exemple) sont soudés au point de contact actif (1C) (2C) pour y former un couple thermo-électrique (lC) (2C) sensible aux variations de tem perature. These two rods of different metals (Steel, Stainless steel,
Nickel, Maillechort or Constantan for example) are welded at the active contact point (1C) (2C) to form a thermoelectric couple (lC) (2C) sensitive to temperature variations.

Les deux branches (1 et 2) ainsi constituées sont immobilisées dans un bloc isolant (3) et leurs tiges peuvent dépasser vers l'arrière de celui-ci en servant de fiches de branchement sur un connecteur (4). The two branches (1 and 2) thus formed are immobilized in an insulating block (3) and their rods can protrude towards the rear thereof by serving as connection plugs on a connector (4).

Les parties métalliques des branches qui sont soumises au courant de haute-fréquence, peuvent être plastifiées ou recouvertes d'un isolant (5) afin de protéger les doigts des utilisateurs des risques de brûlures par courant H.F. The metal parts of the branches which are subjected to high-frequency current, can be plasticized or covered with an insulator (5) in order to protect the fingers of the users from the risk of burns by H.F.

Il est aussi possible de rigidifier l'instrument par un apport de matière non conductrice sur une partie ou sur la totalité des tiges constituant les branches. It is also possible to stiffen the instrument by adding non-conductive material to part or all of the rods constituting the branches.

Bien que les pinces droites de différentes longueurs soient les plus couramment utilisées, il est possible de réaliser, par ce mode de construction, des pinces coudées ou à baÏonnette par exemple,
Le connecteur (4) relié à un câble souple multiconducteur (6) relie la pince à un appareil de commande et de contrôle (7I et à un générateur H.F. (8? ces divers appareils pouvant éventuellement constituer un seul ensemble.Although straight clamps of different lengths are the most commonly used, it is possible to make, by this construction method, bent or bayonet clamps for example,
The connector (4) connected to a flexible multi-conductor cable (6) connects the clamp to a command and control device (7I and to an HF generator (8? These various devices can possibly constitute a single set.

L'appareil (7) comprend un, deux ou plusieurs moyens de contrôle (9) suivant la nature des thermocouples et leur montage;
Ainsi, la pince peut comporter un ou deux thermocouples de même nature ou de natures différentes.The apparatus (7) comprises one, two or more control means (9) depending on the nature of the thermocouples and their mounting;
Thus, the clamp may include one or two thermocouples of the same nature or of different natures.

Dans le premier cas, il existe un thermocouple et un moyen de contrôle à un ou deux seuils de température (arrêt seul ou déclenchement et arrêt). In the first case, there is a thermocouple and a control means with one or two temperature thresholds (stop only or trip and stop).

Dans le second cas, il existe deux thermocouples et deux moyens indépendants de contrôle. l'un assurant le déclenchement, l'autre assurant l'arrêt.  In the second case, there are two thermocouples and two independent means of control. one ensuring triggering, the other ensuring stopping.

Un dispositif contrôlant les deux thermocouples et des moyens de contrôle comportant des filtres H.F. et ne provoquant 1 arrêt que lorsque les deux thermocouples ont atteint un seuil préréglé. peuvent permettre le maintien d'une température plus uniforme. A device controlling the two thermocouples and control means comprising HF filters and causing 1 stop only when the two thermocouples have reached a preset threshold. can help maintain a more uniform temperature.

Des modes de fonctionnement de l'ensemble pinceappareillage de commande et de contrôle peuvent être les suivants
Avec un thermocouple placé à l'extrémité active d'une branche de la pince, le fonctionnement du générateur H.F, . ( 8 ) peut être interrompu au seuil de température choisi et remis en service à un seuil de température minimal.Modes of operation of the control and control gear assembly may be as follows
With a thermocouple placed at the active end of a branch of the clamp, the operation of the HF generator,. (8) can be interrupted at the selected temperature threshold and returned to service at a minimum temperature threshold.

Avec deux thermocouples, chacun étant sur l'extrémité active de l'une des branches; l'un de ces thermocouples interrompt le fonctionnement à un seuil de température maximale; l'autre thermocouple, à un seuil de température minimale, rétablit le fonctionnement. ceci en vue d'obtenir une régulation précise de la température
Suivant une autre possibilité. en intervenant sur le circuit lié au thermocouple interrompant le fonctionment à température minimale. le générateur H.F. peut être arrêté si l'utilisateur n'a pas placé la pince au contact des tissus du corps vivant humain ou animal, donc à leur température. le fonctionnement n'étant alors assuré qu'à cette température (environ 37-C par exemple).With two thermocouples, each on the active end of one of the branches; one of these thermocouples interrupts operation at a maximum temperature threshold; the other thermocouple, at a minimum temperature threshold, restores operation. this in order to obtain a precise regulation of the temperature
According to another possibility. by working on the circuit linked to the thermocouple interrupting the operation at minimum temperature. the HF generator can be stopped if the user has not placed the forceps in contact with the tissues of the living human or animal body, therefore at their temperature. operation is then only ensured at this temperature (approximately 37 ° C. for example).

La pince peut éventuellement être pourvue d'une butée avec ou sans contact électrique pouvant avoir pour objet de commander automatiquement le fonctionnement du générateur H.F. selon l'écartement de ses branches. The clamp may optionally be provided with a stop with or without electrical contact which may have the object of automatically controlling the operation of the H.F. generator according to the spacing of its branches.

Il est bien entendu, enfin, que la présente invention n'a été décrite et revendiquée qu'à titre d'exemple préférentiel et que l'on pourra apporter des équivalences dans ses éléments constitutifs sans, pour autant, sortir du cadre de l'invention,  It is clearly understood, finally, that the present invention has only been described and claimed as a preferred example and that it is possible to provide equivalences in its constituent elements without, however, departing from the scope of the invention,

Claims (11)

REVENDICATIONS 1. Pince chirurgicale à courant haute-fréquence monopolaire et bipolaire - comportant deux branches métalliques à extrémités actives, caractérisée en ce qu'au moins une des deux extrémités actives comporte un thermocouple (1C-2C) relié à un appareillage (7-8) interrompant ou régulant le courant haute-fréquence. 1. Monopolar and bipolar high-frequency surgical forceps - comprising two metal branches with active ends, characterized in that at least one of the two active ends comprises a thermocouple (1C-2C) connected to an apparatus (7-8) interrupting or regulating the high-frequency current. 2. Pince selon la revendication t caractérisée en ce que chaque branche (1-2) est constituée de deux tiges (1A-1B) < 2A-28? soudés en extrémité active de la branche pour y former le thermocouple (1C-2C). 2. Pliers according to claim t characterized in that each branch (1-2) consists of two rods (1A-1B) <2A-28? welded at the active end of the branch to form the thermocouple (1C-2C). 3. Pince selon l'une quelconque des revendications 1 et 2 caractérisée en ce que les deux branches (1-2) à deux tiges (1A-1B) (2A-2B) sont immobilisées dans un bloc isolant (3). 3. Pliers according to any one of claims 1 and 2 characterized in that the two branches (1-2) with two rods (1A-1B) (2A-2B) are immobilized in an insulating block (3). 4. Pince selon la revendication 3 caractérisée en ce que les tiges (1A-1B) (2A-2B) dépassent du bloc isolant (3) pour servir de fiches de connexion. 4. Clamp according to claim 3 characterized in that the rods (1A-1B) (2A-2B) protrude from the insulating block (3) to serve as connection plugs. 5. Pince selon l'une quelconque des revendications 1 à 4 caractérisée en ce que, suivant la nature et le montage des thermocouples, l'appareillage comprend un, deux ou plusieurs moyens de contrôle (9). 5. Clamp according to any one of claims 1 to 4 characterized in that, depending on the nature and mounting of the thermocouples, the apparatus comprises one, two or more control means (9). 6. Pince selon l'une quelconque des revendications 1 à 5 caractérisée en ce qu'elle comprend un thermocouple, l'appareillage comprenant un moyen de contrôle (9) à un ou deux seuils (arrêt seul ou déclenchement et arrêt). 6. Pliers according to any one of claims 1 to 5 characterized in that it comprises a thermocouple, the apparatus comprising a control means (9) with one or two thresholds (stop only or trip and stop). 7. Pince selon l'une quelconque des revendications 1 à 5 caractérisée en ce qu'elle comprend un thermocouple, le courant haute-fréquence étant interrompu à un seuil choisi de température et remis en service à un seuil de température minimale. 7. Clamp according to any one of claims 1 to 5 characterized in that it comprises a thermocouple, the high-frequency current being interrupted at a chosen temperature threshold and returned to service at a minimum temperature threshold. 8. Pince selon l'une quelconque des revendications 1 à 5 caractérisée en ce qu'elle comprend deux thermocouples, l'appareillage comprenant deux moyens indépendants de contrôle (9) l'un assurant le déclenchement. 8. Clamp according to any one of claims 1 to 5 characterized in that it comprises two thermocouples, the apparatus comprising two independent control means (9) one ensuring tripping. l'autre assurant l'arrêt.  the other ensuring stopping. 9. Pince selon l'une quelconque des revendications 1 à 5 caractérisée en ce qu'elle comprend deux thermocouples, l'appareillage comprenant un moyen de contrôle (9) associé et des moyens de contrôle à filtres haute-fréquence ne provoquant l'arrêt que lorsque les deux thermocouples ont atteint un seuil préréglé,  9. Clamp according to any one of claims 1 to 5 characterized in that it comprises two thermocouples, the apparatus comprising an associated control means (9) and control means with high-frequency filters which do not cause the shutdown only when the two thermocouples have reached a preset threshold, 10. Pince selon l'une quelconque des revendications 1 à 5 caractérisée en ce qu elle comprend un thermocouple à seuil minimal le courant haute-fréquence étant déclenché à une température correspondant à celle des tissus du corps du patient. 10. Pliers according to any one of claims 1 to 5 characterized in that it comprises a thermocouple with minimum threshold the high-frequency current being triggered at a temperature corresponding to that of the tissues of the patient's body. 11. Pince selon 1 une quelconque des revendications 1 à 10 caractérisée en ce qu'elle comprend une butée avec ou sans contact électrique.  11. Clamp according to any one of claims 1 to 10 characterized in that it comprises a stop with or without electrical contact.
FR8417545A 1984-11-16 1984-11-16 SURGICAL PLIERS AND ITS CONTROL AND CONTROL APPARATUS Expired FR2573301B3 (en)

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