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
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Prior art keywords
characterized
clamp according
comprises
thermocouple
high
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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 )
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.)
LAMIDEY GILLES
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LAMIDEY GILLES
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30Surgical pincettes without pivotal connections
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1402Probes for open surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00084Temperature
    • A61B2017/00092Temperature using thermocouples
    • A61B2017/00097Temperature 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. <IMAGE>

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 equipment and con trol, considered in itself, without any involvement of surgical treatment method of the human or animal body.

L'utilisation des courants de haute-fréquence pour coaguler les vaisseaux sanguins sectionnés au cours d'opération chirurgicale. The use of high-frequency currents to coagulate blood vessels severed during surgery. 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). is generally carried out using clamps acting either in monopolar mode (see Figure 1 of the accompanying drawing), or in bipolar mode when the instrument is suitable, that is to say with the two electrically insulated branches to the other (see Figure 2 of the accompanying drawing). L'effet de coagulation est contrôle par le chirurgien qui décide. The coagulation effect is controlled by the surgeon decides. lui-même, d'interrompre le passage du courant HF au moment qu'il juge opportun. himself to interrupt the HF current flow 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 extending the action beyond what is necessary to block blood flow and ensure hemostasis, dehydrated tissue dies, and plots come adhere to pincers it is necessary to clean the course of 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 adhesion phenomenon on the active ends of the clamp and in particular avoid so, 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 aims a gripper which one or two active ends comprise a thermocouple connected to an electromechanical or electronic equipment interrupting or regulating the current, high-frequency to a maximum temperature selected.

Les moyens de mesure, de contact ou de régulation sont en principe placés en série avec un interrupteur manuel ou à pédale. The measuring means, contact or control are normally placed in series with a manual switch or pedal. commandé par le chirurgien ou son aide. controlled by the surgeon or assistant. Avec une pince selon l'invention les coagulations sont assurées d'être régulières et non nécrosantes par l'arrêt automatique du courant HF lorsque la température affichée est atteinte au point de préhension. With a clamp according to the invention the coagulation are guaranteed to be regular and non-necrotizing by automatic shutdown of the RF 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 permetttre powering High Frequency of the clamp under the condition that its active ends are at about 37-C (temperature of the patient's tissue when it comes to a human? , the clamp then being electrically inert when it remains at room temperature (20 to 25 C @ for example) even if the operator depresses the foot pedal or the control switch.

Cet avantage protège le générateur HF 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 benefit protects the RF generator against the risk of unnecessarily prolonged operation if the operator continues to push the pedal when he no longer uses 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 BF et HF conformément aux normes de construction des appareils électro-chirurgicaux. The or electromechanical control means or electronic, appropriate and paired with the clamp, are of course made for the safety of the patient and the surgeon, making the isolation and limiting BF leakage currents and HF according to the Building Standards electrosurgical 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 Other features and advantages of the present invention will become apparent from the following description made with reference to the accompanying drawings in which
- Les figures 1 et 2 sont des schémas expliquant la coagulation monopolaire et la coagulation bipolaire; - Figures 1 and 2 are diagrams explaining the monopolar coagulation and bipolar coagulation;
t -la figure 3 est une vue schématique en pers pective d'une pince chirurgicale selon l'invention; t FIG 3 is a schematic view in pers pective of a surgical clip according to the invention;
- la figure 4 représente l'appareillage de commande et de contrôle selon l'invention; - Figure 4 shows the apparatus of command and control according to the 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. Conventional electrosurgical forceps - mono or bipolar - comprise two metal legs of rectangular section or the like coming into contact at their ends by finger pressure.

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 limbs (1 and 2) each consist of two rods (1A - 18) (2A - 2B) of round cross section (or other section or profile) s' tapering towards the active end of the branch where they meet.

Ces deux tiges de métaux différents (Acier, Inox, These two rods of different metals (steel, stainless steel,
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. Nickel, or nickel silver for example Constantan) are welded to the point of operative contact (1C) (2C) to form a thermocouple (IC) (2C) responsive to changes in tem perature.

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 legs (1 and 2) thus formed are immobilized in an insulating block (3) and their stems can protrude rearwardly thereof serving as connecting 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 HF The metal portions of the legs which are subjected to high-frequency current may be laminated or covered with an insulator (5) to protect the fingers burns risk HF current users

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 a nonconductive material intake on a 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, Although straight clamps of various lengths are the most commonly used, it is possible to achieve by this method of construction, angled tweezers or bayonet for example,
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 HF (8? ces divers appareils pouvant éventuellement constituer un seul ensemble. The connector (4) connected to a flexible multi-conductor cable (6) connects the gripper to a command and control unit (7I and a HF generator (8? These various devices may 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; The apparatus (7) comprises one, two or more control means (9) according to the nature of the thermocouples and their assembly;
Ainsi, la pince peut comporter un ou deux thermocouples de même nature ou de natures différentes. Thus, the clip may have one or two thermocouples of the same or of different types.

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 control means to one or two temperature thresholds (one stop or trigger and stop).

Dans le second cas, il existe deux thermocouples et deux moyens indépendants de contrôle. In the second case, there are two thermocouples and two independent means of monitoring. l'un assurant le déclenchement, l'autre assurant l'arrêt. one providing the trigger, the other making the stop.

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

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

Avec deux thermocouples, chacun étant sur l'extrémité active de l'une des branches; With two thermocouples, each of which is on the active end of one of the branches; l'un de ces thermocouples interrompt le fonctionnement à un seuil de température maximale; one of these thermocouples interrupts the operation at a maximum temperature threshold; l'autre thermocouple, à un seuil de température minimale, rétablit le fonctionnement. another thermocouple at a minimum temperature threshold, restores operation. ceci en vue d'obtenir une régulation précise de la température this in order to get an accurate temperature control
Suivant une autre possibilité. Another possibility. en intervenant sur le circuit lié au thermocouple interrompant le fonctionment à température minimale. intervening in the circuit connected to the thermocouple interrupting the minimum temperature at IT WORKS. le générateur HF 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. the HF generator can be stopped if the user did not place the clamp in contact with body tissue living human or animal, so their temperature. le fonctionnement n'étant alors assuré qu'à cette température (environ 37-C par exemple). operation then only being provided at that temperature (about 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 HF selon l'écartement de ses branches. The clamp may optionally be provided with a stop with or without electrical contact can have the purpose of automatically controlling the operation of the RF 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 understood, finally, that the invention has been described and claimed by way of preferred example and that we can make equivalences in its constituent elements without thereby departing from the scope of the invention,

Claims (11)

    REVENDICATIONS
  1. 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. A surgical clip, high-frequency current monopolar and bipolar - comprising two metal legs to 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. 2. Pince selon la revendication t caractérisée en ce que chaque branche (1-2) est constituée de deux tiges (1A-1B) < 2A-28? 2. Clamp according to Claim t, characterized in that each leg (1-2) consists of two rods (1A-1B) <2A-28? soudés en extrémité active de la branche pour y former le thermocouple (1C-2C). welded active end of the leg to form the thermocouple (1C-2C).
  3. 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. Clamp according to any one of claims 1 and 2 characterized in that the two legs (1-2) to two rods (1A-1B) (2A-2B) are immobilized in an insulating block (3).
  4. 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. Gripper according to claim 3 characterized in that the rods (1A-1B) (2A-2B) project from the insulating block (3) to serve as connection pins.
  5. 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, with the nature and the mounting of the thermocouples, the apparatus comprises one, two or more control means (9).
  6. 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. Clamp according to any one of claims 1 to 5 characterized in that it comprises a thermocouple, the apparatus comprising control means (9) to one or two thresholds (one stop or trigger and stop).
  7. 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 is interrupted at a selected threshold temperature and returned to service in a minimum temperature threshold.
  8. 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) ensuring a tripping.
    l'autre assurant l'arrêt. the other ensuring shutdown.
  9. 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 control means (9) associated and high-frequency filters to stop the control means causing only when both thermocouples have reached a preset threshold,
  10. 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. Clamp according to any one of claims 1 to 5 characterized in that it comprises a minimum threshold thermocouple high-frequency current being triggered at a temperature corresponding to that of the patient's body tissues.
  11. 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 1 claims 1 to 10 characterized in that it comprises an abutment with or without electrical contact.
FR8417545A 1984-11-16 1984-11-16 Tweezers and control equipment and control Expired FR2573301B3 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR8417545A FR2573301B3 (en) 1984-11-16 1984-11-16 Tweezers and control equipment and control

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
FR8417545A FR2573301B3 (en) 1984-11-16 1984-11-16 Tweezers and control equipment and control

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FR2573301A1 true true FR2573301A1 (en) 1986-05-23
FR2573301B3 FR2573301B3 (en) 1987-04-30

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