FR2647683A1 - Dispositif d'etanchement/coagulation de sang hors de vaisseaux sanguins - Google Patents
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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
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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
- A61B18/1402—Probes for open surgery
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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
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/282—Jaws
- A61B2017/2825—Inserts of different material in jaws
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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
- A61B2018/00059—Material properties
- A61B2018/00071—Electrical conductivity
- A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
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- A—HUMAN NECESSITIES
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- 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
- A61B2018/00107—Coatings on the energy applicator
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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
- A61B2018/00107—Coatings on the energy applicator
- A61B2018/00119—Coatings on the energy applicator with metal oxide nitride
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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
- A61B2018/143—Needle multiple needles
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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
- A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
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Abstract
Ce dispositif fait passer un courant à haute fréquence entre une pince 1, le vaisseau sanguin étant, maintenu entre les extrémités de la pince, pour être cautérisé et pour coaguler et étancher le sang, le dispositif étant caractérisé en ce que le segment de la pince 1 maintenant le vaisseau sanguin comprend un élément de contact A avec le vaisseau sanguin, constitué d'une matière frittée isolante de l'électricité, ayant une faible conductivité thermique, et l'élément de contact 10a avec le vaisseau sanguin est muni sur sa surface d'électrodes exposées selon un rapport de superficie compris entre 5 et 60 % de la surface totale de l'élément de contact avec le vaisseau sanguin. Le segment de la pince 1 en contact avec le vaisseau sanguin n'est pas chauffé de façon excessive, ce qui évite la brûlure du vaisseau sanguin. Cela élimine tout échec d'étanchement dû à l'enlèvement d'une partie de vaisseau sanguin cautérisé et garantit une excellente coagulation et un excellent étanchement. En outre, l'électrode exposée, disposée à l'extrémité la plus antérieure de la pince, a des fonctions de sectionnement, coagulation et étanchement, de sorte qu'il est possible d'utiliser un seul dispositif pour la coagulation, l'étanchement et le sectionnement.
Description
La présente invention concerne un dispositif d'étanche-
ment/coagulation de sang de vaisseaux (également dénommé ci-après "dispositif d'étanchement/coagulation de vaisseaux sanguins" ou "dispositif de cautérisation"), utilisé pour arrêter l'écoulement de sang hors de vaisseaux au cours d'interventions de neurochirurgie cérébrale, de chirurgie
orthopédique et de chirurgie générale.
Un dispositif classique de cautérisation,de type bipo-
laire, utilise un courant à haute fréquence. On a utilisé un
certain nombre de dispositifs classiques de ce type qui uti-
lisent une méthode d'éclateur engendrant une haute fréquence comprise entre 0,5 et 3 MHz. Les deux électrodes (électrode active et électrode inactive) du dispositif de type bipolaire sont placées aux deux extrémités d'une paire de pinceà tenir à la main. Un courant électrique passe à travers le tissu vivant maintenu entre les extrémités de la pince. Etant donné que seule la partie limitée à cautériser est endommagée par le courant électrique, il est possible d'arrêter complètement l'écoulement de sang hors d'un vaisseau sans endommager d'autres tissus. Plus particulièrement, l'effet d'étanchement
du dispositif est obtenu par cautérisation du vaisseau san-
guin à l'aide du chauffage localisé provoqué par le courant à
haute fréquence passant à travers le tissu vivant.
Toutefois, comme matériau de la pince classique, on utilise principalement l'acier inoxydable. Actuellement, on - 2 - utilise également le titane qui est léger et résiste & la corrosion. Etant donné que ces pinces métalliques ont une
haute conductivité thermique, elles tendent à conduire aisé-
ment la chaleur. En raison de cette tendance, la chaleur d'un vaisseau sanguin chauffé localement est renvoyée à la pince
métallique. A mesure que la pince est utilisée, la tempéra-
ture du bec de la pince s'élève progressivement. Cela pro-
voquerune brûlure entre les extrémités de la pince métallique
et le vaisseau sanguin. Il en résulte qu'une partie du vais-
seau sanguin adhère à l'extrémité de la pince. Cette force
d'adhérence est supérieure à la force de coagulation du vais-
seau sanguin. Lorsque les extrémités de la pince sont sépa-
rées l'une de l'autre une fois la coagulation terminée, la
partie coagulée du vaisseau sanguin est fréquemment sépa-
rée en enlevée. Cela provoque un déchirement du vaisseau san-
guin et fait que l'on n'arrive pas à arrêter l'écoulement du sang. En outre, la matière brûlée adhérant aux extrémités (électrodes) de la pince doit être éliminée par raclage pour une nouvelle utilisation. Ce travail de raclage et de meulage est la source de problèmes inopportuns: modification de la forme des extrémités de la pince et réduction de la précision
de l'intrument.
Les auteurs de la présente invention ont poursuivi des
recherches et effectué des essais pour résoudre les pro-
blèmes indiqués plus haut. Ils sont parvenus à améliorer le dispositif en utilisant une matière frittée isolante de
l'électricité, telle qu'une céramique à base d'oxyde de zir-
conium, ayant une faible conductivité thermique, comme moyen le plus efficace pour empêcher la brûlure de tissus vivants et leur adhérence aux extrémités de la pince, et également en fabriquant les électrodes exposées, constituées d'un adhésif conducteur à base de résine, à partir de la matière frittée isolante, afin d'empêcher l'élévation de la température et la transmission de chaleur d'un vaisseau sanguin aux extrémités
de la pince, en arrêtant complètement l'écoulement de sang.
?6t7683 3-
La figure 1 est une vue générale du dispositif d'étan-
chement/coagulation de vaisseaux sanguins de la présente invention; la figure 2 est une vue partielle agrandie, en perspective, de la partie A de la figure 1; la figure 3 est une vue agrandie en coupe transversale de l'extrémité de la
pince, comprenant l'élément de contact avec le vaisseau san-
guin, représenté sur la figure 2; la figure 4 est une vue partielle agrandie, en perspective, de l'extrémité de la pince d'un mode de réalisation perfectionné de la présente
invention; et la figure 5 est une vue en coupe transver-
sale prise selon la droite V-V de la figure 4.
Des modes de réalisation de la présente invention sont exposés ci-dessous, à l'aide des dessins ci-annexés. La
figure 1 représente une vue d'ensemble du dispositif d'étan-
chement/coagulation de vaisseaux sanguins, du type bipolaire, de la présente invention. Une pince utilisée pour maintenir et coaguler un vaisseau sanguin, pour arrêter l'écoulement du sang, est représentée par 1. Les segments de serrage de la
pince 1 sont revêtus d'un revêtement isolant S. Les extrémi-
tés A de la pince 1, représentées agrandies sur la figure 2, sont constituées de deux segments 10 en acier inoxydable ou en titane, pour le maintien du vaisseau sanguin. La surface interne du segment 10 de maintien de vaisseau sanguin, qui entre effectivement en contact avec le vaisseau sanguin B, est constituée d'un élément de contact 10a avec le vaisseau
sanguin, constitué d'une matière frittée isolante de l'élec-
tricité. Des électrodes exposées 10b, constituées d'un adhé-
sif conducteur à base de résine, se trouvent sur l'élément
a de contact avec le vaisseau sanguin. Une source d'alimen-
tation utilisée pour produire un courant à haute fréquence est désignéepar 2. Le courant de la source d'alimentation 2, alimentant la pince 1 par le fil 4, est mis en circuit et hors circuit à l'aide d'un interrupteur à pédale 3. Les
auteurs de la présente invention ont utilisé une résine con-
ductrice DOTITE9 produite par Fujikura Chemimal Co. Ltd,en
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tant qu'adhésif conducteur de type résine. Cet adhésif con-
ducteur de type résine comprend une poudre d'argent très pur en tant que charge conductrice et une résine époxy à haute résistance thermique. Cet adhésif est de type sans solvant, avec une teneur de 100 % en matière sèche. Les propriétés de
l'adhésif sont données dans le tableau 1.
Tableau 1
Coe enu Poudre d'argent, résine époxy, durcis-
seur Aspect Pâte blanc argenté Viscosité 30-50 Pa.s (Viscotester VT-02) Masse volumique 2,7 (méthode au gobelet) Résistance spécifique 5,0 x 10-4 l-cm ou moins
Force d'adhérence 7 357 MPa/c? (résistance à la trac-
tion/au cisaillement selon JIS K6850, Oc-Cu) L'élément 10Oa de contact avec le vaisseau sanguin est constitué d'une matière frittée (céramique) isolante de l'électricité, comme par exemple l'oxyde de zirconium. La
matière frittée est très dure et très résistante à la corro-
sion. La conductivité thermique d'une matière frittée à base
d'oxyde de zirconium est par exemple de 3,77 W/m.K à 20 C.
Cette valeur est bien inférieure à 16,33 W/m.K pour l'acier inoxydable et à 16,75 W/m.K pour le titane. La conductivité thermique de la matière frittée à base d'oxyde de zirconium est donc inférieure à celle de ces matériaux métalliques. En
conséquence, la chaleur engendrée par la courant à haute fré-
quence passant des électrodes exposées 10b à un vaisseau san-
guin est beaucoup moins irradiée par les éléments 10Oa de con-
tact avec le vaisseau sanguin, constitués de la matière frit-
tée. Cela empêche l'adhérence d'une partie d'un vaisseau san-
guin cautérisé aux éléments 10Oa de contact avec le vaisseau sanguin. Dans le mode de réalisation préféré de la présente invention, les électrodes exposées 10b sont dispersées comme
26 7683
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de multiples points sur les éléments 10a de contact avec le vaisseau sanguin, et sont constituées d'adhésif conducteur de
type résine. Plus particulièrement, plusieurs petites ouver-
tures traversantes 10e sont pratiquées sur les éléments iso-
lants 10a de contact avec le vaisseau sanguin, constitués d'une matière frittde telle que l'oxyde de zirconium, de l.'alumine, du nitrure de silicium ou du carbone de silicium. L'adhésif conducteur de type résine précité est introduit dans les ouvertures traversantes 10e, afin de
fixer l'élé.mnt de contact 10a ayant la forme d'une plaquette dans un évi-
dment 10d formé à l'extrtraté frontale du seg.ent 10 de maintien de
vaisseau sanguin, au moyen d'une couche 10c d'adhésif conduc-
teur de type résine. En outre, l'adhésif conducteur de type résine est exposé par les ouvertures traversantes 10e sur la surface frontale, pour disperser les électrodes exposées 10b comme de multiples points. Le rapport de surface adéquat des électrodes 10b disposées à la surface de l'élément 10a de
contact avec le vaisseau sanguin est compris entre 5 et 60 %.
Si le rapport excède 60 %, la résistance mécanique de l'élément 10a de contact avec le vaisseau sanguin, constitué de céramique, est réduite; si le rapport est inférieur à 5 %, aucun effet adéquat d'étanchement et de cautérisation ne peut
être obtenu, comme l'ont confirmé les essais des inventeurs.
Etant donné que, comme indiqué plus haut, les électrodes exposées 10b de ce mode de réalisation sont dispersées comme
de multiples points, le courant électrique, passant de l'élé-
ment 10a de contact avec le vaisseau sanguin au vaisseau san-
guin B, est presque uniforme, ce qui évite un chauffage loca-
lisé excessif. Les éléments 10a de contact avec le vaisseau sanguin peuvent également être fixés sur les segments 10 de maintien de vaisseau sanguin par utilisation des électrodes b exposées, constituées de l'adhésif conducteur de type résine. Cela peut accroître considérablement le rendement de production.
Les surfaces des éléments 10Oa de contact avec le vais-
seau sanguin doivent être polies comme un miroir, avec une
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rugosité superficielle de 1Ra ou mieux, de sorte que les matières brûlées et adhérant aux surfaces des éléments lOa
peuvent être aisément enlevées.
La dureté Vickers de la céramique à base d'hydroxyde de zirconium est de 122,6 x 105 MPa ou plus, bien supérieure à celle de métaux tels que l'acier inoxydable et le titane. En conséquence, même lorsqu'une partie d'un vaisseau sanguin est brlée et adhère solidement aux éléments 10Oa de contact avec le vaisseau sanguin, constitués de la matière frittée, on peut aisément l'enlever avec un scalpel sans endommager la
surface des éléments de contact.
Un mode de réalisation perfectionné de la présente
invention est exposé ci-dessous, à l'aide des figures 4 et 5.
Ce mode de réalisation perfectionné comprend en outre une électrode exposée 10f disposée à l'extrémité frontale de l'élément 10a de contact avec le vaisseau sanguin. En plus de coagulation et d'étanchement, l'électrode exposée 10f permet le sectionnement de vaisseau sanguin. Cette fonction est offerte pour satisfaire aux besoins suivants. Au cours d'une opération, il faut sectionner de nombreux vaisseaux sanguins et étancher le sang qui s'en écoule, pour progresser vers une partie plus profonde. Lorsqu'on utilise un dispositif sans fonction de sectionnement, il est alors nécessaire de changer
d'instrument, en passant de la pince aux ciseaux, pour sec-
tionner chaque vaisseau sanguin, de sorte que le chirurgien doit fréquemment changer d'instrument pour passer de la pince aux ciseaux et des ciseaux à la pince. Ce transfert est
extrêmement fastidieux et prolongue la durée de l'opération.
Lorsque la fonction de sectionnement est incorporée en
utilisant l'électrode capable de coaguler, étancher et sec-
tionner des vaisseaux sanguins, le chirurgien peut continuer
à étancher et à sectionner tout en tenant la pince. Cela éli-
mine la nécessité du transfert d'instrument lors de l'enlève-
ment des tissus brûlés pour le nettoyage de la pince et lors du sectionnement de vaisseaux sanguins. Il en résulte que la 7 -
durée de l'opération peut être sensiblement réduite.
Pour parvenir aux fins précitées, l'électrode expo-
sée 10f disposée à l'extrémité la plus antérieure de la pince a la forme d'une plaque rectangulaire allongée et a une plus grande superficie que les autres électrodes exposées 10b. Le fil d'alimentation 10h relié à l'électrode diffère du fil d'alimentation 10g relié aux électrodes exposées 10b. Le fil d'alimentation 10h est noyé dans un revêtement isolant S1. La
commutation entre les fils d'alimentation 10g et 10h est com-
mandée, par exemple, par le commutateur à pédale 3. Pour le travail de coagulation et d'étanchement, on applique aux deux électrodes exposées 10b et 10f un courant à haute fréquence
ayant une forme d'onde légèrement ascendante. Pour le sec-
tionnement d'un vaisseau sanguin, les électrodes exposées 10b sont mises hors circuit et on applique à la seule électrode exposée 10f un courant pulsé ayant une forme d'onde fortement
ascendante. Il est souhaitable que les deux électrodes expo-
sées 10f et les électrodes exposées 10b soient formées à l'aide de l'adhésif conducteur à base de résine, ayant les
propriétés déjà énumérées dans le tableau 1.
Contrairement au dispositif classique, ce mode de réa-
lisation perfectionné élimine la nécessité de transfert d'instrument, de la pince aux ciseaux, lorsqu'on sectionne un vaisseau sanguin en utilisant l'électrode exposée 10f après
coagulation et étanchement. Coagulation, étanchement et sec-
tionnement peuvent être effectués à l'aide d'une seule paire
de pinces,ce qui garantit une plus grande commodité.
En plus des modes de réalisation préférés et perfec-
tionnés décrits ci-dessus, la présente invention peut compor-
ter les modes de réalisation sélectionnables suivants.
a) Au lieu de métal, on peut utiliser comme matériau de la pince des matières plastiques ou des céramiques, à condition
que des fils ou réseaux conducteurs soient noyés à l'inté-
rieur de la pince pour donner la conductivité électrique.
b) L'élément de contact avec le vaisseau sanguin s'étend au-
delà du segment de contact avec le sang et est disposé sur
toute la surface de la pince, pour faciliter le moulage.
c) Au lieu d'appliquer à l'électrode exposée, pour le sec-
tionnement, un courant pulsé ayant une forme d'onde forte-
ment ascendante, on applique pour le sectionnement un courant
à haute fréquence et haute énergie.
Le dispositif d'étanchement/coagulation de vaisseaux satiuinsmentionné plus haut, de type bipolaire, avec la pince
de la présente invention, peut donner les effets indiqués ci-
dessous.
(1) L'étanchement est assuré au cours de l'intervention chi-
rurgicale. Cela réduit sensiblement la durée de l'interven-
tion. (2) L'écoulement de sang peut être réduit. Cela diminue les
lésions opératoires infligées au patient.
(3) On peut éviter du travail pour l'enlèvement de matières adhérant aux extrémités de la pince. Même si de telles matières adhèrent aux extrémités, elles peuvent être enlevées facilement. Etant donné que les extrémités de la pince sont très dures, leurs formes peuvent rester inaltérées. Cela garantit la haute précision de la pince pendant une durée prolongée. (4) En utilisant l'adhésif conducteur de type résine en tant qu'électrodes, on peut aisément donner au électrodes des
formes compliquées, ce qui accroit considérablement le rende-
ment de production.
(5) La contrainte thermique due à la différence de coeffi-
cient de dilatation thermique entre le métal et la céramique peut être absorbée par l'adhésif conducteur de type résine, comprenant de la poudre métallique dans la couche d'adhésif lors de la stérilisation à l'autoclave. On peut ainsi éviter la cassure de la céramique de l'élément de contact avec le vaisseau sanguin, et celle-ci peut avoir une plus longue durée d'utilisation. La stérilisation à l'autoclave est ainsi
possible, ce qui élimine la nécessité d'utilisation de stéri-
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lisation par gaz. Cela réduit nettement le temps de stérili-
sation. (6) Dans le cas du mode de réalisation perfectionné, on peut
utiliser une seule pince pour coaguler, étancher et section-
ner les vaisseaux sanguins. Cela élimine la nécessité d'uti- liser des ciseaux et de changer d'instruments, facilitant
ainsi l'intervention. Cet avantage est très précieux, en par-
ticulier dans le cas d'interventions de longue durée, car beaucoup de travail fastidieux peut être éliminé et la durée
de l'intervention peut être réduite.
Il doit être bien entendu que la description qui pré-
cède n'a été donnée qu'à titre illustratif et non limitatif et que toutes variantes ou modifications peuvent y être
apportées sans sortir pour autant du cadre général de la pré-
sente invention.
af
26 77683
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Claims (8)
1. Dispositif d'étanchement/coagulation de vaisseaux sanguins, de type bipolaire, comprenant une pince conductrice(l) reliée à une source d'alimentation électrique à haute fréquence (2), de sorte qu'un courant & haute fréquence passe entre
les extrémités de la pince, un vaisseau sanguin étant main-
tenu entre des segments de maintien (l)devaisseau sanguin, dis-
pesés aux extrémités avant de ladite pince, pour coaguler, étancher et cautériser ledit vaisseau sanguin, dispositif caractérisé en ce que ladite section de mmintien (10) de vaisseau
sanguin comprend un élément de contact (ia) avec le vJaisseau san-
guin, constitué d'une matière frittée isolante de l'électri-
cité, ayant une faible conductivité thermique, et ledit élé-
ment de contact avec le vaisseau sanguin étant muni sur sa surface d'électrodes exposées (10b) selon un rapport de superficie compris entre 5 et 60 % de la surface totale dudit élément de
contact avec le vaisseau sanguin.
2. Dispositif d'étanchement/coagulation de vaisseaux sanguins selon la revendication 1, caractérisé en ce que lesdites électrodes exposées (0lob) sont constituées d'un adhésif
conducteur à base de résine.
3. Dispositif d'étanchement/coagulation de vaisseaux
sanguins selon la revendication 1, caractérisé en ce que le-
dit élément (10a)ie contact avec le vaisseau sanguin a une forme
de plaquette et s'adapte et est fixé dans un évidement(10d) d1a-
ditpiroe, au moyen d'une couche d'adhésif conducteur à base de résine.
4. Dispositif d'étanchement/coagulation de vaisseaux
sanguins selon l'une quelconque des revendications 1 à 3,
caractérisé en ce que ledite élément (10s) de contact avec le vais-
seau sanguin comporte plusieurs ouvertures traversantes dans
le sens de l'épaisseur dzUit&élt de contact (1Oa). avec le vais-
seau sanguin et l'adhésif conducteur à base de résine est introduit dans lesdites ouvertures traversantes, de sorte que
lesdites électrodes exposées (10b) sont dispersées comme de mul-
- 11 -
tiples points à la surface dudit élément de contact (10a)
avec le vaisseau sanguin.
5. Dispositif d'étanchement/coagulation de vaisseaux sanguins selon la revendication 4, caractérisé en ce qu'en plus de fonctions de coagulation et d'étanchement, l'électrode exposée 10b), disposée à l'extrémité la plus antérieure de
ladite pince, comprend en outre une fonction de sectionne-
ment.
6. Dispositif d'étanchement/coagulation de vaisseaux sanguins selon la revendication 1, caractérisé en ce que ledit élément (10Oa) de contact avec le vaisseau sanguin est disposé
de façon étendue sur toute la surface de ladite pince (l).
7. Dispositif d'étanchement/coagulation de vaisseaux sanguins selon la revendication 1, caractérisé en ce que ladite matière frittée isolante de l'électricité est une céramique constituée d'oxyde de zirconium ou d'alumine ou de
nitrure de silicium ou de carbure de silicium.
8. Dispositif d'étanchement/coagulation de vaisseaux sanguins selon la revendication 1, caractérisé en ce que ledit adhésif conducteur de type résine est de type à base de résine époxy, sans solvant, ayant une teneur de 100 % en
matière sèche et comprenant de la poudre d'argent très pur.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP1140192A JP2840674B2 (ja) | 1989-05-31 | 1989-05-31 | 血管凝固止血装置 |
JP2140376A JP3010265B2 (ja) | 1990-05-30 | 1990-05-30 | 血管凝固止血装置 |
Publications (2)
Publication Number | Publication Date |
---|---|
FR2647683A1 true FR2647683A1 (fr) | 1990-12-07 |
FR2647683B1 FR2647683B1 (fr) | 1993-02-12 |
Family
ID=26472788
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
FR9006806A Expired - Fee Related FR2647683B1 (fr) | 1989-05-31 | 1990-05-31 | Dispositif d'etanchement/coagulation de sang hors de vaisseaux sanguins |
Country Status (3)
Country | Link |
---|---|
US (1) | US5151102A (fr) |
DE (1) | DE4017626A1 (fr) |
FR (1) | FR2647683B1 (fr) |
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Cited By (26)
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EP0517243A1 (fr) * | 1991-06-07 | 1992-12-09 | Hemostatic Surgery Corporation | Appareil électro-chirurgical à haute fréquence à tension constante et méthode d'utilisation |
EP0517244A1 (fr) * | 1991-06-07 | 1992-12-09 | Hemostatic Surgery Corporation | Apparail électrochirugical hémostatique bipolaire |
EP0518230A1 (fr) * | 1991-06-07 | 1992-12-16 | Hemostatic Surgery Corporation | Instruments électro-chirurgical bipolair pour endoscopie |
US5324289A (en) * | 1991-06-07 | 1994-06-28 | Hemostatic Surgery Corporation | Hemostatic bi-polar electrosurgical cutting apparatus and methods of use |
US5330471A (en) * | 1991-06-07 | 1994-07-19 | Hemostatic Surgery Corporation | Bi-polar electrosurgical endoscopic instruments and methods of use |
US5472443A (en) * | 1991-06-07 | 1995-12-05 | Hemostatic Surgery Corporation | Electrosurgical apparatus employing constant voltage and methods of use |
US5633578A (en) * | 1991-06-07 | 1997-05-27 | Hemostatic Surgery Corporation | Electrosurgical generator adaptors |
FR2680314A1 (fr) * | 1991-08-16 | 1993-02-19 | Lebosse Guy | Ciseaux de cóoeliochirurgie droit ou courbe de champs electrocoagulants en mode bi polaire. |
EP0558318A2 (fr) * | 1992-02-27 | 1993-09-01 | G2 Design Limited | Dispositif de électrochirurgie bipolaire RF |
EP0558318A3 (en) * | 1992-02-27 | 1993-12-08 | G2 Design Ltd | Apparatus for radio frequency bipolar electrosurgery |
US5451224A (en) * | 1992-02-27 | 1995-09-19 | G2 Design Limited | Apparatus for radio frequency bipolar electrosurgery |
WO1996020652A1 (fr) * | 1994-12-30 | 1996-07-11 | Valleylab, Inc. | Electrodes pourvues d'un revetement partiel, leur fabrication et leur emploi |
US5766166A (en) * | 1995-03-07 | 1998-06-16 | Enable Medical Corporation | Bipolar Electrosurgical scissors |
US6179837B1 (en) | 1995-03-07 | 2001-01-30 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US6350264B1 (en) | 1995-03-07 | 2002-02-26 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US6391029B1 (en) | 1995-03-07 | 2002-05-21 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US6464701B1 (en) | 1995-03-07 | 2002-10-15 | Enable Medical Corporation | Bipolar electrosurgical scissors |
US6334860B1 (en) | 1998-12-18 | 2002-01-01 | Karl Storz Gmbh & Co. Kg | Bipolar medical instrument |
WO2000036986A1 (fr) * | 1998-12-18 | 2000-06-29 | Karl Storz Gmbh & Co. Kg | Instrument bipolaire a usage medical |
US9662514B2 (en) | 1999-06-02 | 2017-05-30 | Covidien Lp | Bipolar or ultrasonic surgical device |
US8845665B2 (en) | 2001-04-20 | 2014-09-30 | Covidien Lp | Bipolar or ultrasonic surgical device |
US6802843B2 (en) | 2001-09-13 | 2004-10-12 | Csaba Truckai | Electrosurgical working end with resistive gradient electrodes |
US6773409B2 (en) | 2001-09-19 | 2004-08-10 | Surgrx Llc | Surgical system for applying ultrasonic energy to tissue |
US8192428B2 (en) | 2001-10-22 | 2012-06-05 | Tyco Healthcare Group Lp | Electrosurgical instrument and method |
US7981113B2 (en) | 2001-10-22 | 2011-07-19 | Surgrx, Inc. | Electrosurgical instrument |
US7517349B2 (en) | 2001-10-22 | 2009-04-14 | Vnus Medical Technologies, Inc. | Electrosurgical instrument and method |
Also Published As
Publication number | Publication date |
---|---|
DE4017626C2 (fr) | 1993-07-01 |
DE4017626A1 (de) | 1990-12-06 |
US5151102A (en) | 1992-09-29 |
FR2647683B1 (fr) | 1993-02-12 |
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