FR2745997A1 - AN ASSEMBLY OF A MANUAL SWITCH AND A FLEXIBLE CONDUCTOR AND CIRCUIT FOR WHICH IT IS INTENDED TO BE USED - Google Patents

Abstract

Assembly formed by a replaceable accessory and a flexible conductor, intended for an electrosurgical instrument. A flexible conductor (17) electrically connects a generator (14) to the instrument by two or more wires (18). A manual switch (19) which includes normally open contacts (20) is attached to one active lead wire and another wire is connected to the other contact (21). A housing (22) placed on the switch (19) is electrically connected to the contact (20). A terminal (23) placed on the instrument is connected to the housing (22) in electrical contact (20) with the active conductor wire. Application to electrosurgical instruments to allow placing on them a disposable manual switch conveniently placed to allow it to be actuated by a finger of the surgeon.

Description

The invention relates to an assembly formed of a flexible conductor

  special and replaceable accessory and a manual switch that is intended for an instrument

  Electrosurgical procedure does not include any manual switch.

  More particularly, a replaceable accessory flexible lead and a manual switch are supported by a terminal of the electrosurgical element so that this switch is accessible to the surgeon who is controlling

  the corresponding energy sent to a patient.

  Any surgical instrument, such as scissors, a grasping instrument, forceps and the like, receives energy from an electrosurgical generator. A foot switch or hand switch controls the sending of energy to the electrosurgical instrument. Surgeons often prefer the convenience of using a manual switch. The hands of the surgeon holding the electrosurgical instrument, the finger actuation of a switch placed on

the instrument is convenient.

  Suppliers frequently equip such electrosurgical instruments without an integrated manual switch for use by the surgeon to minimize cost. This removal facilitates cleaning and sterilization after use if it is a reusable instrument and minimizes the cost of replacement if it is disposable. The importance of adding a convenient finger-operated switch can

not worth the extra price.

  The command of high frequency electrosurgical energy sent to the instrument has long been a

  problem that has been solved in many ways.

  The use of a fluidic control disclosed in U.S. Patent 3,494,363 discloses crushing a pear or closing a vacuum line by the surgeon to control the electrosurgical energy sent to a forceps. U.S. Patent 3,752,160 discloses a disposable electrode switch which is attached to a forceps and is operative when the teeth are crushed against each other. In particular, electrosurgical energy is transmitted in monopolar application when a terminal on the flexible conductor contacts the bare metal of the forceps. U.S. Patents 4,370,980 and 4,552,143 disclose removable manual switches for electrocautery instruments. Conductive elastic clamps fix the manual switches on

  the surgical instrument such as scissors or forceps.

  The electrically connected manual switch allows the energy to pass through the conductive clamp of

  electricity and attaches to the electrosurgical instrument.

  The cutting or cauterizing energy passing through the switch depends on the actuation of the button by the surgeon. Insulated handles of the electrosurgical instrument protect the surgeon against energy, but nothing protects him from the elastic clamp

driver who is exposed.

  There is a demand for conversion of existing conventional electrosurgical instruments so that they can be manually connected using a simple and inexpensive set of replaceable accessory flex cable and manual switch. No combination of such an assembly attaches to the location where the ordinary flexible conductor provides the connection for switching to the finger. No combination of such an assembly isolates the electrical connection. None of these sets provide the mechanical connection to support a remote switch button. None of these sets provides reliable fixation, resistant to longitudinal or lateral movement, relative to the electrosurgical instrument. None of these assemblies provide an insulated and reliable electrical connection and a fastener allowing finger actuation of the switch button positioned to resist movement.

longitudinal and lateral.

  In accordance with the invention, an assembly formed of a replaceable accessory flexible lead and a manual switch for use with an electrosurgical instrument by a surgeon on a patient in a corresponding circuit is preferably connected between a generator and a electrosurgical instrument. The instrument to be connected to the generator in the circuit may include a proximal end to be held by the surgeon and a distal end for electrosurgery. A flexible conductor connected to the generator sends the energy to the instrument very advantageously by two wires or

more.

  A manual switch is electrically connected and removably to one of the leads and is preferably located on the replaceable flexible lead proximate the proximal end of the instrument to allow the surgeon access. The switch is in the electrosurgical circuit. One of two normally open contacts located in the switch may advantageously be attached to the active conductor wire, while a lead of a cutting or coagulation signal is connected to the other contact. According to an advantageous embodiment, a housing placed on the switch can be electrically connected to the active contact. A terminal of the electrosurgical instrument may be shaped to be connected to the housing so that it is in electrical contact with the wire

active driver.

  A switch support to be attached to the instrument prevents relative movement between them. The support is very advantageously isolated from the two contacts, the housing, the terminal and the electrical wires. An actuation button placed on the support is advantageously accessible by the surgeon. This button placed at a distance from the housing and the terminal is very advantageously electrically isolated from the two contacts, the housing, the terminal and the electrical wires. The actuation button is mounted to be movable relative to the support and to close both contacts during use of the instrument when electrosurgical energy is to be delivered to the patient. A handle is on an advantageous embodiment of the instrument for use by the surgeon. An end effector element, or more, placed on the instrument, may advantageously apply electrosurgical energy. The support and the actuation button can be physically placed on the handle such that, when the instrument is grasped by the handle, the button is placed to control the sending of energy by the surgeon's finger. The handle is preferably insulated and placed at the proximal end of the instrument and the effector element or the electrosurgical effector elements may be placed on the opposite side to that of the handle at the distal end of the instrument. This or these elements can

  consist of scissors or grips.

  This element or these end effector elements may be alternatively in a bipolar circuit comprising a return placed on one of these elements. The return is connected to a corresponding conductive loop of the electrosurgical circuit. When this element or these end effector elements are in a monopolar circuit, it may comprise a return pad placed on the patient and forming part of the electrosurgical circuit. The terminal is very advantageously placed near the proximal end of the instrument. The circuit of the instrument for use by a surgeon on a patient may include one or more end effector elements placed on the instrument itself so that they come into contact with the patient's tissue during the procedure. application of electrosurgical energy by the surgeon. The handle of the instrument should be at one end of the instrument that is on the opposite side of the effector element (s) so that they can be positioned by the surgeon during the application of energy. The terminal of the instrument which is close to the handle can receive energy for one or more of said end effector elements and

  it can be electrically isolated from the handle.

  The manual switch can be removably, electrically and mechanically connected to the terminal and be supported by it. The manual switch is preferably connected to the terminal and the power source. The flexible conductor may be removably and electrically connected to the switch by one or more wires for supplying energy to an end effector element or to a plurality of thereof. The generator can be connected to the active wire to send the energy to the manual switch of the instrument. The generator is connected to the return wires connected to the effect element (s)

  end for the return of energy to the generator.

  A switch button for closing the switch can send power to the end effector element or to a plurality thereof so that it is accessible at the location of the handle so that the energy can be selectively sent by the surgeon to one or more of these elements. A support of the button can place it so that it can be operated by the surgeon. The support can carry the button so as to be movable relative to the latter during the actuation of the switch. The support intended to be mechanically connected to the handle preferably prevents any relative movement between them. The stand is isolated from the button and switch to effectively prevent leakage, stray currents and grounding by the surgeon. The holder may have a pressure-sensitive adhesive on it to mount the button on the handle so that the surgeon can access it by a finger. The generator and the flexible conductor are connected to the switch to allow selective electrical connection by wires placed in the conductor to provide surgical power supply to the end effector element or a plurality thereof. The flexible conductor may include a plug for removably connecting the wires to the generator. The manual switch can control the generator in a way that it sends

  electrosurgical energy with a coagula-

  to the end effector element or to more than one thereof. The electrosurgical instrument is preferably elongate between the handle and the effector element (s) so that laparoscopic electrosurgery can be performed by the surgeon by the control by means of the manual switch. A return can be connected to one of the effectors

  end for bipolar electrosurgery.

  The invention will be described in more detail by way of example with reference to the accompanying drawings, in which: FIG. 1 is a perspective view of the assembly formed by a replaceable accessory flexible conductor and a manual switch of FIG. an advantageous embodiment shown on an electrosurgical element; Figure 2 is an exploded perspective view showing a two-piece embodiment of the replaceable flexible conductor and hand switch assembly of Figure 1; Figure 3 is a perspective view showing an alternative embodiment of an assembly formed of a flexible conductor and a manual switch and wherein the switch is separated from the housing for its implementation with the aid of a pressure-sensitive adhesive on the handle of any electrosurgical instrument; Figure 4 is a perspective view of an alternative embodiment of the assembly formed of a flexible conductor and a manual switch placed on an endosurgical instrument; and FIG. 5 is a diagram of an electrosurgical circuit mounted between the generator and

the corresponding instrument.

  Figures 1 to 5 show an assembly 10 consisting of a replaceable accessory flexible conductor and a manual switch, which is intended to be used with a surgical instrument 11 by a surgeon on a patient 12 placed in an electrosurgical circuit 13. The circuit 13 is connected between a generator 14 and the electrosurgical instrument 11. The instrument 11 intended to be connected to the generator 14 of the circuit 13 comprises a proximal end 15 intended to be held by a surgeon and a distal end 16 intended to allow to perform electrosurgery on a patient 12. A flexible conductor 17 shown in Figures 1 to 5 and intended to be connected to the generator 14 allows the surgery using the instrument 11. The driver

  flexible 17 comprises two or more conductor wires 18.

  FIG. 5 diagrammatically represents the active or supply conductor wire 18 ', the return conductor wire (unipolar) 18 ", the return conductor wire (bipolar) 18' '', the conductive wire of the cutting signals 18 '' '' and the

  conductive thread of coagulation signals 18 '' '' '.

  A manual switch 19 selectively and electrically in series with one of the signal wires 18 '' '' or 18 '' '' 'is placed on the replaceable accessory flexible lead 17 near the proximal end 15 of the instrument electrosurgical it so that the surgeon has access to him. The manual switch 19 is in the electrosurgical circuit 13. Two contacts 20 and 21 normally open are placed in the switch 19, the contact 20 being fixed to the active conductor wire 18 'and the other of the signal conductors 18' ' '' or 18 '' '' 'is connected to the other contact 21. A housing 22 is connected to the active conductor wire 18'. A terminal 23 placed in the electrosurgical instrument 11 is shaped to be connected to the housing 22 so that it is in contact with the other wire 18 ', as shown in FIGS. 4 and 5. A support 24 shown in Figures 1, 2, 3 and 4 and on which the switch is mounted, is intended to be attached to the surgical instrument 11 so as to prevent any movement relative thereto. The support 24 is electrically insulated from the two contacts 20 and 21, the housing 22, the terminal 23 and the son 18 conductors. An actuating button 25 placed on the support 24 is accessible by the surgeon. The button 25 is electrically insulated from the two contacts 20 and 21, of the housing 22,

  of the terminal 23 and the conductive wires 18 of FIG.

  The button 25 is movable relative to the support 24 to close the two contacts 20 and 21 normally open during the use of the instrument 11. When it is necessary to send electrosurgical energy to the patient 12, the

  surgeon's finger closes contacts 20 and 21.

  A handle 26 shown in Figures 1 and 4 is on the proximal end 15 of the instrument 11 for use by the surgeon. One or more end effector elements 27 are placed on the distal end 16 of the instrument 11 to apply electrosurgical energy. The holder 24 and the button 25 are physically placed on the handle 26, so that when the instrument 11 is grasped by the latter, the button 25 is placed so that the surgeon's finger can control the sending of electrosurgical energy. . The handle 26 is isolated and placed at the proximal end 15 of the instrument 11. The electrosurgical effector element 27 or more thereof is placed on the opposite side to that of the handle, at the distal end 16 of the 11, as shown in FIGS. 1 and 4. This or these effector elements 27 may consist of scissors 28, as shown in FIG. 4, or may consist of gripping elements as shown in FIG. 1 or in square brackets. (not shown) When the effector element 27 or more thereof are in a bipolar circuit, it is

  there is a return wire 28 as shown in FIG.

  The end effector element is connected to the return conductor wire 18 '' 'to loop the electrosurgical circuit 13. When an end effector element 27 or more thereof is in a monopolar circuit, there is on the patient 12 a return contact pad 29 which is part of the electrosurgical circuit 13 passing through the conductor 18 "as shown in Figure 5. The terminal 23 is placed near the proximal end 15 of the instrument 11, as

shown in Figures 1 and 4.

  The circuit 13 of the electrosurgical instrument 11 for use by the surgeon on the patient 12 comprises one or more end effector elements 27 intended to be brought into contact with the tissue of the patient during the sending of energy by the patient. surgeon. The handle 26 of the instrument 11 is at the proximal end 15 of the latter, on the opposite side to that of the end effector elements 27, so that they can be positioned by the surgeon during the application of electrosurgical energy. The terminal 23 located on the instrument 11 near the handle 26 receives the energy for the end effector elements 27 and is electrically isolated from the handle 26. The manual switch 19 is removably connected electrically and electrically.

  mechanically at terminal 23 and is supported by

  ci, as shown in Figures 1 to 4. The manual switch 19 is electrically connected to the terminal 23 and the signal wire 18 '' '' or 18 '' '' 'so that the energy can be sent selectively by the surgeon to one or more of the end effector elements 27. The flexible conductor 17 is electrically connected to the switch 19 by one or more conductive wires 18 that it houses to send the electrosurgical energy at one or more of the end effector elements 27. The electrosurgical generator 14 is connected to the active conductor wire 18 'for sending energy to the switch 19 of the instrument 11, as shown schematically on the Figure 5. The generator 14 is connected to another of the conductive wires 18 '' 'connected to one of the effector elements 27 for the return of energy to the generator 14 for use in a bipolar process. The button 25, placed on the switch 19 to close the two contacts 20 and 21, sends the energy to one or more of the effectors 27. The support 24 of the

  button 25 places this one within reach of the surgeon.

  The holder 24 carries the button 25 so as to allow movement relative thereto during actuation of the switch 19. The holder 24 is mechanically secured to the handle 26 so as to prevent relative movement between them. The carrier 24 of an alternative embodiment shown in FIG. 3 carries a pressure-sensitive adhesive 30 thereon for securing the button 25 to the handle 26 so that a finger of the surgeon has access to it. While the flexible conductor 17 shown is permanently attached to the switch 19 in FIGS. 1 to 4, those skilled in the art will understand that a connector such as that of FIG.

  separation of the conductor 17 and the switch 19.

  The generator 14 and the assembly 10 comprising the flexible conductor are electrically connected to the switch 19 to allow the selective electrical connection by the son 18 placed in the conductor 17 to ensure the sending of energy to an end effector element 27 or more of them. The flexible conductor 17 comprises a plug 31 shown schematically in FIG. 5 broken line for removably connecting the conductors 18 ', 18 ", 18' '', 18 '' '' and 18 '' '' 'to the generator 14. The switch 19 controls the generator 14 so as to cause the generator 14 to deliver electrosurgical energy with a coagulation signal to one or more of the elements

effectors 27.

  Although not shown in FIGS. 1 and 4, the electrosurgical instrument 11 is elongated between the handle 26 and one or more effector elements 27 so that laparoscopic electrosurgery can be performed by the surgeon by means of the ensured command.

by the switch 19.

  For bipolar surgery, the generator 14 is connected to one of the return wires 18 '' 'in the flexible conductor 17 by means of the receptacle 31. The active electrosurgical output of the generator 14 produces a high frequency signal. Cutting or coagulation signals have different shapes and effects on tissues. In general, the plug 31 and the generator 14 have three connection connections, one, 32, for a cutting signal, one, 33, for a coagulation signal and one, 34, for the output active electrosurgical. The selection by the switch 19 could be designed for coagulation or cutting, two buttons could allow the choice between them or a switch could be used either for cutting or for coagulation, as shown in FIG. The selection of cutting or coagulating waveforms is schematically represented in FIG. 5 by a switch 35 which connects either the cutting wire 18 '' '' or the coagulation wire 18 '' '' 'to the contact 21. This switch 35 could be on the socket 31, the generator 14, in

  the flexible conductor 17 or on the manual switch 19.

  If it is on the latter, the button 25 could be subdivided or could be a rocker in the usual way

  on electrosurgical pencils with integrated switching.

  The closing of the switch 19 is detected in the generator 14 by checking the continuity provided by the two contacts 20 and 21 with respect to a reference that comprises the generator. If continuity is detected between the two contacts 20 and 21, the electrosurgical energy is transmitted by means of the active output connection 34 of the generator to the wire 18 '. Another embodiment of a power supply circuit is described in the patent

U.S. 3,752,160.

  It goes without saying that the invention has been described and shown only as a non-limiting example and that

  various modifications can be made to it.

Claims (10)

  An assembly (10) comprising a replaceable accessory and a flexible lead for use with an electrosurgical instrument (11) by a surgeon on a patient (12) in an electrosurgical circuit (13) for to be connected between an electrosurgical generator (14), the instrument (11) and the patient (12), the instrument (11) comprising a terminal (23) and a proximal end (15) to be held by the surgeon a distal end (16) by which electrosurgery may be performed on the patient (12), said assembly (10) being characterized by comprising: a flexible conductor (17) for electrically connecting the electrosurgical generator (14); ) for feeding the instrument (11) so as to allow electrosurgery, the flexible conductor (17) comprising two or more wires (18); a manual switch (19) electrically connected to one of the wires, the switch (19) being placed on the flexible conductor (17) so as to be close to the proximal end (15) of the instrument (11) so that the surgeon has access to him, the switch (19) in the electrosurgical circuit (13), two normally open contacts (20) being placed in the switch (19), one being attached to the one of the wires and the other wire being connected to the other contact (21); a housing (22) which comprises the switch (19) being electrically connected to the other contact (21) and being shaped so as to be connected to the terminal (23) placed in the instrument (11), the terminal ( 23) thus being in electrical contact (20) with the other wire; a support (24) on which is located the switch (19) being intended to be fixed to the instrument (11) so as to prevent any movement with respect thereto, the support (24) being electrically isolated from both contacts (20), the housing (22), the terminal (23) and the wires and an actuating button (25) placed on the support (24) being accessible to the surgeon and being placed at a distance from the housing (22) and the terminal (23) so that it is convenient for the surgeon, the actuating button (25) being electrically isolated from the two contacts, the housing (22), the terminal (23) and the wires and being mounted on the support (24) for closing the two contacts during use of the instrument (11) when electrosurgical energy patient (12).   An assembly (10) consisting of a replaceable accessory and a flexible lead as claimed in claim 1, characterized by a handle (26) on the instrument (11) for use by the surgeon and one or more end effector elements (27) placed on the instrument (11) for electrosurgical energy application, the support (24) and the actuating button (25) being physically placed on the handle (26) in a manner when the instrument (11) is gripped by the handle (26), the actuating button (25) is placed so that the surgeon's finger can   order the sending of electrosurgical energy.   3. An assembly (10) formed of a replaceable accessory and a flexible conductor according to claim 2, characterized in that the hand switch (19) on the handle (26) is isolated and placed at the proximal end. (15) of the instrument (11) and one or more electrosurgical effector elements are placed on the side opposite to that of the handle (26) at the distal end (16) of the instrument (11).   An assembly (10) formed of a replaceable accessory and a flexible conductor according to claim 2, characterized in that the manual switch (19) is on the handle (26) and the effector element (27) or several of these consist of scissors.   5. An assembly (10) formed of a replaceable accessory and a flexible conductor according to claim 2, characterized in that the manual switch (19) is on the handle (26) and the effector element or several of   these (27) consist of gripping members.   An assembly (10) formed of a replaceable accessory and a flexible conductor according to claim 2, characterized in that the manual switch (19) is electrically connected to one or more end effector elements (27). in a bipolar circuit and a return is placed on one of the end effector elements and connected to one of the wires to complete the electrosurgical circuit (13).   An assembly (10) formed of a replaceable accessory and a flexible conductor according to claim 2, characterized in that the manual switch (19) is electrically connected to one or more end effector elements (27). in a unipolar circuit and a return contact pad (29) is on the patient   (12) within the electrosurgical circuit (13).   8. An electrosurgical circuit (13) comprising an electrosurgical instrument (11) and a corresponding generator (14) for use by a surgeon on a patient (12), characterized in that it comprises: one or more effector elements; end (27) placed on the electrosurgical instrument (11) to be contacted with the patient's tissue (12) during the application of electrosurgical energy by the surgeon; a handle (26) placed on the electrosurgical instrument (11) at the end thereof opposite to that at which one or more end effector elements (27) are located, the handle (26) allowing the the surgeon positioning the effector element (s) (27) during the application of electrosurgical energy; a terminal (23) being placed on the electrosurgical instrument (11) near the handle (26) and being intended to receive the electrosurgical energy for one or more end effector elements (27), the terminal ( 23) being electrically insulated from the handle (26); a manual switch (19) removably, electrically and mechanically connected to the terminal 23 and placed on a support (24), the switch (19) being connected to the terminal (23) and to the electrosurgical energy source and being accessible on the handle (26) so that electrosurgical energy can be selectively sent by the surgeon to one or more end effector elements (27); a flexible conductor (17) electrically connecting the hand switch (19) to one or more conductor wires therein for sending the electrosurgical energy to one or more effector elements (27), the electrosurgical generator (14) being connected to one of the wires for feeding the manual switch (19) with electrosurgical energy, the generator (14) being connected to the other of the wires connected to one of the end effector elements for the return of the electrosurgical energy to the generator (14); the manual switch (19) includes a button for closing it to send surgical energy to one or more end effector elements (27) and a button support (24) placing the latter within range of the surgeon's finger, the support (24) carrying the button so that it is movable relative to him during the actuation of the manual switch (19), the support (24) being secured to the handle (26) so as to prevent any relative movement between them, the support (24) being electrically isolated from the button and the switch manual (19).   Electrosurgical circuit (13) according to claim 8, characterized in that a pressure-sensitive adhesive (30) is placed on the support (24) for mounting the button on the handle (26) so that a   The surgeon's finger can have access to him.   A replaceable manual switch (19) for use with an electrosurgical instrument (11) by a surgeon on a patient (12) in an electrosurgical circuit (13) for connection between an electrosurgical generator (14), the instrument (11) and the patient (12), the instrument (11) comprising a proximal end (15) to be held by the surgeon and a distal end (16) to which electrosurgery can be performed on the patient (12), the electrosurgical circuit (13) comprising a flexible conductor (17) for electrically connecting the electrosurgical generator (14) to allow electrosurgery by means of the replaceable manual switch (19), the flexible conductor (17) comprising two or more lead wires (18), characterized in that two normally open contacts (20) are located in the hand switch (19) so that one of them is electrically connected to the active conductor wire, the two contacts (20) being placed close to the proximal end (15) of the instrument (11) so that the surgeon can access them, the manual switch (19). ) being placed in the electrosurgical circuit (13) so that another wire from the generator (14) is connected to the other contact (21), a housing (22) which comprises the manual switch (19) being connected electrically in contact (20) and being shaped to be connected to a terminal (23) on the electrosurgical instrument (11), the terminal (23) being in electrical contact (20) with the active conductive wire, a support (24) includes a manual switch (19) being attached to the electrosurgical instrument (11) to prevent relative movement with respect thereto, the carrier (24) being electrically isolated from both contacts (20) , the housing (22), the terminal (23) and the 1s and an actuating button (25) being placed on the support (24) so that it is accessible to the surgeon and being positioned at a distance from the housing (22) and the terminal (23), this button (25) being electrically isolated from the two contacts (20), the housing (22), the terminal (23) and the wires, the actuating button (25) being movably mounted relative to the support (24) so that the surgeon can close the two contacts (20) during the use of the instrument (11) when it has to send an energy   electrosurgical patient (12).