GB2362829A

GB2362829A - Resectoscope with sliding bi-polar loop electrodes

Info

Publication number: GB2362829A
Application number: GB0100739A
Authority: GB
Inventors: John Adrian Gardner
Original assignee: Smiths Group PLC
Current assignee: Smiths Group PLC
Priority date: 2000-02-09
Filing date: 2001-01-11
Publication date: 2001-12-05
Also published as: GB0002804D0; GB0100739D0

Abstract

A resectoscope has two loop electrodes 10 and 20 at its patient end mounted on insulated rods 11 and 21, which can be slid relative to one another by means of a finger grip 12 and thumb ring 22 at the machine end of the instrument. The two electrodes 10 and 20 are connected to a bipolar output of an electrosurgery unit 31 so that, when the electrodes are brought together about patient tissue, electrosurgery power is applied to the tissue.

Description

2362829 1 RESECTOSCOPES This invention relates to resectoscopes.

Resectoscopes are used to perform internal surgical procedures under observation by an endoscope. Resectoscopes are often used in the following surgical procedures: transurethral resection of the prostate (TURP), transurethral resection of a bladder tumour (TURBT) and transcervical resection of the endometrium, (TCRE). A conventional resectoscope comprises a rigid endoscope (usually known as a "telescope"), a single monopolar active electrode for an electrosurgery system, a light-guide for illumination, an irrigation conduit and, in some cases, a suction conduit. With conventional resectoscopes, the patient return electrode of the electrosurgery system is provided by a large area plate attached to some part of the body remote from the surgical site. This brings with it two possible sources of problem. First, the return electrode can cause bums where it is attached to the skin if it become partially detached. Second, energy from the active electrode will follow the lowest impedance route, which may lead to unintended coagulation of susceptible organs or body structures by channelling of the electrosurgery current.

It is an object of the present invention to provide an alternative resectoscope.

2 According to one aspect of the present invention there is provided a resectoscope including first and second electrodes located adjacent one another at the patient end of the instrument such that electrosurgery energy can be applied to tissue between the electrodes.

In this way, the need for a large area return electrode is obviated. Also, the flow of electrosurgery current will be more directly between the two electrodes so that it is less likely to flow through regions of tissue not directly between the electrodes. Preferably, the first and second electrodes are spaced from one another longitudinally of the resectoscope and are movable relative to one another. The resectoscope may include first and second rods extending along the length of the instrument, the electrodes being mounted at the patient end of respective ones of the rods and the rods being slidable relative to one another along their length so as to enable the separation of the electrodes to be altered. The electrodes may be loop electrodes.

According to another aspect of the present invention there is provided a resectoscope system including a resectoscope according to the above one aspect of the invention and an electrosurgery unit connected with the electrodes According to a further aspect of the present invention there is provided a resectoscope system including a resectoscope, first and second electrodes located adjacent one another at the patient end of the instrument, first and second rods supporting 3 the respective first and second electrodes and extending along the instrument, the first and second rods being insulated from one another along their length and being slidable relative to one another such as to alter the separation between the two electrodes, the first and second rods being connected with a bipolar output of an electrosurgery unit such that electrosurgery energy can be applied to tissue via the electrodes.

A resectoscope system including a resectoscope according to the present invention, will now be described, by way of example, with reference to the accompanying drawing, which is a side elevation view of the resectoscope.

The resectoscope has an outer tubular sleeve 1 extending along the major part of the length of the instrument. At the patient end 2 of the instrument, the forward, objective end of a telescope 3 protrudes slightly from the sleeve 1. The telescope 3 extends within the sleeve 1 and protrudes at its opposite end 4, where it is formed with an eyepiece 5. The resectoscope could have a video camera clipped to the eyepiece. The telescope 3 has a fibre optic light-guide 13 extending along its length for illumination purposes, the rear end of the light-guide being provided with a connection 6 for connecting to a cable 16 extending to a light source 17. The light source 17 provides illumination via the lightguide 13 of the surgical site being viewed by the surgeon through the telescope 3.

The sleeve 1 also has an inlet tap 7 towards its rear end 4 for connection to a fluid source. The fluid flows via the tap 7 along the sleeve 1 and flows out of its forward end 2 4 to irrigate the surgical site. The irrigating fluid returns along the sleeve 1 and flows out towards its rear end 4 via an outlet tap 8. As so far described, the resectoscope is conventional.

The resectoscope differs ftom previous instruments in that it has two diathermy or electrosurgery electrodes 10 and 20 at the patient end 2. The electrodes 10 and 20 may be of any conventional shape; in this example they are shown as being loop electrodes located adjacent one another and are spaced longitudinally of the instrument. The electrodes 10 and 20 are mounted at the forward end of respective metal rods 11 and 21 extending alongside and insulated from one another along the inside of the sleeve 1. The rod 11 on which the forward electrode 10 is mounted terminates at a fixed finger grip 12 projecting laterally on opposite sides of the sleevel. The finger grip 12 has an electrical connector 14 by which the resectoscope is connected to a first power cable 30, which extends to an electrosurgery unit 3 1 forming a part of the system. The other rod 2 1, to which the rear electrode 20 is fixed, terminates rearwardly of the finger grip 12 in a thumb ring 22 projecting laterally on one side of the telescope eyepiece 5. The thumb ring 22 has a connector 23 by which the rear electrode 20 is connected to a second power cable 3 3, which also extends to the electrosurgery unit 3 1. The electrosurgery unit 3 1 is activated by operating a footswitch 32. The rod 21 and rear electrode 20 are slidable forwardly by moving the thumb ring 22 towards the finger grip 12, so that the two electrodes 10 and 20 can be brought closer together.

The electrosurgery unit 3 1 supplies electrosurgery power to the two electrodes 10 and 20 in a bipolar mode; that is, they are held at different potentials so that current can flow between the two electrodes.

In, for example a TURP procedure, the resectoscope is inserted through an outer metal sheath, which has previously been inserted in the urethra up to the prostate gland. The surgeon views the illuminated prostate through the eyepiece 5 of the telescope 3. By manipulating the resectoscope, the finger grip 12 and thumb ring 22, the surgeon positions the two electrodes 10 and 20 on opposite sides of the part of the prostate to be coagulated. He then applies electrosurgery power by actuating the foot switch 32 so that current flows from the electrosurgery unit 31 one electrode, such as the forward electrode 10, through the tissue and back to the electrosurgery unit 31 via the other electrode 20. In this way, electrosurgery power can be applied to tissue without the need for an external return plate electrode. There is also a considerably reduced risk of electrosurgery current tunnelling into or jumping to adjacent tissue.

It will be appreciated that the two electrodes could be fixed relative to one another or that they could move together in different directions. The resectoscope could have different facilities from those described.

6

Claims

1. A resectoscope including first and second electrodes located adjacent one another at the patient end of the instrument such that electrosurgery energy can be applied to tissue between the electrodes.

A resectoscope according to Claim 1, wherein said first and second electrodes are spaced from one another longitudinally of the resectoscope.

A resectoscope according to Claim 1 or 2, wherein the first and second electrodes are movable relative to one another.

4. A resectoscope according to Claim 3, including first and second rods extending along the length of the instrument, wherein the electrodes are mounted at the patient end of respective ones of the rods, and wherein the rods are slidable relative to one another along their length so as to enable the separation of the electrodes to be altered.

A resectoscope according to any one of the preceding claims, wherein the electrodes are loop electrodes.

6. A resectoscope substantially as hereinbefore described with reference to the accompanying drawings.

7 7. A resectoscope system including a resectoscope according to any one of the preceding claims and an electrosurgery unit connected with said electrodes.

8. A resectoscope system including a resectoscope, first and second electrodes located adjacent one another at the patient end of the instrument, first and second rods supporting the respective first and second electrodes and extending along the instrument, said first and second rods being insulated from one another along their length and being slidable relative to one another such as to alter the separation between the two electrodes, and wherein said first and second rods are connected with a bipolar output of an electrosurgery unit such that electrosurgery energy can be applied to tissue via the electrodes.

9. A resectoscope system substantially as hereinbefore described with reference to the accompanying drawings.

10. Any novel and inventive feature or combination of features as hereinbefore described.