GB2406057A - Surgical instrument and method - Google Patents

Surgical instrument and method Download PDF

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Publication number
GB2406057A
GB2406057A GB0321885A GB0321885A GB2406057A GB 2406057 A GB2406057 A GB 2406057A GB 0321885 A GB0321885 A GB 0321885A GB 0321885 A GB0321885 A GB 0321885A GB 2406057 A GB2406057 A GB 2406057A
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GB
United Kingdom
Prior art keywords
tube
cutting
cutting tool
window
cutting window
Prior art date
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.)
Withdrawn
Application number
GB0321885A
Other versions
GB0321885D0 (en
Inventor
Kester Julian Batchelor
Julian Mark Ebbutt
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.)
Gyrus Medical Ltd
Original Assignee
Gyrus Medical Ltd
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Gyrus Medical Ltd filed Critical Gyrus Medical Ltd
Priority to GB0321885A priority Critical patent/GB2406057A/en
Publication of GB0321885D0 publication Critical patent/GB0321885D0/en
Publication of GB2406057A publication Critical patent/GB2406057A/en
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
    • 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
    • A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • 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
    • A61B2018/00184—Moving parts
    • A61B2018/00202—Moving parts rotating
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00589—Coagulation
    • 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
    • A61B2018/1472—Probes or electrodes therefor for use with liquid electrolyte, e.g. virtual electrodes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/007—Aspiration

Abstract

A surgical instrument comprises a hollow tube (18) having a cutting window (16) at the distal end portion. An inner tube (15) is disposed within the tube (18) and is mounted for rotation about its longitudinal axis. A cutting tool (17) is located at the distal end of the tube (15), and is positioned adjacent to the cutting window (16). An outer tube (14) is provided over the tube (18). A motor (5) is provided for rotating the inner tube (15), and saline is fed to the cutting window (16) via a passageway (25) between the tubes (15) and (18). The inner tube (15) has a central lumen (24) through which tissue cut by the cutting tool (17) is removed under the action of a source of suction (12). The outer surface of the tube 18 is covered with an electrically insulating layer (22) and coagulating RF signals are supplied between the tube (18) and the outer tube (14) so as to coagulate tissue at the cutting window (16). A suction aperture (21) provided in the cutting tool (17) ensures that suction can be supplied to the surgical site regardless of the orientation of the cutting tool (17).

Description

Surgical Instrument and Method This invention relates to a surgical
instrument, and to a system and method for removing tissue from a surgical site on or within a patient's body. In a preferred construction, the invention relates to an electrosurgical system and method that can use electrical and mechanical energy to treat tissue.
Known mechanical surgical instruments include simple scalpels which are used for cutting soft tissue, rotatable shavers which are also used for removing soft tissue, and l 0 rotatable burrs which are used for cutting harder tissue such as bone.
Known electrosurgical instruments include monopolar and bipolar devices, both of which are used primarily for treating or cauterising soft tissue. Typically tissue is removed using a mechanical cutting device such as a shaver (or by an electrosurgical device operating in cutting or vaporisation mode), and then the cauterising device is used to coagulate tissue in order to stench bleeding.
It is known to use a surgical instrument which includes a mechanical element, such as a rotary shaver or burr, and an electrosurgical instrument such as a monopolar or bipolar device. A known instrument of this type is described in US patent specification 5,904,681, which describes an instrument having a shaver or burr rotatably mounted within an outer sleeve, and an electrosurgical electrode mounted at the end of the outer sleeve on the "back" of the instrument (i.e. opposite to the cutting window of the device).
US 6,610,059 is a further device from the same inventor in which an electrosurgical electrode is provided on the back of a mechanical cutting device. One or more suction holes are also provided on the back of the device for the aspiration of bubbles and other debris produced by the operation of the electrosurgical electrode.Another prior art device is US 6,193,715 which provides an adapter for converting a conventional mechanical cutting device such as a shaver or burr into a combined mechanical/eleckosurgical instrument. This patent does not depict any such additional suction holes.
It is an aim of the present invention to provide an improved surgical device, bearing in mind the limitations of the prior art devices described above.
Accordingly, there is provided a surgical instrument comprising: a) an intermediate hollow tube having a central passageway and a cutting window at a distal end thereof; b) an inner hollow tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen; c) a cutting tool disposed at the distal end of the inner tube such that the cutting tool is accessible through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissue-cutting edge, the cut-out providing, in a first orientation of the cutting tool, a first suction passage between the suction lumen and the cutting window; d) an outer tube disposed over the intermediate hollow tube and having an opening at its distal end so as to allow access to the cutting window of the intermediate tube; e) an electrically insulating layer disposed between the intermediate and outer tubes, the intermediate and outer tubes both being electrically conducting; and f) first and second contacts associated with the outer and intermediate tubes respectively for connecting the tubes to respective poles of an electrosurgical generator; the arrangement being such that the rotation of the cutting tool is capable of causing the cutting of tissue in the region of the cutting window, while the intermediate and outer tubes form the electrodes of a bipolar eleckosurgical instrument capable of coagulating tissue in the region of the cutting window, there being additionally provided an aperture in the cutting tool opposite the cut- out and forming, in a second orientation of the cutting tool, an alternative suction passage between the suction lumen and the cutting window.
It will be appreciated that the electrosurgical action of the present instrument is in the region of the cutting window, as opposed to the reverse side of the instrument as in US Patents 5,904,681 and 6,610,059. This means that an electrosurgical coagulating signal can be applied to tissue, either subsequent to or simultaneously with the mechanical cutting, without having to re-orient the instrument. The electrosurgical coagulating signal is applied directly in the same region as the cutting action, i.e. in the proximity of the cutting window. s
The provision of the aperture opposite the cut-out in the cutting tool has several advantages. Firstly, if the rotation of the cutting tool is stopped in order to provide electrosurgical coagulation, there is a possibility that the cutting tool will come to rest with the cutting tool partly or completely blocking the cutting window. This will result little or no suction reaching the surgical site, as the cut-out in the surgical tool is out of alignment with the cutting window. The provision of at least one aperture opposite the cut-out means that suction can be applied to the surgical site (i.e. to remove debris or excess blood) even when the cut-out is out of alignment with the cutting window. This means that coagulation will not be compromised by the presence of debris or excess fluid such as blood or saline.
The electrically insulating layer is provided between the intermediate tube and the outer tube. In a preferred embodiment, the insulating layer is provided by means of an insulating material deposited on to the outer surface of the intermediate layer.
Alternatively, the insulating material can be deposited on to the inner surface of the outer tube. The insulating material is conveniently a nonconductive polymer such as P.T.F.E. or silicone rubber.
In a preferred embodiment, there is also provided a source of irrigating fluid, adapted to irrigate the cutting tool. The irrigating fluid is preferably an electrically conductive fluid such as saline, and is conveniently transmitted to the cutting tool between the inner tube and the intermediate tube. The irrigating fluid not only helps to cool and clean the cutting tool, but also assists in the electrosurgical coagulation process.
The invention further resides in a surgical system including i) a surgical instrument comprising; a) an intermediate hollow tube having a central passageway and a cutting window at a distal end thereof; b) an inner hollow tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen; c) a cutting tool disposed at the distal end of the inner tube such that the cutting tool is accessible through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissue-cutting edge, the cut-out providing, in a first orientation of the cutting tool, a first suction passage between the suction lumen and the cutting window; d) an outer tube disposed over the intermediate hollow tube and having an opening at its distal end so as to allow access to the cutting window of the intermediate tube; e) an electrically insulating layer disposed between the intermediate and outer tubes, the intermediate and outer tubes both being electrically conducting; and f) first and second contacts associated with the outer and intermediate tubes respectively for connecting the tubes to respective poles of an electrosurgical generator; ii) a motor adapted to rotate the inner hollow tube within the intermediate tube; iii) a source of suction connected to the central suction lumen of the inner hollow tube; and iv) an electrosurgical generator connected to the first and second contacts so as to selectively supply RF energy between the intermediate and outer tubes; the arrangement being such that the rotation of the cutting tool is capable of causing the cutting of tissue in the region of the cutting window, while the RF energy supplied to the intermediate and outer tubes coagulate tissue in the region of the cutting window, and there is additionally provided an aperture in the cutting tool opposite the cut- out and forming, in a second orientation of the cutting tool, an alternative suction passage between the suction lumen and the cutting window.
The invention further resides in a method of surgically removing tissue from a surgical site on or in the body of a patient, the method comprising the steps of: i) introducing to the surgical site a surgical instrument comprising a) an intermediate hollow tube having a central passageway and a cutting window at a distal end thereof; b) an inner hollow tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen; c) a cutting tool disposed at the distal end of the inner tube such that the cutting tool is accessible through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissue-cutting edge, the cut-out providing, in a first orientation of the cutting tool, a first suction passage between the suction lumen and the cutting window, and an aperture opposite the cut-out and forming, in a second orientation of the cutting tool, an alternative suction passage between the suction lumen and the cutting window; d) an outer tube disposed over the intermediate hollow tube and having an opening at its distal end so as to allow access to the cutting window of the 1 S intermediate tube; and e) an electrically insulating layer disposed between the intermediate and outer tubes, the intermediate and outer tubes both being electrically conducting; ii) rotating the inner hollow tube such as to cause the cutting tool to rotate adjacent the cutting window; iii) applying suction to the suction lumen of the inner tube so as to cause tissue to be drawn into the cutting window and contacted by the rotating cutting tool; iv) supplying RF energy between the intermediate and outer tubes such that tissue coming into contact therewith in the region of the cutting window is coagulated; and v) manipulating the surgical instrument such as to cut and coagulate tissue at the surgical site.
The invention will now be described in greater detail, by way of example, with reference to the drawings, in which: Figure I is a schematic diagram of a surgical system incorporating a surgical instrument in accordance with the invention; Figure 2 is a sectional side view of the distal end of the surgical instrument of Figure 1; Figure 3 is a schematic view, shown partly in section, of the proximal end of the probe of the surgical instrument of Figure 1, and Figure 4 is a side view of a surgical instrument in accordance with an alternative embodiment of the invention.
Referring to the drawings, Figure 1 shows a surgical system which includes a controller/generator 1 and a handpiece 2 having a detachable surgical probe shown generally at 3. The probe 3 includes a rotatable inner tubular member 15, driven by a motor shown schematically at 5 within the handpiece. Power signals for the motor 5 are supplied to the handpiece 2 from an output socket 6 on the generator 1, via connector cord 7. Activation of the controller I may be performed by means of footswitch 8, coupled to the controller by means of connector cord 9. An inlet port 10 allows saline to be fed from a saline source 11 to the distal end of the probe 3. A source of suction 12 is also provided, coupled to the handpiece by cord 13. Cord 27 supplies electrosurgical coagulation signals from the generator 1 to the probe 3.
Figure 2 shows a sectional view of the distal end 4 of the probe 3. The probe 3 comprises an inner tubular member 15, an outer tubular member 14 and an intermediate tubular member 18. A cutting tool 17 is located at the distal end of the inner member 15, and can be accessed through lateral cutting windows 16 and 19 in the intermediate and outer tubular members respectively. The cutting tool includes a cut-out portion 20 having a periphery constituted by a serrated edge, and a suction aperture 21 located opposite the cut-out portion 20.
The tubes 14, and 18 are both formed of a conductive metallic material such as stainless steel, although the outer tubular member 14 can alternatively be formed of copper (which is better at conducting heat away from the distal end 4 of the probe 3). The intermediate tubular member 18 is coated with an electrically insulating silicone rubber layer 22, the layer 22 stopping marginally short of the distal end of the tube 18 so as to leave exposed portions as shown at 23. The inner tubular member 15 is formed of a non- conducting flexible polymer material, with the cutting tool 17 being fommed of stainless steel. (Altematively, the inner tube 15 can be fommed of stainless steel in which case the cutting tool 17 can be formed integrally with the inner tube 15.) The inner tubular member 15 is hollow defining a suction lumen 24, which in use is connected to the source of suction 12. A passageway 25 between the inner tubular member 15 and the intemmediate member 18 is connected in use to the saline source 11, and is used to deliver saline to the distal end 4 of the probe 3. The outer member 14 is optionally covered with a heat-shrink electrically insulating sleeve 26, covering the probe 3 with the exception of the distal end 4 including the cutting window 19.
Figure 3 shows how the intermediate tubular member 18 and the outer member 14 are connected to the electrosurgical generator 1. A first lead 28 supplies signals from one pole of the generator 1, and is connected to the outer tubular member 14 by means of clip assembly 29. A second lead 30 is connected to the other pole of the generator 1, and is in electrical communication with the intemmediate tubular member 18 by means of second clip assembly 31. The first and second clip assemblies are separated by silicone rubber seal 200, and the clip assemblies are covered by a plastics casing 201.
The use of the instrument will now be described. In use, when the cutting of tissue is required, the motor 5 is activated to rotate the inner tubular member 15, thereby causing the corresponding rotation of the cutting tool 17. The probe 3 is moved to engage tissue to be excised, and the tissue is drawn through the cutting windows 16 and 19 by the suction applied through the suction lumen 24 in the inner member 15. When the tissue enters the cutting window 16, it is severed by the rotation of the cutting tool 17 and the excised tissue is evacuated by the suction along the suction lumen 24.
When the coagulation of tissue is required, the electrosurgical generator 1 is actuated to supply bipolar coagulation signals to the intermediate tube 18 and outer tube 14, via the clip assemblies 29 and 31. Tissue coming into contact with the exposed portions 23 of the intermediate tube 18 will be coagulated by the electrosurgical signals from the generator 1.
In one arrangement, the rotation of the inner member 15 is stopped when coagulation is required. As the intermediate member 18 and inner member 15 are in intimate contact (and as there is no insulating layer therebetween), the electrosurgical signals supplied to the intermediate member will be transmitted to the cutting tool 17. In this arrangement, the cutting tool 17, once it has stopped rotating, can be used to contact tissue in order to perform the coagulation thereof.
Once the drive from the motor 5 has been discontinued, the cutting tool can come to rest in any angular orientation within the intermediate member 18. This means that the cut-out portion 20 in the cutting tool can come to rest fully or partly in communication with the cutting windows 16 and 19, or alternatively it can come to rest completely cut off from the cutting windows 16 and 19. However, the provision of the suction aperture 21, which is positioned opposite the cut-out portion 20, means that the aperture 21 is able to provide a suction pathway in such an event. This means that the suction from the suction lumen 24 is always transmitted through the cutting windows 16 and 19, regardless of the orientation of the cutting tool 17. Excess debris, blood or saline can, in certain circumstances, reduce the effectiveness of the electrosurgical coagulation. The suction aperture 21 ensures that such matter can always be quickly removed, allowing coagulation to commence. 1
In another arrangement the coagulating signals from the generator can be supplied to the tissue while the cutting tool is still being rotated by the motor 5. In this way, the tissue entering the cutting windows is simultaneously cut and coagulated. The suction aperture 21 also facilitates the clearance of tissue within the cutting tool 17. Without the suction aperture 21, there is a risk that coagulated tissue can become adhered to the solid face of the cutting tool opposite the cut-out portion 20. With the suction aperture 21, any such debris will be detached from the face of the cutting tool by the force of the suction entering the suction aperture.
Figure 4 shows an alternative embodiment of surgical device in which the handpiece 2 includes an upper portion 32 and a lower portion 34 defining a pistol grip arrangement.
The upper portion 32 extends generally parallel to the probe 3, while the lower portion 34 extends at an angle thereto. The probe 3 is attached to the upper portion of the handpiece 2 by means of a collet assembly 36. The motor 5 (not shown in Figure 4) is located in the lower portion 34 of the handpiece, and is controlled by signals via control line 219. Fluid irrigation and suction are provided to the handpiece 2 via dual tubing 131, the fluid supply being via tube 124 and the suction supply via tube 130. The dual tubing 131 is attached to the handpiece 2 by means of a connector 112.
A swivel collet assembly 36 is provided at the front end of the upper portion 32 of the handle 2. Disposing the collet assembly 36 at this location enables an operator, such as a surgeon, holding the handle 2 in a pistol grip manner, to touch and rotate the assembly collet 36 or a portion thereof with the tip of at least one of the surgeon's fingers. Rotating at least a portion of the collet assembly 36 in this manner enables the cutting window of the probe 3 to rotate, thereby orienting the direction of the shaving and/or cutting of the desired bodily material.
It will be appreciated by those skilled in the art that the embodiments described above provide both mechanical cutting of tissue and electrosurgical coagulation at substantially the same part of the instrument, thereby avoiding the need for the surgeon to move or otherwise reorient the instrument to change between cutting and coagulation. The provision of the suction aperture 21 in this type of instrument provides additional benefits, ensuring a constant supply of suction and reduced blocking of the instrument. It will be appreciated that alternative arrangements, such as multiple apertures or mesh structures can be employed without departing from the scope of the present invention.

Claims (7)

  1. Claims 1. A surgical instrument comprising; a) an intermediate hollow tube
    having a central passageway and a cutting window at a distal end thereof; b) an inner hollow tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen; c) a cutting tool disposed at the distal end of the inner tube such that the cutting tool is accessible through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissue-cutting edge, the cut-out providing, in a first orientation of the cutting tool, a first suction passage between the suction lumen and the cutting window; d) an outer tube disposed over the intermediate hollow tube and having an opening at its distal end so as to allow access to the cutting window of the intermediate 1 5 tube; e) an electrically insulating layer disposed between the intermediate and outer tubes, the intermediate and outer tubes both being electrically conducting; and f) first and second contacts associated with the outer and intermediate tubes respectively for connecting the tubes to respective poles of an electrosurgical generator; the arrangement being such that the rotation of the cutting tool is capable of causing the cutting of tissue in the region of the cutting window, while the intermediate and outer tubes form the electrodes of a bipolar electrosurgical instrument capable of coagulating tissue in the region of the cutting window, there being additionally provided an aperture in the cutting tool opposite the cut-out and forming, in a second orientation of the cutting tool, an alternative suction passage between the suction lumen and the cutting window.
  2. 2. A surgical instrument according to claim 1, wherein the electrically insulating layer is provided by means of an insulating material deposited on to the outer surface of the intermediate tube.
  3. 3. A surgical instrument according to claim 1 or claim 2, wherein there is additionally provided a source of irrigating fluid, adapted to irrigate the cutting tool.
  4. 4. A surgical instrument according to claim 3, wherein the irrigating fluid is S transmitted to the cutting tool between the inner tube and the intermediate tube.
  5. 5. A surgical instrument according to claim 3 or claim 4, wherein the irrigating fluid is an electrically conducting fluid.
  6. 6. A surgical system including i) a surgical instrument comprising: a) an intermediate hollow tube having a central passageway and a cutting window at a distal end thereof; b) an inner hollow tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen; c) a cutting tool disposed at the distal end of the inner tube such that the cutting tool is accessible through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissue-cutting edge, the cut-out providing, in a first orientation of the cutting tool, a first suction passage between the suction lumen and the cutting window; d) an outer tube disposed over the intermediate hollow tube and having an opening at its distal end so as to allow access to the cutting window of the intermediate tube; e) an electrically insulating layer disposed between the intermediate and outer tubes, the intermediate and outer tubes both being electrically conducting; and f) first and second contacts associated with the outer and intermediate tubes respectively for connecting the tubes to respective poles of an electrosurgical generator; ii) a motor adapted to rotate the inner hollow tube within the intermediate tube; iii) a source of suction connected to the central suction lumen of the inner hollow tube; and iv) an electrosurgical generator connected to the first and second contacts so as to selectively supply RF energy between the intermediate and outer tubes; the arrangement being such that the rotation of the cutting tool is capable of causing the cutting of tissue in the region of the cutting window, while the RF energy supplied to the intermediate and outer tubes coagulate tissue in the region of the cutting window, and there is additionally provided an aperture in the cutting tool opposite the cutout and forming, in a second orientation of the cutting tool, an alternative suction passage between the suction lumen and the cutting window.
  7. 7. A method of surgically removing tissue from a surgical site on or in the body of a patient, the method comprising the steps of i) introducing to the surgical site a surgical instrument comprising a) an intermediate hollow tube having a central passageway and a cutting window at a distal end thereof; b) an inner hollow tube rotatably mounted in the central passageway of the intermediate tube and providing a central suction lumen; c) a cutting tool disposed at the distal end of the inner tube such that the cutting tool is accessible through the cutting window of the intermediate tube, the cutting tool including a cut-out defining a tissuecutting edge, the cut-out providing, in a first orientation of the cutting tool, a first suction passage between the suction lumen and the cutting window, and an aperture opposite the cut-out and forming, in a second orientation of the cutting tool, an alternative suction passage between the suction lumen and the cutting window; d) an outer tube disposed over the intermediate hollow tube and having an opening at its distal end so as to allow access to the cutting window of the intermediate tube; and e) an electrically insulating layer disposed between the intermediate and outer tubes, the intermediate and outer tubes both being electrically conducting; ii) rotating the inner hollow tube such as to cause the cutting tool to rotate adjacent the cutting window; iii) applying suction to the suction lumen of the inner tube so as to cause tissue to be drawn into the cutting window and contacted by the rotating cutting tool; iv) supplying RF energy between the intermediate and outer tubes such that tissue coming into contact therewith in the region of the cutting window is coagulated; and v) manipulating the surgical instrument such as to cut and coagulate tissue at the surgical site.
GB0321885A 2003-09-18 2003-09-18 Surgical instrument and method Withdrawn GB2406057A (en)

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GB2406057A true GB2406057A (en) 2005-03-23

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009095172A1 (en) 2008-01-31 2009-08-06 Karl Storz Gmbh & Co. Kg Bipolar coagulation instrument
US10299855B2 (en) 2009-06-16 2019-05-28 Karl Storz Se & Co. Kg Medical coagulation instrument

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5364395A (en) * 1993-05-14 1994-11-15 West Jr Hugh S Arthroscopic surgical instrument with cauterizing capability
GB2379878A (en) * 2001-09-21 2003-03-26 Gyrus Medical Ltd Precoagulation as ameans to aid tissue removal
US6610059B1 (en) * 2002-02-25 2003-08-26 Hs West Investments Llc Endoscopic instruments and methods for improved bubble aspiration at a surgical site

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5364395A (en) * 1993-05-14 1994-11-15 West Jr Hugh S Arthroscopic surgical instrument with cauterizing capability
GB2379878A (en) * 2001-09-21 2003-03-26 Gyrus Medical Ltd Precoagulation as ameans to aid tissue removal
US6610059B1 (en) * 2002-02-25 2003-08-26 Hs West Investments Llc Endoscopic instruments and methods for improved bubble aspiration at a surgical site

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009095172A1 (en) 2008-01-31 2009-08-06 Karl Storz Gmbh & Co. Kg Bipolar coagulation instrument
US8231622B2 (en) 2008-01-31 2012-07-31 Karl Storz Gmbh & Co. Kg Bipolar coagulation instrument
US10299855B2 (en) 2009-06-16 2019-05-28 Karl Storz Se & Co. Kg Medical coagulation instrument

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Publication number Publication date
GB0321885D0 (en) 2003-10-22

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