GB2552682A - Surgical instrument - Google Patents

Surgical instrument Download PDF

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Publication number
GB2552682A
GB2552682A GB1613362.1A GB201613362A GB2552682A GB 2552682 A GB2552682 A GB 2552682A GB 201613362 A GB201613362 A GB 201613362A GB 2552682 A GB2552682 A GB 2552682A
Authority
GB
United Kingdom
Prior art keywords
electrode
shaft
surgical instrument
tissue treatment
treatment electrode
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.)
Granted
Application number
GB1613362.1A
Other versions
GB2552682B (en
GB201613362D0 (en
Inventor
Benn Chris
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 GB1613362.1A priority Critical patent/GB2552682B/en
Publication of GB201613362D0 publication Critical patent/GB201613362D0/en
Publication of GB2552682A publication Critical patent/GB2552682A/en
Application granted granted Critical
Publication of GB2552682B publication Critical patent/GB2552682B/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

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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
    • 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
    • A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
    • 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
    • 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
    • A61B18/148—Probes or electrodes therefor having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
    • 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
    • A61B2017/320024—Morcellators, e.g. having a hollow cutting tube with an annular cutter for morcellating and removing tissue
    • 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
    • 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
    • A61B2018/00601—Cutting
    • 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
    • A61B2018/1475—Electrodes retractable in or deployable from a housing
    • 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
    • A61B2018/1497—Electrodes covering only part of the probe circumference

Abstract

A surgical instrument (1, Figure 1) comprises a handle (2, Figure 1) from which an instrument shaft 6 extends. A mechanical cutter 8, which may be a shaver blade, is provided at the distal end of shaft 6 and is driven for movement, preferably rotation, relative to the shaft. A tissue treatment electrode 10 is provided that is connectable to a source of electrosurgical energy and that is movable, for example by axial translation, including sliding of an insulating sheath 9, or by rotation, between a first position in which electrode 10 is remote from cutter 8 and a second position in which electrode 10 is closer to cutter 8 but does not protrude from the distal end of shaft 6. A return electrode may be provided by shaft 6, and may be accessible through a window in insulating sheath 9.

Description

(54) Title of the Invention: Surgical instrument
Abstract Title: Surgical instrument with cutter and moveable tissue treatment electrode (57) A surgical instrument (1, Figure 1)comprises a handle (2, Figure 1) from which an instrument shaft 6 extends. A mechanical cutter 8, which may be a shaver blade, is provided at the distal end of shaft 6 and is driven for movement, preferably rotation, relative to the shaft. A tissue treatment electrode 10 is provided that is connectable to a source of electrosurgical energy and that is movable, for example by axial translation, including sliding of an insulating sheath 9, or by rotation, between a first position in which electrode 10 is remote from cutter 8 and a second position in which electrode 10 is closer to cutter 8 but does not protrude from the distal end of shaft 6. A return electrode may be provided by shaft 6, and may be accessible through a window in insulating sheath 9.
FI O ib. Z
FIG. 1
08 17
08 17
SURGICAL INSTRUMENT
This invention relates to a surgical instrument, and in particular for an instrument which combines the options of mechanical cutting and the electrosurgical treatment of tissue. Such systems are commonly used for the treatment of tissue in surgical intervention, most commonly in “keyhole” or minimally invasive surgery, but also in “open” surgery.
There have been previous attempts to combine mechanical cutting with the electrosurgical treatment of tissue. Examples of mechanical shavers with electrosurgical electrodes include US patents 3,945,375, 5,176,677, 5,364,395 and 5,904,681. The present invention attempts to provide an improvement to such electrosurgical cutting instruments.
Accordingly, a surgical instrument is provided for the treatment of tissue, the the instrument comprising a handle, an instrument shaft extending from the handle, a mechanical cutting element at the distal end of the shaft, and drive means for moving the mechanical cutting element relative to the shaft, the instrument further including a tissue treatment electrode and at least one connection by which the tissue treatment electrode may be connected to a source of electrosurgical energy, the tissue treatment electrode having an exposed surface for treating tissue, wherein the tissue treatment electrode is movable between a first position in which the tissue treatment electrode is remote from the mechanical cutting element, and a second position in which the tissue treatment electrode is closer to the mechanical cutting element but not protruding from the distal end of the shaft.
The present invention allows for the tissue treatment electrode to be present in a retracted position when the tissue is being treated using the mechanical cutting element, such that the tissue treatment electrode is not in the way or obscuring the user’s view of the surgical site. However, when the tissue treatment electrode is required for use, it can be moved to a deployed position in which it is closer to the mechanical cutting element.
The drive means preferably causes the mechanical cutting element to rotate with respect to the instrument shaft, with the mechanical cutting element conveniently comprising a shaver blade. The shaver blade typically comprises an inner tubular member rotating within an outer tubular member constituting the instrument shaft. The outer tubular member typically includes a cutting window allowing access to the shaver blade.
Alternatively, the mechanical cutting element can translate longitudinally with respect to the shaft, typically in a reciprocating manner. This longitudinal movement could conceivably be combined with the rotation of a shaver blade in a combined rotating and translating cutting action. Such ultrasonic translational movement will be known to those skilled in the art and will not be discussed further herein.
The tissue treatment electrode is conceivably a monopolar electrode, with the electrical circuit completed via a remote patient return pad. More preferably, the tissue treatment electrode is conveniently part of a bipolar electrode assembly, the bipolar electrode assembly also including a return electrode which is electrically insulated from the tissue treatment electrode by means of an insulation member. According to one convenient arrangement, the tissue treatment electrode is mounted on an insulating sleeve covering the instrument shaft, typically formed of a polymeric material. Conveniently, the return electrode is constituted by the instrument shaft, and the insulating sleeve includes a window exposing a portion of the instrument shaft, the portion of the instrument shaft acting as the return electrode.
According to one arrangement, the tissue treatment electrode is movable between its first and second positions by rotating the electrode with respect to the longitudinal axis of the shaft. Where the tissue treatment electrode is mounted on an insulating sleeve, the tissue treatment electrode is rotated between its first and second positions by the rotation of the insulating sleeve. When the tissue treatment electrode is in its first position, it conceivably lies opposite the cutting window, so as to be out of the way when the shaver blade is being used to cut tissue. When the tissue treatment electrode is in its second position, it conceivably obscures the cutting window. In this way, the tissue treatment electrode is rotated through 180 degrees, from its retracted position to its deployed position for use.
Alternatively, the tissue treatment electrode is movable between its first and second positions by moving the electrode longitudinally with respect to the shaft. Where the tissue treatment electrode is mounted on an insulating sleeve, the tissue treatment electrode is moved between its first and second positions by the longitudinal movement of the sleeve with respect to the shaft. Typically, in its first position, the tissue treatment electrode is axially set back with respect to the cutting window. In its second position, the tissue treatment electrode is conveniently still axially set back with respect to the cutting window, but in a position closer to the cutting window than in its first position. In this way, the tissue treatment electrode is moved longitudinally between its two positions, being moved forwardly to a position nearer the cutting window when required for use. The second position may conceivably see the tissue treatment electrode in a position adjacent the cutting window.
The invention will now be further described, by way of example only, with reference to the accompanying drawings, in which:
Figure 1 is a schematic perspective view of a surgical instrument according to the present invention,
Figure 2 is an enlarged perspective view of the distal end of the instrument of
Figure 1, and
Figure 3 is an enlarged perspective view of the distal end of an alternative embodiment of surgical instrument in accordance with the invention.
Referring to Figure 1, a shaver instrument is shown generally at 1, and comprises a handle 2 and a probe 3 detachable connected to the handle 2. The handle includes push buttons 4 and a slider 5, the purpose of which will be described in more detail subsequently.
Figure 2 shows the probe 3 in more detail. The probe 3 comprises a steel shaft 6 in the form of a hollow tube, the shaft having a cutting window 7 towards its distal end. Located within the shaft 6 is a rotatable shaver blade 8, the shaver blade having serrated teeth (not shown) positioned so as to correspond with the cutting window 7. The shaver blade 8 is also in the form of a hollow tube, the tube being rotated by a motor (not shown) positioned within the handle 2.
The steel shaft 6 is covered with a polymeric sleeve 9, the sleeve finishing short of the distal end of the shaft so as to leave the cutting window 7 exposed. The sleeve carries a tissue treatment electrode 10, the electrode 10 being capable of being connected to an electrosurgical generator by means of a lead (not shown). The sleeve 9 separates the electrode 10 from the steel shaft 6 which acts as a return electrode, a portion of the shaft 6 being exposed through a return window 11 cut out of the sleeve 9.
In use, when the user of the instrument wishes to use the shaver blade 8 to cut tissue, the user presses one of the buttons 4 which activates the motor to rotate the shaver blade 8 within the shaft 6. The movement of the serrated teeth past the edges of the cutting window 7 cuts tissue, which is then removed through the hollow interior of the shaver blade 8, usually with the assistance of suction. When tissue is being cut by the shaver blade, the slider 5 is generally kept in the retracted position shown in Figure
I. In this position, the sleeve 9 is retracted to maintain the electrode 10 axially set back and out of the way of the cutting window, as shown in Figure 2.
When the user of the instrument wishes to use the electrode 10 to cut or coagulate tissue, the slider 5 is advanced to move the sleeve, and hence the electrode 10, further down the shaft 6. In this position, the electrode is still proximal of the cutting window 7, but much closer thereto, such that the electrode 10 is positioned adjacent tissue to be treated. A different one of the buttons 4 is pushed to provide either a cutting or a coagulating RF waveform to the electrode 10, as required. Current passes through the tissue to the portion of the shaft exposed through the return window
II, which acts as a return electrode. When the electrosurgical treatment of tissue has been completed, the slider 5 can be returned to its retracted position, withdrawing the sleeve 9, and hence the electrode 10, to its original position.
The movement of the slider 5 can advance and retract the electrode between deployed and retracted positions. The shaver blade 8 and the electrode 10 can be used alternatively, for mechanical and electrosurgical treatment of tissue. If desired, the shaver blade 8 and the electrode 10 can be used concurrently, such that tissue is simultaneously cut by the shaver blade and coagulated by the electrode.
Figure 3 shows an alternative embodiment of probe, in which steel shaft 6 and shaver blade 8 are as previously described. However, in this embodiment the polymeric sleeve 9 extends to the distal end of the shaft, and includes a sleeve window
12. The sleeve window 12 exposes the area of the instrument including the cutting window 7, rotation of the sleeve 9 with respect to the shaft 6 causing the sleeve to alternately expose and obscure the cutting window. The tissue treatment electrode 10 is located on the sleeve 9 opposite the sleeve windowl2.
When the user wishes to use the shaver blade 8 to cut tissue mechanically, the sleeve is rotated such that the sleeve window 12 exposes the cutting window 7, with the electrode being located out of the way on the opposite side of the instrument. This is the configuration shown in Figure 3, and the shaver blade is rotated to cut tissue as previously described.
When the user wishes to use the tissue treatment electrode 10, the sleeve is rotated (an actuation mechanism located on the handle) to cause the electrode 10 to rotate around to the position formerly occupied by the cutting window. The electrode 10 is now in position to treat tissue, as previously described with reference to the earlier embodiment of Figure 1 & 2.
Those skilled in the art will appreciate that modifications to the above can be made without departing from the scope of the present invention, and that alternative configurations of components can be employed. Although the electrode 10 is described herein as constituting part of a bipolar electrode assembly together with the shaft 6, the electrode 10 may operate as a monopolar electrode in combination with a remote patient return pad. While a shave blade 8is described and illustrated, other mechanical cutting elements such as burrs or morcellators can be employed, as can ultrasonic vibration as opposed to rotation. Whichever combinations are employed, the electrode 10 can be moved between retracted and deployed positions, depending on which method of tissue treatment is intended.

Claims (17)

1. A surgical instrument for the treatment of tissue, the instrument comprising
5 a handle, an instrument shaft extending from the handle, a mechanical cutting element at the distal end of the shaft, and drive means for moving the mechanical cutting element relative to the shaft, the instrument further including a tissue treatment electrode and at least one connection by which the tissue treatment electrode may be connected to a source of electrosurgical energy, the tissue treatment electrode having an
10 exposed surface for treating tissue, wherein the tissue treatment electrode is movable between a first position in which the tissue treatment electrode is remote from the mechanical cutting element, and a second position in which the tissue treatment electrode is closer to the mechanical cutting element but not protruding from the distal end of the shaft.
2. A surgical instrument according to claim 1, wherein the drive means causes the mechanical cutting element to rotate with respect to the instrument shaft.
3. A surgical instrument according to claim 2, wherein the mechanical cutting
20 element comprises a shaver blade.
4. A surgical instrument according to claim 3, wherein the shaver blade comprises an inner tubular member rotating within an outer tubular member constituting the instrument shaft.
5. A surgical instrument according to claim 4, wherein the outer tubular member includes a cutting window allowing access to the shaver blade.
6. A surgical instrument according to any preceding claim, wherein the tissue
30 treatment electrode is part of a bipolar electrode assembly, the bipolar electrode assembly also including a return electrode which is electrically insulated from the tissue treatment electrode by means of an insulation member.
7. A surgical instrument according to claim 6, wherein the tissue treatment electrode is mounted on an insulating sleeve covering the instrument shaft.
8. A surgical instrument according to claim 6 or claim 7, wherein the return electrode is constituted by the instrument shaft.
9. A surgical instrument according to claim 7 and 8, wherein the insulating sleeve includes a window exposing a portion of the instrument shaft, the portion of the instrument shaft acting as the return electrode.
10. A surgical instrument according to any preceding claim, wherein the tissue treatment electrode is movable between its first and second positions by rotating the electrode with respect to the longitudinal axis of the shaft.
11. A surgical instrument according to at least claims 7 and 10, wherein the tissue treatment electrode is rotated between its first and second positions by the rotation of the insulating sleeve.
12. A surgical instrument according to at least claims 5 and 10, wherein in its first position, the tissue treatment electrode lies opposite the cutting window.
13. A surgical instrument according to claim 12, wherein in its second position the tissue treatment electrode obscures the cutting window.
14. A surgical instrument according to any of claims 1 to 9, wherein the tissue treatment electrode is movable between its first and second positions by moving the electrode longitudinally with respect to the shaft.
15. A surgical instrument according to at least claims 7 and 14, wherein the tissue treatment electrode is moved between its first and second positions by the longitudinal movement of the sleeve with respect to the shaft.
16. A surgical instrument according to at least claims 5 and 14, wherein in its first position, the tissue treatment electrode is axially set back with respect to the cutting window.
17. A surgical instrument according to at least claims 5 and 14, wherein in its second position, the tissue treatment electrode is axially set back with respect to the cutting window, but closer to the cutting window than in its first position.
Intellectual
Property
Office
Application No: GB1613362.1 Examiner: Simon Rose
GB1613362.1A 2016-08-03 2016-08-03 Surgical instrument Active GB2552682B (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
GB1613362.1A GB2552682B (en) 2016-08-03 2016-08-03 Surgical instrument

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
GB1613362.1A GB2552682B (en) 2016-08-03 2016-08-03 Surgical instrument

Publications (3)

Publication Number Publication Date
GB201613362D0 GB201613362D0 (en) 2016-09-14
GB2552682A true GB2552682A (en) 2018-02-07
GB2552682B GB2552682B (en) 2019-02-27

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Family Applications (1)

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019209749A1 (en) * 2018-04-23 2019-10-31 Aaron Germain Arthroscopic devices and methods
GB2598332A (en) * 2020-08-26 2022-03-02 Gyrus Medical Ltd Electrosurgical instrument
EP3967252A1 (en) * 2020-09-15 2022-03-16 Mazor Robotics Ltd. Multifunctional surgical tool and system

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6010476A (en) * 1996-12-02 2000-01-04 Angiotrax, Inc. Apparatus for performing transmyocardial revascularization
US20020173776A1 (en) * 2001-05-10 2002-11-21 Batchelor Kester J. Surgical instrument
GB2379878A (en) * 2001-09-21 2003-03-26 Gyrus Medical Ltd Precoagulation as ameans to aid tissue removal
US20130345704A1 (en) * 2012-06-20 2013-12-26 Gyrus Ent, L.L.C. Bipolar surgical instrument with two half tube electrodes

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6010476A (en) * 1996-12-02 2000-01-04 Angiotrax, Inc. Apparatus for performing transmyocardial revascularization
US20020173776A1 (en) * 2001-05-10 2002-11-21 Batchelor Kester J. Surgical instrument
GB2379878A (en) * 2001-09-21 2003-03-26 Gyrus Medical Ltd Precoagulation as ameans to aid tissue removal
US20130345704A1 (en) * 2012-06-20 2013-12-26 Gyrus Ent, L.L.C. Bipolar surgical instrument with two half tube electrodes

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019209749A1 (en) * 2018-04-23 2019-10-31 Aaron Germain Arthroscopic devices and methods
US11883053B2 (en) 2018-04-23 2024-01-30 RELIGN Corporation Arthroscopic devices and methods
GB2598332A (en) * 2020-08-26 2022-03-02 Gyrus Medical Ltd Electrosurgical instrument
EP3967252A1 (en) * 2020-09-15 2022-03-16 Mazor Robotics Ltd. Multifunctional surgical tool and system

Also Published As

Publication number Publication date
GB2552682B (en) 2019-02-27
GB201613362D0 (en) 2016-09-14

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