GB2565113A - Electrosurgical instrument - Google Patents

Electrosurgical instrument Download PDF

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Publication number
GB2565113A
GB2565113A GB1712433.0A GB201712433A GB2565113A GB 2565113 A GB2565113 A GB 2565113A GB 201712433 A GB201712433 A GB 201712433A GB 2565113 A GB2565113 A GB 2565113A
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GB
United Kingdom
Prior art keywords
core
exposed
electrode
sheath
electrosurgical instrument
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
GB1712433.0A
Other versions
GB201712433D0 (en
GB2565113B (en
Inventor
John Hoodless Richard
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 GB1712433.0A priority Critical patent/GB2565113B/en
Publication of GB201712433D0 publication Critical patent/GB201712433D0/en
Publication of GB2565113A publication Critical patent/GB2565113A/en
Application granted granted Critical
Publication of GB2565113B publication Critical patent/GB2565113B/en
Expired - Fee Related 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
    • 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
    • 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
    • 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
    • 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
    • A61B2018/00196—Moving parts reciprocating lengthwise
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1422—Hook
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1425—Needle
    • A61B2018/1432—Needle curved
    • 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
    • A61B2218/002—Irrigation

Abstract

An electrode for an electrosurgical instrument comprises an elongate, non-linear conductive core 4 that contains at least one curved portion 19, 21, and an insulating sheath 5 situated over the core 4 such that it covers a part of it while leaving another part exposed. The sheath 5 is further slidable over the core 4 between first E and second F positions, and wherein the amount of the core 4 that is exposed in the first position E differs from the amount exposed in the second position F. In a first arrangement the exposed portion of the core 4 forms a tissue contacting portion with a first shape in the sheaths first position E and a second shape in the sheaths second position F. In a preferable arrangement the exposed portion forms a tissue contacting portion in the form of a hook when the sheath 5 is in the first position E and a loop in the second position F. The sheath 5 may additionally, or alternately, be closely fitted over the conductive core 4. An electrosurgical instrument comprising the electrode and having a moveable actuator (23, Fig 4) for effecting the sheaths movement is also taught.

Description

This invention relates to an electrosurgical instrument suitable instrument for the treatment of tissue. Such instruments are commonly used for the vaporisation and/or coagulation of tissue in surgical intervention, most commonly in “keyhole” or minimally invasive surgery, but also in “open” surgery.
Electrosurgical instruments are growing in sophistication and complexity, with the number of electrodes increasing and the size of electrodes decreasing. Often a procedure is complex such that instruments with different shaped electrodes are required for different parts of the procedure. The present invention attempts to address this problem by providing a simple and efficient electrosurgical instrument, capable of providing more than one type of electrode.
Accordingly, an electrode for an electrosurgical instrument is provided, the electrode comprising an electrically conductive core, the core being generally elongate in structure and non-linear such that it contains at least one curved portion, and an insulating sheath situated over the core such that it covers at least part of the core while leaving at least another part of the core exposed, the sheath being slideable over the core between at least first and second positions, the amount of the core that is exposed being different for the first position as compared with the second position, whereby, when the insulating sheath is in the first position the exposed portion forms a tissue contacting portion with a first shape, and when the insulating sheath is in the second position the exposed portion forms a tissue contacting portion with a second shape.
The above electrode is therefore capable of being deployed in two or more different configurations, depending on whether the sheath is in its first or second position. Conveniently, the insulating sheath fits closely over the insulating sheath. This is different from other instruments with loosely-fitting sheaths, which sometimes provide a suction or irrigation lumen between the electrode and the sheath. In the present invention, the sheath is merely used to cover or expose part of the electrode, depending on which shape electrode is required.
According to a first convenient arrangement, when the insulating sheath is in the first position, the exposed portion forms a tissue contacting portion in the form of a hook. The hook typically comprises a distal straight portion, a proximal straight portion and a curved portion therebetween. Conveniently, the curved portion between the two straight portions is such that the two straight portions are perpendicular one to the other. This provides an electrode capable of cutting and resecting tissue otherwise difficult to access with a conventional needle electrode.
According to a second convenient arrangement, when the insulating sheath is in the second position, the exposed portion forms a tissue contacting portion in the form of a loop. The loop typically comprises a distal portion and a proximal portion, the distal portion being at 180 degrees to the proximal portion. Conceivably, the loop is semi-circular in shape.
Alternatively, the loop comprises a distal straight portion, a proximal straight portion and an intermediate straight portion, and first and second curved portions, the first curved portion being situated between the distal straight portion and the intermediate straight portion, and the second curved portion being situated between the intermediate straight portion and the proximal straight portion. Conceivably, the first curved portion is such that the distal straight portion is perpendicular to the intermediate straight portion. Furthermore, the second curved portion is conceivably such that the intermediate straight portion is perpendicular to the proximal straight portion.
The electrode may all be located in a single plane, or alternatively the part of the core which is covered by the insulating sheath is in a first plane, and the part of the core which is exposed in in a second plane. The provision of parts of the electrode in different planes increases the versatility of the electrode for accessing difficult to reach tissue.
The invention also resides in an electrosurgical instrument comprising,
a) an elongate shaft,
b) an electrode mounted in fixed relationship to the shaft, the electrode comprising an electrically conductive core, the core being generally elongate in structure and non-linear such that it contains at least one curved portion, and an insulating sheath closely fitted over the core such that it covers at least part of the core while leaving at least another part of the core exposed, and
c) an actuator movable between first and second positions, the movement of the actuator causing the sheath to slide over the core between at least first and second positions, the amount of the core that is exposed being different for the first position as compared with the second position.
Conveniently, when the actuator is in its first position the exposed portion of the core forms a tissue contacting portion with a first shape, and when the actuator is in its second position the exposed portion of the core forms a tissue contacting portion with a second shape. Typically, the electrode lies within the cross-sectional dimension of the shaft, so as to enable the instrument to be inserted through a lumen or trocar of limited diameter.
The instrument conveniently also includes a lumen for suction and/or irrigation. According to one convenient arrangement, the lumen is in the form of a tube contained within the sheath. In this way, the lumen can be used for suction and/or irrigation, removing material or delivering fluid to or from the close vicinity of the electrode tip. The tube conceivably moves with the sheath between its first and second positions. In this way the tube can be moved along with the sheath such that when the exposed part of the core changes, the location of the distal end of the tube changes with it.
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 side view of the distal end an electrosurgical instrument in accordance with the present invention,
Figure 2 is a schematic side view of the distal end an alternative embodiment of electrosurgical instrument in accordance with the present invention,
Figure 3 is a perspective view of a further embodiment of electrosurgical instrument in accordance with the present invention,
Figure 4 is a schematic sectional side view of an electrosurgical instrument in accordance with the present invention,
Figure 5 is a schematic side view of the distal end an alternative embodiment of electrosurgical instrument in accordance with the present invention, and
Figure 6 is a cross-sectional end view of the tip of the instrument of Figure 5.
Referring to Figure 1, an electrosurgical instrument is shown generally at 1, and includes an elongate shaft 2 from the distal end of which extends and electrode 3. The electrode 3 comprises an electrically conductive core 4, formed of titanium or stainless steel, and being at least partly covered by a sheath 5. The sheath 5 is formed from an electrically-insulating material such as a polymer material, and fits closely over the core
4.
The core 4 is non-linear in shape in a longitudinal direction, such that it comprises different portions with different shapes. Emerging from the shaft 2 is a proximal straight portion 6. Next is a curved portion 7, curved downwardly with respect to the longitudinal axis of the shaft as shown in Figure 1. Finally, at the distal end of the curved portion is a short distal straight portion 8.
The instrument 1 can be used in two configurations. In a first configuration, the sheath 5 is present in the position A shown in Figure 1, such that it covers the curved portion 7 leaving only the distal straight portion 8 exposed. In this configuration, the electrode acts as a straight electrode extending at 90 degrees from the longitudinal axis of the shaft. In a second configuration, an actuator (not shown in Figure 1) is operated to retract the sheath 5 into the position B shown in Figure 1. In position B, the sheath leaves exposed both the distal straight portion 8 and the curved portion 7. Thus, in position B, the electrode acts a hook electrode with a 90 degree curvature.
Figure 2 shows an alternative instrument, reference numerals 2, 4 & 5 depicting the shaft, core, and sheath respectively as before. In Figure 2, however, the electrode 3 has a more complex shape, including straight portions 9, 11, 13 & 15, and curved portions 10, 12 & 14 respectively. Starting at the proximal end of the electrode 3, a proximal straight portion 9 emerges from the shaft 2. Next is a curved portion 10, curved downwardly with respect to the longitudinal axis of the shaft. Next is a second proximal straight portion 11 leading into a second proximal curved portion 12 which is curved upwardly with respect to the longitudinal axis of the shaft. Next is an intermediate straight portion 13 extending upwardly with respect to the shaft axis. Next is a distal curved portion 14, once again curved downwardly with respect to the shaft axis. Finally, a distal straight portion 15 extends downwardly with respect to the shaft axis and terminates in an electrode distal tip 16.
In use, the instrument 1 can be used in various configurations as before. In a first configuration, the sheath 5 is present in the position C shown in Figure 1, such that it covers the portions 9 to 13 and part of the distal curved portion 14. This position C leaves the remainder of the distal curved portion 14 and the distal straight portion 15 exposed. The shape of the exposed core is thus that of a largely straight, downwardly extending needle electrode.
In a second configuration, an actuator (not shown in Figure 2) is operated to retract the sheath 5 into the position D shown in Figure 2. In position D, the sheath 5 covers the portions 9 to 12 and part of the straight intermediate portion 13. This position D leaves the remainder of the straight intermediate portion 13, the curved portion 14 and the distal straight portion 15 exposed. The shape of the exposed core is thus that of a hook electrode with a 90 degree curve between one end and the other.
Figure 3 shows an alternative arrangement in which the shaft 2, core 4, and sheath 5 are designated as before. In this arrangement, the shape of the electrode 3 is even more complex, being changeable between a hook configuration and a loop configuration. In the embodiment of Figure 3, portions 9, 10, 11, 12 & 13 are as previously described, the difference being that the curvature of portions 10 & 12 is in a sideways plane as compared with the downward plane of Figure 2. In Figure 3, intermediate straight portion 13 leads into downwardly curved portion 17, followed by downward straight portion 18. At the lowest end of downward straight portion 18 is first lateral curved portion 19, lateral straight portion 20 and second lateral curved portion 21. Finally, upwardly extending distal straight portion 22 is connected to second lateral curved portion 21, providing a termination of the electrode 3. Thus, in the electrode of Figure 3, portions 9 to 13 are in a sideways plane X, while portions 18 to 22 are in a transverse plane Y.
In use, the electrode is operable in a hook configuration in which the sheath 5 is in position E, covering portions 9 to 19 and part of lateral straight portion 20. This leaves exposed the remainder of lateral straight portion 20 together with the portions 21 and 22. This provides a generally hook-shaped exposed electrode, for use when such an electrode is required. In an alternative configuration, the actuator (not shown in Figure 3) is operated to move the sheath 5 to position F as shown in Figure 3, in which only portions 9 to 13 are covered. This leaves portions 17 to 22 exposed, to form a loop for tissue resection and coagulation.
Figure 4 shows the instrument 1, with the electrode 3 consisting of the core 4 and the insulating sheath 5. The instrument includes an actuator in the form of a thumb slide 23, slideable within the shaft 2. The thumb slide 23 has a body portion 24 which is attached to the sheath 5 such that when the thumb slide is moved between positions A & B in Figure 4, the sheath is moved between positions A & B also. In this way, longitudinal movement of the thumb slide 23 extends and retracts the sheath 5 between its different positions in order to change the amount of the core 4 that is exposed, and hence the shape of the tissue contacting portion of the electrode.
Figures 5 & 6 show an instrument with a suction and/or irrigation feature. The tip of the instrument is as described with reference to Figure 2, with the shaft 2, core 4 and sheath 5 designated as before. However, in the arrangement of Figure 5 & 6 the sheath contains not only the core 4 but also an elongate tube 25. By connecting the tube 25 to a source of suction, material in the vicinity of the electrode 3 can be evacuated from the surgical site. Similarly, by connecting the tube to a source of fluid, the surgical site can be irrigated. In Figure 5, the tube 25 is retracted and advanced along with the sheath 5 between positions C & D, such that its distal end is always in the vicinity of the exposed portion of the core 4. Where a thumb slide is employed as illustrated in Figure 4, the thumb slide moves the sheath 5 and the tube 25 as a single unit.
Other embodiments will be apparent to those skilled in the art without departing from the scope of the present invention. A variety of non-linear configurations for the core 4 can be envisaged, with the different positions of the sheath 5 creating different shaped electrodes as required by the user.

Claims (19)

1. An electrode for an electrosurgical instrument, the electrode comprising, an electrically conductive core, the core being generally elongate in structure and non-linear such that it contains at least one curved portion, and an insulating sheath situated over the core such that it covers at least part of the core while leaving at least another part of the core exposed, the sheath being slideable over the core between at least first and second positions, the amount of the core that is exposed being different for the first position as compared with the second position, whereby, when the insulating sheath is in the first position the exposed portion forms a tissue contacting portion with a first shape, and when the insulating sheath is in the second position the exposed portion forms a tissue contacting portion with a second shape.
2. An electrode according to claim 1, wherein the insulating sheath fits closely over the insulating sheath.
3. An electrode according to claim 1 or claim 2, wherein, when the insulating sheath is in the first position, the exposed portion forms a tissue contacting portion in the form of a hook.
4. An electrode according to claim 3, wherein the hook comprises a distal straight portion, a proximal straight portion and a curved portion therebetween.
5. An electrode according to claim 4, wherein the curved portion between the two straight portions is such that the two straight portions are perpendicular one to the other.
6. An electrode according to any preceding claim, wherein, when the insulating sheath is in the second position, the exposed portion forms a tissue contacting portion in the form of a loop.
7. An electrode according to claim 6, wherein the loop comprises a distal portion and a proximal portion, the distal portion being at 180 degrees to the proximal portion.
8. An electrode according to claim 7, wherein the loop is semi-circular in shape.
9. An electrode according to claim 7, wherein the loop comprises a distal straight portion, a proximal straight portion and an intermediate straight portion, and first and second curved portions, the first curved portion being situated between the distal straight portion and the intermediate straight portion, and the second curved portion being situated between the intermediate straight portion and the proximal straight portion.
10. An electrode according to claim 9, wherein the first curved portion is such that the distal straight portion is perpendicular to the intermediate straight portion.
11. An electrode according to claim 9 or claim 10, wherein the second curved portion is such that the intermediate straight portion is perpendicular to the proximal straight portion.
12. An electrode according to any of preceding claim, wherein the part of the core which is covered by the insulating sheath is in a first plane, and the part of the core which is exposed in in a second plane.
13. An electrosurgical instrument comprising an elongate shaft, and an electrode according to any of claims 1 to 12.
14. An electrosurgical instrument comprising,
a) an elongate shaft,
b) an electrode mounted in fixed relationship to the shaft, the electrode comprising an electrically conductive core, the core being generally elongate in structure and non-linear such that it contains at least one curved portion, and an insulating sheath closely fitted over the core such that it covers at least part of the core while leaving at least another part of the core exposed,
c) an actuator movable between first and second positions, the movement of the actuator causing the sheath to slide over the core between at least first and second positions, the amount of the core that is exposed being different for the first position as compared with the second position.
15. An electrosurgical instrument according to claim 14, wherein when the actuator is in its first position the exposed portion of the core forms a tissue contacting portion with a first shape, and when the actuator is in its second position the exposed portion of the core forms a tissue contacting portion with a second shape.
16. An electrosurgical instrument according to claim 14 or claim 15, wherein the electrode lies within the cross-sectional dimension of the shaft.
17. An electrosurgical instrument according to any of claims 14 to 16, wherein the instrument includes a lumen for suction and/or irrigation.
18 An electrosurgical instrument according to claim 17, wherein the lumen is in the form of a tube contained within the sheath.
19. An electrosurgical instrument according to claim 18, wherein the tube moves with the sheath between its first and second positions.
GB1712433.0A 2017-08-02 2017-08-02 Electrosurgical instrument Expired - Fee Related GB2565113B (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
GB1712433.0A GB2565113B (en) 2017-08-02 2017-08-02 Electrosurgical instrument

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
GB1712433.0A GB2565113B (en) 2017-08-02 2017-08-02 Electrosurgical instrument

Publications (3)

Publication Number Publication Date
GB201712433D0 GB201712433D0 (en) 2017-09-13
GB2565113A true GB2565113A (en) 2019-02-06
GB2565113B GB2565113B (en) 2022-06-15

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5472441A (en) * 1993-11-08 1995-12-05 Zomed International Device for treating cancer and non-malignant tumors and methods
US20020188290A1 (en) * 2001-06-06 2002-12-12 Hugh Sharkey Intervertebral disc device employing prebent sheath
US20070038214A1 (en) * 1999-10-08 2007-02-15 Intuitive Surgical, Inc. Minimally invasive surgical hook apparatus
WO2016147471A1 (en) * 2015-03-13 2016-09-22 オリンパス株式会社 Treatment instrument
CN205814415U (en) * 2016-02-04 2016-12-21 上海安通医疗科技有限公司 A kind of multi-electrode radio frequency ablation catheter for renal artery

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5472441A (en) * 1993-11-08 1995-12-05 Zomed International Device for treating cancer and non-malignant tumors and methods
US20070038214A1 (en) * 1999-10-08 2007-02-15 Intuitive Surgical, Inc. Minimally invasive surgical hook apparatus
US20020188290A1 (en) * 2001-06-06 2002-12-12 Hugh Sharkey Intervertebral disc device employing prebent sheath
WO2016147471A1 (en) * 2015-03-13 2016-09-22 オリンパス株式会社 Treatment instrument
CN205814415U (en) * 2016-02-04 2016-12-21 上海安通医疗科技有限公司 A kind of multi-electrode radio frequency ablation catheter for renal artery

Also Published As

Publication number Publication date
GB201712433D0 (en) 2017-09-13
GB2565113B (en) 2022-06-15

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PCNP Patent ceased through non-payment of renewal fee

Effective date: 20230802