JP2000503873A - Electric surgical incision device - Google Patents

Abstract

Abstract: An improved electrosurgical lancing device (10) for connecting to an electrosurgical generator (22) comprises a non-conductive support member (12) having a peripheral edge (16). And a conductive member (14) that is separate from the support member and is disposed along at least a part of the outer peripheral edge of the support member. The conductive member is electrically connected to an electrosurgical generator suitable for transmitting sufficiently high frequency electrical energy to the conductive member. Thereby, the conductive member can cut the body tissue. The support member has an outer shape that facilitates manipulation of body tissue whether or not electrical energy is present in the conductive member.

Description

DETAILED DESCRIPTION OF THE INVENTION                           Electric surgical incision device                               Background of the Invention 1. Field of the invention   The present invention relates to an electrosurgical electrode device for surgically incising body tissue. 2. Technology background   Electrosurgical devices are widely used in surgery, and traditional non-electric surgical devices The advantages of using an electrical surgical device over a device are well-recognized in surgery. You. It is effective for cauterizing and incising body tissue. If you try to use it, you will inevitably use a unipolar circuit. Single-pole circuits are capable An electrosurgical generator with two outlet connections, dynamic and distributed, is provided. Minute The divergent outlet is connected to a dispersing pad worn on the patient's body. Electric surgical power generator The machine sends high-frequency electrical energy into the patient's body via a distributed connection, The active connection is in contact with the patient's body or connected to an electrode located in the vicinity You. In this way, the electrical energy present in the body is converted to a specific field near the electrodes. Concentrated in the place. The cells of the body that are exposed to this concentrated electrical energy are heated And is exploded by an arc of sparks from the electrodes to the cells. In this way, The circuit is complete and cauterization and incision are performed, depending on the further technology.   The shape and size of the electrode can be changed according to the purpose of surgery. Normally seen in surgery What is needed is an electrosurgical device that utilizes thin wire electrodes. Wire type The poles are usually needle-shaped or ring-shaped. Because of its thinness, surgeons can Since it is possible to concentrate electric energy in a limited area, Both poles and annular electrodes are efficient lancing devices. Therefore, during the incision process Where full access to energy is desired and where it is not desired to cut or burn tissue Unnecessary exposure of electrical energy to the position is prevented. Electrosurgical incision process The principle governing is well known and thin wire electrodes are the best lancing device Views are not a surprising conclusion for any informed surgeon.   However, wire-type electrodes are said to lack mechanical stiffness and are generally fragile There is a limit to the lancing action due to its nature. This means that the electrodes can become hot during the surgical incision process. This is especially true from becoming. Furthermore, the surgeon does not need to energize the incision electrode. Should be exposed to the electrical energy of an electrosurgical incision Mechanical devices for separating (ie, cold or mechanical dissection) tissue Often, it is desirable to use them. This thin electrode has a suitable incision Mechanical isolation of body tissue due to insufficient mechanical reinforcement Of course, it doesn't work as well.   Electrosurgical devices commonly used for electrosurgical and mechanical incisions are paddles. Type electrode. This elongated, flat electrode provides the mechanical strength to enable mechanical incision And apply sufficient current to its end to perform a good electrosurgical incision. Can be inside. However, compared to needle or ring electrodes, paddles Type electrodes are a source of much of the high frequency electrical energy supplied by electrosurgical generators Flow through the side of the paddle electrode to body tissue where electrical exposure or incision is not desired. Therefore, it is an inefficient cutting device. In some cases, pass through the side of the paddle electrode The flowing current is useful for cauterizing the wound created during the incision. However, many In many cases, the current is a waste of current that places an extra burden on the electrosurgical generator. Generator must be set to a higher power to perform the incision Will not be. In addition, the use of paddle-type electrodes can cause tissue along the incision to be exposed to high temperatures. Complications that cause frequent damage and that tissue adheres to the paddle-type electrode Also cause. However, paddle-type electrodes have excellent mechanical strength and A flat shape that acts as a rudder that can guide the electrode well along a straight or smooth curve It has the advantage of having. The problem of conducting on the side of the paddle electrode One attempt to solve the problem is to reduce the current that normally flows through the sides, To prevent adhesion to the paddle type electrode, a plastic such as Teflon is typically used. It has been practiced to apply the sides of a paddle-type electrode with a stick. This solution is At the high frequencies used in pneumatic surgery, the metal of the paddle penetrates the plastic coating. Therefore, there is a large current that is electrically connected to the body It has not worked. Thus, a permanent solution has not yet been realized.   As mentioned above, the disadvantages of wire and paddle electrodes have been eliminated, Providing a surgical incision device with a closed electrode is an advance in the art . In particular, it concentrates electrical energy in a limited area of body tissue and has improved Mechanical incision is possible by having sufficient mechanical rigidity to enable incision It would be an advance in the art to provide an electrosurgical incision device that: still Other developments in the art are simple and economical with the above features. It is to provide a device that can be manufactured.   Such an electrosurgical lancing device is disclosed below.                               BRIEF SUMMARY OF THE INVENTION   The present invention provides an electrosurgical incision device generally used in all fields of surgical incision. Offer. In particular, the present invention provides an electrosurgical lancing device as an active outlet in a monopolar circuit. Considered to use. The present invention focuses on currents where the incision is desired Dissects body tissue effectively through a cell lysis process that utilizes the heat generated by It is designed to be. The device operates even when no electrical energy is supplied. Yes, it is possible to mechanically dissect body tissue. Compared with conventional paddle type electrode In comparison, incision efficiency has been improved by focusing the current more strongly on the tissue. You. Tissue thermal damage is reduced by eliminating current escaping from the cutting edge . This means placing the conductive member along the outer periphery of the non-conductive support member. Therefore, it is completed. In this embodiment, the conductive member is thinner than a wire-type electrode. It becomes. The support member supports and strengthens the wire-type electrode for better incision, Add rigidity. Due to the stiffness provided by the non-conductive support member, the surgeon Manipulating the device to position the device and guide the device along the exact path to make an incision Can be. Furthermore, when flowing or stopping electric energy to the conductive member, The support member must have sufficient mechanical strength to operate the device and cut through tissue. give.   The support member usually has a shape and length suitable for incising body tissue, Can be embodied as a paddle shape having two surfaces and a width. Supporting members are efficient To make incisions. In addition, the outer peripheral edge of the support member is formed thick, and sufficient strength is provided. Guaranteed. The support member is rigid, thermally stable, and made of non-conductive material. Preferably, Therefore, the supporting member is supported by the body tissue together with the conductive member to be supported. Strength and convenience when exposed to the heat generated by the electrical energy flowing inside You will have both. In addition, the support member does not pass electrical energy, so Energy does not flow on the main surface of the support member, but along the outer periphery where the conductive member is located. It just stays flowing. As a result, electrical energy is transmitted to the conductive It will be given only to the point of contact. In the present embodiment, the support member Made of any of the known ceramic materials or plastics It may be made of any other non-conductive material having a suitable rigidity.   An electrode embodied in the present invention includes a handle for operation by a surgeon. The electrode may also include an adapter-type connector at the proximal end, Is inserted into a common handle for surgical electrodes known to those skilled in the art, and It will be electrically connected to the generator through the handle. The supporting member is c It extends from the end of the handle or connector. The conductive member is a part of the support member Alternatively, it may be arranged on the entire exposed portion of the outer peripheral edge. In the known technology, the shape of the support member, Changing the position of the conductive member along at least a portion of the outer peripheral edge of the support member; It has been found that more design profiles are possible. Such various Different operation of the device due to different shapes and different connection points of electrical energy Such changes would result in a method that deviates from the scope of the invention. Not something.   The connection between the conductive member and the electrosurgical generator may be made by a normal connection line or other suitable Achieved by using the method. Connection line is suitable for carrying high-frequency current And are preferably insulated. Electric surgical generator is hand Of a type commonly used in the industry to pass intraoperative high frequency electrical energy It is. During surgery, the electric surgical generator generates high-frequency energy, The energy is transmitted to the conductive member through the connection line. Then the surgeon will To the body tissue at the specific location where the incision is required.                               BRIEF DESCRIPTION OF THE FIGURES   For a better understanding of the present invention, reference is made to the drawings in detail. Drawings of the present invention Only representative specific examples are shown and do not limit the scope of the present invention. Drawing Are used to elaborate on other features of the present invention. In the drawing,   FIG. 1 is a perspective view showing an embodiment of the electrosurgical incision apparatus of the present invention.   FIG. 2 is an electrical diagram of the present invention showing the thickness of the support member and the location of the conductive member along the outer periphery. 1 is a side view showing an embodiment of a surgical incision apparatus.   FIG. 3 shows one embodiment of the electrosurgical incision device of the present invention showing the front or back surface of the support member. It is a side view which shows the form.   FIG. 4 is an enlarged sectional view of the support member taken along line 4-4 in FIG.   FIGS. 5 and 6 show an electric type having a conductive part including a supplementary member other than the support member. It is a side view which shows another example of embodiment of the medical incision apparatus.   FIG. 7 shows an electrical component having a portion of a conductive member (shown in phantom) passing through a support member. 1 is a side view showing an embodiment of a surgical incision apparatus.   FIG. 8 illustrates one embodiment of an electrosurgical lancing device having a support member extending from a handle. It is a perspective view which shows the form.                           Description of the preferred embodiment   In the drawings, the same members are denoted by the same reference numerals. With reference to FIGS. An electrosurgical lancing device 10 is shown. The lancing device 10 has a monopolar active output. Can be used as a mouth. The incision device 10 includes a support member 1 made of a tough and non-conductive material. 2 and a conductive member 14. The conductive member 14 is embodied in a wire-type electrode. Preferably. This embodiment is mentioned in the specification. But A conductive member 14 such as a conductive material in the form of a precipitate, an etch or a spray. Other embodiments are understood to be within the scope of the invention, and are recognized by those skilled in the art. You. The material of the support member 12 is thermally stable, and the support member 12 is electrically conductive. It is preferable not to be affected by the heat generated when passing through the conductive member 14. Its material is one of the various ceramic substrates known and used by those skilled in the art. Preferably, it can be made of other suitable materials such as plastic. The support member 12 is suitable for incising body tissue, the front surface, the back surface, the width, and the outer edge 1. 6. Various shapes including a paddle shape similar to a normal paddle type electrode having May be. Alternatively, the support member 12 may be provided with various knives as shown in FIGS. It may have the shape of a blade or a scalpel. The support member 12 is a conductive member on the top. 14 with a thin peripheral edge 16 having a cold or mechanical incision With sufficient mechanical strength to cut and manipulate body tissue without passing energy I have. There is sufficient space at the outer peripheral edge 16 to receive the conductive member 14. That In addition, as shown in FIG. 4, the groove 1 along the outer peripheral edge 16 on which the conductive member 14 is securely seated. Along with 5, a design in which the support member 12 is formed can be selected.   The conductive member 14 separates from the support member 12 and is used for incising a body tissue. It is made of a substance suitable for passing air energy. In the present embodiment, the conductive The member 14 is fixed to the outer peripheral edge 16 of the support member 12 so that the surgeon can It can be guided to a position where body tissue is to be brought into contact.   In the preferred embodiment shown in FIGS. 1 to 3, the conductive member 14 It is embodied as a wire loop with wires forming loops around it. best In the embodiment, the conductive member 14 is disposed along the entire outer peripheral edge 16 that is exposed. Is done. However, various shapes and embodiments are possible. As an example, figure As shown in FIGS. 5 and 6, the loop formed by the conductive member 14 is Other fillers such as air may be included. As shown in FIGS. 4 may be partially arranged along the outer peripheral edge 16. In FIG. The conductive member 14 is partially disposed along the outer peripheral edge 16, and a part of the conductive member 14 is It is inside the support member 12. In FIG. 8, the conductive member 14 and the support member 12 are outside. The conductive member 14 has the shape of a scalpel, and the conductive member 14 has a leading edge (leadi) of the support member 12. ng edge). These configurations depart from the scope of the invention Various embodiments are possible without doing so.   The usual method in the art is to connect one end of the conductive Is to attach the sex member 14. The adapter type connector 20 is And the electrical energy is transferred from the electrosurgical generator 22 to the handle 26. And the connector 20 to the conductive member 14. FIG. 1 is electrically connected 2 shows the position of the handle 26 and the connector 20 at the time of being pressed.   As shown in FIG. 1, the support member 12 and the conductive member 14 are It extends from the end of the connector 20. The connector 20 has two functions. Ko Nectar 20 is an electrical energy source from a conductive carrier such as an electrosurgical generator 22. And engage the energy source to transfer electrical energy to the conductive member 14. The connector 20 To facilitate holding and operating the lancing device 10 by hand, the support member 12 and The conductive member 14 and the handle 26 can be mounted on the handle 26. Connector 20 It has an external shape known in the art, and its proximal end is a receiving side, a well-known hand in the art. It can be inserted into the dollar 26.   Handle 26 receives connector 20 in a mechanical engagement manner and a proximal end of handle 26. Electrical energy via connection 18 from the head to an electric surgical generator 22 Tell FIG. 1 shows that the handle 26 has an internal cavity 17 for receiving a connecting line 18. And shows the best mode of the present invention.   The connection line 18 is connected to the electric surgical generator 22 and the proximal end of the handle 26. Part or middle part, and then along the longitudinal axis of the handle 26, Preferably, it enters the interior cavity 17 of the handle 26. The connection line 18 is electrically connected Is connected to the The connection line 18 is insulated, Can be transmitted to the conductive member 14 through the adapter type connector 20. Book In an embodiment, the connecting line 18 coming out of the electrosurgical generator 22 is a connecting line. 18 is shielded in a cable 24 suitable for protection.   Electrosurgical generators 22 are well known in the art and may be of the type used. That is, it can output high-frequency electric energy in an adjustable manner. Electric surgical generator 2 By adjusting the output of the second, the operator or surgeon can tell that the conductive member 14 is A sufficient amount of high frequency electrical energy can be dissected through connection line 18 to allow the tissue to be dissected. 20 and then to the conductive member 14.   Many other embodiments are possible without departing from the scope of the invention. example For example, instead of the connector 20, the connection member 18 directly connects to the conductive member 14. It is possible. As shown in FIG. 8, the support member 12 is used without using the connector 20. And the conductive member 14 may be extended from the distal end of the handle 26. At this time , Handle 26 provides electrical energy from electrosurgical generator 22 to conductive member 14. It has means to tell.   The device of the present invention can be incorporated in various embodiments. Some of them have been described above and are only shown. The present invention is a basic feature of the present invention. It may be embodied in other forms without departing from the invention. Form described Is considered in all respects to be illustrative and not restrictive. Therefore The scope of the invention is indicated by the appended claims rather than by the foregoing description. .

[Procedure of Amendment] Article 184-8, Paragraph 1 of the Patent Act [Submission date] February 10, 1998 (1998.2.10) [Correction contents]                                 The scope of the claims 1. A non-conductive support member having an outer peripheral edge,   Separate from the support member arranged along at least a part of the outer peripheral edge of the support member A conductive member,   The conductive member is configured to be in electrical communication with one electrode of an electrosurgical generator. Being formed, the conductive member is a body as an active contact of a unipolar circuit. Electric surgical generator is high enough to be able to cut the weave That electrical energy of a frequency can be transmitted to the conductive member; For electrical communication with the electric surgical generator used in the monopolar circuit with Pneumatic surgical incision device. 2. 2. The electrosurgical incision according to claim 1, wherein the conductive member comprises a wire-type electrode. Place. 3. 3. An electrosurgical device according to claim 2, wherein said wire-type electrode comprises a tungsten wire. For incision device. 4. 3. The electrical device according to claim 2, wherein said wire electrode comprises a stainless steel wire. Surgical incision device. 5. The conductive member forms a wire loop electrode, and the support member is located at the center of the loop. The electrosurgical incision device according to claim 1, which is filled with: 6. The electrosurgical device according to claim 1, wherein a portion of the conductive member is inside the support member. For incision device. 7. 2. An electrosurgical incision according to claim 1, wherein said support member comprises a thermally stable material. Opening device. 8. 2. The support member has a paddle shape having a front surface, a back surface, and an outer peripheral edge. An electrosurgical incision device according to claim 1. 9. 2. The electrosurgical incision according to claim 1, wherein the support member is made of a ceramic material. Place. 10. The support member reduces body tissue when there is no electrical energy to the conductive member. The electrosurgical incision device according to claim 1, wherein the electrosurgical incision device is operable. 11. The support member has a groove along at least a part of an outer peripheral edge of the support member. The electrosurgical incision device of claim 1, wherein the device is shaped and the conductive member is seated in a groove. . 12. An adapter connector, the adapter connector having a proximal end and a distal end That the support member extends from the distal end of the adapter connector. The electrosurgical incision device according to claim 1, further comprising: 13. The adapter connector is electrically and electrically handy to facilitate manual operation. 13. The electrosurgical incision device of claim 12, wherein the electrosurgical incision device is contoured to engage the tool. . 14． A non-conductive support member having an outer peripheral edge,   It is arranged separately from the support member and along at least a part of the outer peripheral edge of the support member. A conductive member,   An adapter-type connector for electrically communicating with the conductive member, and the adapter-type connector The adapter has a proximal end and a distal end, and the support member is the adapter type connector. Of the electrosurgical generator Being formed to be in electrical communication with one electrode; For electrical communication with the electric surgical generator used in the monopolar circuit consisting of Pneumatic surgical incision device. 15. The proximal end of the adapter connector is received in an electrical and mechanical engagement manner. The electrosurgical incision according to claim 14, further comprising a handle formed in the same manner. Place. 16. Penetrating the interior of the handle, the adapter-type connector electrically Communication with the power generator so that the conductive member can cut through body tissue As the electric surgical generator uses the adapter-type connector to The connection line according to claim 15, further comprising a connection line capable of transmitting a signal to the conductive member. Electrosurgical incision device. 17． The electrosurgical device according to claim 14, wherein the support member comprises a thermally stable material. For incision device. 18. The support member can manipulate body tissue without electrical energy to the conductive member. The electrosurgical incision device according to claim 14, wherein the electrosurgical dissection device is configured to be cut. 19. The support member has a groove along at least a part of an outer peripheral edge of the support member. The electric type according to claim 14, wherein the conductive member is seated in the groove. Surgical incision device. 20. The electric type according to claim 14, wherein a part of the conductive member is inside the support member. Surgical incision device. 21. The electrosurgical incision according to claim 14, wherein the conductive member comprises a wire-type electrode. Opening device. 22. A handle having a proximal end and a distal end;   A non-conductive, thermally stable support member extending from the distal end of the handle; That the support member is formed so that body tissue can be manipulated,   It is separate from the support member and extends from the handle to reduce the outer peripheral edge of the support member. A conductive member disposed along a part thereof, and the conductive member is an electric surgical generator. Is formed in electrical communication with one electrode of the So that the member can cut through body tissue as the active contact of the monopolar circuit. The pneumatic surgical generator can sufficiently transmit high frequency electrical energy to the conductive member What you can do For electrically communicating with an electric surgical generator used in a monopolar circuit comprising Surgical incision device. 23. The electrosurgical generator comprises a method of electrically communicating with the conductive member. 23. The electrosurgical lancing device according to claim 22, further comprising a connection line. 24. The support member has a groove along at least a part of an outer peripheral edge of the support member. 23. The electrosurgical incision according to claim 22, wherein the conductive member is seated in the groove. Opening device. 25. The electrosurgical incision according to claim 22, wherein the conductive member comprises a wire-type electrode. Opening device.

Claims (1)

[Claims] 1. A non-conductive support member having an outer peripheral edge,   Separate from the support member arranged along at least a part of the outer peripheral edge of the support member A conductive member,   The conductive member is in electrical communication with an electrosurgical generator, such that the conductive member is electrically conductive. The electrosurgical generator must have a sufficiently high frequency for the electrical members to cut through body tissue. That electrical energy can be transmitted to the conductive member; An electrosurgical incision device for electrically communicating with an electrosurgical generator comprising: 2. 2. The electrosurgical incision according to claim 1, wherein the conductive member comprises a wire-type electrode. Place. 3. 3. An electrosurgical device according to claim 2, wherein said wire-type electrode comprises a tungsten wire. For incision device. 4. 3. The electrical device according to claim 2, wherein said wire electrode comprises a stainless steel wire. Surgical incision device. 5. The conductive member forms a wire loop electrode, and the support member is located at the center of the loop. The electrosurgical incision device according to claim 1, which is filled with: 6. The electrosurgical device according to claim 1, wherein a portion of the conductive member is inside the support member. For incision device. 7. 2. The electrosurgical incision according to claim 1, wherein said support member comprises a thermally stable material. apparatus. 8. 2. The support member has a paddle shape having a front surface, a back surface, and an outer peripheral edge. An electrosurgical incision device according to claim 1. 9. 2. The electrosurgical incision according to claim 1, wherein the support member is made of a ceramic material. Place. 10. The support member reduces body tissue when there is no electrical energy to the conductive member. The electrosurgical incision device according to claim 1, wherein the electrosurgical incision device is operable. 11. The support member has a groove along at least a part of an outer peripheral edge of the support member. The electrosurgical incision device of claim 1, wherein the device is shaped and the conductive member is seated in a groove. . 12. An adapter connector, the adapter connector having a proximal end and a distal end That the support member extends from the distal end of the adapter connector. The electrosurgical incision device according to claim 1, further comprising: 13. The adapter connector is electrically and mechanically to facilitate manual operation. The electrosurgical incision according to claim 12, configured to engage the handle. Opening device. 14． A non-conductive support member having an outer peripheral edge,   It is arranged separately from the support member and along at least a part of the outer peripheral edge of the support member. A conductive member,   An adapter-type connector for electrically communicating with the conductive member, and the adapter-type connector The adapter has a proximal end and a distal end, and the support member is the adapter type connector. Extending from the end of An electric surgical incision device for electrically communicating with an electric surgical generator comprising: 15. The proximal end of the adapter connector is received in an electrical and mechanical engagement manner. The electrosurgical incision according to claim 14, further comprising a handle formed in the same manner. Place. 16. Penetrating the interior of the handle, the adapter-type connector electrically Communication with the power generator so that the conductive member can cut through body tissue As the electric surgical generator uses the adapter-type connector to The connection line according to claim 15, further comprising a connection line capable of transmitting a signal to the conductive member. Electrosurgical incision device. 17． The electrosurgical device according to claim 14, wherein the support member comprises a thermally stable material. For incision device. 18. The support member can manipulate body tissue without electrical energy to the conductive member. The electrosurgical incision device according to claim 14, wherein the electrosurgical dissection device is configured to be cut. 19. The support member has a groove along at least a part of an outer peripheral edge of the support member. The electric type according to claim 14, wherein the conductive member is seated in the groove. Surgical incision device. 20. The electric type according to claim 14, wherein a part of the conductive member is inside the support member. Surgical incision device. 21. The electrosurgical incision according to claim 14, wherein the conductive member comprises a wire-type electrode. Opening device. 22. A handle having a proximal end and a distal end;   A non-conductive, thermally stable support member extending from the distal end of the handle; That the support member is formed so that body tissue can be manipulated,   It is separate from the support member and extends from the handle to reduce the outer peripheral edge of the support member. A conductive member disposed along a part thereof, and the conductive member is electrically electrosurgical. By contacting the generator, the conductive member can dissect body tissue The electric surgical generator sufficiently transfers high frequency electrical energy to the conductive member. What you can do An electrosurgical incision device for electrically communicating with an electrosurgical generator comprising: 23. The electrosurgical generator comprises a method of electrically communicating with the conductive member. 23. The electrosurgical lancing device according to claim 22, further comprising a connection line. 24. The support member has a groove along at least a part of an outer peripheral edge of the support member. 23. The electrosurgical incision according to claim 22, wherein the conductive member is seated in the groove. Opening device. 25. The electrosurgical incision according to claim 22, wherein the conductive member comprises a wire-type electrode. Opening device.