US1695485A - Electrosurgical apparatus - Google Patents

Description

Dec. 18, 1928. 1,695,485

. C. FAYER' ELEGTRO SURGICAL APPARATUS Filed Aug. 6, 1924 2 Sheets-Sheet 1 IN VEN TOR Grams: Ewen WWW H/s ATTORNEY Dec. 18,1928. 1,695,485

C. FAYER ELECTED SFJRGI GAL APPARATUS Filed Aug- 6, 1924 2 Sheets-Sheet 2 INVENTOR C/mmes He m-R HIS ATTORNEY Patented Dec. 18, 1928.

UNITED STATES PATENT OFFICE.

CHARLES FAYER, 0F FLUSHING, NEW YORK, ASSIGIN'OR T0 WAP ILER ELECTRIC COM- PANY, 'INC., A CORPORATION OF NEW YORK.

ELECTROSURGICAL APPARATUS.

Application filed August 6, 1924. Serial No. 730,359.

My invention relates to electro-surgical apparatus of a type adapted for use in removing malignant and parasitic growths, false tissues and injured or diseased parts, without loss of blood and without danger of causing healthy tissues to become infected.

More particularly stated, I seek to produce an electro-surgical apparatus having two distinct functions: namely, first, to enable the surgeon to cut the tissues efliciently and without loss of blood, and second, to enable him to so treat a given part, such for instance as a malignant growth, as to place it in such condition, prior to its removal, that its removal cannot cause infection to spread from it to healthy tissues or to other parts.

A very diflicult branch of surgery, and one ofiering some hard problems, is the removal of malignant growths. It has often happened that the mere removal of the growth was not within itself a difiicult problem, and that the growth could be removed without loss of blood, or undue nervous shock to the patient, and yet there was danger that malignant cells, carried by or contained within the growth to be removed,

would become detached and pass freely into the veins and arteries. This meant that the malignant cells would be carried to other parts of the body and might find lodgment,

perchance in or near some vital center, where v they might then set up malignant neoplasms; or in other words start up new growths also malignant in character.

One of the main objects of my invention is to enable the surgeon to pick out, arbitrarily and in accordance with his judgment, a particular volume -of living tissue, constituting or containing a malignant growth the removal of which is desirable, and then to treat the particular volume of tissue thus selected, isolating and shutting it ofi from the circulatory system, and finally to remove the volume of tissue thus treated, without causing it to release or disengage malignant cells, and without loss of blood by the patient.

I find it practicable to accomplish both of c the steps just mentioned by using a single cautcry electrode, first energized by currents 'of one kind for the purpose of coagulating soluble abluminoids in a layer of tissue surrounding the volume of tissue to be removed, and then energized by currents of a different kind for causing the needle to serve as a cutting knife, and thus used for cutting out the predetermined volume of tissue. The cutting member of the electrode may be an ordinar sewing needle.

I fin that it is practicable to energize the surgical electrode in the two ways just mentioned so that the two steps of the operation, namely, the coagulation and the cutting, can be performed separately but in rapid succes- S1011, so as to constitute practically a single continuous operation. I find it is easy for a surgeon, in using my improved apparatus, to first energize. the needle by currents of a kind suitable for purposes of coagulation, and then to instantly change the action and energize the needle by the action of currents adapted for heating and thereby cutting. The saving of time between the two successive steps of the operation is very important, as it enables a malignant growth to be removed so quickly, after beingprepared for removal, as to reduce to a minimum a number of difi'erent dangers always present during a surgical operation of this kind.

Speaking briefly, I use damped oscillations for purposes of coagulation, and undamped or sustained oscillations for enabling the surgical electrode to do its cutting.

In my apparatus as a whole there are two distinct parts, one for producing the damped oscillations and the other for producing the undamped oscillations. By means of a single controlling mechanism connected with undamped oscillations of high potential and high frequency.

My invention further contemplates means for adjusting the apparatus'for producing the undamped oscillations so that the operator', before the operation, can test the apparatus as to its working condition, and thus avoid all necessity for stopping to do experimenting as a prelude to the actual work of operating.

My invention further contemplates mechanism to be connected with the oscillation tubes, to prevent overheating them when no current is being consumed and yet while the device is otherwise active.

Reference is made to the accompanying drawing forming a part of this specification,

mechanism for changing the character of the circuits, to adapt them for coagulating and for cutting.

Figure 3 is a perspective, showing how the needle is used in the removal of a malignant growth.

Figure 4 is a fragmentary perspective showing how the needle is used for coagulation, in preparing a malignant growth for removal.

A conducting plate 5, preferably a sheet of metal, is used to some extent as an operating table, the body of the patient or the part to be operated upon resting diretly upon the i plate, as indicated at 6. An electric knife is shown at 7, and is simply an insulating handle carrying a metallic needle 8 which may be an ordinary sewing needle, and which is energized by means of a cord 7 or other conductor, as may be understood from Figure 1.

The controller mechanism appears at 9 in Figure 2 and has the form of a board carrying various parts, as hereinafter described.

The controller mechanism is secured in position by aid of holes 9, through which bolts or other fastenings are extended.

A number of contact buttons appear at 11, 12, 13, 14, 15, 16, and a binding post is shown at 17. sprin contact member 18 is mounted 'to be roe ed between limits defined by a pair of pins 20, 20, serving as limiting stops. A g

A switch arm 10 moves with the spring contact member 18, and carries a contact member 19 of substantially V-sha e, as ma be understood from Figure 2. he switc arm 10 has two normal positions in whichit is active and one in which it is idle, its idle positlon being indicated in Figure 2. If

rom-th1s position it be rocked slightly in a counter clockwise direction according to this figure, the contact member 19 establishes metallic communication between the two contact buttons 11, 12, and the spring contact member 18 establishes metallic communication between the contact button 15 and the binding post 17. If however, the contact arm 10 he rocked slightly in a clockwise direction according to Figure 2, the contact member 19 is brought to extend from the contact button 13 to the contact button 14, and the spring contact member 18 is brought to extend from the binding post 17 to the contact button 16. The significance of these positions is hereinafter explained.

A pair of leads are shown at 21 and 22, and for purposes here contemplated may be considered as a source of alternating current. From the lead 22 a conductor 23 extends to the binding post 17 of the controller mechanism 9, above described and shown more particularly in Figure 2.

From the contact button 16 a wire 24 leads to a variable inductance 25, and from the latter a wire 26 leads to the primary winding 27 of a transformer 28. The secondary winding 29 of this transformer is by wires 30 and 31 connected with a series spark gap 32. consequently the spark gap 32 are by means of wires 33 and 34 connected with condensers 35 and 36.

A wire 37 is connected with the condenser 36 and with an inductance coil 38, the latter being connected with a binding post 39. A sliding contact 40 engages the inductance coil 38 and is joined to a wire 41 leading to the condenser 35.

Thus the member 38 is essentially-a variable inductance, bridged across the wires 37 and 41 and consequently across the condensers 35 and 36 as well as across the spark gap 32.

A wire 42 is connected with the wire 41 and with the sliding contact 40 and also with the contact button 14. A wire 43 is connected with the wire 37 and with the inductance coil 38 and also with a wire 44, this last mentioned wire leading to the metallic plate 5.

Y The a paratus just described constitutes what I d dsignate as my coagulating circuit; that is, the circuit which I use in connection with the electric knife 7 with its needle 8 for purposes for bringing about coagulation throughout the malignant growth or other parts to be removed, as indicated in Figure 4. Y

The surgeon first inserts a new needle 8 in the electric knife 7, and the patientbe ing in position, for instance with his forearm 6 resting upon the plate 5 as indicated in Figure 1, the surgeon rocks the switch arm 10 to the limit of its travel to the right according to Figures 1 and 2. The surgeon next grasps the electric knife 7 and repeatedly thrusts the needle 8 into the part to be coagulated, as indicated in Figure 4. This causes the coagulation to take place.

The electric circuits energized when the device is thus used for coagulation will now be described. a

A primary circuit may lows: main 22, conductor 23, contact button 17, spring contact member 18, contact'but- These wires 30 and 31, and

be traced as folton 16, wire 24, variable inductance 25, wire 26, primary winding 27 of transformer 28, wire 51, lead 21, to power house or other source of electric supply, and thence back by lead 22 to the point of beginning. I

The circuit just traced is the primary circuit of the transformer 28.

The primary circuit may be controlled by means of the variable inductance 25.

The transformer 28 being energized by the primary circuit just described, a secondary circuit may be traced through the spark ga as follows:

becondary winding 29, wire 30, spark gap 32, wire 31, and back to secondary winding 29.

Another circuit, connected with the spark gap 32, and adapted for producing damped oscillations, may be traced as follows: spark gap 32, wire 33, condenser 35, wires 41 and 42, contact button 14, contact member 19, contact button 13, wire 7*, electric knife 7 with its needle 8, anatomical part 6 being operated upon, metallic plate 5, wires 44, 43 and 37, condenser 36 and wire 34, back to spark gap 32.

By means of the binding post 39 and the variable inductance 38, the currents just described can also be used upon a small scale, for trivial operations, such as the removal of warts and moles.

In Figure 1 is shown a broken line a-a, representing a partition or floor. The apparatus above described in detail as using damped oscillations for purposes of coagulation is located upon one side of this-partition or floor, and hence is shown at the right of the broken line. The apparatus using undamped oscillations for purposes of cutting, however, is located upon the other side of the partition or floor, and therefore appears at the left of the broken line.

These last mentioned circuits will now be described.

Connected with the contact button 15 is a wire 45 which leads to a variable inductance 46. From the latter a wire 47 leads to the primary winding 48 of a transformer 49. From this primary winding 48, wires 50 and 51 extend to the lead 21.

The transformer 49 is provided with two secondary windings 52 and 53, connected together, and also connected with a pair of condensers 54, 55 by means of wires 56, 57, 58. A wire 59 is connected with the condensers 54, 55 and with the wire -57,an d leads to the primary winding 60 of an oscillation transformer 61.

A condenser 62 is by a wire 63. connected with the wire 59 and with one end of the primary winding 60. This condenser 62 is also by means of a wire 64 connected with the proximate middle portion of the winding 60. Thus the condenser is bridged across a portion of the primary winding 60.

The purpose of this arrangement is to connected with the contact button 11, and is also by means of a wire 66 connected with the wires 43 and 44. I

'A glower tube 67, filled with rarefied neon, is used as an indicator for indicating the condition of. the circuit used, as hereinafter described, iii cutting. The glower tube 67 is bridged across the wires 66, 66, and is connected with a hand switch 70 whereby it may be rendered active or idle.

The operator in order to ascertain the condition of the circuit in which the glower tube is immediately associated, closes the hand switch 70 and then brings the circuit into such condition that the neon tube 67 glows to a maximum extent. The glow emitted by the neon tube thus indicates to the operator the condition of the circuit for producing the undamped oscillations and used for cutting. When the glow is at a maximum the circuit is ready for cutting.

A vario-coupler is shown at 71 and is connected with one end of the primary winding 60 of the oscillation transformer 61. A condenser 72 is connected with the primary winding 60, and is bridged across the vario- I coupler 71. x w A wire 73 is connected with the condenser 72 and vario-coupler 71 and is also connected with a resistance 74, in parallel with a are provided with plates 80, 80, and from these plates two wires 81, 82, lead to the two wires 56 and 58, and thus into communication with the condensers 54, 55.

The filaments of the oscillation tubes are shown at 83, 83, and are connected by the wires 84, 85, with the secondary winding 86 of a transformer 87 .This transformer is provided with a primary winding 88 whereby it is energized, and is used for supplying currents to heat the filaments 83. I therefore designate the transformer 87 as a heating transformer.

The primary winding 88 is by means of wires 89 and 90 connected with the leads 22 and 21. I provide a variable resistance 91 for controlling the primary currents supplied from the leads 21 and 22 for energizing the transformer 87.

The primary circuit of the heating transformer may be traced as follows: lead21, variable resistance 91, wire 90, primary winding 88, wire 89 to lead 22, thence to power house or other source of electrical energy and back to lead 21.

p This circuit heats both filaments.

The primary circuit for energizing the transformer 49 may be traced as follows: lead 22, wire 23, binding post 17, spring contact member, 18, contact button 15, wire 45, variable inductance 46, Wire 47, primary Winding 48 of transformer 49, wires 50 and 51 to lead 21, and thence to source of electric supply and back to lead 22.

The grid connection into the oscillation tube 79 may be traced as follows: winding 52 of transformer 49, wires 57 and 59, winding 60, vario coupler 71, wire 73, resistance 74 and condenser in parallel with each other, wires 76 and 77, and grid 78 of valve tube 79.

A grid connection into the oscillation tube 79 can be traced as follows: secondary winding 53 of transformer 49, wires 57 and 59, winding 60 of transformer 61, variocoupler 71 and condenser 72 in parallel with each other, wire 73, resistance 74 and condenser 75 in parallel with each other, wires 76 and 7 7 and grid 78 of oscillation tube 79.

The main grid connections used in connection withthe oscillation tube 79, for producing undamped oscillations, may be traced through that oscillation tube as follows: secondary winding 52 of transformer 49, Wires 57 and 59, winding 60 of transformer 61, vario-coupler 71 and condenser 72 in parallel with each other, filament 83 of oscillation tube 79, plate 80 of the same tube, and wires 81 and 56, back to secondary winding 52.

The main circuit used in connection with the oscillation tube 79, for producing undamped oscillations, may be traced as follows: secondary winding 53 of transformer 49, wires 57 and 59, winding 60 of transformer 61, vario-coupler 71 and condenser 72 in parallel with each other, filament 83 of the oscillation tube 7 9, plate 80 of this tube and wires 82 and 58, back to secondary winding 53.

The two main circuits just traced, one through the oscillation tube 79 and the other through the oscillation tube 79, are

energized alternately so that all current imand metallic plate 5, and thence back by wires 44 and 66 to secondary winding 65.

The circuit just traced is the one in which undamped oscillations are used for so energizing the needle 8 as to enable the latter to be used for heating or cutting.

The condenser 62, connected as above described and as shown in Figure 1, comes into active use whenever the apparatus shown in the left hand portion of Figure 1 is fully energized, and yet for the moment the electric knife 7 with its needle 8 is not in use. Suppose, for instance, that during a cutting operation the surgeon for a few moments lifts the electric knife out of engagement 80 with the anatomical member 6, but without stopping, checking or in any way interfering with the flow of the undamped oscillations. Under these conditions there would be a tendency for the oscillation tubes: 79 and 79- to become unduly heated. When this condition arises, however, the excess of current is taken up by the action of the condenser 62, the net result being that the transformer 61 is not full energized, and that no excess of current ows through the oscillation tubes. Thus the condenser 62 and its immediate connections tend to. prevent such injury to the tubes or wiring as might otherwise ensue from excessive currents. 1

In Figure 4 my apparatus is shown as used for making a cut in the anatomical member 6, say for instance a forearm. This cut may be made directly and without any preparation of the part to be as shown in Figure 3, but is preferably made after the part is subjected to the step of coagulation as above described, and as indicated in Figure 4. Without the step of coagulation, the out has the appearance indicated in Figure 3.

I do not limit myself to the precise mechanism shown, as variations may be made therein without departing from my invention, the scope of which may be eo-extensive with my clalms.

- Having thus described my invention, what v I claim as new and desire to secure by Letters Patent is as follows:

1. In an electro-surgical apparatus the combination of mechanism for producing damped oscillations, mechanism for producing undamped oscillations, a surgical electrode common to both of said mechanisms, and a switch connected with both of said first mentioned mechanism and with said surgical electrode, for enabling said surgical electrode to be energized by said first mentioned mechanisms alternately.

2. In an electrosurgical apparatus the combination of a surgical electrode, a cut ting circuit provided with'means for energizing said surgical electrode by means of undamped oscillations, and a signalling member connected with said cutting circuit for indicating the condition of said cutting circuit for purpose of cutting.

3. In an eletro-surgical apparatus the combination of a surgical electrode, a coagulating circuit and a cutting circuit common to said electrode, and a switch connected with said electrode and with said coagulating circuit and said cutting circuit, for enabling the operator to render either of said circuits idle while the other is active.

4. In an elcctro-surgical apparatus, the combination of a cutting circuit provided with means for producing undamped oscillations, a surgical electrode to be energized by said undamped oscillations, and indicating mechanism connected with said cutting circuit for indicating the condition thereof for the purpose of energizing said ary circuit for cutting, another transformer;

provided with a primary circuit whereby-it may be energized and with a secondary cir-v cuit for coagulating, and a switch connected with all of said circuits and provided with means for opening one of said primary circuits while closing the other, said controller mechanism being further provided with.

means for opening one of said secondary circuits while closlng the other.

7. An electro-surgical apparatus compris-' ing a transformer provided with a primary winding and a secondary winding, electrically operated coagulatlng mechanism connected with said secondary winding and energized thereby, oscillation tubes connected with said primary winding, means for energizing said primary winding and said oscillation tubes, and a member bridged across a portion of said primary winding for preventing said oscillation tubes from becoming overheated.

8. An electro-surgical apparatus compris;

ing'a transformer provided with a pair of windings connected inductively together, electrically operated surgical mechanism connected with one of said windings and energized thereby, oscillation tubes conformer, a surgical electrode connected with said spark gap, and capacity and inductance introduced between said surgical electrode and said spark gap and apportioned for the purpose of damping the oscillations whereby said surgical electrode is energized.

10. In an electro-surgical apparatus the combination of a transformer provided with a primary .winding whereby it may be energized and further provided with a secondary circuit for cutting, another transformer provided with a primary circuit whereby it may be energized and further providedwith a secondary circuit for coagulating, controller mechanism connected with all of said circuits and provided with means for opening oneof said primary circuits and one of said secondary circuits while closing the other of said primary circuits and the other of said secondary circuits, and a cautery electrode connected with said controller. and

by movements-thereof connected with and other, and a cautery electrode common toboth of said secondary circuits and adapted to be energized by either of said secondary circuits, said cautery electrode being connected with said controller mechanism and thereby connected with and disconnected from the secondary circuit.

Signed at Long Island City, in the county of Queens and State of New York, this 2nd day of August, 1924.

CHARLES FAYER.

DISCL IM 1,695,485.-Cha;'le8 Fag er, Flushing, N .v-Y. qEmcdfnosfinglpiip AriARATUsi V dated December 18, 1928, fiDieeleimer filed Margh 21, 193 ,1 by" the esfg Wappler Electric Company, Inc.

Enters this disclaimer to that part of saidsp ecifiddfiipri 13nd which fire the following woi'ds, to wit:

9. An elotro-surgical apparatus comprisihg id trdhsfdrnier pfdi ride d with primarywinding whereby-it'may be energized and flirthe provided with a secondary winding, asjiark gap connectedwith said transformef, asurgiqgl electrode comiected with said spark gap, and capacitj 'and ind otgncgfintrbdutjed betwee 'said surgical electrode and said spark gap, findfagzdrtioned for theipulipo sdoffdampmg the oscil-"Q I

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