WO1993007822A1 - Instruments chirurgicaux et accessoires destines a ces instruments - Google Patents

Instruments chirurgicaux et accessoires destines a ces instruments Download PDF

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Publication number
WO1993007822A1
WO1993007822A1 PCT/GB1992/001900 GB9201900W WO9307822A1 WO 1993007822 A1 WO1993007822 A1 WO 1993007822A1 GB 9201900 W GB9201900 W GB 9201900W WO 9307822 A1 WO9307822 A1 WO 9307822A1
Authority
WO
WIPO (PCT)
Prior art keywords
blade
handle
resector
guard
instrument
Prior art date
Application number
PCT/GB1992/001900
Other languages
English (en)
Inventor
Josaphat Joseph Kabukoba
Original Assignee
Josaphat Joseph Kabukoba
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 Josaphat Joseph Kabukoba filed Critical Josaphat Joseph Kabukoba
Publication of WO1993007822A1 publication Critical patent/WO1993007822A1/fr

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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
    • A61B18/149—Probes or electrodes therefor bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/062—Measuring instruments not otherwise provided for penetration depth

Definitions

  • the invention relates to surgical instruments and parts therefore, in particular surgical instruments used for cutting, scraping and/or cauterising human tissue.
  • Surgical instruments for cutting, scraping and cauterising human tissue are known and are generally provided with a blade which may be of conventional form - that is to say a sharpened metal blade - or be a heated metal part operable to cut, scrape and at the same time cauterise human tissue as the blade is drawn across the surface of tissue.
  • a blade which may be of conventional form - that is to say a sharpened metal blade - or be a heated metal part operable to cut, scrape and at the same time cauterise human tissue as the blade is drawn across the surface of tissue.
  • an endometrial loop resector - an instrument which comprises an elongate handle having an electrical power connection therealong to supply electrical power to a loop shaped blade carried at one end of the handle to extend generally at an angle (e.g. at right angles) to the longitudinal axis of the handle.
  • a first object of the invention is the provision of means which will alleviate or overcome the difficulty noted above and provide a ready method of controlling the depth by which a blade used in cutting, scraping or cauterising may pass into tissue on which it is being used.
  • a second object of the invention is the provision of a device attachable to a bladed surgical instrument to ensure the depth of cut of the blade may be controlled.
  • a third-object of the invention is the provision of a bladed surgical instrument, the instrument further including means enabling the control of the depth of any cut of the blade of the instrument.
  • Another object of the present invention is to provide an arrangement which alleviates and/or overcomes this difficulty.
  • the invention provides a part attachable to a bladed surgical instrument, said part comprising guard means adapted when the part is attached to the instrument to lie adjacent the blade of the instrument and thereby be operable to control the depth to which the blade may enter tissue.
  • the part may be attachable to the blade of the instrument, or to a handle of the instrument.
  • the part preferably includes means enabling adjustment of the position of the guard means relative to the blade.
  • the spacing of the guard means and blade may be adjustable.
  • the part is attachable to a handle of the instrument and movable therealong.
  • the part desirably includes clip means enabling the part to be attached to a handle of a surgical instrument, said clip means being formed with an arm extending therefrom which arm carries said guard means.
  • the guard means comprises a single guard element.
  • This guard element may be carried, in use, to the side of the blade of the instrument adjacent the handle, or in the alternative to the side of the blade of the instrument spaced from the handle.
  • the guard means comprises two guard elements which, in use, respectively lie on either side of the blade of the surgical instrument.
  • the or each guard element lies, in use, substantially parallel to and spaced from the blade of the surgical instrument.
  • the or each guard element may be provided with a portion extending, in use, generally normally of a blade with which is it associated in use.
  • the position of the guard means is adjustable to enable variation and control of the depth to which the blade may cut into tissue.
  • a second aspect of the invention provides a surgical instrument incorporating a part as defined above.
  • the instrument may be an endometrial loop resector.
  • An endometrial loop resector embodying the invention may comprise a generally elongate handle carrying at one end thereof a blade, the resector further incorporating a part attachable to the handle and formed integrally with an arm extending towards the blade and carrying adjacent the blade a guard member.
  • the arm is preferably deformable enabling movement of the guard member relative to the blade such that the relative heights of the guard member and the blade may be adjusted.
  • the part is advantageously fixable to the handle at various positions along its length enabling adjustment of the spacing of the guard member from the blade.
  • the guard member may comprise a pair of guard elements respectively positioned on either side of the blade of the instrument.
  • the guard member may comprise a single guard element located to that side of the blade adjacent the handle of the instrument.
  • each guard element preferably approximates to that of the blade.
  • each guard element extends, in use, generally parallel to blade and is provided, at the extremity . ' lereof, with a portion extending generally normally of said blade.
  • Another arrangement embodying the invention provides an endometrial loop resector comprising an elongate handle supporting at one end a blade and further incorporating a part fixable on the blade, said part being provided with slots receiving side portions of said blade
  • Yet another arrangement embodying the invention provides an endometrial loop resector comprising an elongate handle supporting at one end a blade and further incorporating a resilient member centrally apertured in which the blade of the resector may be passed and held by the resilient action of said part, the arrangement being such that the position of said part of said blade may be adjusted.
  • An endometrial loop resector as defined above may be provided with a blade which is pivotally supported on the end of said handle and is movable about the axis of said pivot such that the angle of the plane of the blade may be varied relative to the plane including the longitudinal axis of the handle.
  • said blade is spring biased to a first position.
  • said blade when said blade is in said first position it lies in a plane extending normally of a plane including the longitudinal axis of said handle.
  • the resector may be further provided with means attached to the blade and extending along the length of the handle to the end thereof remote from said blade, the arrangement being such that movement of said means by a surgeon holding the device at the said remote end of the handle will cause the blade to pivot from said first position - with advantage said means comprises a cord or cords.
  • Said guard member may be arranged to move with said blade.
  • An endometrial loop resector as defined above may further be provided with a handle, or a support therefor, which is non-linear or capable of being deformed to a non ⁇ linear shape.
  • the handle of said instrument or said support therefore incorporates a plurality of light fibres allowing light to be taken to a position adjacent the said blade and a view of tissue adjacent the blade to be seen by a person using the instrument.
  • Figure 1 shows at A, B and C a side, plan and end views respectively of an endometrial loop resector having a part embodying the present invention.
  • Figure 2 shows a modified form of the resector of Figure 1 .
  • FIG 3 illustrates modifications which may be made to the form of the guard members of Figures 1 and 2, and
  • FIG. 4 to 6 illustrate further embodiments of the invention.
  • Figure 1 shows an endometrial loop resector to comprises an elongate hollow handle 10, of metal and/or plastics material, which has passing therealong electrical leads 12 operable to supply power to a generally arcuate blade 1 supported at one end of handle 10 on a pair of arms 16 extending from one end of the handle.
  • the arms 16 are cranked at 18 such that the lowermost part 20 (as viewed in Figures 1 and 3) of blade 14 lies just below the longitudinal axis of handle 10.
  • the instrument shown in the Figure is a standard endometrial loop resector.
  • the resector shown in the Figure is itted with a part controlling the depth by which blade 14 may pass into tissue as the instrument is used.
  • This part comprises a clip 22 of malleable metal or plastics material which is crimped onto the handle 10 as shown.
  • Clip 22 carries an arm extending forwardly towards the head of the instrument - which passes the end of handle 10. Thereafter the arm 24 diverges into two arms 26 each of which is cranked at 28 such that they lie generally parallel to the arms 16 supporting the blade 14 of the instrument.
  • arms 26 remote from clip 22 carry an arcuate guard element 30 which, when the clip is fitted to the instrument, lies generally parallel to the blade 14.
  • the lowermost edge of guard element 30 lies a short distance - shown in Figure 1A at 32 - above the lowermost edge of part 20 of blade 14 and defines the extent to which blade 14 may enter tissue as the instrument is used.
  • a surgeon may, if he desires, vary the spacings 32 and 34 and thus the depth of cut permitted. Variation of spacing 32 being effected by simply bending arms 26 upwardly or downwardly (as viewed in Figure 1A). Similarly the spacing 34 may be varied by repositioning clip 22 along the length of handle 10.
  • FIG. 2 illustrates a modified form of the part which embodies the invention.
  • the part shown in Figure 2 is carried on an endometrial loop resector substantially the same as that shown in Figure 1 and parts of that instrument are given the same reference numerals.
  • the arrangement of Figure 2 provides a clip 42 crimped onto handle 10 of the resector as shown.
  • the part shown in Figure 2 differs from that shown in Figure 1 in so far as its arms 44 overlie (as viewed in
  • FIG 2 the arms 16 of the instrument. At the end of the arms 44 remote from clip 42 there are provided two guard elements 46 and 48.
  • Guard element 46 is, it can be seen from the Figure, to the side of the blade 14 remote from the handle 10 whilst guard element 48 depends from arms 44 between arms 16 and lies between blade 14 and the end of handle 10. This arrangement - in providing two guard element
  • FIG. 3A is a scrap side view of a head portion of an endometrial loop resector fitted with a part embodying the invention. From this Figure the blade 14 can be seen to have associated with it guard element 46 and 48 (as described with reference to Figure 2). Each of these guard elements is provided at its lowermost (as viewed in the Figure) end with a portion 47 and 49 which is turned away from the blade 14 - that is to say the portions 47 and 49 extend generally normally of the plane of the blade 14. It will be appreciated that by providing that the guard element associated with the blade 14 are shaped in this way the efficacy of the guard in preventing that the blade cutting too deeply into human tissue will be increased.
  • the forms parts 47 and 49 may have when viewed in plan, may vary and three different shapes are shown in Figures 3B, 3C and 3D. Again, the form of the portions 47 and 49 when viewed from the side may be varied - as shown in Figure 3E - to further ensure the instrument will move smoothly over tissue when fitted with a part embodying the invention.
  • Figure 4 shows a further embodiment of the invention in which the part for controlling the depth which the blade of an endometrial resector can cut into tissue is clipped directly onto the blade and is not attached to the handle of the instrument.
  • Part 50 is, as illustrated, positioned directly on the head 52 of the resector.
  • Part 50 comprises a mass of any suitable metal or plastics material which is formed with slots 54 sized such that the arms 56 of the loop resector blade are resiliently held or are a friction fit in them.
  • an element 58 of the part 50 extends above the arms 60 which support the blade to ensure the part 50 remains at a desired position on the head - the lower edge of part 50 being at a spacing 62 above the lowermost, cutting, edge of the blade of the resector.
  • a further embodiment of the invention is shown in
  • Figure 5 in which the part for controlling the depth of cut shown at 70 to comprise a resilient metal or plastics element having a central aperture 72 in which the blade 74 of a resector is received.
  • Part 70 is positioned on the blade 74 by pushing the two ends of the part 70 inwardly to widen the central aperture 72 - against the natural resilience of the material of which the part is made - to enable it to be positioned on blade 74 at a height desired by a surgeon. It will be appreciated that when the pressure on the opposed ends of the elements 70 is released - whilst the blade 74 is within the aperture 72 - the natural resilience of the material of which the part 70 is made will cause it grip the head 74.
  • the parts 50 and 70 which are disclosed therein may comprise separate elements formed with inter-engaging means enabling them to be positioned on the blade of the instrument and then pushed together such that they are clamped in the desired location.
  • the method of fixing the part to the instrument may of course be varied - it is envisaged for example that the handle part 10 of the instrument shown in Figures 1 to 4 can be provided with a clip operable to secure the part onto the instrument in use.
  • Other forms of attachment of the part to the instrument may be used - any suitable means for attachment of the part to the instrument being effective.
  • Figure 6 illustrates a modified form of resector generally such as shown in Figure 1 , showing at A and B respectively plan and side views of this modified form of resector.
  • the resector shown in Figure 6 has a handle 80 supporting a loop resector blade 82 pivotally mounted at 84 on one end of the handle.
  • the blade 82 extends both above and below the plane including the longitudinal axis - indicated generally at 86 in Figure 6A - of the handle 80.
  • the resector is further provided with a spring member 88 attached to and carried by handle 80 and bearing on an upper part 90 of blade 82, part 90 being above the plane 86 including the longitudinal axis of the handle as viewed in Figure 6A.
  • cord 96 runs along the length of the handle 80 - passing through guide loops 98 formed thereon.
  • cord 96 is attached to an operating lever 100 mounted at 102 on the end of the handle 80 remote from the blade.
  • Mounting 102 provides pivotal mounting of lever 100 on the end of handle 80 but also is arranged to provide frictional resistance to movement of lever 100 so that the lever will maintain any position to which it is moved by a user against the bias of spring 88 on blade 82.
  • a surgeon may move the lever 100 (e.g. in the direction of arrow X) to cause movement of the blade 82 about pivot 84 (e.g. in the direction of arrow Y) to a position in which the blade will, thereafter, be held until the lever 100 is again moved.
  • the spring member 88 acts to bias the blade against the frictional resistance in mounting 102 (via the tension in cords 94 and 96 and holds the blade in any desired position.
  • a modified form of resector shown in Figure 6 may be used with the guard arrangements shown in Figures 1 to 5.
  • the guards (which are not shown in Figure 6) may be fixed relative to the movable blade 82 (such as in the arrangements of Figure 1 and 2) or be carried with that blade (such as in the arrangements of Figures 3, 4 and 5).
  • the particular configuration shown in Figure 6 may be varied without departing from the scope of the invention. Alterations which may be made include the relative positioning of blade 82 and handle 80 may be altered (e.g. the blade may be located wholly beneath the plane 86); the points of attachment of cords 94; and the location of spring 88 (it may be provided beneath handle 80 if blade 82 is wholly beneath the handle).
  • the operating lever 100 may be replaced by any suitable means enabling movement, and the cords may be replaced a rod or any other suitable means for transmitting that movement along the length of handle 80.
  • the means for transmitting movement along the handle 80 may if desired pass along the interior of a hollow handle.
  • the variation in the resector blade angle provided by this arrangement is important as it allows a surgeon to work on a curved surface without straining his arm or neck.
  • a handle for an endometrial loop resector - or a support therefore - may be provided as a conduit which may be either permanently curved or be deformable (e.g. be provided with a section or deformable sheath) to allow a surgeon to blend it to any desired curvature.
  • the interior of the conduit may include bundles of optical fibres, irrigation systems and the like.
  • the handle is curved enables a surgeon readily to reach all surfaces of a curved, convex or concave, womb without himself assuming difficult postures or positions.
  • Resectors of forms other than those shown may of course be used with the arrangements now described - for example contact laser resectors which are coming into more widespread use at present.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

Un accessoire adaptable à un instrument chirurgical à lame comprend un élément de protection (26) adjacent à la lame (20), qui règle la profondeur à laquelle la lame peut pénétrer dans le tissu. L'accessoire peut être fixé à la lame ou à un manche de l'instrument, et peut comprendre un dispositif permettant d'ajuster la position de l'élément de protection par rapport à la lame. L'écartement entre cet élément et la lame peut être réglé, ainsi que les hauteurs relatives. L'accessoire peut comprendre un élément de retenue (22) qui permet de le fixer en différentes positions le long du manche, l'élément de retenue étant fabriqué en une seule pièce avec un bras de prolongement qui porte l'élément de protection. Cet élément peut se composer d'une partie unique soutenue d'un côté de la lame ou de l'autre, ou il peut se composer de deux parties respectivement placées de chaque côté de la lame. Des instruments de résection comprenant une lame dont l'angle peut être modifié par rapport au manche, et comprenant un manche incurvé ou pouvant être recourbé, pourvu de fibres optiques qui permettent à la lumière d'être transportée vers la lame afin que l'utilisateur puisse voir les tissus coupés par la lame.
PCT/GB1992/001900 1991-10-16 1992-10-16 Instruments chirurgicaux et accessoires destines a ces instruments WO1993007822A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB9121937.8 1991-10-16
GB919121937A GB9121937D0 (en) 1991-10-16 1991-10-16 Surgical instruments and parts therefore

Publications (1)

Publication Number Publication Date
WO1993007822A1 true WO1993007822A1 (fr) 1993-04-29

Family

ID=10703004

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1992/001900 WO1993007822A1 (fr) 1991-10-16 1992-10-16 Instruments chirurgicaux et accessoires destines a ces instruments

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Country Link
AU (1) AU2798192A (fr)
GB (2) GB9121937D0 (fr)
WO (1) WO1993007822A1 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2810228B1 (fr) * 2000-06-15 2003-01-10 Isaac Jacques Kadoch Outil de coupe destine a la resection chirurgicale de tissus
GB2549279B (en) * 2016-04-11 2021-08-04 Gyrus Medical Ltd Electrode assembly

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE523136C (de) * 1931-04-20 Heinrich Loeb Dr AErztliches Instrument zum Brennen
US2056377A (en) * 1933-08-16 1936-10-06 Wappler Frederick Charles Electrodic instrument
DE2521719A1 (de) * 1975-05-15 1976-11-25 Delma Elektro Med App Elektrochirurgische vorrichtung
DE3423356A1 (de) * 1984-06-25 1986-01-02 Berchtold Medizin-Elektronik GmbH & Co, 7200 Tuttlingen Elektrochirurgisches hochfrequenz-schneidinstrument
WO1987001576A1 (fr) * 1985-09-17 1987-03-26 Jensen Ronald P Bistouri avec limiteur de profondeur de coupe demontable
EP0481310A1 (fr) * 1990-10-15 1992-04-22 Olympus Winter & Ibe Gmbh Electrode de coupe pour résectoscope médical

Family Cites Families (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3945117A (en) * 1973-02-15 1976-03-23 Rudolph Beaver, Inc. Surgical blade with adjustable blade guard
US4569133A (en) * 1983-01-06 1986-02-11 Sharpoint, Inc. Depth limited cutter
IL68193A (en) * 1983-03-22 1986-11-30 Rosenberg Lior Dermatome for cutting skin
EP0162836A1 (fr) * 1983-10-05 1985-12-04 JENSEN, Ronald P. Bistouri a profondeur de coupe fixe
SU1174007A1 (ru) * 1983-11-03 1985-08-23 Донецкий государственный медицинский институт им.М.Горького Сепаровочный нож

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE523136C (de) * 1931-04-20 Heinrich Loeb Dr AErztliches Instrument zum Brennen
US2056377A (en) * 1933-08-16 1936-10-06 Wappler Frederick Charles Electrodic instrument
DE2521719A1 (de) * 1975-05-15 1976-11-25 Delma Elektro Med App Elektrochirurgische vorrichtung
DE3423356A1 (de) * 1984-06-25 1986-01-02 Berchtold Medizin-Elektronik GmbH & Co, 7200 Tuttlingen Elektrochirurgisches hochfrequenz-schneidinstrument
WO1987001576A1 (fr) * 1985-09-17 1987-03-26 Jensen Ronald P Bistouri avec limiteur de profondeur de coupe demontable
EP0481310A1 (fr) * 1990-10-15 1992-04-22 Olympus Winter & Ibe Gmbh Electrode de coupe pour résectoscope médical

Also Published As

Publication number Publication date
AU2798192A (en) 1993-05-21
GB9121937D0 (en) 1991-11-27
GB2261170A (en) 1993-05-12
GB9221809D0 (en) 1992-12-02

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