WO1994017741A1 - Forceps de biopsie endoscopique a cautere bipolaire selectif - Google Patents

Forceps de biopsie endoscopique a cautere bipolaire selectif Download PDF

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Publication number
WO1994017741A1
WO1994017741A1 PCT/US1994/001576 US9401576W WO9417741A1 WO 1994017741 A1 WO1994017741 A1 WO 1994017741A1 US 9401576 W US9401576 W US 9401576W WO 9417741 A1 WO9417741 A1 WO 9417741A1
Authority
WO
WIPO (PCT)
Prior art keywords
jaws
conductive
pull wires
electrically
biopsy forceps
Prior art date
Application number
PCT/US1994/001576
Other languages
English (en)
Inventor
Charles R. Slater
Matthew A. Palmer
John R. Whittier
Aaron R. Zwiefel
Original Assignee
Symbiosis Corporation
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 Symbiosis Corporation filed Critical Symbiosis Corporation
Priority to AU61748/94A priority Critical patent/AU6174894A/en
Priority to JP6518385A priority patent/JPH08509623A/ja
Priority to DE4490796T priority patent/DE4490796T1/de
Publication of WO1994017741A1 publication Critical patent/WO1994017741A1/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
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
    • A61B1/3132—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for laparoscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/06—Biopsy forceps, e.g. with cup-shaped jaws
    • 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
    • A61B18/1402—Probes for open surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/0088—Material properties ceramic
    • 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
    • A61B2018/00059—Material properties
    • A61B2018/00071—Electrical conductivity
    • A61B2018/00077—Electrical conductivity high, i.e. electrically conducting
    • 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
    • A61B2018/00059—Material properties
    • A61B2018/00071—Electrical conductivity
    • A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
    • 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
    • A61B2018/00107—Coatings on the energy applicator
    • 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
    • A61B2018/00107—Coatings on the energy applicator
    • A61B2018/00148—Coatings on the energy applicator with metal
    • 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
    • A61B18/1206—Generators therefor
    • A61B2018/1246—Generators therefor characterised by the output polarity
    • A61B2018/126—Generators therefor characterised by the output polarity bipolar
    • 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
    • A61B2018/1412—Blade
    • 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
    • A61B2018/1412—Blade
    • A61B2018/1415—Blade multiple blades
    • 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
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
    • A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws
    • 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
    • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/60—General characteristics of the apparatus with identification means
    • A61M2205/6063—Optical identification systems
    • A61M2205/6081—Colour codes

Definitions

  • the present invention relates to endoscopic biopsy forceps medical devices. More particularly, the invention relates to endoscopic biopsy forceps devices having bipolar cautery capabilities.
  • bipolar cautery instruments the electric current path is from one electrode, through the tissue to be cauterized, and then through to the other electrode and out the instrument. Thus, only that tissue between the two electrodes is being cauterized.
  • monopolar instruments the patient effectively becomes the second electrode, and the current must be dissipated through the patient.
  • control of the cautery location is not exact, and tissue surrounding the tissue to be cauterized is also subject to different degrees of cautery.
  • the bipolar cautery biopsy forceps of the present invention generally includes: a conduit; a pair of jaws pivotally mounted at the distal end of the conduit and having electrically conductive distal portions and electrically conductive proximal portions, wherein the jaws are electrically insulated from each other when the jaws are in a relative open position; a pair of electrically conductive pull wires which are insulated as they extend through the conduit but which electrically and mechanically contact the jaws at their electrically conductive proximal portions; and an actuation means coupled to the pull wires for opening and closing the jaws.
  • the proximal ends of the conductive pull wires are uninsulated and terminate in a contact or coupling means which couples to an electrical cautery source.
  • the electrical cautery source may be foot activated or hand activated, and/or the bipolar cautery biopsy forceps may include an electrical switch for actuating the cautery function.
  • the jaws of the bipolar cautery biopsy forceps are preferably constructed with a proximal conductive uninsulated tang into which the distal end of the pull wire connects, a distal conductive cutting surface, and a pivot point between the proximal tang and distal cutting surface around which the jaws pivot for opening and closing.
  • the jaws are insulated from each other.
  • a clevis which is insulated from the jaws is preferably mounted on the distal end of the conduit and provides an insulated pivot pin around which the jaws pivot.
  • the cutting surfaces of the distal ends of the jaws preferably include metal cutting teeth. Some or all of the teeth may be insulated, but at least a portion of at least one tooth on each jaw is uninsulated so as to provide bipolar electrodes.
  • the jaws are formed via investment casting or MIM (metal injection molding) and then coated with an insulating polymer or ceramic material.
  • the jaws are formed by insert molding metal teeth and tang components which may be formed via casting, stamping, or photochemical milling or machining (PCM) in a non-conductive polymer material.
  • a third jaw embodiment involves odling the jaws from ceramic (CIM) and selectively plating the teeth and tang areas with a suitable metal (e.g. gold) .
  • Preferred aspects of the invention include: providing an insulating combination sleeve-washer for insulating the jaws and clevis pin from each other or alternatively providing an integral insulating clevis pin - washer for insulating the jaws; forming the conduit as a flexible coil; mounting the jaws on a clevis coupled to the distal end of the flexible coil; forming the proximal end of each jaw as a tang and coupling the pull wires to the tangs by means of Z-bends in the wires; and securing a handle to the proximal end of the main coil wherein the handle comprises a central slotted shaft about which a displaceable spool is disposed.
  • proximal movement of the spool with respect to the central shaft effects a pull on the pull wires so as to create a pivotable motion of the tangs on the proximal end of the jaws, thereby causing the jaws to close.
  • Movement of the spool distally with respect to the central shaft effects a compression on the pull wire thus causing movement of the tangs thereby causing the jaws to open.
  • Other preferred aspects of the invention include: fitting a cross block or blocks and mating the cross block(s) within a slot across the proximal end of the spool; coupling the proximal ends of the pullwires to the cross block(s) ; and providing a coupling in the spool for an electrical cautery source.
  • Figure 1 is a side elevation view, partially in cross- section of a bipolar cautery biopsy forceps assembly of the invention
  • Figure 2 is an enlarged side elevation view of the distal end of the selective bipolar cautery biopsy forceps instrument of Fig. l;
  • Figure 3a is an enlarged top plan view of the clevis of Fig. 2;
  • Figure 3b is an enlarged top plan view of the clevis pin of Fig. 2;
  • Figure 3c is an enlarged top plan view of the lower jaw of Fig. 2;
  • Figure 3d is an enlarged top plan view of an insulating sleeve and washer of Fig. 2;
  • Figure 3e is an enlarged top plan view of the upper jaw of Fig. 2;
  • Figure 4 is a cross sectional view of the coil connection to the handle of the bipolar cautery biopsy forceps instrument of Fig. 1;
  • Figure 5 is a cross sectional view of the spool of Fig. 1 which utilizes a first embodiment of T-shaped pull-wire holding blocks according to the invention
  • Figure 5-1 is a top view in partial cross-section of the spool of Fig. 5;
  • Figure 5a is a cross sectional view of a second embodiment of T-shaped pull-wire holding blocks
  • Figure 5b is a view similar to Figure 5a but of a third embodiment of T-shaped pull-wire holding blocks
  • Figure 5c is a cross sectional view of pull-wire holding plates
  • Figure 5d is a top plan view of the holding plate embodiment of Figure 5c showing cautery plug connections
  • Figure 5e is a view similar to Figure 5d of an alternate embodiment of cautery plug connections
  • Figure 5f is a view similar to Figure 5 but with a cross block in place of the T-blocks;
  • Figure 5g is a view similar to Figure 5f but with an alternate pull wire gripping fixture
  • Figure 5h is a cross sectional view of a die for crimping the pull wires and covering sheath used in Fig. 5g;
  • Figure 5i is a cross sectional view of one embodiment of covering sheath for the pull wires
  • Figure 6 is side elevation view of a conductive jaw with selective polymer coating
  • Figure 7 is a side elevation view of an injection molded plastic jaw whose teeth are rendered conductive by an external conductive trace;
  • Figure 8a is a side elevation view of selectively conductive insert injection molded jaw
  • Figure 8b is a side elevation view of the conductive insert of Figure 8a;
  • Figure 8c is an enlarged top plan view of the conductive insert of Figure 8b;
  • Figure 9 is a view similar to Figure 2 showing an alternate embodiment of jaws;
  • Figure 9a is an enlarged plan view of one of the jaws of Figure 9;
  • Figure 9b is a side elevation view of one of the jaws of Figure 9; .
  • Figure 9c is a front view of the jaw of Figure 9b;
  • Figure 9d is a view similar to Figure 9a but of a second alternate embodiment of jaws
  • Figure 10 is a view similar to Figure 3d showing an alternate embodiment of washer, sleeve and clevis pin;
  • Figure 10a is a cross sectional view along line A-A in Figure 10.
  • Figure 10b is a cross sectional view along line B-B in Figure 10.
  • a biopsy forceps assembly 10 having a distal end 12, comprising a jaw assembly 14, and a proximal end 16 comprising a handle 17, a spool 19 and a thumb ring 21 for manipulation of the assembly.
  • the handle 17 is provided with a longitudinal slot 112 in communication with an axial bore 92.
  • a cross block 110 (or other pull-wire holding means) is slidable within slot 112 and is carried by a diametrical slot 116 in the proximal end of spool 19.
  • the cross block 110 is coupled to pull wires 60 as described in more detail below with reference to Figures 5, and 5a-5h.
  • the pull wires extend through axial bore 92 into a main coil 50 and both the main coil 50 and the pull wires 60 extend to the distal end 12 of the biopsy forceps 10.
  • the jaw assembly 14 comprises a pair of jaws 18, each of which is preferably a duplicate of the other.
  • Each jaw 18, as may be seen in Figures 2, 3c, 3e, and 6, is a generally elongated somewhat hemispherically shaped structure having a distal end and a proximal end.
  • On the distal end of each jaw 18 is an array of teeth 20 generally radially directed about a point "R", as exemplified in Figure 3c.
  • Each jaw 18 has a generally longitudinal center line as may be seen in Figures 3c and 3e. The teeth 20 on one side of the longitudinal center line of each jaw 18 are displaced by one half pitch from the corresponding teeth 20 on the other side of the longitudinal center line.
  • each jaw 18 comprises a tang 24 which has a generally semicircular recess position 26 on its outer side.
  • a bore 30 extends transversely through the midsection of the jaw 18 between the distal and proximal ends of each jaw 18, and a clevis pin 28 extends through the bore 30 on each respective jaw 18.
  • Each jaw 18 has an annular boss 33 disposed about the outer face of its bore 30, as shown in Figures 3c and 3e. The boss 33 acts as a bearing surface to reduce the typical friction found on prior art endoscopic biopsy forceps devices.
  • the clevis pin 28 (Fig. 3b) is received in a hole 32 in clevis 34 as shown in Figure 3a.
  • the clevis 34 extends proximally, as shown in Figure 2, into a hub 40 and is provided with an inner threaded portion 35 for receiving a main tubular coil 50.
  • the selectively conductive jaws 18 are insulated from each other and from the clevis pin 28, which is normally stainless steel, by a one piece non-conductive combination washer/sleeve 29 (seen in Fig. 3d) which is preferably a polymer with a thickness of approximately .005 - .015 inches.
  • the washer/sleeve 29 has a washer portion 129 and a sleeve portion 229.
  • the washer portion 129 prevents the facing surfaces of the proximal and pivot portions of the jaws 18 from contacting each other, while the sleeve portion 229 prevents a conductive clevis pin from electrically coupling the jaws 18.
  • the clevis 34 is preferably non-conductive.
  • a preferred material for forming the clevis is a VECTRA polymer available from Hoechst-Celanese, or an equivalent.
  • the clevis pin 28 (Fig. 3b) may be made of polymer; in which case the washer/sleeve 29 need only include the washer portion 129.
  • the main coil 50 is a comprised of a stainless steel rod of approximately .021 inch diameter which is tightly wound and preloaded into a main coil having an outer diameter of approximately .09 inches and a length of approximately seven feet.
  • a stiffening mechanism 300 As seen in Figure 2, at least a portion of the coil 50 as well as a portion of the clevis hub 40 are covered by a stiffening mechanism 300. Although the coil is made stiffer than would be otherwise, damage to an endoscope through which the biopsy forceps device is inserted is avoided, as the shrink wrap is lubricious and smooth.
  • a polyethylene (PE) sheath 54 also extends through approximately the entire length inside coil 50 as shown in Figs. 1 and 4.
  • Pull wires 60 extend through sheath 54 and sheath 54 acts as a bearing between pull wires 60 and the lumen of the main coil 50.
  • the distal end of each pull wire 60 has an uninsulated Z- bend therein.
  • the Z-bend of each pull wire 60 has a portion 62 which is rotatably disposed in the recess 26 in the tang 24 of each cutter jaw 18 by extending through a bore 66 near the proximal end of the tang 24, as best shown in Figures 2 and 3c.
  • Each pull wire 60 has a reflex curve 70 as shown in Figure 2 extending between their distal ends and the distal end of the main coil 50.
  • the reflex curve 70 helps to open the cutter jaws 18 when the spool 19 on the handle 17 is displaced distally thereto.
  • the remainder of each pull wire is covered with an insulating sheath 61 up to its proximal end which is described in more detail below.
  • a crimp ferrule 102 is shown extending from inside the axial bore 92 of the handle outwardly, so that the crimp ferrule 102 extends slightly distally of the distal end of the handle 17.
  • the crimp ferrule 102 is secured to the inner walls of the bore 92 by barbs 104.
  • the crimp ferrule is disposed about the main coil 50, and the coil 50 is secured within the crimp ferrule 102 by one or more crimps 106.
  • a strain relief sheath (not shown) surrounds the distal end of the handle and the proximal end of the coil, and limits twist and movement of the main coil 50 with respect to the bore 92 while preventing a sharp bend of the coil 50 at the distal end of the handle 17.
  • the proximal end of the pull wires 60 extend through the proximal end of the main coil 50 and through metal anti-kinking tubes 109 (see Fig. 5i) , and are locked into non-conductive T-shaped blocks 110 carried by spool 19 in slot 116, as shown in Figure 5.
  • the anti-kinking tubes 109 of pull wires 60 are bent at 71 into a "Y" configuration as shown, and a proximal electrical connection 64 of the pull wires is made by set screws 114 and button screws 214.
  • Set screws 114 secure the proximal electrical connection 64 of pull wires 60 to the T-shaped blocks 110, while the button screws 214 are used to secure conductor connectors 39 which connect to wires 39a from an electrical source 100 (Fig. 1) to the set screws 214.
  • the conductor connector 39 is placed between the button screw 214 and the T-block 110, and the button screw is tightened so that an electrical connection is made between the conductor and the T-shaped block.
  • the non-conductive T-shaped blocks 110 pass through slot 112 in the handle 17 which is in communication with the axial bore 92 ( Figure 1) and are held in place.
  • the proximal ends 64 of the pull wires 60 are uninsulated and pass through the T-shaped blocks 110.
  • the pull wires 60 are secured in the T-shaped blocks 110 by set screws 114. Movement of the spool 19 which is disposed about the central shaft of handle 17 thereby effects movement of the pull wires 60 disposed within the main coil 50, the distal ends of which are attached to the tangs 24 on the cutter jaws 18 as shown in Figures 1 and 2.
  • pull wires are electrically conductive and insulated along their length except for their distal Z-bend connection 62 to the tangs 24 of the jaws 18 and their proximal connection at 64 to an electrical source.
  • pull wires 60 are separated at the T-shaped blocks 110 and secured by separate set screws 114 as shown in Figure 5 whereby they are electrically coupled to contacts (described in detail below) for coupling with an electrical source 100.
  • a recess 119 in spool 19 is provided for an insulated cover (not shown) .
  • the electrical source 100 may be foot or hand activated, and if desired an electrical switch (not shown) may be provided on the spool in order to provide additional control.
  • FIGS. 5a and 5b Alternative configurations of the T-shaped blocks 110 are shown in Figures 5a and 5b.
  • the pull wires 60 are bent at 71 and insert molded into an ABS or other plastic sheath 209 described below with reference to Figure 5h.
  • the sheath 209 is provided with a flare 113a or 113b which engages a space Ilia or 111b between a pair of T-shaped blocks 110a or 110b.
  • the flare may be stepped (113a) or ramped (113b) . Electrical connection is made by means of set screws as shown in Figure 5.
  • the pull-wire engaging mechanism 110c comprises a pair of substantially parallel conductive plates spaced apart from each other. The plates are provided with holes 107 for receiving the uninsulated proximal ends 64 of the pull wires 60.
  • the uninsulated ends 64 of pull wires 60 are provided with Z-bends similar to those at their distal ends.
  • the Z-bends at 64 engage holes 107 in plates 110c as shown in Figure 5c.
  • the substantially parallel conductive plates 110c are supported by recesses in the spool, and terminate at the side of spool 19 with an electrical socket 139 for receiving blades 239 of a male cautery plug.
  • the plates could terminate in male prongs for connecting to a female cautery plug.
  • prongs 339 are mounted in the spool 19.
  • the electrical connection between the prongs 339 and the metal plates llOd is provided by biasing the bent ends 348 of metal plates llOd against ball contacts 349 integral with prongs 339.
  • a collar 359 integral with spool 19 surrounds prongs 339 to aid in securing the female cautery plug 101 coupled with an electrical source 100 to the spool 19.
  • a non-conductive cross block 120 shown in Figure 5f is used for gripping pull wires 60.
  • the non-conductive cross block 120 passes through slot 112 in the handle 17 which is in communication with the axial bore 92 ( Figure 1) .
  • the proximal ends 64 of the pull wires 60 are uninsulated and pass through the cross block 120.
  • the pull wires 60 are secured in the cross block 120 by set screws 114. Electrical connection is made by set screws 114 screwed into metal anchor blocks 114a located within spool 19 at either end of cross block 120.
  • a recess 119 in spool 19 is provided for an insulated cover (not shown) .
  • fixtures 210 shown in Figure 5g are used for securing and electrically coupling the pull wires 60.
  • the pull wires 60 and anti-kinking tubes 109 are crimped by die 310 as shown in Figure 5h.
  • the crimped tubes 109 with pull wires 60 are then fitted into a corresponding recess 210 in the spool 19.
  • the wire may be soldered or otherwise connected to the bipolar cautery forceps instrument, or a plug or receptacle may be provided on the end of the wire for an oppositely corresponding plug or receptacle on the instrument.
  • Figure 5i shows an arrangement of inner and outer sheaths which protect and insulate pull wires 60.
  • metal anti-kinking tubes 109 are preferably utilized around the insulation 61 of pull wires 62 to prevent the pull wires 60 from kinking.
  • an insulative sheath 208 is preferably placed around the anti-kinking tube 109 of one of the pull wires 60.
  • Both the inner sheath 208 and the other anti-kinking tube 109 of the other pull wire 60 are then preferably covered by an outer sheath 209 which holds the tubes 109 in close proximity for easy passage through the instrument.
  • a jaw 18 which has a limited or selective conducting (electrode) surface is seen.
  • the jaw 18 is preferably formed by casting a conductive metal as described in parent application 07/837,046 hereto, and subsequently coating the jaw with a very thin highly insulating polymer such as PARYLENE manufactured by Union Carbide.
  • PARYLENE preferably is deposited evenly on the jaw surfaces by applying it in a tumbling or other process in a vacuum at room temperature.
  • the teeth 20 and connecting portion 66 of tang 24 are preferably masked before coating so that those surfaces remain conductive.
  • the teeth and tang are not masked, after the polymer coating has been applied it is removed from the teeth 20 and connecting portion 66 of tang 24 via machining, grit blasting, or other processing. It will be appreciated that instead of removing the polymer from the connecting portion 66, the hole 66 can be drilled after coating to provide an uninsulated surface.
  • the insulating washer/sleeve 29 is not absolutely required because the clevis hole will be coated with insulation. However, use of the insulating washer/sleeve is still preferred in order to prevent current from passing through the insulation of closely abutting portions of the jaws. Moreover, as coating may eventually wear off the inside diameter of hole 30, use of sleeve 29 is advisable.
  • Figure 7. Another mechanism for creating a selectively conductive jaw is shown in Figure 7.
  • the jaw 18 is formed via injection molding a ceramic 218 such as alumina, zirconia, etc.
  • the formed jaw is provided with conductive plating traces 318 which are provided on the ceramic surface or in the ceramic, as well as on the teeth 20 and at the pull wire connection 66.
  • the teeth 20 are electrically connected to the pull wire connection 66.
  • the plating may be applied by sputtering or by other suitable procedures.
  • FIG. 8a - 8c Yet another mechanism for constructing a selectively conductive jaw is shown in Figures 8a - 8c.
  • a conductive skeleton portion 418 of the jaw is formed,by casting, stamping, or by photochemical milling or machining, and the skeleton portion 418 is preferably provided with staking holes 4i9.
  • the skeleton is then used as an insert for in an insert-type injection mold which is filled with plastic 518. While in the mold, the plastic flows through the staking holes 419 and anchors the conductive skeleton 418 mechanically.
  • the mold is designed such that at least the conductive teeth 20 are exposed while the remainder of the skeleton 418 is encased within plastic 518. As seen in phantom in Fig.
  • the pull wire connection area 66 of the skeleton 418 may also be exposed during insert molding so that it is not necessary to drill out hole 66 in order to guarantee electrical connection to the pull wire. Also, because of the manner in which the jaws are formed, it will be appreciated that the plastic 518 may be caused to totally cover some of the teeth, or a portion of some or all of the teeth.
  • FIGS 9, 9a, 9b, and 9c show an alternate embodiment of jaws 918 according to another aspect of the invention. These jaws are similar to the jaws 18 shown in Figures 2, 3c and 3e, as each jaw has a clevis pin bore 930 with an annular boss 933, a tang 924 and a recess 926 for receiving a pull wire (not shown) through a pull wire bore 966. Unlike the jaws 18 described above, however, jaws 918 are provided with teeth 920 which extend around the entire perimeter of the jaw. As shown best in Figure 9a, teeth 920 are arranged in a distal array 921, a proximal array 922 and two side arrays 923.
  • the proximal and distal arrays are radially directed about points el and e2 respectively which lie on center line CL somewhat proximal of and somewhat distal of a center point R.
  • the straight side arrays 923 are arranged to join the proximal and distal curved arrays.
  • the teeth 920 are, like the teeth 20 of jaws 18, displaced by one half pitch relative to the center line.
  • Figure 9d shows another alternate embodiment of jaw 918a.
  • This jaw is similar to jaw 918 described above except for its tang 924.
  • the tang 924 includes a lateral extension 924a which crosses center line CL.
  • the lateral extension 924a is provided with an interior recess 926a which communicates with recess 926 through pull wire bore 966.
  • recess 926a is slightly offset from recess 926. This offset better accommodates the Z-bend in pull wires 60. It should be noted however, that with the arrangement of Fig. 9d, the jaws of the biopsy forceps instrument cannot be identical. Additional details of a similar tang arrangement may be obtained with reference to copending SN 07/680,392 which is hereby incorporated by reference herein.
  • FIGS 10, 10a, and 10b show an alternate embodiment of the insulating washer/sleeve and clevis pin discussed above with reference to Figs. 3b and 3d.
  • the washer, sleeve, and clevis pin are a single non-conductive unit 929.
  • the non-conductive unit 929 has a generally flat washer portion 912 which lies between jaws 18 (alternatively 918) , a generally cylindrical (solid) sleeve portion 932, which resides in bores 30 (alternatively 930) , and a generally cylindrical (solid) clevis pin portion 922 which engages hole 32 of clevis 34 ( Figure 3a) .
  • Forming the sleeve, washer and clevis pin as a single unit 929 has the advantage of preventing fluids and other biological material from entering the space between the jaws. It also lends to a more reliable construction since the clevis pin is unable to disengage from the clevis.
  • the non-conductive clevis 34 ( Figure 3a) must be flexible enough so that its arms 34a, 34b can be spread while the jaws with the non-conductive clevis pin/washer/sleeve unit 929 are inserted between them.
  • the clevis 34 should be resilient enough so that after the jaws and the washer/sleeve/clevis pin 929 are aligned between arms 34a, 34b, the arms will grip the clevis pin of the unit in the holes 32 of the clevis arms. It should also be appreciated that while it is not absolutely necessary for the non- conductive unit 929 to have the stepped sleeve portion 932, such a step is desirable to provide a bearing or stop surface for the clevis.

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Abstract

Un forceps de biopsie endoscopique (10) à cautère bipolaire possède un conduit, une paire de mâchoires opposées articulées (18), deux fils de traction conducteurs (60) et un organe de commande. Les mâchoires opposées articulées (18) sont situées à l'extrémité distale du conduit. Chaque mâchoire est pourvue d'une surface coupante à son extrémité distale et d'une queue (24) à son extrémite proximale. Au moins une partie de la surface coupante est conductrice électriquement et une partie de la queue est conductrice électriquement et couplée électriquement à la surface coupante conductrice. Le reste de la mâchoire est de préférence non conducteur ou est revêtu d'un isolant. Le fil de traction conducteur (60) est couplé à la partie conductrice de la queue (24) de chaque mâchoire (18) et est isolé le long de son prolongement à travers le conduit vers une partie poignée (17) comprenant l'organe de commande. Celui-ci est accouplé aux extrémités proximales de fils de traction, de façon que son déplacement exerce une traction sur les fils et articule les mâchoires. L'organe de commande est également pourvu d'un dispositif de couplage électrique le couplant aux extrémités proximales des fils de traction et permettant un branchement facile sur une source électrique de cautérisation.
PCT/US1994/001576 1993-02-11 1994-02-09 Forceps de biopsie endoscopique a cautere bipolaire selectif WO1994017741A1 (fr)

Priority Applications (3)

Application Number Priority Date Filing Date Title
AU61748/94A AU6174894A (en) 1993-02-11 1994-02-09 Endoscopic biopsy forceps devices with selective bipolar cautery
JP6518385A JPH08509623A (ja) 1993-02-11 1994-02-09 選択的両極性焼灼器を有する内視的生検鉗子装置
DE4490796T DE4490796T1 (de) 1993-02-11 1994-02-09 Pinzetten mit selektiver bipolarer Kauterisation zur endoskopischen Biopsie

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US1659593A 1993-02-11 1993-02-11
US08/016,595 1993-02-11

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WO1994017741A1 true WO1994017741A1 (fr) 1994-08-18

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AU (1) AU6174894A (fr)
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WO (1) WO1994017741A1 (fr)

Cited By (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0765639A1 (fr) * 1995-09-29 1997-04-02 Ethicon Endo-Surgery, Inc. Dispositif électrochirurgical de compression comprenant une électrode bipolaire partiellement isolée
EP0797959A1 (fr) * 1996-03-29 1997-10-01 Ethicon Endo-Surgery, Inc. Ciseaux bipolaires
US5683388A (en) * 1996-01-11 1997-11-04 Symbiosis Corporation Endoscopic bipolar multiple sample bioptome
US6193715B1 (en) 1999-03-19 2001-02-27 Medical Scientific, Inc. Device for converting a mechanical cutting device to an electrosurgical cutting device
EP1079745A1 (fr) * 1998-05-01 2001-03-07 Perfect Surgical Techniques, Inc. Instruments chirurgicaux bipolaires a champs electriques focalises
US6514252B2 (en) 1998-05-01 2003-02-04 Perfect Surgical Techniques, Inc. Bipolar surgical instruments having focused electrical fields
DE10018674B4 (de) * 1999-04-14 2005-06-16 Pentax Corp. Biopsiezange für Endoskope
DE102004031928A1 (de) * 2004-06-23 2006-01-19 Aesculap Ag & Co. Kg Chirurgisches Instrument
EP2147650A1 (fr) * 2008-07-23 2010-01-27 Olympus Medical Systems Corp. Instrument de traitement des hautes fréquences
WO2011018157A1 (fr) * 2009-08-13 2011-02-17 Olympus Winter & Ibe Gmbh Tige tubulaire pour un instrument chirurgical ainsi qu'instrument chirurgical
EP2430999A1 (fr) * 2009-05-13 2012-03-21 Sumitomo Bakelite Co., Ltd. Pince hémostatique à haute fréquence pour endoscope
CN103735309A (zh) * 2014-01-28 2014-04-23 金黑鹰 一种腔镜手术用多功能器械
US9173699B2 (en) 2011-07-07 2015-11-03 Yamashina Seiki Co., Ltd. Endoscopic forceps
US9186204B2 (en) 2008-05-15 2015-11-17 River Seiko Corporation Endoscopic high-frequency hemostatic forceps
EP2921120A4 (fr) * 2012-11-13 2016-07-20 Olympus Corp Outil de traitement pour endoscope
US9681857B2 (en) 2003-06-18 2017-06-20 Boston Scientific Scimed, Inc. Endoscopic instruments and methods of manufacture
CN113384306A (zh) * 2020-03-11 2021-09-14 杭州安杰思医学科技股份有限公司 双极电处理装置

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US5553624A (en) * 1993-02-11 1996-09-10 Symbiosis Corporation Endoscopic biopsy forceps jaws and instruments incorporating same
JP3126323B2 (ja) * 1996-11-01 2001-01-22 株式会社貝印刃物開発センター 内視鏡用処置具における処置部の構造
US5980510A (en) * 1997-10-10 1999-11-09 Ethicon Endo-Surgery, Inc. Ultrasonic clamp coagulator apparatus having improved clamp arm pivot mount
JP5073895B2 (ja) 2001-09-25 2012-11-14 オリンパス株式会社 内視鏡用処置具
JP3989784B2 (ja) * 2002-07-17 2007-10-10 ペンタックス株式会社 内視鏡用嘴状処置具
JP4420593B2 (ja) * 2002-07-29 2010-02-24 Ｈｏｙａ株式会社 内視鏡用バイポーラ型高周波処置具
US7762960B2 (en) 2005-05-13 2010-07-27 Boston Scientific Scimed, Inc. Biopsy forceps assemblies
JP5403959B2 (ja) * 2008-07-08 2014-01-29 オリンパスメディカルシステムズ株式会社 高周波処置具
JP6153686B2 (ja) * 2015-06-25 2017-06-28 オリンパス株式会社 医療用部材、医療機器
WO2017122321A1 (fr) 2016-01-14 2017-07-20 オリンパス株式会社 Manipulateur
JP7130627B2 (ja) * 2016-09-09 2022-09-05 インテュイティブ サージカル オペレーションズ， インコーポレイテッド ステープラビーム構造
KR102571929B1 (ko) * 2021-06-18 2023-08-29 주식회사 파인메딕스 조직 절제용 포셉

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EP0317526A1 (fr) * 1987-11-16 1989-05-24 Consiglio Nazionale Delle Ricerche Cathéter de biopsie endocardiaque, pouvant également être utilisé pour identifier le point d'origine d'une arythmie ventriculaire
US5133727A (en) * 1990-05-10 1992-07-28 Symbiosis Corporation Radial jaw biopsy forceps
EP0518230A1 (fr) * 1991-06-07 1992-12-16 Hemostatic Surgery Corporation Instruments électro-chirurgical bipolair pour endoscopie

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EP0317526A1 (fr) * 1987-11-16 1989-05-24 Consiglio Nazionale Delle Ricerche Cathéter de biopsie endocardiaque, pouvant également être utilisé pour identifier le point d'origine d'une arythmie ventriculaire
US5133727A (en) * 1990-05-10 1992-07-28 Symbiosis Corporation Radial jaw biopsy forceps
EP0518230A1 (fr) * 1991-06-07 1992-12-16 Hemostatic Surgery Corporation Instruments électro-chirurgical bipolair pour endoscopie

Cited By (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0765639A1 (fr) * 1995-09-29 1997-04-02 Ethicon Endo-Surgery, Inc. Dispositif électrochirurgical de compression comprenant une électrode bipolaire partiellement isolée
US5683388A (en) * 1996-01-11 1997-11-04 Symbiosis Corporation Endoscopic bipolar multiple sample bioptome
US6019758A (en) * 1996-01-11 2000-02-01 Symbiosis Corporation Endoscopic bipolar multiple sample bioptome
EP0797959A1 (fr) * 1996-03-29 1997-10-01 Ethicon Endo-Surgery, Inc. Ciseaux bipolaires
US5700261A (en) * 1996-03-29 1997-12-23 Ethicon Endo-Surgery, Inc. Bipolar Scissors
EP1079745A1 (fr) * 1998-05-01 2001-03-07 Perfect Surgical Techniques, Inc. Instruments chirurgicaux bipolaires a champs electriques focalises
EP1079745A4 (fr) * 1998-05-01 2001-11-07 Perfect Surgical Tech Inc Instruments chirurgicaux bipolaires a champs electriques focalises
US6514252B2 (en) 1998-05-01 2003-02-04 Perfect Surgical Techniques, Inc. Bipolar surgical instruments having focused electrical fields
US6193715B1 (en) 1999-03-19 2001-02-27 Medical Scientific, Inc. Device for converting a mechanical cutting device to an electrosurgical cutting device
DE10018674B4 (de) * 1999-04-14 2005-06-16 Pentax Corp. Biopsiezange für Endoskope
US9681857B2 (en) 2003-06-18 2017-06-20 Boston Scientific Scimed, Inc. Endoscopic instruments and methods of manufacture
DE102004031928A1 (de) * 2004-06-23 2006-01-19 Aesculap Ag & Co. Kg Chirurgisches Instrument
US9186204B2 (en) 2008-05-15 2015-11-17 River Seiko Corporation Endoscopic high-frequency hemostatic forceps
EP2147650A1 (fr) * 2008-07-23 2010-01-27 Olympus Medical Systems Corp. Instrument de traitement des hautes fréquences
EP2430999A1 (fr) * 2009-05-13 2012-03-21 Sumitomo Bakelite Co., Ltd. Pince hémostatique à haute fréquence pour endoscope
CN102421385A (zh) * 2009-05-13 2012-04-18 住友电木株式会社 内窥镜高频止血钳
EP2430999A4 (fr) * 2009-05-13 2012-10-31 Sumitomo Bakelite Co Pince hémostatique à haute fréquence pour endoscope
WO2011018157A1 (fr) * 2009-08-13 2011-02-17 Olympus Winter & Ibe Gmbh Tige tubulaire pour un instrument chirurgical ainsi qu'instrument chirurgical
US9173699B2 (en) 2011-07-07 2015-11-03 Yamashina Seiki Co., Ltd. Endoscopic forceps
EP2921120A4 (fr) * 2012-11-13 2016-07-20 Olympus Corp Outil de traitement pour endoscope
US9956031B2 (en) 2012-11-13 2018-05-01 Olympus Corporation Treatment device for endoscope
CN103735309A (zh) * 2014-01-28 2014-04-23 金黑鹰 一种腔镜手术用多功能器械
CN113384306A (zh) * 2020-03-11 2021-09-14 杭州安杰思医学科技股份有限公司 双极电处理装置

Also Published As

Publication number Publication date
DE4490796T1 (de) 1996-01-11
JPH08509623A (ja) 1996-10-15
JP2005193061A (ja) 2005-07-21
AU6174894A (en) 1994-08-29
JP4328726B2 (ja) 2009-09-09

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