WO2017017191A1

WO2017017191A1 - Resectoscope and light guide cable for a resectoscope

Info

Publication number: WO2017017191A1
Application number: PCT/EP2016/068014
Authority: WO
Inventors: Sebastian STÜHLE
Original assignee: Olympus Winter & Ibe Gmbh
Priority date: 2015-07-29
Filing date: 2016-07-28
Publication date: 2017-02-02
Also published as: DE102015009616A1

Abstract

During treatment, resectoscopes (10) are connected to a light guide cable (29), a ground cable (26), and an HF cable (24). Due to this, both the range of motion of the operator is unnecessarily limited, and there can be the risk that cables are unintentionally pulled off the resectoscope (10). The invention describes a resectoscope (10) and a light guide cable (29) for a resectoscope (10), via which the freedom of movement and the working safety are improved. In addition, according to the invention, the light guide cable (29) is combined with the ground cable (26) and/or the HF cable (24) into one unit.

Description

applicant:

Olympus Winter & Ibe GmbH

Kuehnstrasse 61

22045 Hamburg

Resectoscope and fiber optic cable for a resectoscope

description

The invention relates to a resectoscope according to the preamble of claim 1. Furthermore, the invention relates to an optical fiber cable for a resectoscope according to the preamble of claim 6.

Resectoscopes of the type described here are preferably used for treatment in the area of the bladder, in particular in the region of the prostate. However, the field of application of these resectoscopes is not limited to these areas, but rather includes the treatment of all organs, preferably in the human abdomen.

For the treatment of diseased organs, resectoscopes usually have an elongate shaft which is guided into the body of a patient. This shaft can be assigned different tools. For example, a resectoscope for high-frequency surgery has an electrode which can be acted upon by high-frequency alternating current at a distal end of a shaft-like electrode carrier, preferably in the form of a loop. The electrode can be contacted via at least one, for example, with the electrode support, electrical conductor at a proximal end of the resectoscope or the shaft with corresponding electrode contacts with a high frequency source. For treatments to be performed on the patient, such as tissue cutting, the electrode carrier with the electrode is longitudinally displaceable on the resectoscope. For this, the electrode carrier is usually held in a coupled motion with its proximal end region on a slide mounted longitudinally displaceably on the shaft tube of the resectoscope. In known resectoscopes, the carriage at least one contact, via which the tool can be acted upon by a high frequency current of the high frequency source or a high frequency generator. The shaft tube with the carriage arranged thereon is also referred to as a conveyor. Various transporters for use on monopolar or bipolar resectoscopes are known from the prior art. In bipolar resectoscopes, both poles of the high-frequency generator or of the high-frequency source are usually connected to the resectoscope or to the feed dog. In addition to the active electrode transmitting the high-frequency current, a neutral electrode or a ground line is provided on the resectoscope, which returns or discharges the outflowing current into the tissue to be treated after it has been introduced into the tissue to be treated. The neutral electrode on the bipolar resectoscope is known to be formed by a metallic component, such as a mounting plate also known as an optical disk, the resectoscope. The electrical contacting of the active electrode and the neutral electrode can be done by two separate cables, namely an RF cable and a ground cable or alternatively by a Y-cable or by a two-end cable whip, which is connected to the high-frequency generator.

For the resectoscopic treatment of the tissue, it is essential that the rectoscope has an optical system with which the area to be treated can be viewed. For the observation of the area to be treated, it must be illuminated. This typically serve light guide elements, such as preferably a bundle of optical fibers. These end on the one hand at the distal end portion of the shaft for illuminating the field of view and on the other hand in the proximal region of the shaft for coupling light. In general, the light is coupled, for example by a cold light source in the light fibers. An optical fiber cable transmits corresponding light from the light source to the optical fibers of the resectoscope optics. For connecting a fiber-optic cable, a light-guide connecting piece is usually arranged on the resectoscope optics. The light guide connecting piece thus serves in particular for releasable connection to the optical fiber cable.

Accordingly, during processing of the tissue to be treated, the resectoscope is connected to at least one optical fiber cable and an RF supply for the tool. Since the RF supply of the tool is usually two cables, the operating range of the surgeon during the processing becomes unnecessarily restricted by the cables and the fiber optic cable. In addition to the limited freedom of movement of the surgeon, there is a risk that the connection of the cable or the optical fiber cable to the resectoscope, by unintentionally pulling off the cables, is interrupted. This can lead to damage of the instrument or even injury to the surgeon or the patient, especially when disconnecting the RF cable or the ground cable.

The object of the present invention is therefore to improve the freedom of movement and safety at work.

A Resektoskop to solve this problem has the features of claim 1. Accordingly, it is provided according to the invention that the optical fiber cable with the ground cable and / or the RF cable form a unit, in particular are combined to form a unit. Typically, the optical fiber cable and the ground cable and / or the RF cable are material, force and / or form-fitting connected to each other. When combining or connecting the optical fiber cable to the ground cable, the number of limiting the range of motion of the surgeon cable is reduced by at least one. Furthermore, by fixing the ground cable to the optical cable, the risk of unwanted disconnection of the cable can be reduced. Thus, this expansion of the cable increases both the range of motion of the surgeon, as well as increases the reliability. Just as described before summarizing the fiber optic cable with the ground cable, the fiber optic cable can also be combined with the RF cable. Moreover, it may alternatively be conceivable that the optical fiber cable is merged with the ground cable and the RF cable to form a unit, so that instead of three cables only one cable is connected to the resectoscope.

The present invention may also preferably provide that the optical fiber cable has a separate cable as a ground cable and / or a separate cable as an HF cable. For this purpose, for example, the additional cable or the additional cable is incorporated directly into the optical fiber cable. It is also conceivable that the fiber optic cable is assigned an idle line, through which a ground cable and / or an RF cable can be pulled as needed or request. In particular, the present invention can further provide that the at least one separate line in the interior of the optical fiber cable, in particular at least partially enclosed by a cable sheath of the optical fiber cable or outside along the optical fiber cable, preferably helically guided around the optical fiber cable around, preferably at least partially on the optical fiber cable fitting, is arranged. By this fixed assignment of the cable or the cable to the optical fiber cable is a fixation and thus stabilization of the electrical connection. A further advantageous embodiment of the present invention may provide that a coupling means of the optical fiber cable, a contact element for electrically connecting the separate line serving as a ground cable with the neutral electrode and / or a contact element for electrically connecting the separate line serving as an RF cable with the HF Having contact. The coupling means of the optical fiber cable can be, for example, a plug connection or a plug, with which the optical fiber cable is plugged onto the optical fiber connecting piece of the resectoscope. Thus, the electrical connection between the ground cable or the RF generator and the resectoscope can also be produced by establishing the connection between the optical fiber cable and the fiber optic connection piece of the resectoscope. Similarly, the electrical connection between the RF cable and the resectoscope or the RF generator and the resectoscope could be made by coupling the optical fiber cable with the light guide connecting piece. The contact element may preferably be a cable which can be connected by a further connection means to a ground contact which is conductively connected to the neutral electrode. The cable can be led out laterally from the optical fiber cable, for example. Moreover, the contact element may also be a pin. In addition, it is conceivable that the at least one separate line protrudes from the optical cable or is longer than this and is guided directly to the ground contact or the neutral electrode and / or to the RF contact. It is also conceivable that the coupling means of the optical fiber cable is connected via a conductive contact directly to the neutral electrode, in particular via an optical unit. This integration of the connections in an existing connection of the optical fiber cable facilitates the installation of the Resektoskopes and creates the Other increased safety, since the electrical connection to the resectoscope can not be unintentionally separated.

Furthermore, it can provide the present invention that the Lichtleiteranschluss- connection has a contact element for electrically connecting the serving as ground cable separate line with the neutral electrode and / or a contact element for electrically connecting the RF cable serving as a separate line with the RF contact , Thus, according to the above-described feature, with the light pipe connecting piece, the requirement is created to couple the at least one separate line to the resectoscope in a simple and secure manner.

An optical fiber cable for Resektoscopes to solve the aforementioned object has the features of claim 6. Accordingly, it is provided that the resectoscope, which is associated with the optical fiber cable according to the invention, has at least one of the features shown above. Moreover, it is inventively provided that the optical fiber cable is combined with a ground cable for connection to a formed on the resectoscope neutral electrode of the resectoscope and / or an RF cable for connection to an electrically connected to a tool of the resectoscope RF contact to a unit. The connection between the optical fiber cable and the ground cable and / or the RF cable can be formed material, force and / or positive fit. By this combination of the optical fiber cable to the ground cable and / or the RF cable to a unit, a compactness can be achieved, through which the application or handling of the optical fiber cable is designed to save space and safe.

The invention further provides that the ground cable is designed as a separate line of the optical fiber cable and / or the RF cable is designed as a separate line of the optical fiber cable. The at least one separate line in the interior of the optical fiber cable can, in particular at least partially, enclosed by a cable sheath of the optical cable, or outside along the optical fiber cable, preferably helically guided around the optical fiber cable around, preferably at least partially adjacent to the optical fiber cable arranged. Through this combination, a condition is created around the resectoscope, which grants the surgeon a particularly great freedom of movement. Furthermore, the present invention can provide, in particular, that a first end of the optical fiber cable has a first coupling means for connection to the resectoscope, wherein the first coupling means is a contact element for electrically connecting the separate line designed as ground cable to the neutral electrode of the resectoscope and / or a contact element for electrically connecting the RF cable designed as a separate line with the RF contact. The contact element is formed, for example, as a cable, which is connectable by a further connection means with a ground contact, which is associated with the neutral electrode in an electrically conductive manner. In addition, the contact element may also be a pin. Moreover, it is also conceivable that the at least one separate line protrudes from the optical fiber cable or from the coupling means or is longer than this and is guided directly to the ground contact and / or to the RF contact. Furthermore, it can be inventively provided that at a second end of the optical fiber cable, a second coupling means for connection to a light source is arranged, wherein the second coupling means is a contact element for electrically connecting the grounded cable as a separate line with an RF generator and / or a Contact element for electrically connecting the RF cable designed as a separate line with the RF generator. By the optical fiber cable according to the invention thus a cable is provided which supplies the resectoscope both with light, and electrically. In addition, a reliable and secure connection to the resectoscope and the RF generator is provided by the coupling means at the first and second ends of the optical fiber cable.

Preferred embodiments of the invention will be described in more detail below with reference to the drawing. In this show:

1 side view of a resectoscope,

Fig. 2 side view of a second embodiment of the resectoscope, and

Fig. 3 side view of another embodiment of the resectoscope. A first embodiment of the resectoscope 10 according to the invention is shown schematically in FIG. In the resectoscope 10 shown in FIG. 1 (as well as in FIGS. 2 and 3), a distal region of a shaft 11 and a tool 12 are not shown. For a detailed description of the shaft 1 1 and the tool 12 reference is made to the general state of the art, where said elements are sufficiently illustrated.

A shown in Fig. 1 conveyor 13 is connected to the tubular shaft 1 1. At a proximal end of the conveyor 13, an optical tube 35 of an optical unit 14 is inserted into the shaft 1 1. The optical tube 35 of the optical unit 14 passes through the shaft 1 1 of the conveyor 13, so that the treatment room can be observed distally in front of the resectoscope 10 by means of the optical unit 14.

At the proximal end of the conveyor 10, an end body 15, also known as an optical disk, is fixedly arranged on the shaft 11. The end body 15 is connected via a spring element 16 with a along the shaft 1 1 longitudinally displaceable carriage 17. The spring element 16 is shown here only schematically. Thus, for example, it is provided that the spring element 16 has a torsion, bending, tension or tension spring formed spring part, which holds the carriage 17 with respect to the end body 15 in a biased rest position.

On the carriage 17, a first handle part 18 is arranged. Another, second presently arranged on the end body 15 grip member 19 is here annular, but may also have a different configuration. For the operation of the handle parts 18 and 19, these are moved by fingers of the surgeon relative to each other against the spring force of the spring element 16. As a result, the carriage 17 is moved along the shaft 1 1.

The only partially illustrated tool 12 is supported by a guide tube 20, guided along the shaft 1 1. In this case, the tool 12 is inserted with a tool shank in the attached to the shaft 1 1 guide tube 20. The tool shank of the tool 12 is mounted longitudinally displaceable in the guide tube 20. In its proximal end region, the tool 12 is attached to the carriage 17 in a motion-coupled manner. In a longitudinal displacement of the carriage 17 along the shaft 1 1 is also moved the tool 12. In this case, the distal end of the tool 12 is displaced in the axial direction of the shaft 1 1.

The optical unit 14 can be used to observe the tissue to be treated located in the region of the distal end of the tool 12. At the proximal end of the optical unit 14, an eyepiece 21 is provided for visual observation by the operator or for connection of a camera.

For the high-frequency treatment of the patient, the tool 12 is connected to a high-frequency source, not shown. For this purpose, the carriage 17 is assigned an HF contact 22. At this RF contact 22, a plug 23 is connected to an RF cable 24 in the embodiment shown in FIG. The RF contact 22 is connected within the carriage body via an electrical line 25 to the tool 12. The line 25 for connecting the tool 12 to the RF contact 22 is designed such that it can follow the movement of the carriage. Furthermore, a ground cable 26 leads from an electrically connected to the shaft 1 1 point also connected to the RF generator, not shown. In the embodiment of the resectoscope 1 1 shown in FIG. 1, the ground cable 26 is electrically connected by a ground contact 36 on the end body 15 with the shaft 1 1.

A locking element 27 designed, for example, as a locking pin serves for the detachable connection of the tool 12 to the carriage 17. The locking element 27 can be designed, for example, to be actuated by finger pressure, a first finger pressure serving to lock the tool 12 and a second finger pressure releasing the locking.

Since the area to be treated is usually in the dark, it should be illuminated for observation. For illuminating the treatment area, a light guide element (not shown), preferably in the form of a fiber bundle, is arranged in the optical tube 35. A fiber bundle can in particular be divided into a plurality of sub-bundles to form selective illumination areas. These fiber bundles are used to pass light generated, for example, by a cold light source. Fiber bundles are also flexible and therefore easy to install with bends. The light guide passes through the optics tube 35 from its distal end to its proximal end and is guided to the light guide connecting piece 28 for coupling the light. This light guide connecting piece 28 is connected to a fiber optic cable 29. The fiber optic cable 29 shown only in sections in FIG. 1 leads to a suitable light source, not shown. For passing the light, the optical fiber cable 29 may comprise one or more bundles of optical fibers, which are enclosed by a cable sheath. For connecting the optical fiber cable 29 to the optical fiber connection piece 28, the optical fiber cable 29 has a coupling means 30. About this coupling means 30, the light of the optical fiber cable 29 is coupled in a known manner in the optical unit 14.

According to the invention, the optical fiber cable 29 shown in FIG. 1 has, in addition to the light-conducting elements, a separate line 31, which serves as ground cable 26 here. In this variant, it is provided that the separate line 31 is enclosed by a cable sheath of the Lichtleierkabels 29. At the end, not shown, of the optical fiber cable 29, the line 31 can be led out of the optical fiber cable 29 and the mass or the RF generator are supplied. The coupling means 30 can have an electrical contact, by means of which the ground cable 26 is electrically connectable to the line 31. In the embodiments illustrated in the figures, the ground cable 26 is led out of the Lichtleierkabel 29 and is connected via the exposed end to the ground contact 36.

In a further embodiment of FIG. 2, the ground cable 26 is not guided in the optical fiber cable 29, but outside, helically as a separate line 32 to the optical fiber cable 29 around. Moreover, it is also conceivable that both the ground cable 26, and the RF cable 24 outside, helically are guided around the fiber optic cable 29 as separate lines around.

Fig. 3 shows a further embodiment in which both the RF cable 24 and the ground cable 26 are guided as a separate line 33 and 34 through the optical fiber cable 29.

Thus, in all embodiments, the number of connected to the resectoscope 10 cable is reduced by the fact that at least one cable for the RF supply of the tool 12 is merged with the optical fiber cable 29. It should be pointed out explicitly at this point that the resectoscopes 10 shown in FIGS. 1, 2 and 3 are merely schematic, greatly simplified exemplary embodiments and, moreover, a large number of possible further exemplary embodiments are conceivable.

ßezugszeichenliste

10 resectoscope

12 shaft

14 tool

16 transporter

18 optical unit

20 end body

22 spring element

24 sleds

26 first handle part

28 second handle part

30 guide tube

32 eyepiece

34 RF contact

36 plugs

38 RF cables

40 line

42 ground cables

44 locking element

46 fiber optic connection piece

48 fiber optic cable

50 coupling agents

52 separate line

54 separate line

56 separate line

58 separate line

60 optics tube

62 earth contact

*****

Claims

claims

1 . Resectoscope (10) for high-frequency surgery with an elongated shaft (1 1) for insertion into a body, along the shaft (1 1) longitudinally displaceable guided tool (12), an optical unit (14) for observing the resectoscope (10 ) to be processed treatment area, wherein the optical unit (14) has a light guide connecting piece (28) for connecting a fiber optic cable (29) for optical coupling with a in an optical tube (35) of the optical unit (14) guided light guide, an RF contact (22 ) for electrical contacting of the tool (12) with a connectable to a pole of a high-frequency generator RF cable (24) and with a ground contact (36) for electrically contacting a connectable to the high-frequency generator ground cable (26) with a on the Resektoskop (10) formed neutral electrode, characterized in that the optical fiber cable (29) with the ground cable (26) and / or the RF cable (24) to an on are summarized.

2. resectoscope (10) according to claim 1, characterized in that the optical fiber cable (29) has a separate line (31) as a ground cable (26) and / or a separate line (34) as an RF cable (24).

3. resectoscope (10) according to claim 1 or 2, characterized in that the at least one separate line (31) in the interior of the optical fiber cable (29), in particular at least partially surrounded by a cable sheath of the optical fiber cable (29), or outside of the optical fiber cable (29) along, preferably helically guided around the optical fiber cable (29) around, preferably at least partially adjacent to the optical fiber cable (29), is arranged.

4. resectoscope (10) according to any one of claims 2 or 3, characterized in that a coupling means (30) of the optical fiber cable (29) a contact element for electrically connecting the ground cable (26) serving as a separate line (31) with the neutral electrode and / or a contact element for the electrical connection of the RF cable (24) serving as a separate line (34) with the RF contact (22).

Resectoscope (10) according to any one of claims 2 to 4, characterized in that the light guide connecting piece (28) has a contact element for electrically connecting the grounding cable (26) serving as a separate line (31) with the neutral electrode and / or a contact element for electrical connection the separate line (34) serving as RF cable (24) with the RF contact (22).

Optical fiber cable (29) for a resectoscope (10), in particular according to one of Claims 1 to 5, characterized in that the optical fiber cable (29) is connected to a ground cable (26) for connection to a neutral electrode of the resectoscope (9) formed on the resectoscope (10). 10) and / or an RF cable (24) for connection to a with a tool (12) of the Resektoskopes (10) electrically connected RF contact (22) is combined to form a unit.

Optical cable (29) for a resectoscope (10) according to claim 6, characterized in that the ground cable (26) as a separate line (31) of the optical fiber cable (29) is formed and / or the RF cable (24) as a separate Line (34) of the optical fiber cable (29) is formed.

Optical fiber cable (29) for a resectoscope (10) according to claim 6 or 7, characterized in that the at least one separate line (31) in the interior of the optical fiber cable (29), in particular at least partially enclosed by a cable sheath of the optical fiber cable (29), or on the outside of the optical fiber cable (29) along, preferably helically guided around the optical fiber cable (29) around, preferably at least partially adjacent to the optical fiber cable (29), is arranged.

Optical cable (29) for a resectoscope (10) according to any one of claims 6 to 8, characterized in that a first end of the optical fiber cable (29) comprises a first coupling means (30) for connection to the resectoscope (10), wherein the first coupling means (30) a contact element for the electrical connection of the ground line (26) formed as a separate line (31) with the neutral electrode of the Resektoskopes (10) and / or a contact element for electrically connecting the RF cable (24) formed as a separate line (34) having the RF contact (22).

10. optical fiber cable (29) for a resectoscope (10) according to any one of claims 6 to 9, characterized in that at a second end of the optical fiber cable (29) a second coupling means for connection to a light source is arranged, wherein the second coupling means is a contact element for electrically connecting the grounding cable (26) formed as a separate line (31) with an RF generator and / or a contact element for electrically connecting the RF cable (24) formed as a separate line (34) with the RF generator.