WO2017017191A1 - Résectoscope et câble optique pour résectoscope - Google Patents

Résectoscope et câble optique pour résectoscope Download PDF

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Publication number
WO2017017191A1
WO2017017191A1 PCT/EP2016/068014 EP2016068014W WO2017017191A1 WO 2017017191 A1 WO2017017191 A1 WO 2017017191A1 EP 2016068014 W EP2016068014 W EP 2016068014W WO 2017017191 A1 WO2017017191 A1 WO 2017017191A1
Authority
WO
WIPO (PCT)
Prior art keywords
cable
optical fiber
resectoscope
fiber cable
separate line
Prior art date
Application number
PCT/EP2016/068014
Other languages
German (de)
English (en)
Inventor
Sebastian STÜHLE
Original Assignee
Olympus Winter & Ibe Gmbh
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 Olympus Winter & Ibe Gmbh filed Critical Olympus Winter & Ibe Gmbh
Publication of WO2017017191A1 publication Critical patent/WO2017017191A1/fr

Links

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
    • A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
    • 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
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00066—Proximal part of endoscope body, e.g. handles
    • 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
    • A61B1/00112—Connection or coupling means
    • A61B1/00117—Optical cables in or with an endoscope
    • 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
    • A61B1/307—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 the urinary organs, e.g. urethroscopes, cystoscopes
    • 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
    • A61B1/06—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 with illuminating arrangements
    • A61B1/07—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 with illuminating arrangements using light-conductive means, e.g. optical fibres
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00505—Urinary tract
    • A61B2018/00517—Urinary bladder or urethra
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00547—Prostate
    • 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
    • A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes

Definitions

  • 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.
  • 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.
  • resectoscopes usually have an elongate shaft which is guided into the body of a patient.
  • This shaft can be assigned different tools.
  • 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.
  • the electrode carrier with the electrode is longitudinally displaceable on the resectoscope.
  • 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.
  • 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.
  • 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.
  • the rectoscope 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.
  • 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.
  • 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.
  • 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.
  • the optical fiber cable with the ground cable and / or the RF cable form a unit, in particular are combined to form a unit.
  • the optical fiber cable and the ground cable and / or the RF cable are material, force and / or form-fitting connected to each other.
  • the fiber optic cable can also be combined with the RF cable.
  • 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.
  • the additional cable or the additional cable is incorporated directly into the optical fiber cable.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • the contact element may also be a pin.
  • 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.
  • 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.
  • the Lichtleiteran gleich- 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 ,
  • 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.
  • 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.
  • 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.
  • the contact element may also be a pin.
  • 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.
  • 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.
  • FIG. 2 side view of a second embodiment of the resectoscope
  • 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.
  • a distal region of a shaft 11 and a tool 12 are not shown.
  • 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.
  • 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.
  • 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.
  • 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.
  • a first handle part 18 is arranged 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.
  • 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.
  • 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.
  • the tool 12 is attached to the carriage 17 in a motion-coupled manner.
  • 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.
  • an eyepiece 21 is provided at the proximal end of the optical unit 14, for visual observation by the operator or for connection of a camera.
  • the tool 12 is connected to a high-frequency source, not shown.
  • the carriage 17 is assigned an HF 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.
  • 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.
  • 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.
  • the optical fiber cable 29 may comprise one or more bundles of optical fibers, which are enclosed by a cable sheath.
  • 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.
  • 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.
  • the separate line 31 is enclosed by a cable sheath of the Lichtleier horrs 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.
  • the ground cable 26 is led out of the Lichtleier mecanic 29 and is connected via the exposed end to the ground contact 36.
  • 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.
  • 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.

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

Abstract

Au cours d'un traitement, des résectoscopes (10) sont reliés à un câble optique (29), à un câble de masse (26) et à un câble HF (24). Ceci a pour conséquence d'une part une réduction inutile du jeu de mouvement de l'opérateur et d'autre part le risque peut se présenter que des câbles soient involontairement tirés du résectoscope (10). L'invention concerne un résectoscope (10) et un câble optique (29) destiné à un résectoscope (10) permettant d'améliorer la liberté de mouvement et la sécurité opératoire. A cet effet, le câble optique (29) forme une unité avec le câble de masse (26) et/ou le câble HF (24).
PCT/EP2016/068014 2015-07-29 2016-07-28 Résectoscope et câble optique pour résectoscope WO2017017191A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102015009616.8 2015-07-29
DE102015009616.8A DE102015009616A1 (de) 2015-07-29 2015-07-29 Resektoskop und Lichtleiterkabel für ein Resektoskop

Publications (1)

Publication Number Publication Date
WO2017017191A1 true WO2017017191A1 (fr) 2017-02-02

Family

ID=56683914

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2016/068014 WO2017017191A1 (fr) 2015-07-29 2016-07-28 Résectoscope et câble optique pour résectoscope

Country Status (2)

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DE (1) DE102015009616A1 (fr)
WO (1) WO2017017191A1 (fr)

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1997024074A1 (fr) * 1995-12-29 1997-07-10 Microgyn, Inc. Dispositif et procede pour electrochirurgie
US20030195512A1 (en) * 2002-04-12 2003-10-16 Muller Richard P. Medical device with improved power plug connection
GB2402072A (en) * 2003-05-30 2004-12-01 Winter & Ibe Olympus Ureter Resectoscope
US20090005772A1 (en) * 2007-06-28 2009-01-01 Rhytec Limited Tissue treatment apparatus
US20100022824A1 (en) * 2008-07-22 2010-01-28 Cybulski James S Tissue modification devices and methods of using the same
GB2517962A (en) * 2013-09-06 2015-03-11 Ol Medical Ltd Medical applicator

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998008430A1 (fr) * 1996-08-26 1998-03-05 Stryker Corporation Endoscope avec source lumineuse integree autoregulatrice
DE19915284A1 (de) * 1999-04-03 2000-10-19 Winter & Ibe Olympus Endoskopisches Gerät
DE202011052506U1 (de) * 2011-12-28 2012-04-04 Tekno-Medical Optik Chirurgie Gmbh Resektoskop

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1997024074A1 (fr) * 1995-12-29 1997-07-10 Microgyn, Inc. Dispositif et procede pour electrochirurgie
US20030195512A1 (en) * 2002-04-12 2003-10-16 Muller Richard P. Medical device with improved power plug connection
GB2402072A (en) * 2003-05-30 2004-12-01 Winter & Ibe Olympus Ureter Resectoscope
US20090005772A1 (en) * 2007-06-28 2009-01-01 Rhytec Limited Tissue treatment apparatus
US20100022824A1 (en) * 2008-07-22 2010-01-28 Cybulski James S Tissue modification devices and methods of using the same
GB2517962A (en) * 2013-09-06 2015-03-11 Ol Medical Ltd Medical applicator

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