WO2019238918A1 - Résectoscope comprenant un tube de rinçage monté de manière à pouvoir coulisser longitudinalement - Google Patents

Résectoscope comprenant un tube de rinçage monté de manière à pouvoir coulisser longitudinalement Download PDF

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Publication number
WO2019238918A1
WO2019238918A1 PCT/EP2019/065665 EP2019065665W WO2019238918A1 WO 2019238918 A1 WO2019238918 A1 WO 2019238918A1 EP 2019065665 W EP2019065665 W EP 2019065665W WO 2019238918 A1 WO2019238918 A1 WO 2019238918A1
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WO
WIPO (PCT)
Prior art keywords
tube
resectoscope
flushing
cladding
shaft
Prior art date
Application number
PCT/EP2019/065665
Other languages
German (de)
English (en)
Inventor
Martin Horn
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 WO2019238918A1 publication Critical patent/WO2019238918A1/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
    • A61B18/1485—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
    • A61B1/012—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 characterised by internal passages or accessories therefor
    • A61B1/015—Control of fluid supply or evacuation
    • 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
    • A61B1/12—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 cooling or rinsing arrangements
    • A61B1/126—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 cooling or rinsing arrangements provided with means for cleaning in-use
    • 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
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/149—Probes or electrodes therefor bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00982—General structural features
    • A61B2017/00991—Telescopic means
    • 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
    • A61B2018/00184—Moving parts
    • A61B2018/00196—Moving parts reciprocating lengthwise
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • 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
    • A61B2018/0091—Handpieces of the surgical instrument or device
    • 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
    • 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
    • A61B2018/1407—Loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/005—Auxiliary appliance with suction drainage system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/007—Auxiliary appliance with irrigation system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002—Irrigation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/007—Aspiration

Definitions

  • the invention relates to a resectoscope of the type mentioned in the preamble of claim 1.
  • Resectoscopes of the generic type are used primarily in urology for surgical work in the bladder and in the ureter. They are usually used for resection and vaporization of tissue, for example tissue in the lower urinary tract.
  • the resectoscopes comprise a longitudinally displaceable electrosurgical passage instrument which, after the resectoscope has been inserted, with its distal working end out of the distal end of the shaft tube of the
  • the electrosurgical passage instrument can comprise an electrosurgical electrode in the form of a loop or plasma button at its distal working end.
  • electrosurgical electrode in the form of a loop or plasma button at its distal working end.
  • OES PRO resectoscopes Olympus
  • the instruments contain an optical system by means of which the site of the intervention can be monitored during the operation.
  • the resectoscopes are equipped with a rinsing device that permanently rinses the tissue lying in front of the distal end of the shaft.
  • irrigation fluid is continuously passed through an inner shaft and emerges at the distal end of the resectoscope.
  • the backflow of the rinsing liquid usually occurs through a gap between the inside and Outer shaft.
  • the outer shaft has numerous rinsing holes for liquid absorption.
  • a resectoscope with the features of claim 1.
  • the object is achieved by using a rinsing tube which can be displaced longitudinally in the resectoscope shaft and which, after insertion of the distal end of the resectoscope, can be pushed to the point of intervention in the distal direction beyond the end of the cladding tube.
  • the invention thus relates to a resectoscope for endoscopic surgery with a tubular shaft which comprises an elongate cladding tube and an inner tube arranged in the cladding tube and an irrigation tube arranged in the cladding tube next to the inner tube, an optical system being arranged in the inner tube , characterized in that the flushing tube is mounted in the jacket tube so as to be longitudinally displaceable. Holes can optionally be arranged in a wall of the distal end region of the irrigation tube.
  • the flushing liquid flows away from the instrument in a uniform manner, similar to the use of a suprapubic overflow regulator. Turbulence in front of the optics is thus reduced to a minimum. Furthermore, according to the invention, there is no need to provide the distal end of the cladding tube with flushing bores. It is therefore preferred that the cladding tube of the resectoscope according to the invention has no rinsing holes. The cladding tube is therefore more atraumatic than comparable cladding tubes in conventional resectoscopes.
  • the resection system according to the invention is particularly suitable for prostate resection, since particularly heavy bleeding can occur here.
  • the resectoscope can also be used for a variety of other operations, such as bladder resections.
  • the length by which the irrigation tube is pushed beyond the distal end of the cladding tube can be adapted to the anatomical conditions and the operating conditions.
  • the resectoscope has a tubular shaft.
  • the resectoscope for holding and operating comprises a handle system, which usually consists of two handle parts.
  • the endoscope shaft comprises an elongated cladding tube.
  • An inner tube is arranged in the interior of the cladding tube.
  • a flushing tube is arranged radially next to the inner tube in the interior of the cladding tube.
  • the irrigation tube is arranged above a transverse plane of the resectoscope.
  • a resectoscope can be divided into different areas by a transverse plane that intersects the shaft tube in the longitudinal direction and horizontally and a sagittal plane that is perpendicular to the transverse plane, the longitudinal axis of a shaft tube lying both in the sagittal plane and in the transverse plane.
  • the transverse plane cuts the shaft tube transversely and in a position of use of the resectoscope in a horizontal orientation and the sagittal plane cuts the shaft tube vertically and in a position of use of the resectoscope in a vertical orientation.
  • the sagittal plane can in particular lie parallel to a movement plane which is described in the case of a relative movement of, for example for the actuation of a slide of the resectoscope, pivotally mounted handle parts on the resectoscope.
  • the irrigation tube is arranged in a 12 o'clock position above the inner tube, so that the longitudinal axis of the irrigation tube lies in the sagittal plane of the resectoscope.
  • the inner tube will usually include various components that are common in resectoscopes. This includes the optics and an electrode tool, both of which pass through the inner tube.
  • the shaft preferably has an electrode tool arranged in the interior of the inner tube, the electrode tool in particular comprising a cutting loop.
  • the electrode tool can also comprise a plasma button or another electrosurgical cutting tool at its distal end.
  • a rinsing liquid is guided through the shaft into the interior of the body during the procedure.
  • This rinsing liquid can be used, for example, to wash away pieces of tissue that are released during resectoscopy.
  • the rinsing liquid serves to remove cloudiness, for example caused by blood, from the field of view of the optics.
  • the rinsing liquid is preferably supplied to the inside of the body through an inflow through the inner tube.
  • the contaminated rinsing liquid is drained through a drain element. According to the invention, this drainage element is formed by a flushing pipe.
  • the irrigation tube is inserted in order to have irrigation and / or body fluids flowing through it, preferably in the proximal direction.
  • holes can be formed in a wall of the distal end region of the flushing tube.
  • the flushing liquid can be removed or sucked off into the flushing pipe through the holes.
  • an outflow of the liquid through the open distal end of the flushing tube can also be sufficient, so that alternative embodiments without flushing holes in a wall of the flushing tube are conceivable.
  • a rinsing device or a pump can be assigned to the proximal end of the resectoscope or the shaft, so that the rinsing liquid can first be introduced into the interior of the body at a predetermined pressure.
  • excess liquid will run off spontaneously through the flushing pipe.
  • the irrigation liquid forms a laminar flow when it enters the body cavity, which flow is at least almost parallel to a longitudinal axis of the shaft or an optical axis of the optics and permits visual inspection of the extended electrode.
  • the flushing tube is mounted in a longitudinally displaceable manner in the cladding tube. The distal end region of the irrigation tube can thus be displaced beyond the distal end of the cladding tube after the instrument has been inserted atraumatically into the body of a patient. It is preferred that the irrigation tube can be pushed at least 2 cm, for example at least 3 cm, beyond the distal end of the cladding tube.
  • the flushing tube for example in its proximal end region, can be designed to be telescopically extendable and insertable.
  • the rinsing tube is constructed in several parts, for example from a plurality of sub-elements which can be pushed into one another.
  • the sub-elements are axially displaceable relative to one another, i.e. they can be moved back and forth in the axial direction.
  • Appropriate systems are known to those skilled in the art. It is understood that the system of sub-elements is liquid-tight against the exterior of the flushing pipe.
  • the proximal end region of the flushing tube can be flexible, for example tubular.
  • Such a flexible end region can be pulled out of the resectoscope, for example the main body of the resectoscope, and inserted again.
  • the cladding tube has at least one guide device along its inner wall, which receives the flushing tube in a longitudinally displaceable manner.
  • the rinsing tube can, for example, be clamped between the inner wall of the cladding tube and one or more holding elements formed in the inner wall of the cladding tube.
  • the inner wall of the cladding tube preferably one or more, preferably at least two, holding elements.
  • the holding elements support the irrigation tube and possibly also the inner tube against movements transverse to the longitudinal axis of the resectoscope. This means that the holding elements secure the flushing pipe and possibly also the inner pipe at least in regions against lateral evasion.
  • the holding elements can be designed, for example, as protuberances on the inner wall of the cladding tube, the protuberances preventing movements of the flushing tube transversely to the longitudinal axis and extending parallel to the longitudinal axis of the shaft.
  • the flushing pipe is thus clamped in the transverse direction.
  • the holding elements can, for example, essentially fill the space in the interior of the cladding tube outside the inner tube and the flushing tube. It goes without saying that the free rotation of the inner tube and the longitudinal displacement of the flushing tube are not impaired by the holding elements.
  • the resectoscope also has an actuation system by means of which the irrigation tube can be moved axially in the distal and proximal directions.
  • the actuation system will generally be arranged at least partially on the handle or main body of the resectoscope.
  • the actuation system can include, for example, conventional slide controls, lever systems and / or rotary controls.
  • the actuation system can comprise a slider that is displaceable in the longitudinal direction and the longitudinal displacement of which is transferred directly into a longitudinal displacement of the flushing pipe.
  • the actuation system can comprise a lever system, a force being exerted on the flushing pipe in the axial direction via a lever arm.
  • the actuation system with a rotary wheel for actuation.
  • the rotary wheel can, for example, around the main body of the resectoscope, i.e. be rotatable about the longitudinal axis of the resectoscope.
  • the rotary movement can be transferred into a longitudinal displacement of the flushing pipe via a corresponding thread.
  • Experts are able to implement and design these and other suitable actuation mechanisms.
  • the cross section of the cladding tube will generally have an oval shape, since the flushing tube and inner tube are arranged next to one another. Nevertheless, the outer diameter of the shaft is comparable to the outer diameters of known resectoscopes, since the gap between the inner tube and the cladding tube, which was required in the prior art for the backflow of the rinsing liquid, can be dispensed with.
  • the inner tube will generally have an essentially round cross section.
  • the flushing tube has a cross section with a convexly curved section and a concave-curved section, i.e. a cross section in sickle shape.
  • the sickle shape preferably has rounded corners or tips.
  • the concave section - the inside of the sickle shape - preferably borders at least in sections on the outer wall of the inner tube. Where the concave section does not adjoin the inner tube, the flushing tube can adjoin the holding elements described elsewhere.
  • the various tubes of the shaft namely the cladding tube, the flushing tube and the inner tube, can be made of different materials. Suitable materials are known to those skilled in the art. It is preferred that the rinsing tube is made of plastic, for example made of polyether ether ketone (PEEK).
  • PEEK polyether ether ketone
  • the irrigation tube can be designed for single use (“single-use") and can be disposed of accordingly after its use. In this way, the use of contaminated or damaged rinsing pipes is completely ruled out and instrument assembly is simplified as much as possible.
  • FIG. 1 is a schematic side view of a resectoscope according to the invention, in which the irrigation tube for inserting the instrument is retracted to the site of engagement in the shaft.
  • FIG. 2 shows a schematic side view of the resectoscope from FIG. 1, in which the irrigation tube is pushed distally in the longitudinal direction of the shaft beyond the distal end of the cladding tube;
  • Figure 3 is a schematic cross-sectional view taken along line 2-2 in Figures 1 and 2;
  • FIG. 4 shows a schematic, perspective view of the distal end region of the resectoscope according to the invention from FIG. 2.
  • FIG. 1 and 2 show highly schematic side views of a resectoscope 10 according to the invention, in which the rinsing tube 18 for withdrawing the instrument is retracted into the shaft 12 (FIG. 1) or distally in the longitudinal direction of the shaft 12 via the distal end of the shaft 12 Cladding tube 14 is pushed out (Fig. 2).
  • the resectoscope 10 comprises a shaft 12 which has a cladding tube 14.
  • a rinsing tube 18 and an inner tube 16 run inside the cladding tube 14.
  • the flushing pipe 18 is arranged to be longitudinally displaceable in the cladding pipe 14 and is protected against transverse displacements by holding elements 36, 38 (not shown here) (see FIG. 3).
  • the flushing tube 18 can be moved axially in the distal and proximal direction by an actuating mechanism, not shown here, in a positively guided manner. As shown in FIG. 2, it can be pushed over the distal end of the cladding tube 14.
  • the flushing tube 18 has holes 24 in its distal end region, which are provided as flushing openings. The washing liquid and other liquids can be sucked into the washing pipe 14 through the holes 24. For this purpose, a vacuum can be applied to the flushing pipe 14. Alternatively, the liquid can flow off the flushing pipe 14 without applying a vacuum.
  • the flushing tube 23 is designed to be telescopically extendable in a manner not shown.
  • the inner tube 16 is mounted rotatably about its longitudinal axis in the cladding tube 14 and is traversed by a rod-shaped lens 20 and an electrode tool 40.
  • An embodiment is shown in which the electrode tool 40 and the optics 20 protrude slightly beyond the distal end of the cladding tube 14. In this regard, however, a large number of variations are conceivable.
  • the inner tube 16 and the flushing tube 18 can, as shown, be made somewhat shorter than the cladding tube 14 or the same length or longer.
  • the electrode tool 40 has a cutting loop 42 at its distal end, by means of which tissue can be removed by electrosurgical ablation. Here, a high-frequency electrical voltage is applied to the cutting loop 42 in order to cut tissue.
  • An eyepiece or alternatively a camera for displaying the treatment area can be arranged at the proximal end of the optics 20. At the distal end of the optics 20, this has, for example, a lens, not shown, which is directed towards the area to be operated.
  • An electronic sensor such as a CCD chip, can also be assigned to the optics 20.
  • the resectoscope 10 shown has a passive transporter in which the slide 52 is displaced in the distal direction against the distal, first handle part 44 by a relative movement of the handle parts 44 and 46 arranged proximally from the shaft 12 against a spring force applied by a spring bridge 48.
  • the electrode tool 40 and / or the optics 20 are positively guided to the distal in a manner not shown.
  • the handle parts 44, 46 are relieved, the spring force generated by the spring bridge 48 forces the slide 52 back into its rest position, the shaft 12 and thus also the electrode tool 40 and / or the optics 20 being pulled in the proximal direction.
  • an electrosurgical intervention with the electrode tool 40 can be carried out without manual operator force, that is to say passively.
  • FIG. 3 shows a schematic cross-sectional view of the shaft 12 along the line 2-2 in FIGS. 1 and 2.
  • the cladding tube 14 has an inner wall with holding elements 36, 38 which are formed from protuberances of the inner wall.
  • the holding elements 36, 38 each extend over the length of the shaft 12 in the longitudinal direction and prevent movements of the flushing tube 18 transversely to the longitudinal direction of the shaft 12.
  • the flushing tube 18 has a crescent-shaped cross section with a convexly curved section 26 and a concavely curved section 28.
  • flushing pipe 18 has a concave and a convex side.
  • the sickle tips adjoin the holding elements 36, 38.
  • the inner tube 16 which is enclosed on more than 50% of its surface by the inner wall 34 of the cladding tube 14, then lies on the concavely curved side of the flushing tube 18.
  • the inner tube 16 comprises the optics 20 and an electrode tool 40 in the manner described elsewhere.
  • FIG. 4 shows a schematic, perspective view of the distal end region of the resectoscope according to the invention from FIG. 2.
  • the distal end region 23 of the irrigation tube 18 is pushed distally over the cladding tube 14.
  • the arrow marking in the figure indicates that the irrigation tube 18 is reversibly displaceable in the distal or proximal direction.
  • the flushing tube 18 has holes 24 in its distal end region, which are designed as flushing openings. Through the flushing openings, the backflow of the flushing liquid and any contamination of this liquid takes place during an operation.
  • a holding element 36 can also be seen, which stabilizes the flushing pipe 18 during a longitudinal displacement.
  • a ceramic tip 50 in the form of an annular end piece is permanently assigned to the inner tube 16, which is not visible here. This ceramic tip 50 is used for the electrical insulation of the working instrument against the cladding tube 14. A formation of the end piece from plastic is also conceivable.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
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  • Engineering & Computer Science (AREA)
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  • Endoscopes (AREA)

Abstract

L'invention concerne un résectoscope pour la chirurgie endoscopique pourvu d'une tige tubulaire, qui comprend un tube enveloppant étiré en longueur et un tube intérieur disposé dans le tube enveloppant ainsi qu'un tube de rinçage disposé dans le tube enveloppant à côté du tube intérieur. Une optique est disposée dans le tube intérieur. Le résectoscope est caractérisé en ce que le tube de rinçage est monté de manière à pouvoir coulisser longitudinalement dans le tube enveloppant.
PCT/EP2019/065665 2018-06-15 2019-06-14 Résectoscope comprenant un tube de rinçage monté de manière à pouvoir coulisser longitudinalement WO2019238918A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102018114448.2A DE102018114448A1 (de) 2018-06-15 2018-06-15 Resektoskop mit längsverschiebbar gelagertem Spülrohr
DE102018114448.2 2018-06-15

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WO2019238918A1 true WO2019238918A1 (fr) 2019-12-19

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PCT/EP2019/065665 WO2019238918A1 (fr) 2018-06-15 2019-06-14 Résectoscope comprenant un tube de rinçage monté de manière à pouvoir coulisser longitudinalement

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WO (1) WO2019238918A1 (fr)

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Publication number Priority date Publication date Assignee Title
DE102021102735A1 (de) 2021-02-05 2022-08-11 Olympus Winter & Ibe Gmbh Resektoskop, Elektrodeninstrument für ein Resektoskop sowie Führungselement für ein Elektrodeninstrument

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