WO2020048127A1 - 外科用电极组件 - Google Patents

外科用电极组件 Download PDF

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Publication number
WO2020048127A1
WO2020048127A1 PCT/CN2019/081999 CN2019081999W WO2020048127A1 WO 2020048127 A1 WO2020048127 A1 WO 2020048127A1 CN 2019081999 W CN2019081999 W CN 2019081999W WO 2020048127 A1 WO2020048127 A1 WO 2020048127A1
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WO
WIPO (PCT)
Prior art keywords
electrode
outer tube
inner tube
tube
distal
Prior art date
Application number
PCT/CN2019/081999
Other languages
English (en)
French (fr)
Inventor
李玉华
曹建国
Original Assignee
江苏昊普生物医学科技有限公司
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
Priority claimed from CN201811024436.9A external-priority patent/CN109009423B/zh
Priority claimed from CN201821446420.2U external-priority patent/CN209269870U/zh
Application filed by 江苏昊普生物医学科技有限公司 filed Critical 江苏昊普生物医学科技有限公司
Priority to US17/273,273 priority Critical patent/US20210186597A1/en
Priority to EP19857797.5A priority patent/EP3847985A4/en
Publication of WO2020048127A1 publication Critical patent/WO2020048127A1/zh

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    • 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
    • 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
    • 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
    • A61B18/1447—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 wherein sliding surfaces cause opening/closing of the end effectors
    • 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
    • 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
    • A61B2018/0013—Coatings on the energy applicator non-sticking
    • 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
    • A61B2018/00321—Head or parts thereof
    • 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
    • A61B2018/00321—Head or parts thereof
    • A61B2018/00327—Ear, nose or throat
    • 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
    • A61B2018/00434—Neural system
    • A61B2018/00446—Brain
    • 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
    • A61B2018/00589—Coagulation
    • 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
    • A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
    • A61B2018/0094—Types of switches or controllers
    • A61B2018/00946—Types of switches or controllers slidable
    • 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
    • A61B2018/1425—Needle
    • A61B2018/1432—Needle curved
    • 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
    • A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
    • 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
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery

Definitions

  • the present disclosure relates to a hemostatic tool for surgery, and in particular to an electrode assembly for surgery.
  • Electrocoagulation as an efficient and reliable hemostatic method, is widely used in surgery.
  • Surgical electrode assembly is especially suitable for small-channel deep surgery such as minimally invasive microsurgery, neurosurgery, and transnasal approach. It is particularly suitable for use with nasal and ventriculoscopy, and is mainly used for minimally invasive microsurgery or neurosurgery. Electrocoagulation for surgery to stop bleeding. Because the operating space for various surgeries is limited, and the larger the surgical incision or channel, the greater the secondary damage to the patient. Therefore, the surgical channels are strived to be minimized and minimally invasive.
  • bipolar electrocoagulation forceps are commonly used in the existing surgery.
  • the main principle is to install two pieces of tweezers in a fixed seat, and pinch the tweezers with fingers to pinch the blood vessels of the two tweezers. Or tissue, so that the high-frequency current passing through the tips of the two forceps passes through the clamped local blood vessel or tissue, and the thermal effect of the high-frequency current is used to dehydrate and shrink the blood vessel wall, coagulate the blood in the blood vessel, and make the blood vessel and blood clot Mutually integrated into one to achieve the purpose of effective hemostasis.
  • the distance between the front rod of the two forceps entering the human body is at least 10mm and the length is limited. Nasal approach, ventriculoscopy, etc.) to stop bleeding deep into the tissue, especially when used in minimally invasive microsurgery and neurosurgery.
  • the large volume of the forceps entering the human body prevents simultaneous use with other instruments.
  • the tip is often prone to misalignment during meshing, which affects the electrocoagulation effect and efficiency.
  • An existing electrode assembly for surgery uses an inner tube and an outer tube to cooperate with each other to realize the approach and separation of the electrode tip.
  • the curvature of the outer pipe will be slightly different, which causes the outer pipe to be pressed tightly against the convex side of the inner pipe, especially on the convex side.
  • Significantly increased friction, or even stuck which results in a significant limitation on the degree of bending of the inner and outer tubes, and it is not possible to ideally avoid the interference of the handle with other simultaneously used instruments by bending, and If the bending is too large, the friction will be greatly increased and the operation sensitivity of the electrode will be reduced, which will affect the operation efficiency.
  • the outer tube pushing device of the existing electrode assembly for surgery includes a handle spring sheet.
  • the screw plug and the outer tube are retreated by the elasticity of the handle spring sheet itself, which requires the elasticity of the handle spring sheet itself.
  • the spring leaf is often unable to provide sufficient elastic restoring force based on its structure, which will reduce the operating sensitivity of the electrode assembly and hinder the operation efficiency.
  • the width needs to be designed to be large in order to ensure the elasticity, which makes the operator often pinch the middle finger undesirably when pressing the two handle springs with the thumb and forefinger, which greatly hinders the comfort of operation. Security and convenience.
  • the electrode sleeve of the conventional electrode assembly for surgery is easily worn by the outer tube.
  • the wall of the electrode sleeve is more likely to be worn due to its non-wear-resistant material and its thin wall, so that its insulation ability is damaged.
  • it may be considered to try to use other materials to make electrode sleeves but based on the special structural requirements of the electrode sleeves of ventriculoscopy electrode assemblies, it is difficult to find good abrasion-resistant materials to make electrode sleeves. R & D to use is usually very time consuming and costly. Therefore, there is an urgent need for an electrode sleeve that can protect the electrode in a simple, reliable, and low-cost manner, reducing or even completely avoiding the wear of the electrode sleeve by the outer tube.
  • the electrode tip is preferably small to improve the accuracy of the operation, but the small electrode tip is more likely to be blocked by the outer tube during the operation, which will also reduce the accuracy and convenience of the operation. Sex and comfort.
  • the present disclosure aims to provide a surgical electrode assembly capable of solving at least one of the aforementioned problems existing in the related art.
  • a surgical electrode assembly having a distal end farther from an operator during use and a proximal end closer to the operator during use.
  • the electrode assembly includes an electrode device, a manipulation device, and an electrode driving device.
  • the electrode device is disposed at a distal end of the electrode assembly, and the electrode device includes a first electrode and a second electrode, and the first electrode and the second electrode can be close to each other at a first position away from each other. Move between the second positions.
  • the manipulation device is disposed at a proximal end of the electrode assembly and is used to manipulate the operation of the electrode device.
  • the electrode driving device is disposed between the manipulation device and the electrode device, and is configured to drive a first electrode and a second electrode of the electrode device in the first position and the second position under the action of the manipulation device.
  • the manipulation device includes a housing and an actuation mechanism at least partially disposed within the housing, the actuation mechanism being capable of actuating the electrode driving device.
  • the actuation mechanism includes a crank device, a slider device operatively connected to the crank device, and a damping device.
  • the slider device has a rest position and a working position. In the absence of external force, the damping effect of the damping device makes the slider device be in a rest position, and the slider device is operatively connected to the electrode driving device.
  • the first electrode and the second electrode are in a first position far from each other.
  • An operator can apply a force to the crank device and push the slider device through the crank device. Therefore, the slider device can move toward the working position against the damping effect of the damping device, thereby driving the first position of the electrode device.
  • An electrode and a second electrode move from the first position to the second position.
  • the surgical electrode assembly ensures that sufficient actuation force is provided, including a reset force, is more ergonomic, greatly improves the operating sensitivity of the surgical electrode assembly, and further improves the surgical efficiency, Safety and operational comfort.
  • the slider device moves toward a static position under the reset force of the damping device, so that the first electrode of the electrode device and The second electrode moves from the second position to the first position under the action of its own elastic force, wherein the slider device pushes and resets the crank device while moving toward the rest position.
  • the electrode driving device includes an inner tube and an outer tube capable of relative movement in a longitudinal direction.
  • the distal end of the inner tube is connected to the proximal ends of the first electrode and the second electrode
  • the outer tube is sleeved on the inner tube and the distal end of the outer tube abuts against the first electrode And the second electrode so that the inner tube and the outer tube can move the first electrode and the second electrode between the first position and the second position.
  • the slider device is operatively connected to the outer tube, so that the outer tube can move with the movement of the slider device.
  • the slider device is operatively connected to the inner tube, so that the inner tube can move with the movement of the slider device.
  • a damping device is disposed between the slider device and the housing.
  • the damping device is a coil spring or a hollow elastomer.
  • the slider device has a distal portion having a smaller radial size, a proximal portion having a larger radial size, and a shoulder, a coil spring, or a hollow located between the distal portion and the proximal portion.
  • the elastic body can be sleeved on the distal portion of the slider device and abut against the shoulder.
  • the manipulation device further includes a fixing block for fixing the inner tube in the housing, and the fixing block is disposed at a distance near the slider device.
  • the proximal end of the inner tube extends into and is fixed to the longitudinal through hole of the fixing block.
  • the fixing block is further provided with a lateral through hole extending from an outer peripheral surface of the fixing block to a longitudinal through hole of the fixing block, wherein the fastening element can be introduced into the lateral through hole. Inside and press against the inner tube.
  • the fastening element is a screw or a rivet.
  • a flange is formed at a proximal opening of the outer tube, and a hollow slider device is provided with a corresponding groove on an inner peripheral surface thereof.
  • the proximal end of the outer tube can be shaped by the flange and the groove. It is fixedly locked in the slider device.
  • the slider device is provided with a guide portion
  • the housing is provided with a matching guide portion for cooperating with the guide portion
  • the guide portion is a guide piece protruding from the slider device
  • the mating guide portion is a mating guide piece protruding from an inner peripheral surface of the housing.
  • stop portions that limit the maximum sliding distance of the slider device are respectively provided at both ends of the mating guide piece.
  • the housing includes an upper case and a lower case manufactured by molding or additive manufacturing.
  • one crank device is provided on each side of the housing.
  • the crank device includes a crank and a link, the distal end of the link is pivotally connected to a common slider device, and the proximal end of the link is pivotally connected to the distal end of the corresponding crank, The proximal end of the crank is pivotably connected to a common cylinder protruding from the inner periphery of the housing.
  • the common post is made with a groove in the middle, and a wire connected to the electrode can pass through the groove.
  • the crank is designed as a narrow and long pressing handle.
  • a conveying channel for conveying a flushing liquid is provided inside the inner pipe, or between the inner pipe and the outer pipe, or outside the outer pipe.
  • the first electrode and the second electrode are fixed to the inner tube by an adhesive.
  • the adhesive is an epoxy resin adhesive.
  • the inner tube is squashed at the first electrode and the second electrode protruding into the inner tube, thereby pressing the inner tube with the first electrode and the second electrode together.
  • the distal opening of the outer tube is configured with an outward flange.
  • the distal portions of the first electrode and the second electrode are bent up, down, or formed straight.
  • a clamping surface for clamping a human target tissue in a distal portion of the first electrode and the second electrode forms a step on a transition portion toward a proximal portion of the first electrode and the second electrode.
  • the step is configured to prevent the electrode sleeve on the proximal portion of the electrode from contacting each other during the closing process of the first electrode and the second electrode.
  • the distal portions of the first electrode and the second electrode are subjected to anti-coagulation adhesion treatment.
  • the distal end of the outer tube has a flat conical structure
  • the flat conical structure includes a plane extending forward near the centerline of the outer tube, the plane being substantially perpendicular to the first electrode and the first A clamping surface of a distal portion of the two electrodes for clamping a target tissue of a human body.
  • the inner tube is squashed at the first electrode and the second electrode protruding into the inner tube, so that the inner tube is pressed together with the first electrode and the second electrode, and then passes through the inner tube.
  • An adhesive is injected into the inner tube to further fix the first electrode and the second electrode to the inner tube.
  • a surgical electrode assembly having a distal end farther from an operator during use and a proximal end closer to the operator during use.
  • the electrode assembly includes an electrode device, a manipulation device, and an electrode driving device.
  • the electrode device is disposed at a distal end of the electrode assembly, and the electrode device includes a first electrode and a second electrode, and the first electrode and the second electrode can be close to each other at a first position away from each other. Move between the second positions.
  • the manipulation device is disposed at a proximal end of the electrode assembly and is used to manipulate the operation of the electrode device.
  • the electrode driving device is disposed between the manipulation device and the electrode device, and is configured to drive a first electrode and a second electrode of the electrode device in the first position and the second position under the action of the manipulation device. Between sports.
  • the electrode driving device includes an outer tube and an inner tube, and the outer diameter of the inner tube is smaller than the inner diameter of the outer tube, so as to be sleeved on the inner side of the outer tube, so that the inner tube and the outer tube can move along the outer tube. The longitudinal movement of the inner tube and the outer tube is relative to each other.
  • the inner tube has a proximal portion of the inner tube at the proximal end, a distal portion of the inner tube at the distal end, and a curved portion of the inner tube between the proximal portion of the inner tube and the distal portion of the inner tube.
  • the curved portion of the inner tube has a certain bending curvature, so that the distal portion of the inner tube and the proximal portion of the inner tube are disposed at an angle to each other
  • the outer tube has a proximal portion of the outer tube located at the proximal end, The distal portion of the outer tube and the outer tube connection portion between the proximal portion of the outer tube and the distal portion of the outer tube.
  • the outer tube connecting portion is adapted to the inner tube curved portion, so that when the operating device is manipulated to make the inner tube and the outer tube perform relative movement, the outer tube connecting portion allows: the inner tube
  • the curved portion of the inner tube of the tube is relatively moved in a longitudinal direction with the outer tube without interfering with a proximal portion and a distal portion of the outer tube of the outer tube.
  • the surgical electrode assembly can achieve, for example, the following technical effects:
  • the arrangement of the curved tube can greatly improve the convenience of the surgical electrode assembly when it enters the human body channel during surgery, and reduces the surgical electrode assembly and the human body channel during the operation. Undesirable touching or even scratching of the human body tissue, and based on the bending, the handle part of the electrode assembly does not interfere with instruments used simultaneously, such as aspirators.
  • the surgical electrode assembly greatly reduces the large frictional force and even jams when the inner tube and the outer tube are relatively moved in the longitudinal direction under a large degree of bending, thereby greatly improving the operation sensitivity of the surgical electrode assembly during surgery. And operation accuracy, these advantages are essential for the successful completion of the operation.
  • the outer tube connecting portion is a tubular portion having an opening on the outer tube, and is made in one piece with the proximal portion of the outer tube and the distal portion of the outer tube.
  • the bent connection portion can be exposed at least partially from the opening.
  • the longitudinal and circumferential dimensions of the opening are sufficient to allow: the inner tube curved portion of the inner tube
  • the relative movement between the outer tube proximal portion and the outer tube distal portion of the outer tube is smoothly performed in the longitudinal direction without interfering with the outer tube proximal portion and the outer tube distal portion of the outer tube.
  • the opening of the outer tube connection portion occupies at least one half of the circumference of the outer tube and exposes the convex side of the curved portion of the inner tube.
  • a part of the distal end portion of the inner tube and / or a part of the proximal end portion of the inner tube can be exposed from the opening of the outer tube connection portion.
  • the distal end and the proximal end of the opening of the outer tube connection portion are always at a distance from the vertex of the curved portion of the inner tube when in use.
  • the distal edge and / or the proximal edge of the opening are curled inwardly or encapsulated, so that the distal edge and / or the proximal edge of the opening do not scrape when contacting the human target tissue.
  • Injury human target tissue
  • the outer tube connecting portion and the distal portion of the outer tube are separate parts and are fixedly connected in an installed state, and / or the outer tube connecting portion and the proximal portion of the outer tube are The manufactured parts are separated and fixedly connected in the installed state.
  • the fixed connection is achieved by riveting, screwing, welding, and / or bonding.
  • the outer pipe connection portion extends around all or part of the periphery of the inner pipe.
  • the outer pipe connection portion includes at least one curved rod and / or at least one curved flat plate and / or at least one curved plate curved in a lateral direction.
  • the degree of bending of the curved portion of the inner pipe and the degree of bending of the outer pipe connecting portion can be changed simultaneously.
  • the inner tube bending portion and the outer tube connection portion are made of a flexible material so as to achieve a change in the degree of bending.
  • the degree of bending of the bent portion of the inner pipe and the degree of bending of the outer pipe connecting portion are changed between 10 ° and 60 °.
  • the degree of curvature of the curved portion of the inner tube and the degree of curvature of the outer tube connection portion are changed between 30 ° and 40 °.
  • the surgical electrode assembly enters a human body through the nose.
  • a conveying channel for conveying a flushing liquid is provided inside the inner pipe, or between the inner pipe and the outer pipe, or outside the outer pipe.
  • the first electrode and the second electrode are fixed to the inner tube by an adhesive.
  • the adhesive is an epoxy resin adhesive.
  • the inner tube is squashed at the first electrode and the second electrode protruding into the inner tube, thereby pressing the inner tube with the first electrode and the second electrode together.
  • the distal opening of the outer tube is configured with an outward flange.
  • the distal portions of the first electrode and the second electrode are bent up, down, or formed straight.
  • a clamping surface for clamping a human target tissue in a distal portion of the first electrode and the second electrode forms a step on a transition portion toward a proximal portion of the first electrode and the second electrode.
  • the step is configured to prevent the electrode sleeve on the proximal portion of the electrode from contacting each other during the closing process of the first electrode and the second electrode.
  • the distal portions of the first electrode and the second electrode are subjected to anti-coagulation adhesion treatment.
  • the distal end of the outer tube has a flat conical structure
  • the flat conical structure includes a plane extending forward near the centerline of the outer tube, the plane being substantially perpendicular to the first electrode and the first A clamping surface of a distal portion of the two electrodes for clamping a target tissue of a human body.
  • the inner tube is squashed at the first electrode and the second electrode protruding into the inner tube, so that the inner tube is pressed together with the first electrode and the second electrode, and then passes through the inner tube.
  • An adhesive is injected into the inner tube to further fix the first electrode and the second electrode to the inner tube.
  • a surgical electrode assembly having a distal end farther from an operator during use and a proximal end closer to the operator during use.
  • the electrode assembly includes an electrode device, an inner tube, and an outer tube.
  • the electrode device is disposed at a distal end of the electrode assembly, and the electrode device includes a first electrode and a second electrode, and the first electrode and the second electrode can be close to each other at a first position away from each other. Move between the second positions.
  • the distal end of the inner tube is fixedly connected to the proximal ends of the first electrode and the second electrode.
  • the outer tube is sleeved on the inner tube and the distal end of the outer tube abuts on the outside of the curved proximal portion of the first electrode and the second electrode, so that the first tube and the outer tube can move relative to each other in the longitudinal direction to An electrode and a second electrode move between a first position and a second position.
  • On the far side of the inner tube at least outside the electrode sleeves of the first and second electrodes, at least a part of the electrode sleeves of the first and second electrodes is provided with a wear-resistant protective member, and the inner tube and the outer tube During relative movement in the longitudinal direction, the front end of the outer tube can slide on the wear-resistant protective member.
  • the surgical electrode assembly can achieve, for example, the following technical effects: the simple installation of the wear-resistant protective member effectively solves the technical problem that the electrode sleeve of the electrode is easily worn by the outer tube. Especially in the case of a ventricular endoscope electrode assembly, the electrode sleeve wall is thin and is more prone to wear and tear, leading to damage to the insulation capability. In the common solution, it is usually attempted to use other materials to make the electrode sleeve of the electrode, but based on the special requirements of the electrode sleeve of the ventriculoscopy electrode assembly, it is difficult to achieve and very expensive, and it is difficult to find the ideal Electrode sleeve material.
  • the wear-resistant protective member of this embodiment can protect the electrode sleeve of the electrode in a simple, reliable and low-cost manner, so that the problem of abrasion resistance of the material of the electrode sleeve is not considered at all, which increases the material selection. range.
  • the wear-resistant protective member extends from the distal end of the inner tube and is made in one piece with the inner tube, and the wear-resistant protective member and the electrode sleeve are fixedly connected in an installed state.
  • the wear-resistant protective member and the inner tube are made separately, and a proximal end of the wear-resistant protective member and a distal end of the inner tube are fixedly connected in an installed state, and the wear-resistant protective member It is fixedly connected with the electrode sleeve in the installed state.
  • the abrasion-resistant protective member and the inner tube are separately made parts and are not connected to each other, and the abrasion-resistant protective member and the electrode sleeve are fixedly connected in an installed state.
  • the wear-resistant protection member is made of a wear-resistant material.
  • the wear protection is made of stainless steel.
  • the fixed connection between the wear-resistant protective member and the electrode sleeve is achieved by bonding, hot-melt connection, or encapsulation injection molding.
  • the fixed connection between the wear protection member and the inner tube is achieved by riveting, screwing, welding, and / or bonding.
  • the distal end of the outer tube has a flat conical structure
  • the flat conical structure includes a plane extending forward near the centerline of the outer tube, the plane being substantially perpendicular to the first electrode and the first A clamping surface of a distal portion of the two electrodes for clamping a target tissue of a human body.
  • the surgical electrode assembly is used in conjunction with a ventricleoscope.
  • a conveying channel for conveying a flushing liquid is provided inside the inner pipe, or between the inner pipe and the outer pipe, or outside the outer pipe.
  • the first electrode and the second electrode are fixed to the inner tube by an adhesive.
  • the adhesive is an epoxy resin adhesive.
  • the inner tube is squashed at the first electrode and the second electrode protruding into the inner tube, thereby pressing the inner tube with the first electrode and the second electrode together.
  • the distal opening of the outer tube is configured with an outward flange.
  • the distal portions of the first electrode and the second electrode are bent up, down, or formed straight.
  • a clamping surface for clamping a human target tissue in a distal portion of the first electrode and the second electrode forms a step on a transition portion toward a proximal portion of the first electrode and the second electrode.
  • the step is arranged so that the electrode sleeve on the proximal portion of the electrode is prevented from contacting each other during the closing process of the first electrode and the second electrode.
  • the length of the clamping surface is between 2 mm and 4 mm.
  • the distal portions of the first electrode and the second electrode are subjected to anti-coagulation adhesion treatment.
  • the fixed connection between the wear-resistant protective member and the electrode sleeve is realized by a fin on the wear-resistant protective member for covering the circumference of the electrode sleeve.
  • the inner tube is squashed at the first electrode and the second electrode protruding into the inner tube, so that the inner tube is pressed together with the first electrode and the second electrode, and then passes through the inner tube.
  • An adhesive is injected into the inner tube to further fix the first electrode and the second electrode to the inner tube.
  • FIG. 1 illustrates a top view of a first embodiment of a surgical electrode assembly according to the present disclosure
  • FIG. 2 is a front view of the surgical electrode assembly in FIG. 1;
  • FIG. 3 illustrates a front view of an outer tube with an opening of the surgical electrode assembly of FIG. 1;
  • FIG. 4 illustrates a perspective view of a lower case of the operating device of the surgical electrode assembly in FIG. 1;
  • FIG. 5 is a perspective view of a slider device of a manipulation device of the surgical electrode assembly in FIG. 1;
  • FIG. 6 illustrates a perspective view of an upper case of the operating device of the surgical electrode assembly in FIG. 1;
  • FIG. 7 illustrates a top view of a second embodiment of a surgical electrode assembly according to the present disclosure
  • FIG. 8 is a front view of the surgical electrode assembly in FIG. 7;
  • FIG. 9 is an enlarged view of a part I of the surgical electrode assembly in FIG. 7; FIG.
  • FIG. 10 is an enlarged view of part II of the surgical electrode assembly in FIG. 8.
  • the terms “installation”, “connected”, “coupled”, “connected”, “fixed” and other terms should be understood in a broad sense, unless explicitly stated and limited, for example, they may be fixed connections or It is a detachable connection or an integral connection; it can be a mechanical connection or an electrical connection; it can be a direct connection or an indirect connection through an intermediate medium; it can be the internal communication of two components.
  • the specific meanings of the above terms in the present disclosure can be understood according to specific situations.
  • distal refers to a direction away from an operator when using the surgical electrode assembly of the present disclosure
  • proximal refers to a direction approaching the operator when using the surgical electrode assembly of the present disclosure
  • FIG. 1 and 2 illustrate a first embodiment of a surgical electrode assembly according to the present disclosure, which is used in conjunction with a nasal mirror, referred to herein as a nasal mirror electrode assembly 100.
  • the nasal cavity electrode assembly 100 includes: two electrodes 15, 16 and a lead 3 electrically connected to the electrodes 15, 16; an inner tube 18 fixed to the proximal ends of the electrodes 15, 16; ⁇ ⁇ 18 ⁇ ⁇ ⁇ ⁇ 17 ⁇ 17 on the outer tube 17.
  • the nasal cavity electrode assembly 100 further includes a manipulation device 25 connected to the inner tube 18 and the outer tube 17, and the outer tube 17 can be moved longitudinally relative to the inner tube 18 by actuation of the manipulation device 25.
  • the lead 3 is connected to the high-frequency electric knife through the power line 1.
  • the distal portions of the electrodes 15, 16 are tips for operation, and the shape of the tips is designed to bend up (see Fig. 2), thereby reducing the obstruction of the field of view during surgery and thus facilitating the precise gripping of human target tissues.
  • the shape of the tip can also be designed to be curved or straight.
  • the tips of the electrodes 15 and 16 are respectively provided with clamping surfaces for clamping a target tissue of a human body on opposite inner sides. In order to reduce or avoid adhesion of the electrode tip with the target tissue of the human body during the surgery, the electrode tip can be treated with anti-coagulation.
  • the proximal portions of the electrodes 15, 16 are curved and provided with insulated electrode sleeves 13, 14 respectively.
  • the clamping surface of the distal tip of the electrode forms a step on the transition to the proximal portion of the electrode to prevent the electrode sleeves 13 and 14 on the proximal portion of the electrode from contacting each other during the closing of the electrodes 15 and 16 to interfere with the clamping surface. Hold human target tissue.
  • the proximal ends of the electrodes 15, 16 are fixed to the inner tube 18.
  • the inner tube 18 is provided with an opening (not shown, for example, a circular or oval or rectangular opening) for filling an adhesive such as epoxy resin, and the adhesive is used to attach the electrodes 15 and 16.
  • the proximal end of the wire and the adjacent part of the lead wire 3 are fixed to the inner tube 18, so as to prevent the electrodes 15 and 16 from oscillating in the inner tube 18.
  • the inner tube 18 can be squashed at the electrode protruding into the inner tube 18 to press the inner tube 18 with the electrodes 15 and 16 together to further ensure the fixation of the electrodes 15 and 16 and the inner tube 18.
  • the fixing of the inner tube 18 to the electrodes 15 and 16 can be performed as follows.
  • the inner tube 18 is flattened at the electrodes 15 and 16 protruding into the inner tube 18 so as to press the inner tube 18 and the electrodes 15 and 16 together. Together, the electrodes 15 and 16 and the inner tube 18 are further fixed by injecting an adhesive into the inner tube 18.
  • the outer tube 17 is sleeved on the inner tube 18, and by the longitudinal movement of the outer tube 17 relative to the inner tube 18, the electrodes 15, 16 can be radially separated from each other to enter the first position or radially adjacent to each other to enter the second position.
  • the electrodes 15, 16 are fixedly connected to the distal end of the inner tube 18.
  • the electrodes 15, 16 are confined within the outer tube 17, so that the electrodes 15, 16 are mutually Radial approach; when the outer tube 17 moves proximally relative to the inner tube 18, the electrodes 15, 16 are exposed from the outer tube 17, so that the electrodes 15, 16 are radially separated from each other based on their own elasticity.
  • the distal opening of the outer tube 17 is configured with an outward flange, which is at least in contact with the electrode sleeves 13 and 14.
  • the contact portion of 14 is smooth, thereby reducing the wear of the distal end of the outer tube 17 to the outside of the electrode sleeves 13 and 14.
  • the outer diameter of the outer tube 17 is 1.5 to 3.5 mm, which is only 1/4 to 1/3 of the distance between the two tweezers of an ordinary bipolar electrocoagulation forceps, and the length of the outer tube can be more than 350 mm.
  • the electrodes 15 and 16 are also slimmer, and their average thickness is only 1/2 to 2/3 of the distal portion of the tip of an ordinary electrocoagulation forceps. Therefore, the nasal endoscope electrode assembly according to the present disclosure is more suitable for small nasal channels. Deep surgery.
  • the inner tube 18 has a proximal portion of the inner tube at the proximal end, a distal portion of the inner tube at the distal end, and a proximal portion of the inner tube based on the flexibility of the internal passage of the nasal cavity.
  • the inner tube curved portion between the portion and the inner tube distal portion, the inner tube curved portion has a certain bending curvature, so that the inner tube distal portion and the inner tube proximal portion are disposed at an angle to each other, and the outer tube 17 has a proximal end Outer tube proximal portion 27, distal outer tube distal portion 26, and outer tube connecting portion 28 with a bend between the outer tube proximal portion 27 and the outer tube distal portion 26 (see FIG. 3) .
  • an opening 22 may be provided at least on the convex side of the outer tube connection portion 28 of the outer tube 17 (see FIG. 3).
  • the size of the opening 22 is designed so that the widest part of the inner tube 18 can leave the opening 22 without scraping the edges of the opening 22, thereby minimizing the inner tube 18 when the inner tube 18 and the outer tube 17 move relative to each other. Friction with the outer tube 17.
  • the longitudinal and circumferential dimensions of the opening are sufficient to allow the curved portion of the inner tube 18 to be in the outer tube proximal portion 27 and the outer tube of the outer tube 17
  • the distal portions 26 smoothly move relative to each other in the longitudinal direction without the inner tube curved portion of the inner tube 18 interfering with the outer tube proximal portion 27 and the outer tube distal portion 26 of the outer tube 17.
  • the opening of the outer tube connection portion 28 occupies approximately one-half of the circumference of the outer tube and exposes the convex side, but not the concave side, of the curved portion of the inner tube, which greatly reduces the inner tube 18 and the outer The contact area of the tube 17 where friction is most likely to occur.
  • the arc length of the portion of the outer tube left at the opening is approximately one-half the circumference of the outer tube when viewed toward the outer tube cross section.
  • the ratio "half" is only one embodiment of the present disclosure.
  • the opening can be designed to occupy more than one-half or less than one-half of the circumference of the outer tube according to actual needs, as long as the opening can achieve: inner
  • the curved portion of the inner tube of the tube 18 smoothly moves in the longitudinal direction between the outer tube proximal portion 27 and the outer tube distal portion 26 of the outer tube without being related to the outer tube proximal portion 27 and the outer tube distal portion of the outer tube. 26 interfered.
  • whether the convex side or the concave side of the curved portion of the inner tube is specifically exposed may also be selected according to the actual application situation with the purpose of reducing friction as much as possible.
  • the opening 22 may extend only a small distance from the manipulation device 25. In some embodiments, the distance is less than 1 cm, preferably less than 0.5 cm.
  • the circumferential length of the outer tube connection portion 28 of the outer tube 17 at the setting opening 22 is less than or equal to half of the circumference of the outer tube 17 and thereby further ensure the relative movement of the inner tube 18 and the outer tube 17 No large friction occurs.
  • the outer tube connecting portion 28 of the outer tube 17 and the inner tube curved portion of the inner tube 18 are at least partially spaced when the inner tube 18 and the outer tube 17 are relatively moved in the longitudinal direction, thereby reducing friction during the relative movement in the longitudinal direction.
  • the distal and proximal edges of the opening 22 should always have a certain distance from the apex of the curved portion of the inner tube of the inner tube 18, and the distance is designed such that the distal and proximal edges of the opening 22 are using an electrode assembly It is difficult or impossible to contact the human target tissue, thereby reducing or eliminating the possibility that the distal edge and the proximal edge of the opening 22 will scratch the human target tissue during surgery.
  • the distal and proximal edges of the opening 22 are curled inward or enveloped with a suitable material to greatly reduce their sharpness to ensure that the distal and proximal edges of the opening 22 are in the surgical process. It will not scratch the human target tissue during contact with human target tissue.
  • the outer tube connection portion 28 and the outer tube distal portion 27 and / or the outer tube proximal portion 26 are separately made parts, and the outer tube connection portion 28 and the outer tube distal portion 27 and The outer tube proximal portion 26 is fixedly connected in the installed state.
  • the outer tube connection portion 28 may be, for example, a rod or a plate with a bent portion or the like.
  • the outer tube connection portion 28 is used to transmit force from the manipulation device 25 to the outer tube distal end portion 26 of the outer tube 17 under the condition of generating as little friction as possible, thereby realizing the desired between the inner tube 18 and the outer tube 17 Relative motion in the longitudinal direction.
  • the outer tube connection portion 27 is fixedly connected to the outer tube distal portion 26 and the outer tube proximal connection portion 27 of the outer tube 17, such as by riveting, screwing, welding, and / or bonding.
  • the outer tube connection portion 28 extends around all or a portion of the periphery of the curved portion of the inner tube of the inner tube 18.
  • the curved portion of the inner tube 18 and the outer tube connection portion 28 of the outer tube 17 are made of a flexible material, and the degree of bending of the curved portion of the inner tube and the degree of bending of the outer tube connection portion 28 can be changed at the same time.
  • the degree of curvature of the curved portion of the inner tube and the degree of curvature of the outer tube connection portion 28 varies between 10 ° and 60 °. It has proved to be very advantageous after several tests that the degree of bending of the curved portion of the inner tube and the degree of bending of the outer tube connecting portion 28 varies between 30 ° and 40 °. Therefore, the bending degree of the nasal endoscope electrode assembly can be adjusted according to the actual needs of different operations and other instruments used in common.
  • a delivery channel for delivering a rinsing liquid, such as physiological saline, may be provided inside the inner tube 18, between the inner tube 18 and the outer tube 17, or outside the outer tube 17.
  • the delivery channel is provided inside the inner tube 18 or outside the outer tube 17 so as not to hinder relative longitudinal movement between the inner tube 18 and the outer tube 17.
  • the manipulating device 25 can be held by an operator to realize relative longitudinal movement of the inner tube 18 and the outer tube 17.
  • the manipulation device 25 includes a housing and an actuating mechanism at least partially disposed within the housing.
  • the housing of the manipulation device 25 includes an upper case 19 and a lower case 20.
  • the two-piece housing enables simple and low-cost manufacturing.
  • the upper case 19 and the lower case 20 may be molded or manufactured by an additive manufacturing method (3D printing method).
  • the upper shell 19 and the lower shell 20 are fixed with a front screw cap 12 at the front end and the rear screw cap 21 at the rear end. Therefore, the upper shell 19 and the lower shell 20 are formed with threads at the front and rear ends, and the screw connection can realize the upper shell 19 And the lower case 20 is more reliably fastened.
  • other connection methods may be provided to fix the upper shell 19 and the lower shell 20, such as a clamp connection, a screw or rivet connection, and the like.
  • the middle of the upper shell 19 and the lower shell 20 can be connected by an internal buckle or a clamp on the outer periphery or a screw connection or riveting, and the connection can also be made in the middle to reliably prevent the elongated upper and lower shells 19, 20 from being in the middle. Unwanted separation.
  • the housing includes a fixing block 5 for fixing the inner tube 18 in the housing.
  • the fixing block 5 is locked in the housing, and therefore the fixing block 5 and the inner tube 18 cannot move relative to the housing.
  • the actuating mechanism includes a crank device, a slider device 10 and a coil spring 11 that cooperate with the crank device.
  • the crank device includes a crank 4 and a connecting rod 9.
  • other suitable damping devices may be used, such as a hollow elastomer.
  • a crank 4 and a connecting rod 9 are respectively provided at the joints of the upper shell 19 and the lower shell 20 on both sides of the housing.
  • the two cranks 4 are pivotably connected at their proximal ends to a cylinder 29 protruding from the lower case 20.
  • the proximal ends of the two links 9 are pivotably connected to the distal ends of the cranks 4 respectively, and the distal ends of the two links 9 are pivotally connected to the protrusions on both sides of a common slider device 10. ⁇ (see Figure 5) 30.
  • the slider device 10 is directly fixedly connected to the outer tube 17, so that the longitudinal movement of the outer tube 17 is realized when the slider device 10 moves.
  • the fixing block 5 is located between the slider device 10 and the pillar 29, and the slider device 10 is disposed at a distance from the far side of the fixing block 5 and is hollow.
  • the inner tube 18 extends through the slider device 10 from far to near and the proximal end of the inner tube 18 is fixed in the fixing block 5.
  • the proximal end of the inner tube 18 extends into and through a longitudinal through hole (not shown) of the fixing block 5 and is fastened in the longitudinal through hole by a fastening element 6.
  • a lateral through hole (not shown) is preferably made perpendicular to the inner tube 18, and the lateral through hole extends to the longitudinal through hole of the fixing block 5.
  • the fastening element 6 can be introduced into the lateral through hole from the outside and pressed against the inner tube 18.
  • the fastening element is, for example, a fastening screw or a rivet.
  • the proximal end of the outer tube 17 is fixed to the slider device 10.
  • a flange 42 is formed at the proximal opening of the outer tube 17, and the slider device 10 is provided on its inner peripheral surface corresponding to the proximal opening flange 42 of the outer tube 17. (See FIG. 5), so that the proximal end of the outer tube 17 can be fixed in the slider device 10 in a form-fitting manner.
  • the slider device 10 is provided with a guide portion 32 (see FIG. 5), and a matching guide portion 33 (see FIG. 4) for cooperating with the guide portion 32 is provided on the inner periphery of the housing.
  • the cooperative action of 33 can limit the movement of the slider device 10 to a linear movement.
  • the guide portion 32 is four vertically opposite guide pieces 32 protruding from the proximal portion 36 of the slider device 10 and extending in the longitudinal direction of the slider device 10.
  • Two mating guide pieces 33 protruding from the inner peripheral surface of the lower case 20 and the inner peripheral surface of the upper case 19 and extending parallel to each other in the longitudinal direction of the case. In the installed state, the guide pieces 32 of the slider device abut each other. Inside the mating guide piece 33 in the housing. Stopper portions 34 that can be abutted by the ends of the guide piece 32 are respectively provided at two ends of each of the two matching guide pieces 33.
  • the stopper portions 34 define the position of the slider device 10. Maximum sliding distance.
  • the distal portion 35 of the slider device 10 is formed in a cylindrical shape and forms a shoulder 37 with the proximal portion 36, whereby the coil spring 11 can be sleeved on the cylindrical distal portion 35 of the slider device 10 and attached at the proximal end. Abutting on the shoulder 37, the distal end of the coil spring 11 abuts on the annular flange 38 protruding from the inner periphery of the housing.
  • the two connecting rods 9 push the slider device 10 and the outer tube 17 to move distally, and the outer tube 17 pushes the two electrodes 15 and 16 to achieve a clamping action.
  • the springback force of the spring 11 is directly applied to the slider device 10 and returned to the same position.
  • the slider device 10 pushes the two cranks 4 back to the initial state, while the two electrodes 15, 16 are based on their own elasticity. Open again. As a result, the electrodes 15 and 16 are brought closer to and farther from each other.
  • the pillar 29 protruding from the inner periphery of the housing is located on the central axis of the lower shell 20 and a groove extending from the top of the pillar 29 toward the bottom of the pillar is made in the middle, and is connected to the electrodes 15 and 16
  • the wire 3 can pass through the groove.
  • a corresponding column 39 protrudes from the inner periphery of the upper case 19 on the central axis of the upper case 19. In the installed state, the free end of the corresponding column 39 abuts on the freedom of the column 29. It can prevent the wires 3 from moving out of the groove of the pillar 29 and can also position the upper case 19 and the lower case 20 during installation.
  • crank 4 is designed as a long pressing handle and is so narrow that the middle finger is not pinched when the two cranks 4 are pressed with the thumb and forefinger, thereby greatly improving the safety of operation. And convenience.
  • a non-slip structure such as a convex-concave structure, may be provided on the pressing surface of the crank 4.
  • a clamping block 2 is provided between the cylinder 29 and the rear screw cap 21 near the rear screw cap 21.
  • the clamping block 2 is integrally formed with the power cord, and the clamping block 2 is caught in the shell.
  • the power cord 1 is reliably fixed in the housing.
  • the conductor of the wire 3 and the conductor of the power supply line 1 are welded together, so as to realize the electrical connection between them.
  • the nasal electrode assembly in this embodiment has, for example, the following advantages: the surgical electrode assembly ensures that sufficient actuation force is provided, including a reset force, is more ergonomic, greatly improves the operation sensitivity of the surgical electrode assembly, and then greatly improves the operation. Efficiency, safety and operational comfort.
  • the arrangement of the curved tube can greatly improve the convenience of the nasal cavity electrode assembly when it is introduced into the human body through the nose and during surgery, and reduce the undesired contact between the nasal cavity electrode assembly and the human tissue in the nasal passage during surgery. It is scratched, and the handle portion of the electrode assembly does not interfere with a simultaneously used instrument such as an aspirator based on the bending.
  • Adjustability of the bending degree can better adapt the nasal endoscope electrode assembly to different surgical requirements and other instruments used at the same time so that they do not interfere.
  • the large friction force even when the inner tube and the outer tube are relatively moved in the longitudinal direction under a large degree of bending is greatly reduced. Stuck, thereby greatly improving the operating sensitivity and accuracy of the nasal endoscope electrode assembly during the operation, and these advantages are critical to the successful completion of the operation.
  • FIG. 7 to 10 show a second embodiment of a surgical electrode assembly.
  • This surgical electrode assembly is used in conjunction with a ventriculoscopy, and is referred to herein as a ventriculoscopy electrode assembly 200.
  • the manipulation device 1025 in this embodiment is basically the same as the embodiment of the nasal mirror electrode assembly 100. Please refer to the description of the manipulation device 25 of the nasal mirror electrode assembly 100 in the previous embodiment, so it will not be described again. Next, the differences between this embodiment and the previous embodiment will be mainly explained.
  • FIG. 7 and 8 show a plan view and a front view of a ventricular mirror electrode assembly 200, respectively. It can be seen that, compared with the previous embodiment, in this embodiment, the inner tube 1018 and the outer tube 1017 are straight and thinner, the electrodes 1015, 1016 are also thinner and shorter, and the electrode tips are straight, of course The electrode tip can also be bent up or down as required.
  • the electrode sleeves 1013 and 1014 are correspondingly thinner.
  • FIG. 9 shows an enlarged view of part I in FIG. 7.
  • a wear-resistant protective member 1024 for protecting the electrode sleeves 1013 and 1014 is provided.
  • the wear-resistant protective member 1024 can protect the electrode sleeves 1013 and 1014 and prevent the outer ends of the electrode sleeves 1013 and 1014 from scratching the outer ends of the electrode sleeves 1013 and 1014 when the inner tube 1018 and the outer tube 1017 are moved in the longitudinal direction.
  • the wear protection 1024 may be made of a wear resistant material, such as stainless steel.
  • the flange structure of the distal opening of the outer tube 1017 can be used together with the wear protection 1024 to further protect the electrode sleeves 1013, 1014 from abrasion.
  • the wear-resistant protection piece 1024 may extend from the distal end of the inner tube 1018 and be made in one piece with the inner tube 1018, and the wear-resistant protection piece 1024 is fixedly connected to the electrode sleeves 1013 and 1014 in the installed state.
  • the wear protection member 1024 and the inner tube 1018 are made separately, and the proximal end of the wear protection member 1024 and the distal end of the inner tube 1018 are fixedly connected in the installed state, and the wear protection member 1024 is fixedly connected to the electrode sleeves 1013 and 1014 in an installed state.
  • the abrasion-resistant protective member 1024 and the inner tube 1018 are separately made components and are not connected to each other, and the abrasion-resistant protective member 1024 and the electrode sleeves 1013 and 1014 are fixedly connected in an installed state.
  • the fixed connection of the wear protection member 1024 and the inner tube 1018 can be realized in a form-locking, force-locking, and / or material-locking manner, for example, by riveting, screwing, welding, and / or bonding.
  • the fixed connection of the wear-resistant protective member 1024 and the electrode sleeves 1013 and 1014 is implemented as follows. That is, wings are respectively provided on both sides of the distal end of each wear-resistant protective member 1024, and during installation, Each fin is wrapped or wound around the electrode sleeve 1013, 1014 around the circumference of the electrode sleeve 1013, 1014, so as to achieve the mechanical fixed connection of the wear-resistant protective member 1024 and the electrode sleeve 1013, 1014.
  • the fixed connection can also be realized by adhesive bonding, hot-melt connection or encapsulation.
  • FIG. 10 shows an enlarged view of part II in FIG. 8.
  • the distal end of the outer tube 1017 has a flat tapered structure 1040, which includes two flat surfaces 1041 extending forward and gradually closer to the centerline of the outer tube.
  • the flat surfaces 1041 are basically A gripping surface perpendicular to the inside of the electrode tip for gripping a target tissue of a human body.
  • the flat tapered structure 1040 at the distal end of the outer tube can effectively prevent the outer tube 1017 from blocking the field of vision and causing inconvenience in operation, thereby greatly improving the convenience and accuracy of the operation.
  • the tip length of the electrode can be 2mm to 4mm. With a small tip length, the tissue to be clamped can be more accurately clamped, and the surrounding tissue is not undesirably clamped.
  • the inner tube 1018 has been flattened at the electrode protruding into the inner tube 1018, the distal end of the inner tube 1018 and the proximal ends of the electrodes 1015, 1016 are pressed together, so the distal end of the outer tube caused by the flat tapered structure 1040 The narrowing of y does not hinder the relative movement of the inner tube 1018 and the outer tube 1017 in the longitudinal direction.
  • the ventricular endoscope electrode assembly in this embodiment has the following advantages, for example: the arrangement of the wear-resistant protective member is simple and effective, and the technical problem that the electrode sleeve of the electrode is easily worn by the outer tube is solved. Especially in the case of a ventricular endoscope electrode assembly, the electrode sleeve wall is thin and is more prone to wear and tear, leading to damage to the insulation capability. In the common solution, it is usually attempted to use other materials to make the electrode sleeve of the electrode, but based on the special requirements of the electrode sleeve of the ventriculoscopy electrode assembly, it is difficult to achieve and very expensive, and it is difficult to find the ideal Electrode sleeve material.
  • the wear-resistant protective member of this embodiment can protect the electrode sleeve of the electrode in a simple, reliable and low-cost manner, so that the problem of abrasion resistance of the material of the electrode sleeve is not considered at all, which increases the material selection. range.
  • the tapered structure can be obtained in the simplest and most reliable way without adding additional mechanisms and without changing other existing components. It is very important, which can greatly improve the accuracy of clamping, improve the efficiency of surgery, and reduce the risk of misoperation.
  • the present disclosure may include any feature or combination of features implicitly or explicitly disclosed, or a summary thereof, and is not limited to any of the limited scope listed above. Any of the described elements, features and / or structural arrangements may be combined in any suitable manner.

Abstract

一种外科用电极组件（100），包括：具有电极（15，16）的电极装置；操纵装置（25）；用于驱动电极（15，16）运动的电极驱动装置；电极驱动机构包括内管（18）和外管（17），内管（18）具有内管弯曲部分，外管具有外管连接部分（28），外管连接部分（28）与内管弯曲部分相适配，使得当操纵操纵装置（25）使内管（18）和外管（17）相对运动时，外管连接部分（28）允许：内管弯曲部分与外管（18）沿纵向相对运动而不与外管近端部分（27）和外管远端部分（26）发生干涉。该电极组件（100）弯曲管的设置可以提高外科用电极组件（100）在手术过程中进入人体通道时的便利性、灵活性和精确度。

Description

外科用电极组件 技术领域
本公开涉及一种外科手术用的止血工具，尤其是一种外科用电极组件。
背景技术
目前，医疗器械精细化、专业化是一个目标和趋势。电凝作为一种高效、可靠的止血方式，被广泛应用于外科手术中。外科用电极组件尤其是适用于微创显微外科、神经外科和经鼻入路手术等小通道深部手术使用，特别适合与鼻腔镜、脑室镜配合使用，主要应用于微创显微外科或神经外科手术的电凝止血。由于各种手术的操作空间是有限的，而且手术切口或通道越大，对病人的二次伤害越大，所以手术通道都力求最小化、微创化。
现有外科手术中普遍使用各种形状的双极电凝镊，其主要原理是通过将两片镊片装在一个固定座内，通过手指捏合镊片，使两镊片的尖部夹住血管或组织，从而使通过两镊片尖部的高频电流通过夹住的局部血管或组织，利用高频电流的热效应，使血管壁脱水皱缩、血管内血液凝固，并使血管与血凝块互融为一体，而达到有效止血目的。由于普通双极电凝镊的镊片较宽、结构体积较大，进入人体的两镊片前杆部分间距最大至少10mm以上，而且长度有限，因此不适用于对微创伤口或从小通道(如经鼻入路、脑室镜等)深入组织内部的伤口进行止血，尤其在微创显微外科和神经外科手术中使用时有很大局限性。此外基于镊片进入人体部分的较大体积而妨碍与其它器械同时使用。另外由于普通双极电凝镊的镊片前伸部分较长，尖部在啮合时常易出现错位，影响电凝效果和效率。
现有的一种外科用电极组件通过内管和外管的配合作用实现电极尖端的靠近和远离。
由于具有不同直径的内管和外管同时弯曲时弯曲曲率会略有不同，从而导致外管尤其是在凸侧会紧紧压靠于内管的凸侧，进而在外管相对于内管运动时会产生显著增大的摩擦力，甚至会出现卡死现象，这导致了内外管的可弯曲程度大幅受限，而不能理想地通过弯曲来理想地避免手柄与其它同时使用的器械的干涉，并且如果弯曲稍微过大则会大幅增加摩擦力而降低电极的操作灵敏度，影响手术效率。
此外，现有外科用电极组件的外管推动装置包括手柄弹簧片，在手松开手柄时， 依靠手柄弹簧片自身的弹性使螺塞和外管后退，这就对手柄弹簧片的自身弹性要求很高并且为了保证弹性也将其宽度设计得比较大，但弹簧片基于其结构而时常不能提供足够的弹性复位力，这会降低电极组件的操作灵敏度，妨碍手术效率。此外由于需要为了保证弹力而将其宽度设计得较大，这就使得操作人员在用拇指和食指按压两个手柄弹簧片时经常会不希望地夹住中指，由此大大妨碍了操作的舒适性、安全性和便利性。
另外，现有外科用电极组件的电极套管容易被外管磨损。尤其是在脑室镜电极组件的情况下，电极套管壁因其材料不耐磨以及其壁较薄而更容易被磨损以至于绝缘能力被损坏。在通常的解决方案中可能会考虑尝试采用其它材料来制造电极套管，但基于脑室镜电极组件的电极套管的特殊结构要求，很难找到良好的耐磨材料来制造电极套管，并且材料的研发到使用通常非常耗时且高成本。因此，迫切需要一种能够通过简单可靠且低成本的方式来保护电极的电极套管，减小甚至完全避免外管对电极套管的磨损。
此外，尤其是在脑室镜电极组件的情况下，电极尖端最好比较小以提高操作精确性，但小的电极尖端在手术中更容易被外管遮挡视野，这也会降低手术精确性、便利性和舒适性。
发明内容
因此，本公开旨在提供一种外科用电极组件，其能够解决现有技术中存在的上述问题中的至少一个。
根据本公开的一个方面，提供了一种外科用电极组件，所述电极组件具有在使用时更远离操作人员的远端和在使用时更靠近操作人员的近端。所述电极组件包括电极装置、操纵装置和电极驱动装置。所述电极装置设置于所述电极组件的远端，所述电极装置包括第一电极和第二电极，所述第一电极和所述第二电极能够在彼此远离的第一位置与彼此靠近的第二位置之间运动。所述操纵装置设置于所述电极组件的近端，用于操纵电极装置的操作。所述电极驱动装置设置于所述操纵装置与所述电极装置之间，用于在操纵装置的作用下驱动所述电极装置的第一电极和第二电极在所述第一位置与第二位置之间运动。所述操纵装置包括壳体和至少部分地设置在壳体内的致动机构，所述致动机构能够致动所述电极驱动装置。所述致动机构包括曲柄装置、与所述曲柄装置操作连接的滑块装置和阻尼装置。所述滑块装置具有静止位置和工作位置， 在没有外力施加的情况下，所述阻尼装置的阻尼作用使得所述滑块装置处于静止位置，所述滑块装置与所述电极驱动装置操作相连，在所述滑块装置的静止位置，所述第一电极和所述第二电极处于彼此远离的第一位置。操作人员能够对所述曲柄装置施加作用力并且通过所述曲柄装置推动所述滑块装置，所述滑块装置因此能够克服阻尼装置的阻尼作用朝向工作位置运动，从而驱动所述电极装置的第一电极和第二电极从所述第一位置向所述第二位置运动。
通过该外科用电极组件能实现例如如下技术效果：该外科用电极组件确保提供足够的致动力包括复位力，更加符合人体工程学，大幅提高外科用电极组件的操作灵敏度，进而大幅提高手术效率、安全性和操作舒适性。
根据本公开的一个实现方式，在操作人员不再对所述曲柄装置施加作用力时，滑块装置在阻尼装置的复位力的作用下朝向静止位置运动，从而所述电极装置的第一电极和第二电极在自身弹力的作用下从所述第二位置向所述第一位置运动，其中，滑块装置在朝向静止位置运动的同时推动曲柄装置并使之复位。
根据本公开的一个实现方式，所述电极驱动装置包括能够沿纵向相对运动的内管和外管。
根据本公开的一个实现方式，所述内管的远端连接于第一电极和第二电极的近端，所述外管套设在内管上并且外管的远端贴靠在第一电极和第二电极上，从而内管和外管能够使第一电极和第二电极在第一位置与第二位置之间运动。
根据本公开的一个实现方式，滑块装置与外管操作连接，使得外管能随着滑块装置的运动而运动。
根据本公开的一个实现方式，滑块装置与内管操作连接，使得内管能随着滑块装置的运动而运动。
根据本公开的一个实现方式，阻尼装置被设置在滑块装置和壳体之间。
根据本公开的一个实现方式，阻尼装置是螺旋弹簧或中空的弹性体。
根据本公开的一个实现方式，滑块装置具有径向尺寸较小的远侧部、径向尺寸较大的近侧部以及位于远侧部和近侧部之间的凸肩，螺旋弹簧或中空的弹性体能够套设在滑块装置的远侧部上并且抵靠凸肩。
根据本公开的一个实现方式，操纵装置还包括用于将内管固定在壳体内的固定块，固定块设置在滑块装置近侧一定距离处。
根据本公开的一个实现方式，内管的近端伸入并固定至固定块的纵向通孔。
根据本公开的一个实现方式，固定块还设有侧向通孔，所述侧向通孔从固定块的外周面延伸至固定块的纵向通孔，其中，紧固元件能够引入侧向通孔内并压靠在内管上。
根据本公开的一个实现方式，所述紧固元件是螺钉或铆钉。
根据本公开的一个实现方式，外管的近端开口构成有凸缘，中空的滑块装置在其内周面设有相对应的槽，外管的近端通过所述凸缘和槽能够形锁合地固定在滑块装置内。
根据本公开的一个实现方式，滑块装置设有导向部，壳体设有用于与导向部配合作用的配合导向部。
根据本公开的一个实现方式，导向部是从滑块装置突出的导向片，配合导向部是从壳体内周面突出的配合导向片。
根据本公开的一个实现方式，在所述配合导向片的两端分别设有限定滑块装置的最大滑动路程的止挡部。
根据本公开的一个实现方式，壳体包括模制或者增材制造而成的上壳和下壳。
根据本公开的一个实现方式，在壳体的两侧各设置一个曲柄装置。
根据本公开的一个实现方式，曲柄装置包括曲柄和连杆，连杆的远端可枢转地连接于共同的滑块装置，连杆的近端可枢转地连接于相应曲柄的远端，而曲柄的近端可枢转地连接于从壳体内周凸出的共同的柱体。
根据本公开的一个实现方式，所述共同的柱体在中间制有凹槽，连接于电极的导线能够穿过该凹槽。
根据本公开的一个实现方式，曲柄设计为窄长形的按压手柄。
根据本公开的一个实现方式，在内管内部、或者在内管与外管之间、或者在外管外部设有用于输送冲洗液的输送通道。
根据本公开的一个实现方式，第一电极和第二电极通过粘合剂与内管固定。
根据本公开的一个实现方式，所述粘合剂是环氧树脂胶。
根据本公开的一个实现方式，在伸入内管内的第一电极和第二电极处将内管压扁，从而将内管与第一电极和第二电极压合在一起。
根据本公开的一个实现方式，外管的远端开口构造有向外的凸缘。
根据本公开的一个实现方式，第一电极和第二电极的远侧部上弯、下弯或者呈直形地构成。
根据本公开的一个实现方式，第一电极和第二电极的远侧部的用于夹持人体目标组织的夹持面在向第一电极和第二电极的近侧部的过渡部上形成台阶，所述台阶设置成防止电极近侧部上的电极套管在第一电极和第二电极闭合过程中互相接触。
根据本公开的一个实现方式，第一电极和第二电极的远侧部作防电凝粘连处理。
根据本公开的一个实现方式，外管的远端具有扁锥形结构，所述扁锥形结构包括朝前逐渐靠近外管中心线延伸的平面，所述平面基本上垂直于第一电极和第二电极的远侧部的用于夹持人体目标组织的夹持面。
根据本公开的一个实现方式，在伸入内管内的第一电极和第二电极处将内管压扁，从而将内管与第一电极和第二电极压合在一起，然后通过在内管中注入粘合剂而将第一电极和第二电极与内管进一步固定。
根据本公开的另一个方面，提供了一种外科用电极组件，所述电极组件具有在使用时更远离操作人员的远端和在使用时更靠近操作人员的近端。所述电极组件包括电极装置、操纵装置和电极驱动装置。所述电极装置设置于所述电极组件的远端，所述电极装置包括第一电极和第二电极，所述第一电极和所述第二电极能够在彼此远离的第一位置与彼此靠近的第二位置之间运动。所述操纵装置设置于所述电极组件的近端，用于操纵电极装置的操作。所述电极驱动装置设置于所述操纵装置与所述电极装置之间，用于在操纵装置的作用下驱动所述电极装置的第一电极和第二电极在所述第一位置与第二位置之间运动。所述电极驱动装置包括外管和内管，所述内管的外径小于所述外管的内径，从而套设于所述外管的内侧，使得所述内管和所述外管能够沿所述内管和所述外管的纵向进行相对运动。所述内管具有位于近端的内管近端部分、位于远端的内管远端部分和位于内管近端部分与内管远端部分之间的内管弯曲部分。所述内管弯曲部分具有一定弯曲曲率，从而使得所述内管远端部分和内管近端部分彼此成角度设置，所述外管具有位于近端的外管近端部分、位于远端的外管远端部分和位于外管近端部分与外管远端部分之间的外管连接部分。所述外管连接部分与所述内管弯曲部分相适配，使得当操纵所述操纵装置使所述内管和所述外管进行相对运动时，所述外管连接部分允许：所述内管的内管弯曲部分与所述外管沿纵向进行相对运动而不与所述外管的外管近端部分和外管远端部分发生干涉。
通过该外科用电极组件能实现例如如下技术效果：弯曲管的设置可以使得外科用电极组件在手术过程中进入人体通道时的便利性大幅提高，并且减少了手术期间外科用电极组件与人体通道内的人体组织的不希望的触碰甚至刮伤，并且基于该弯曲而使 得电极组件的手柄部分不会与同时使用的器械例如吸引器发生干涉。该外科用电极组件大幅降低了在弯曲程度较大的情况下在内管和外管沿纵向相对运动时的大的摩擦力甚至卡死，由此大幅提高了手术时外科用电极组件的操作灵敏度和操作精确性，而这些优点对于手术顺利完成而言是至关重要的。
根据本公开的一个实现方式，所述外管连接部分为外管上具有开口的管状部分，并且与外管近端部分和外管远端部分是一件式制成的，所述内管的弯曲连接部分能够至少部分地从所述开口露出。
根据本公开的一个实现方式，当操纵所述操纵装置使所述内管和所述外管进行相对运动时，所述开口的纵向和周向尺寸足以允许：所述内管的内管弯曲部分在所述外管的外管近端部分和外管远端部分之间顺畅地沿纵向进行相对运动而不与所述外管的外管近端部分和外管远端部分发生干涉。
根据本公开的一个实现方式，当朝向外管的横截面观察时，所述外管连接部分的开口至少占外管圆周的二分之一并且使内管弯曲部分的凸侧露出。
根据本公开的一个实现方式，内管远端部分的一部分和/或内管近端部分的一部分能够从所述外管连接部分的开口露出。
根据本公开的一个实现方式，在使用时所述外管连接部分的开口的远端边缘和近端边缘距内管弯曲部分的顶点始终具有距离。
根据本公开的一个实现方式，所述开口的远端边缘和/或近端边缘向内卷曲或者被包封，从而开口的远端边缘和/或近端边缘与人体目标组织接触时不会刮伤人体目标组织。
根据本公开的一个实现方式，所述外管连接部分与外管远端部分是分开制成的部件并且在安装状态下固定连接，和/或所述外管连接部分与外管近端部分是分开制成的部件并且在安装状态下固定连接。
根据本公开的一个实现方式，所述固定连接通过铆接、螺纹连接、焊接和/或粘接实现。
根据本公开的一个实现方式，外管连接部分绕内管的全部四周或部分周边延伸。
根据本公开的一个实现方式，所述外管连接部分包括至少一个弯曲的杆和/或至少一个弯曲的扁平板和/或至少一个弯曲的在横向方向上成弧形的板。
根据本公开的一个实现方式，内管弯曲部分的弯曲程度和外管连接部分的弯曲程度能够同时改变。
根据本公开的一个实现方式，内管弯曲部分和外管连接部分由挠性材料制成，以便实现弯曲程度的改变。
根据本公开的一个实现方式，内管弯曲部分的弯曲程度和外管连接部分的弯曲程度在10°至60°之间改变。
根据本公开的一个实现方式，内管弯曲部分的弯曲程度和外管连接部分的弯曲程度在30°至40°之间改变。
根据本公开的一个实现方式，所述外科用电极组件经鼻进入人体内。
根据本公开的一个实现方式，在内管内部、或者在内管与外管之间、或者在外管外部设有用于输送冲洗液的输送通道。
根据本公开的一个实现方式，第一电极和第二电极通过粘合剂与内管固定。
根据本公开的一个实现方式，所述粘合剂是环氧树脂胶。
根据本公开的一个实现方式，在伸入内管内的第一电极和第二电极处将内管压扁，从而将内管与第一电极和第二电极压合在一起。
根据本公开的一个实现方式，外管的远端开口构造有向外的凸缘。
根据本公开的一个实现方式，第一电极和第二电极的远侧部上弯、下弯或者呈直形地构成。
根据本公开的一个实现方式，第一电极和第二电极的远侧部的用于夹持人体目标组织的夹持面在向第一电极和第二电极的近侧部的过渡部上形成台阶，所述台阶设置成防止电极近侧部上的电极套管在第一电极和第二电极闭合过程中互相接触。
根据本公开的一个实现方式，第一电极和第二电极的远侧部作防电凝粘连处理。
根据本公开的一个实现方式，外管的远端具有扁锥形结构，所述扁锥形结构包括朝前逐渐靠近外管中心线延伸的平面，所述平面基本上垂直于第一电极和第二电极的远侧部的用于夹持人体目标组织的夹持面。
根据本公开的一个实现方式，在伸入内管内的第一电极和第二电极处将内管压扁，从而将内管与第一电极和第二电极压合在一起，然后通过在内管中注入粘合剂而将第一电极和第二电极与内管进一步固定。
根据本公开的又一个方面，提供了一种外科用电极组件，所述电极组件具有在使用时更远离操作人员的远端和在使用时更靠近操作人员的近端。所述电极组件包括电极装置、内管和外管。所述电极装置设置于所述电极组件的远端，所述电极装置包括第一电极和第二电极，所述第一电极和所述第二电极能够在彼此远离的第一位置与彼 此靠近的第二位置之间运动。所述内管的远端固定连接于第一电极和第二电极的近端。所述外管套设在内管上并且外管的远端贴靠在第一电极和第二电极的弯曲的近侧部的外侧，从而通过内管和外管的沿纵向相对运动能够使第一电极和第二电极在第一位置与第二位置之间运动。在内管远侧，至少在第一电极和第二电极的电极套管外侧，在第一电极和第二电极的电极套管的至少一部分上设有耐磨保护件，在内管与外管沿纵向相对运动时，外管前端能够在耐磨保护件上滑动。
通过该外科用电极组件能实现例如如下技术效果：耐磨保护件的设置简单有效地解决了电极的电极套管容易被外管磨损的技术问题。尤其是在脑室镜电极组件的情况下，电极套管壁很薄且更易被磨损而导致绝缘能力损坏。在通常的解决方案中通常会尝试采用其它材料来制造电极的电极套管，但基于脑室镜电极组件的电极套管的特殊要求，这是很难实现的并且非常昂贵的，并且很难找到理想的电极套管材料。但通过本实施例的耐磨保护件能够通过简单可靠且低成本的方式保护电极的电极套管，以至于完全不需再考虑电极套管材料耐磨性的问题，这就增大了材料选择范围。
根据本公开的一个实现方式，所述耐磨保护件从内管远端延伸出并且与内管一件式制成，并且耐磨保护件与电极套管在安装状态下固定连接。
根据本公开的一个实现方式，所述耐磨保护件与内管是分开制成的部件，并且耐磨保护件的近端与内管的远端在安装状态下固定连接，并且耐磨保护件与电极套管在安装状态下固定连接。
根据本公开的一个实现方式，所述耐磨保护件与内管是分开制成的部件并且不互相连接，并且耐磨保护件与电极套管在安装状态下固定连接。
根据本公开的一个实现方式，所述耐磨保护件由耐磨材料制成。
根据本公开的一个实现方式，所述耐磨保护件由不锈钢制成。
根据本公开的一个实现方式，耐磨保护件与电极套管的固定连接通过粘接、热熔连接或者包封注塑实现。
根据本公开的一个实现方式，耐磨保护件与内管的固定连接通过铆接、螺纹连接、焊接和/或粘接实现。
根据本公开的一个实现方式，外管的远端具有扁锥形结构，所述扁锥形结构包括朝前逐渐靠近外管中心线延伸的平面，所述平面基本上垂直于第一电极和第二电极的远侧部的用于夹持人体目标组织的夹持面。
根据本公开的一个实现方式，所述外科用电极组件与脑室镜配合使用。
根据本公开的一个实现方式，在内管内部、或者在内管与外管之间、或者在外管外部设有用于输送冲洗液的输送通道。
根据本公开的一个实现方式，第一电极和第二电极通过粘合剂与内管固定。
根据本公开的一个实现方式，所述粘合剂是环氧树脂胶。
根据本公开的一个实现方式，在伸入内管内的第一电极和第二电极处将内管压扁，从而将内管与第一电极和第二电极压合在一起。
根据本公开的一个实现方式，外管的远端开口构造有向外的凸缘。
根据本公开的一个实现方式，第一电极和第二电极的远侧部上弯、下弯或者呈直形地构成。
根据本公开的一个实现方式，第一电极和第二电极的远侧部的用于夹持人体目标组织的夹持面在向第一电极和第二电极的近侧部的过渡部上形成台阶，所述台阶设置成，使得防止电极近侧部上的电极套管在第一电极和第二电极闭合过程中互相接触。
根据本公开的一个实现方式，所述夹持面的长度处于2mm至4mm之间。
根据本公开的一个实现方式，第一电极和第二电极的远侧部作防电凝粘连处理。
根据本公开的一个实现方式，耐磨保护件与电极套管的固定连接通过耐磨保护件上的用于包覆电极套管圆周的翼片实现。
根据本公开的一个实现方式，在伸入内管内的第一电极和第二电极处将内管压扁，从而将内管与第一电极和第二电极压合在一起，然后通过在内管中注入粘合剂而将第一电极和第二电极与内管进一步固定。
参照示例性实施例的如下详细描述并结合附图，可以更全面地明白本公开的其它目的、特征和细节。
本领域技术人员通过参照下面列出的附图阅读相应实施例的如下详细描述，将会明白相应实施例以及各种另外的实施例的优点。此外，下面所讨论的附图的各个特征没有必要按比例绘制。附图中的各个特征和元件的尺寸可以扩大或缩小，以更清楚地示出本公开的实施例。
附图说明
图1示出根据本公开的外科用电极组件的第一实施例的俯视图；
图2示出图1中的外科用电极组件的主视图；
图3示出图1中的外科用电极组件的具有开口的外管的主视图；
图4示出图1中的外科用电极组件的操纵装置的下壳的立体图；
图5示出图1中的外科用电极组件的操纵装置的滑块装置的立体图；
图6示出图1中的外科用电极组件的操纵装置的上壳的立体图；
图7示出根据本公开的外科用电极组件的第二实施例的俯视图；
图8示出图7中的外科用电极组件的主视图；
图9示出图7中的外科用电极组件的局部Ⅰ的放大图；
图10示出图8中的外科用电极组件的局部Ⅱ的放大图。
具体实施方式
下面描述本公开的各个说明性实施例。在本说明书中，仅为了解释起见，在附图中示意性地描绘各个系统、结构和装置，但未描述实际系统、结构和装置的所有特征，比如熟知的功能或结构并未详细描述，以避免不必要的细节使得本公开模糊不清。当然应该明白，在任何实际应用时，需要作出许多具体实施决策以达到开发者或使用者的特定目标，并且需要遵从与系统相关和行业相关的限制，这些特定目标可能随着实际应用的不同而不同。此外，应该明白，这样的具体实施决策虽然是复杂的且耗费大量时间的，然而这对于受益于本申请的本领域普通技术人员来说是例行任务。
本文使用的术语和短语应该被理解和解释为具有与相关领域技术人员对这些术语和短语的理解一致的含义。本文的术语或短语的一致用法不意在暗示术语或短语的特殊定义，即，与本领域技术人员所理解的普通和惯常含义不同的定义。对于意在具有特殊含义的术语或短语，即，与技术人员所理解的不同的含义，这种特殊定义将在说明书中以定义方式明确列出，直接且毫不含糊地给出术语或短语的特殊定义。
在本公开中，除非另有明确的规定和限定，术语“安装”、“相连”、“联接”、“连接”、“固定”等术语应做广义理解，例如，可以是固定连接，也可以是可拆卸连接，或一体地连接；可以是机械连接，也可以是电连接；可以是直接相连，也可以通过中间媒介间接相连，可以是两个元件内部的连通。对于本领域普通技术人员而言，可以根据具体情况理解上述术语在本公开中的具体含义。
在本公开中，“远侧”是指在使用本公开的外科用电极组件时远离操作人员的方向，而“近侧”是指在使用本公开的外科用电极组件时靠近操作人员的方向。
接下来结合附图详细描述本公开的实施例。
图1和图2示出根据本公开的外科用电极组件的第一实施例，该外科用电极组件 与鼻腔镜配合使用，在此称为鼻腔镜电极组件100。
如图1和2所示，鼻腔镜电极组件100包括：两个电极15、16以及电连接至电极15、16的导线3；固定至电极15、16近端的内管18；以及套设在内管18上的外管17。鼻腔镜电极组件100还包括连接于内管18和外管17的操纵装置25，并且通过操纵装置25的致动可以使外管17相对于内管18沿纵向运动。导线3通过电源线1与高频电刀连接。接下来详细阐述各个部件的具体构成和连接方式。
电极15、16的远侧部是用于作业的尖端，并且尖端的形状设计成上弯(参见图2)，由此减少手术期间视野的遮挡并且因此便于人体目标组织的精确夹持。在其它实施例中，尖端的形状也可以设计成下弯或者呈直形。电极15、16的尖端在相对的内侧分别设有用于夹持人体目标组织的夹持面。为了减少或避免在手术过程中电极尖端与人体目标组织粘连在一起，电极尖端可作防电凝粘连处理。
电极15、16的近侧部呈弯曲状并且分别设有绝缘的电极套管13、14。电极远侧尖端的夹持面在向电极近侧部的过渡部上形成台阶，以防止电极近侧部上的电极套管13、14在电极15、16闭合过程中互相接触而干涉夹持面夹持人体目标组织。
电极15、16的近端固定至内管18。在内管18上设有用于填充粘合剂(例如环氧树脂胶)的开口(未示出，开口例如可以是圆形或者椭圆形或者矩形开口)，粘合剂用于将电极15、16的近端以及相邻的部分导线3固定于内管18，从而防止电极15、16在内管18中的串动。此外还可以在伸入内管18内的电极处将内管18压扁，从而将内管18与电极15、16压合在一起，以进一步确保电极15、16与内管18的固定。内管18与电极15、16的固定可如下进行，即，首先在伸入内管18内的电极15、16处将内管18压扁，从而将内管18与电极15、16压合在一起，然后通过在内管18中注入粘合剂而将电极15、16与内管18进一步固定。
外管17套设在内管18上，并且通过外管17相对于内管18沿纵向运动，电极15、16可以彼此径向远离而进入第一位置或者彼此径向靠近而进入第二位置。具体来说，电极15、16与内管18的远端固定连接，当外管17相对于内管18向远侧运动时，电极15、16被约束在外管17内，从而电极15、16彼此径向靠近；当外管17相对于内管18向近侧运动时，电极15、16从外管17露出，从而电极15、16基于自身弹性而彼此径向分开。
为了减小外管17远端与电极15、16的电极套管13、14外侧的摩擦，外管17的远端开口构造有向外的凸缘，该凸缘至少在与电极套管13、14的接触部位是光滑的， 由此降低外管17远端对电极套管13、14外侧的磨损。
外管17的外部直径为1.5～3.5mm，仅为普通双极电凝镊两镊片间距的1/4～1/3，而外管长度可达350mm以上。此外，电极15、16也更纤细，其平均厚度仅为普通电凝镊尖远侧部的1/2～2/3，因此，按照本公开的鼻腔镜电极组件更加适用于经鼻的小通道深部手术治疗。
为了便于将鼻腔镜电极组件经鼻引入人体内，基于鼻腔内部通道的弯曲性，内管18具有位于近端的内管近端部分、位于远端的内管远端部分和位于内管近端部分与内管远端部分之间的内管弯曲部分，内管弯曲部分具有一定弯曲曲率，从而使得内管远端部分和内管近端部分彼此成角度设置，并且外管17具有位于近端的外管近端部分27、位于远端的外管远端部分26和位于外管近端部分27与外管远端部分26之间的具有弯曲部的外管连接部分28(参看图3)。
在具有不同直径的内管18和外管17同时弯曲时，内管18和外管17的弯曲曲率会略有不同，从而外管17的凸侧会压靠到内管18的凸侧，进而在沿纵向相对运动时产生显著增大的摩擦力，甚至会由于卡死而导致内管18和外管17的沿纵向相对运动不能进行，因此，为了在内管18和外管17沿纵向相对运动时减小摩擦、尤其是内管18和外管17的凸侧接触区域产生的摩擦，可以至少在外管17的外管连接部分28的凸侧设置开口22(参看图3)。
开口22的尺寸设计成使得内管18的最宽处能在不刮擦开口22边缘的情况下离开开口22，由此在内管18和外管17相对运动时最大程度地减小内管18与外管17之间的摩擦。当操纵所述操纵装置25使内管18和外管17进行相对运动时，开口的纵向和周向尺寸足以允许内管18的内管弯曲部分在外管17的外管近端部分27和外管远端部分26之间顺畅地沿纵向进行相对运动而内管18的内管弯曲部分不与外管17的外管近端部分27和外管远端部分26发生干涉。
朝向外管横截面观察，外管连接部分28的开口大致占外管圆周的二分之一并且使内管弯曲部分的凸侧、而非凹侧露出，这样大幅减小了内管18和外管17的最易产生摩擦处的接触面积。换句话说，朝向外管横截面观察，在开口处留下的外管部分的弧长大致是外管周长的二分之一。比例“二分之一”仅是本公开的一个实施例，当然可根据实际需求将开口设计成占外管圆周的多于二分之一或者少于二分之一，只要开口能够实现：内管18的内管弯曲部分在外管的外管近端部分27和外管远端部分26之间顺畅地沿纵向进行相对运动而不与外管的外管近端部分27和外管远端部分26发生 干涉。当然，具体使内管弯曲部分的凸侧还是凹侧露出，也可根据实际应用情况本着尽可能减小摩擦的目的相应进行选择。在所示示例中，开口22可以延伸至距操纵装置25仅很小的距离处。在一些实施例中，所述距离小于1cm、优选小于0.5cm。
在一些实施例中，外管17的外管连接部分28在设置开口22处的环周长度小于或等于外管17的周长的一半并且由此进一步确保在内管18和外管17相对运动时不会出现大的摩擦。外管17的外管连接部分28与内管18的内管弯曲部分在内管18和外管17沿纵向相对运动时至少部分地间隔开，由此在沿纵向相对运动时减小摩擦。
在使用时开口22的远端边缘和近端边缘距内管18的内管弯曲部分的顶点应当始终具有一定距离，该距离设计成，使得开口22的远端边缘和近端边缘在使用电极组件时不易或者不会与人体目标组织接触，由此减小或消除开口22的远端边缘和近端边缘在手术时刮伤人体目标组织的可能性。
在一些实施例中，开口22的远端边缘和近端边缘向内卷曲或者用合适的材料包封，从而大幅减小其锋利程度，以确保开口22的远端边缘和近端边缘在手术过程中与人体目标组织接触时不会刮伤人体目标组织。
在一些实施例中，外管连接部分28与外管远端部分27和/或外管近端部分26是分开制成的部件，并且所述外管连接部分28与外管远端部分27和/或外管近端部分26在安装状态下固定连接。外管连接部分28可以例如是带有弯曲部的杆或板等。外管连接部分28用于在产生尽可能小的摩擦的情况下从操纵装置25向外管17的外管远端部分26进行力传递，进而实现内管18和外管17之间的所希望的沿纵向相对运动。外管连接部分27与外管17的外管远端部分26和外管近端连接部分27固定连接，例如通过铆接、螺纹连接、焊接和/或粘接。在一些实施例中，外管连接部分28绕内管18的内管弯曲部分的全部四周或部分周边延伸。
有利的是，内管18的内管弯曲部分和外管17的外管连接部分28由挠性材料制成，内管弯曲部分的弯曲程度和外管连接部分28的弯曲程度能够同时改变。内管弯曲部分的弯曲程度和外管连接部分28的弯曲程度在10°至60°之间改变。经过多次试验证明非常有利的是，内管弯曲部分的弯曲程度和外管连接部分28的弯曲程度在30°至40°之间改变。由此可以根据不同手术的实际需要以及共同使用的其它器械来调整鼻腔镜电极组件的弯曲程度。
用于输送冲洗液、例如生理盐水的输送通道可以设置在内管18内部、在内管18与外管17之间、或者在外管17外部。在一些实施例中，输送通道设置在内管18内 部或者在外管17外部，由此不会妨碍内管18和外管17之间的沿纵向相对运动。
操纵装置25可以被操作人员手持，用于实现内管18和外管17的沿纵向相对运动。操纵装置25包括壳体和至少部分地设置在壳体内的致动机构。
由图1、图2、图4和图6可见，操纵装置25的壳体包括上壳19和下壳20。两件式的壳体能实现简单且低成本的制造。上壳19和下壳20可以模制而成或者通过增材制造方法(3D打印方法)制造而成。
上壳19和下壳20在前端用前螺盖12固定，在后端用后螺盖21固定，因此上壳19和下壳20在前端和后端成型有螺纹，螺纹连接能实现上壳19和下壳20更可靠的紧固。在此当然可设置其它连接方式将上壳19和下壳20进行固定连接，如卡箍连接、借助于螺钉或者铆钉连接等。在上壳19和下壳20中间可以通过内部的卡扣或者在外周上的卡箍或者螺纹连接或铆接而连接，在中间也进行连接可以实现可靠地防止长形的上下壳19、20在中间不希望的分离。
由图1可见，壳体包括用于将内管18固定在壳体内的固定块5。固定块5卡锁在壳体内，并且因此固定块5以及内管18不能相对于壳体运动。
由图1可见，致动机构包括曲柄装置和与曲柄装置配合作用的滑块装置10和螺旋弹簧11。曲柄装置包括曲柄4和连杆9。代替弹簧元件11，还可以是其它合适的阻尼装置，例如中空的弹性体等。在按压曲柄4时，滑块装置10能够克服螺旋弹簧11的弹力向远侧运动，在松开曲柄4时，滑块装置10能够在螺旋弹簧11的弹力作用下向近侧运动。
由图1可见，在壳体的两侧在上壳19和下壳20相接处分别设置一个曲柄4和一个连杆9。两个曲柄4以其近端可枢转地连接于从下壳20凸出的柱体29。两个连杆9的近端分别可枢转地连接于曲柄4的远端，而两个连杆9的远端可枢转地连接于一个共同的滑块装置10上的两侧的凸出部(参见图5)30。滑块装置10直接与外管17固定连接，从而在滑块装置10运动时实现外管17的沿纵向运动。
固定块5位于滑块装置10和柱体29之间，并且滑块装置10设置在固定块5远侧一定距离处并且是中空的。内管18从远向近延伸穿过滑块装置10并且内管18的近端固定在固定块5内。
在一些实施例中，内管18的近端伸入并穿过固定块5的纵向通孔(未示出)并被紧固元件6紧固在该纵向通孔中。从固定块5的外周面出发优选垂直于内管18制有侧向通孔(未示出)，该侧向通孔延伸至所述固定块5的纵向通孔。紧固元件6能 够从外侧引入侧向通孔内并压靠在内管18上。所述紧固元件例如是紧固螺钉或铆钉。
外管17的近端固定在滑块装置10上。为了将外管17与滑块装置10固定连接，外管17的近端开口构成有凸缘42，滑块装置10在其内周面设有与外管17的近端开口凸缘42相对应的槽31(参见图5)，从而外管17的近端能够形锁合地固定在滑块装置10内。
在滑块装置10上设有导向部32(参见图5)，在壳体内周上设有用于与导向部32配合作用的配合导向部33(参见图4)，通过导向部32和配合导向部33的配合作用能够将滑块装置10的运动限定为直线运动。参见图5，导向部32是突出于滑块装置10的近侧部36并沿滑块装置10纵向方向延伸的四个上下对置的导向片32，参见图4和图6，配合导向部33是突出于下壳20内周面和上壳19内周面的并沿壳体纵向方向彼此平行延伸的各两个配合导向片33，在安装状态下，滑块装置的导向片32分别贴靠在壳体中的配合导向片33内侧。在各两个配合导向片33的两端在配合导向片33之间分别设有能由导向片32的端部贴靠的止挡部34，通过所述止挡部34限定滑块装置10的最大滑动路程。
滑块装置10的远侧部35构成为圆柱形并且与近侧部36形成凸肩37，由此螺旋弹簧11能够套设在滑块装置10的圆柱形远侧部35上并且在近端贴靠在凸肩37上，螺旋弹簧11的远端贴靠在从壳体内周凸出的环形凸缘38上。
在捏合两侧的曲柄4时，两连杆9推动滑块装置10及外管17向远侧运动，外管17推动两个电极15、16实现夹闭动作。在手松开时，弹簧11的回弹弹力直接施加于滑块装置10并使其回位，同时滑块装置10推动两曲柄4回位至初始状态，而同时两电极15、16基于自身弹性又张开。由此实现电极15、16的互相靠近和远离。
由图4可见，从壳体内周凸出的柱体29位于下壳20的中轴线上并且在中间制有从柱体29顶部出发朝向柱体底部延伸的凹槽，连接于电极15、16的导线3能够穿过该凹槽。由图6可见，在上壳19的中轴线上从上壳19的内周凸出有对应柱体39，在安装状态下，所述对应柱体39的自由端贴靠在柱体29的自由端上，从而能够防止导线3从柱体29的凹槽中移出并且还能起到在安装时定位上壳19和下壳20的作用。
由图1和2可见，曲柄4设计为长形的按压手柄，并且设计为如此窄，使得在用拇指和食指按压两个曲柄4时不会夹住中指，由此大幅提高了操作的安全性和便利性。在曲柄4的按压表面上可以设有防滑结构、例如凸凹结构。
由图1可见，在壳体内，在柱体29和后螺盖21之间靠近后螺盖21处设有卡块2， 所述卡块2与电源线一体成型，卡块2被卡在壳体内的相应卡槽内，从而将电源线1可靠地固定在壳体内。在卡块2左侧，导线3的导体与电源线1的导体焊接在一起，从而实现它们之间的电连接。
在本实施例中的鼻腔镜电极组件具有例如以下优点：该外科用电极组件确保提供足够的致动力包括复位力，更加符合人体工程学，大幅提高外科用电极组件的操作灵敏度，进而大幅提高手术效率、安全性和操作舒适性。弯曲管的设置可以使得鼻腔镜电极组件在经鼻引入人体时以及在手术过程中的便利性大幅提高，并且减少了手术期间鼻腔镜电极组件与鼻腔通道内的人体组织的不希望的触碰甚至刮伤，并且基于该弯曲而使得电极组件的手柄部分不会与同时使用的器械例如吸引器发生干涉。弯曲程度的可调整性可以将鼻腔镜电极组件更好地适配于不同的手术需求以及适配于同时使用的其它器械使得它们不发生干涉。另外，通过在外管的连接部分上设置开口或者以连接元件代替外管的连接部分，大幅降低了在弯曲程度较大的情况下在内管和外管沿纵向相对运动时的大的摩擦力甚至卡死，由此大幅提高了手术时鼻腔镜电极组件的操作灵敏度和操作精确性，而这些优点对于手术顺利完成而言是至关重要的。
图7至图10示出外科用电极组件的第二实施例。该外科用电极组件与脑室镜配合使用，在此称为脑室镜电极组件200。在该实施例中的操纵装置1025基本与鼻腔镜电极组件100实施例相同，请参看在上一实施例中对鼻腔镜电极组件100的操纵装置25的相关描述，因此不再赘述。接下来主要阐述本实施例与上一实施例的不同之处。
图7和图8分别示出脑室镜电极组件200的俯视图和主视图。可看到，相比于上一实施例，在本实施例中，内管1018和外管1017是直线的并且更细，电极1015、1016也更加细和短并且电极尖端是直形的，当然根据需要电极尖端也可以上弯或下弯。电极套管1013、1014也相应更细。
图9示出图7中的局部Ⅰ的放大图。从图9中可看到，在内管1018远侧，在电极的电极套管1013、1014外侧，设有用于保护电极套管1013、1014的耐磨保护件1024。在内管1018与外管1017沿纵向相对运动时，外管1017远端在耐磨保护件上滑动、而不是在电极套管1013、1014上滑动。因此，耐磨保护件1024可以保护电极套管1013、1014，防止在内管1018和外管1017沿纵向相对运动时外管1017远端将电极套管1013、1014外侧刮伤而损坏电极套管1013、1014的绝缘能力。耐磨保护件1024可以由耐磨材料、例如不锈钢制成。外管1017的远端开口的凸缘构造可以与耐磨保护件1024共同使用，从而进一步保护电极套管1013、1014免受磨损。
耐磨保护件1024可以从内管1018远端延伸出并且与内管1018一件式制成，并且耐磨保护件1024与电极套管1013、1014在安装状态下固定连接。在替代实施例中，耐磨保护件1024与内管1018是分开制成的部件，并且耐磨保护件1024的近端与内管1018的远端在安装状态下固定连接，并且耐磨保护件1024与电极套管1013、1014在安装状态下固定连接。在替代实施例中，耐磨保护件1024与内管1018是分开制成的部件并且不互相连接，并且耐磨保护件1024与电极套管1013、1014在安装状态下固定连接。
耐磨保护件1024与内管1018的固定连接可以形锁合、力锁合和/或材料锁合地实现，例如可以通过铆接、螺纹连接、焊接和/或粘接实现。在本实施例中，耐磨保护件1024与电极套管1013、1014的固定连接如下实现，即，在每个耐磨保护件1024的远端的两侧分别设有翼片，并且在安装时将各翼片围绕电极套管1013、1014的圆周包覆或者缠绕在电极套管1013、1014上，从而实现耐磨保护件1024与电极套管1013、1014的机械式固定连接。替选地，该固定连接也可以通过粘接、热熔连接或者包封注塑实现。
图10示出图8中的局部Ⅱ的放大图。从图10中可看到，外管1017的远端具有扁锥形结构1040，所述扁锥形结构1040包括两个朝前逐渐靠近外管中心线延伸的平面1041，所述平面1041基本上垂直于电极尖端内侧的用于夹持人体目标组织的夹持面。经多次试验已证明，外管远端的扁锥形结构1040可以有效防止外管1017遮挡视野而引起操作不便，从而大幅改善操作的便利性和精确性。特别是当电极尖端是直形并且尺寸较小时，例如在脑室镜电极组件的情况下，这是尤为有利的。在该实施例中，电极的尖端长度可以是2mm至4mm，借助小的尖端长度可以更精确地夹持住需要夹持的组织，避免不希望地连带夹持周围的组织。
由于在伸入内管1018内的电极处已将内管1018压扁以将内管1018远端与电极1015、1016近端压合在一起，所以由扁锥形结构1040引起的外管远端的变窄不会妨碍内管1018与外管1017的沿纵向相对运动。
在本实施例中的脑室镜电极组件具有例如以下优点：耐磨保护件的设置简单有效地解决了电极的电极套管容易被外管磨损的技术问题。尤其是在脑室镜电极组件的情况下，电极套管壁很薄且更易被磨损而导致绝缘能力损坏。在通常的解决方案中通常会尝试采用其它材料来制造电极的电极套管，但基于脑室镜电极组件的电极套管的特殊要求，这是很难实现的并且非常昂贵的，并且很难找到理想的电极套管材料。但通 过本实施例的耐磨保护件能够通过简单可靠且低成本的方式保护电极的电极套管，以至于完全不需再考虑电极套管材料耐磨性的问题，这就增大了材料选择范围。此外，锥形结构的设置能够通过最为简单可靠的方式在不增加附加机构并且不改变其它现有部件的情况下获得了手术时更好的视野，这对于手术中用电极尖端夹持组织而言是非常重要的，这能够大幅提高夹持精确性，提高手术效率，减小误操作风险。
本公开可以包括隐含或明确公开的任何特征或特征组合或其概括，不局限于上述罗列的任何限定的范围。所述的有关任何元件、特征和/或结构布置可以以任何适合的方式组合。
以上公开的特定实施例仅是示例性的，对于受益于本文的教导的本领域技术人员来说显然的是，可以以不同但等同的方式修改和实施本公开。例如，可以按不同的顺序执行上述方法步骤。显然的是，可对以上公开的具体实施例进行改变和修改，并且所有这些变型都被认为是落入本公开的范围和精神之内。

Claims (14)

  1. 一种外科用电极组件，所述电极组件具有在使用时更远离操作人员的远端和在使用时更靠近操作人员的近端，其特征在于，所述电极组件包括：
    电极装置，所述电极装置设置于所述电极组件的远端，所述电极装置包括第一电极和第二电极，所述第一电极和所述第二电极能够在彼此远离的第一位置与彼此靠近的第二位置之间运动；
    操纵装置，所述操纵装置设置于所述电极组件的近端，用于操纵电极装置的操作；
    电极驱动装置，所述电极驱动装置设置于所述操纵装置与所述电极装置之间，用于在操纵装置的作用下驱动所述电极装置的第一电极和第二电极在所述第一位置与第二位置之间运动；
    其中，所述电极驱动装置包括外管和内管，所述内管的外径小于所述外管的内径，从而套设于所述外管的内侧，使得所述内管和所述外管能够沿所述内管和所述外管的纵向进行相对运动，所述内管具有位于近端的内管近端部分、位于远端的内管远端部分和位于内管近端部分与内管远端部分之间的内管弯曲部分，所述内管弯曲部分具有一定弯曲曲率，从而使得所述内管远端部分和内管近端部分彼此成角度设置，所述外管具有位于近端的外管近端部分、位于远端的外管远端部分和位于外管近端部分与外管远端部分之间的外管连接部分，其中，所述外管连接部分与所述内管弯曲部分相适配，使得当操纵所述操纵装置使所述内管和所述外管进行相对运动时，所述外管连接部分允许：所述内管的内管弯曲部分与所述外管沿纵向进行相对运动而不与所述外管的外管近端部分和外管远端部分发生干涉。
  2. 按照权利要求1所述的外科用电极组件，其中，所述外管连接部分为外管上具有开口的管状部分，并且与外管近端部分和外管远端部分是一件式制成的，所述内管的弯曲连接部分能够至少部分地从所述开口露出；
    优选地，当操纵所述操纵装置使所述内管和所述外管进行相对运动时，所述开口的纵向和周向尺寸足以允许：所述内管的内管弯曲部分在所述外管的外管近端部分和外管远端部分之间顺畅地沿纵向进行相对运动而不与所述外管的外管近端部分和外管远端部分发生干涉；
    优选地，当朝向外管的横截面观察时，所述外管连接部分的开口至少占外管圆周 的二分之一并且使内管弯曲部分的凸侧露出。
  3. 按照权利要求2所述的外科用电极组件，其中，内管远端部分的一部分和/或内管近端部分的一部分能够从所述外管连接部分的开口露出；和/或
    其中，在使用时所述外管连接部分的开口的远端边缘和近端边缘距内管弯曲部分的顶点始终具有距离；和/或
    其中，所述开口的远端边缘和/或近端边缘向内卷曲或者被包封，从而开口的远端边缘和/或近端边缘与人体目标组织接触时不会刮伤人体目标组织。
  4. 按照权利要求1至3中任一项所述的外科用电极组件，其中，所述外管连接部分与外管远端部分是分开制成的部件并且在安装状态下固定连接，和/或所述外管连接部分与外管近端部分是分开制成的部件并且在安装状态下固定连接；
    优选地，所述固定连接通过铆接、螺纹连接、焊接和/或粘接实现；
    优选地，外管连接部分绕内管的全部四周或部分周边延伸；
    优选地，所述外管连接部分包括至少一个弯曲的杆和/或至少一个弯曲的扁平板和/或至少一个弯曲的在横向方向上成弧形的板。
  5. 按照权利要求1至4中任一项所述的外科用电极组件，其中，内管弯曲部分的弯曲程度和外管连接部分的弯曲程度能够同时改变；
    优选地，内管弯曲部分和外管连接部分由挠性材料制成，以便实现弯曲程度的改变；
    优选地，内管弯曲部分的弯曲程度和外管连接部分的弯曲程度在10°至60°之间、尤其是在30°至40°之间改变。
  6. 按照权利要求1至5中任一项所述的外科用电极组件，其中，所述外科用电极组件经鼻进入人体内。
  7. 按照权利要求1至6中任一项所述的外科用电极组件，其中，在内管内部、或者在内管与外管之间、或者在外管外部设有用于输送冲洗液的输送通道。
  8. 按照权利要求1至7中任一项所述的外科用电极组件，其中，第一电极和第二电极通过粘合剂与内管固定；
    优选地，所述粘合剂是环氧树脂胶。
  9. 按照权利要求1至8中任一项所述的外科用电极组件，其中，在伸入内管内的第一电极和第二电极处将内管压扁，从而将内管与第一电极和第二电极压合在一起。
  10. 按照权利要求1至9中任一项所述的外科用电极组件，其中，外管的远端开口构造有向外的凸缘；和/或
    其中，第一电极和第二电极的远侧部上弯、下弯或者呈直形地构成。
  11. 按照权利要求1至10中任一项所述的外科用电极组件，其中，第一电极和第二电极的远侧部的用于夹持人体目标组织的夹持面在向第一电极和第二电极的近侧部的过渡部上形成台阶，所述台阶设置成防止电极近侧部上的电极套管在第一电极和第二电极闭合过程中互相接触。
  12. 按照权利要求1至11中任一项所述的外科用电极组件，其中，第一电极和第二电极的远侧部作防电凝粘连处理。
  13. 按照权利要求1至12中任一项所述的外科用电极组件，其中，外管的远端具有扁锥形结构，所述扁锥形结构包括朝前逐渐靠近外管中心线延伸的平面，所述平面基本上垂直于第一电极和第二电极的远侧部的用于夹持人体目标组织的夹持面。
  14. 按照权利要求1至13中任一项所述的外科用电极组件，其中，在伸入内管内的第一电极和第二电极处将内管压扁，从而将内管与第一电极和第二电极压合在一起，然后通过在内管中注入粘合剂而将第一电极和第二电极与内管进一步固定。
PCT/CN2019/081999 2018-09-04 2019-04-10 外科用电极组件 WO2020048127A1 (zh)

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