WO2023062289A1 - Electrosurgical device - Google Patents

Electrosurgical device Download PDF

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Publication number
WO2023062289A1
WO2023062289A1 PCT/FR2021/051787 FR2021051787W WO2023062289A1 WO 2023062289 A1 WO2023062289 A1 WO 2023062289A1 FR 2021051787 W FR2021051787 W FR 2021051787W WO 2023062289 A1 WO2023062289 A1 WO 2023062289A1
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WO
WIPO (PCT)
Prior art keywords
wire
central
advantageously
central branch
approximately
Prior art date
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PCT/FR2021/051787
Other languages
French (fr)
Inventor
Geoffrey CREPATTE
Guillaume Noury
Original Assignee
Lamidey Noury Medical
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.)
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Application filed by Lamidey Noury Medical filed Critical Lamidey Noury Medical
Priority to PCT/FR2021/051787 priority Critical patent/WO2023062289A1/en
Publication of WO2023062289A1 publication Critical patent/WO2023062289A1/en

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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
    • A61B18/149—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
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00059—Material properties
    • A61B2018/00071—Electrical conductivity
    • A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00107—Coatings on the energy applicator
    • A61B2018/00136—Coatings on the energy applicator with polymer
    • 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
    • A61B2018/00601—Cutting

Definitions

  • the present invention relates to an electrosurgical device which makes it possible, on the one hand, to lift tissues by means of a mechanical action and, on the other hand, to cut and/or coagulate tissues by an electrical action.
  • These devices are used in particular for the endoscopic resection of living tissues, such as a prostate, a bladder or a tumour.
  • Such an electrosurgical device is connected to a power source and includes an electrode to produce plasma, used to cut tissue and/or coagulate bleeding that may occur during tissue detachment.
  • the electrically active electrode has a semi-circular shape with a radius of approximately 3 to 4 mm.
  • the plasma generated has a corresponding height of about 3 to 4 mm. This therefore generates a corresponding depth of cut of approximately 3 to 4 mm, which can present a risk, for example in the case of bladder resection, the wall thickness of which is generally less than 3 mm, with therefore risk of bladder perforation.
  • Document EP1974683 describes an electrosurgical device composed of a first part which is a front shield and of a second part which is a filament forming the electrode.
  • the front shield is necessary because the electrode, which is semi-circular in shape, lacks rigidity and could bend during use if used to mechanically detach tissue. However, this could reduce the performance and life of the electrode.
  • the device of document EP1974683 uses the front shield to perform the mechanical action of lifting and detaching the tissues.
  • a disadvantage of this device is that the mechanical and electrical actions never occur at the same place, making it difficult to coagulate bleeding tissue quickly and precisely.
  • the object of the present invention is to provide an electrosurgical device which does not reproduce the aforementioned drawbacks.
  • the object of the present invention is in particular to provide an electrosurgical device which makes it possible to carry out its mechanical and electrical actions at exactly the same place.
  • the present invention also aims to provide an electrosurgical device which limits the risks of lack of visibility caused by the mechanical action of the device.
  • Another object of the present invention is to provide an electrosurgical device which makes it possible to control the maximum depth of cut, thereby improving safety for the surgeon by reducing the risks of tissue perforation.
  • the present invention also aims to provide an electrosurgical device which is simple and/or inexpensive to manufacture and to assemble.
  • the subject of the present invention is thus an electrosurgical device comprising a main tube and an operational distal part, projecting out of said main tube, said operational distal part comprising a wire which forms approximately a U comprising two parallel parts connected by a central part, said central part being curved downwards, in particular by an angle of between 30° and 90°, said curved central part being approximately U-shaped, with two lateral branches connected by a central branch, said two lateral branches being covered with an insulating protective sheath, with only said central branch of said wire not coated to form an electrically active electrode to generate a cutting and/or coagulation plasma.
  • said central branch of said wire is in the form of an arc of a circle.
  • said wire is made of tungsten.
  • said uncovered central branch has a length of between 1 and 5 mm, advantageously between 2 and 4 mm, preferably about 3 mm.
  • said wire has a diameter greater than 0.25 mm, advantageously greater than 0.4 mm.
  • said wire has a diameter of less than 0.6 mm.
  • said wire has a diameter of approximately 0.5 mm.
  • Figure 1 is a schematic view of an electrosurgical device according to an advantageous embodiment
  • Figure 2 is an enlarged view of detail A of Figure 1
  • FIG. 3 is an overall schematic illustration of the use of an electrosurgical device according to the invention.
  • FIG. 3 which illustrates a transurethral procedure
  • a resectoscope 10 connected to a high frequency power supply device 20.
  • a foot control 30 can be connected to the high frequency power supply device 20.
  • the resectoscope 10 comprises a hollow outer jacket 11 forming an endoscope through which an electrosurgical device 40, visible in FIG. 1, can be inserted into the patient's body.
  • the electrosurgical device 40 includes a main tube 41 and a distal operative part 42, projecting out of the main tube 41, and illustrated in more detail in Figure 2.
  • This distal part 42 comprises a wire 43 which forms approximately a U comprising two parallel parts 47 connected by a central part 49.
  • the wire 43 is advantageously made of a sufficiently rigid electrically conductive material, such as tungsten or stainless steel.
  • Tungsten has the particular advantage of not deforming or only slightly deforming when it is heated. In addition, it is more rigid than the materials generally used in this type of electrosurgical device, such as iridium and platinum alloys.
  • the two parallel parts 47 of the U can be arranged in respective sleeves 45.
  • the central part 49 connecting the two parallel parts of the U is curved downwards, advantageously by an angle comprised between 30° and 90°.
  • This curved central part 49 itself forms approximately a U, with two lateral branches 44 connected by a central branch 48. It should be noted that any shape with two lateral branches connected by a central branch is possible, for example a rounded V.
  • each side branch 44 and the central branch 48 each form an arc of a circle.
  • the curved central part 49 is used on the one hand to carry out a mechanical action, to unstick and detach the tissues, and on the other hand to carry out two electrical actions, namely a cutting action when the tissues resist the mechanical action. , and a clotting action when the mechanically detached tissues caused bleeding.
  • the high frequency power supply device 20 supplies a cutting current or a coagulation current to said curved central part 49, according to the request of the surgeon.
  • the two lateral branches 44 are covered with an insulating protective sheath, leaving only the central branch 48 of the wire 43 uncovered, to form the electrically active electrode which generates the cutting plasma and/or of clotting.
  • the insulating protective sheath can be formed from any suitable insulating material, such as polytetrafluoroethylene (PTFE) or silicone.
  • wire 43 has a diameter greater than 0.25 mm, advantageously greater than 0.4 mm.
  • wire 43 has a diameter of less than 0.6 mm.
  • wire 43 has a diameter of about 0.5 mm.
  • the uncovered central branch 48 forms an arc of a circle having a length comprised between 1 and 5 mm, advantageously comprised between 2 and 4 mm, preferably approximately 3 mm.
  • the electrode is rigid enough to serve both for the mechanical action tissue detachment and for the electrical action of tissue cutting and/or coagulation.
  • This sufficient rigidity therefore makes it possible to eliminate the front shield imposed by the document EP1974683, which makes it possible to carry out the mechanical action and the electrical action at exactly the same place. This makes it possible in particular to coagulate any bleeding without any delay as soon as it appears, and in particular without having to move the electrode over the bleeding. The surgeon's visibility is thus greatly improved compared to the device of document EP1974683.
  • the electrically active central branch 48 forms an arc of a circle of short length surrounded by side branches 44 sheathed, so that the plasma is formed only on the central branch 48.
  • the present invention therefore provides an electrosurgical device which comprises a curved central part 49, advantageously of semi-circular shape, with the mechanical pushing action which is carried out with the whole of this curved central part to take off and detach the tissues. If tissues resist this mechanical action, only the central branch 48 not covered with a sheath generates a localized cutting plasma and of low height to cut these tissues, with control of the depth of cut.

Abstract

An electrosurgical device comprising a main tube and an operational distal portion (42) which projects out of the main tube, the operational distal portion (42) comprising a wire (43) which forms an approximate U-shape comprising two parallel portions (47) connected by a central portion (49), the central portion being downwardly curved, in particular by an angle of between 30° and 90°, the curved central portion (49) being approximately U-shaped with two lateral branches (44) connected by a central branch (48), the two lateral branches (44) being covered by an insulating protective sheath with only the central branch (48) of the wire (43) not being covered so as to form an electrically active electrode for plasma cutting or coagulation.

Description

Dispositif électrochirurgical Electrosurgical device
La présente invention concerne un dispositif électrochirurgical qui permet d'une part de soulever les tissus par le biais d’une action mécanique et d'autre part de couper et/ou coaguler des tissus par une action électrique. The present invention relates to an electrosurgical device which makes it possible, on the one hand, to lift tissues by means of a mechanical action and, on the other hand, to cut and/or coagulate tissues by an electrical action.
Ces dispositifs sont notamment utilisés pour la résection par voie endoscopique de tissus vivants, tel qu'une prostate, une vessie ou une tumeur. These devices are used in particular for the endoscopic resection of living tissues, such as a prostate, a bladder or a tumour.
Un tel dispositif électrochirurgical est relié à une source d’énergie et comprend une électrode pour produir un plasma, utilisé pour couper des tissus et/ou coaguler des saignements susceptibles d'apparaitre lors des détachements des tissus. Such an electrosurgical device is connected to a power source and includes an electrode to produce plasma, used to cut tissue and/or coagulate bleeding that may occur during tissue detachment.
Dans les dispositifs existants, l'électrode électriquement active a une forme semi-circulaire de rayon d'environ 3 à 4 mm. Ainsi, lorsque cette électrode est utilisée pour couper des tissus qui résistent au détachement mécanique par poussée, le plasma généré a une hauteur correspondante d'environ 3 à 4 mm. Ceci génère donc une profondeur de coupe correspondante d'environ 3 à 4 mm, ce qui peut présenter un risque, par exemple dans le cas d'une résection de vessie, dont l'épaisseur de paroi est généralement inférieure à 3 mm, avec donc un risque de perforation de la vessie. In existing devices, the electrically active electrode has a semi-circular shape with a radius of approximately 3 to 4 mm. Thus, when this electrode is used to cut tissue that resists mechanical detachment by pushing, the plasma generated has a corresponding height of about 3 to 4 mm. This therefore generates a corresponding depth of cut of approximately 3 to 4 mm, which can present a risk, for example in the case of bladder resection, the wall thickness of which is generally less than 3 mm, with therefore risk of bladder perforation.
Le document EP1974683 décrit un dispositif électrochirurgical composé d’une première partie qui est un bouclier avant et d’une deuxième partie qui est un filament formant l'électrode. Le bouclier avant est nécessaire car l'électrode, de forme semi-circulaire, manque de rigidité et risquerait de se plier lors de son utilisation si elle était utilisée pour détacher mécaniquement les tissus. Or, ceci pourrait diminuer les performances et la durée de vie de l'électrode. Pour éviter d'avoir à remplacer l'électrode plusieurs fois lors d'une opération, le dispositif du document EP1974683 utilise le bouclier avant pour réaliser l'action mécanique de soulèvement et détachement des tissus. Un inconvénient de ce dispositif est que les actions mécanique et électrique ne se produisent jamais au même endroit, et il est donc difficile de coaguler rapidement et précisément les tissus qui saignent. En effet, en cas de saignement provoqué par l'action mécanique du bouclier, ce saignement se produit en avant de l'électrode, et le chirurgien doit d'abord déplacer le dispositif pour amener l'électrode sur la source du saignement pour y exercer son action de coagulation. Pendant ce petit laps de temps, le saignement a le temps de se répandre, et le bouclier risque de davantage provoquer de saignements lors du déplacement du dispositif. Ainsi, avec ce dispositif du document EP1974683, il y a un risque que le chirurgien manque de visibilité à cause d'une part de la présence du bouclier et d'autre part des possibles saignements. Document EP1974683 describes an electrosurgical device composed of a first part which is a front shield and of a second part which is a filament forming the electrode. The front shield is necessary because the electrode, which is semi-circular in shape, lacks rigidity and could bend during use if used to mechanically detach tissue. However, this could reduce the performance and life of the electrode. To avoid having to replace the electrode several times during an operation, the device of document EP1974683 uses the front shield to perform the mechanical action of lifting and detaching the tissues. A disadvantage of this device is that the mechanical and electrical actions never occur at the same place, making it difficult to coagulate bleeding tissue quickly and precisely. Indeed, in case of bleeding caused by the mechanical action of the shield, this bleeding occurs in front of the electrode, and the surgeon must first move the device to bring the electrode to the source of the bleeding to exert its coagulation action there. During this small amount of time, the bleeding has time to spread, and the shield may cause more bleeding when moving the device. Thus, with this device of the document EP1974683, there is a risk that the surgeon lacks visibility due on the one hand to the presence of the shield and on the other hand to possible bleeding.
La présente invention a pour but de fournir un dispositif électrochirurgical qui ne reproduit pas les inconvénients susmentionnés. The object of the present invention is to provide an electrosurgical device which does not reproduce the aforementioned drawbacks.
La présente invention a notamment pour but de fournir un dispositif électrochirurgical qui permet de réaliser ses actions mécanique et électrique exactement au même endroit. The object of the present invention is in particular to provide an electrosurgical device which makes it possible to carry out its mechanical and electrical actions at exactly the same place.
La présente invention a également pour but de fournir un dispositif électrochirurgical qui limite les risques de manque de visibilité provoqués par l'action mécanique du dispositif. The present invention also aims to provide an electrosurgical device which limits the risks of lack of visibility caused by the mechanical action of the device.
La présente invention a également pour but de fournir un dispositif électrochirurgical qui permet de maîtriser la profondeur maximale de coupe, pour ainsi améliorer la sécurité pour le chirurgien en diminuant les risques de perforation des tissus. Another object of the present invention is to provide an electrosurgical device which makes it possible to control the maximum depth of cut, thereby improving safety for the surgeon by reducing the risks of tissue perforation.
La présente invention a aussi pour but de fournir un dispositif électrochirurgical qui soit simple et/ou peu coûteux à fabriquer et à assembler. The present invention also aims to provide an electrosurgical device which is simple and/or inexpensive to manufacture and to assemble.
La présente invention a ainsi pour objet un dispositif électrochirurgical comprenant un tube principal et une partie distale opérationnelle, faisant saillie hors dudit tube principal, ladite partie distale opérationnelle comprenant un fil qui forme environ un U comportant deux parties parallèles reliées par une partie centrale, ladite partie centrale étant recourbée vers le bas, notamment d'un angle compris entre 30° et 90°, ladite partie centrale recourbée étant environ en forme de U, avec deux branches latérales reliées par une branche centrale, lesdites deux branches latérales étant recouvertes d'une gaine de protection isolante, avec seulement ladite branche centrale dudit fil non recouverte pour former une électrode électriquement active pour générer un plasma de coupe et/ou de coagulation. The subject of the present invention is thus an electrosurgical device comprising a main tube and an operational distal part, projecting out of said main tube, said operational distal part comprising a wire which forms approximately a U comprising two parallel parts connected by a central part, said central part being curved downwards, in particular by an angle of between 30° and 90°, said curved central part being approximately U-shaped, with two lateral branches connected by a central branch, said two lateral branches being covered with an insulating protective sheath, with only said central branch of said wire not coated to form an electrically active electrode to generate a cutting and/or coagulation plasma.
Avantageusement, ladite branche centrale dudit fil est en forme d'arc de cercle. Advantageously, said central branch of said wire is in the form of an arc of a circle.
Avantageusement, ledit fil est en tungstène. Advantageously, said wire is made of tungsten.
Avantageusement, ladite branche centrale non recouverte a une longueur comprise entre 1 et 5 mm, avantageusement entre 2 et 4 mm, de préférence environ 3 mm. Advantageously, said uncovered central branch has a length of between 1 and 5 mm, advantageously between 2 and 4 mm, preferably about 3 mm.
Avantageusement, ledit fil a un diamètre supérieur à 0,25 mm, avantageusement supérieur à 0,4 mm. Advantageously, said wire has a diameter greater than 0.25 mm, advantageously greater than 0.4 mm.
Avantageusement, ledit fil a un diamètre inférieur à 0,6 mm. Advantageously, said wire has a diameter of less than 0.6 mm.
Avantageusement, ledit fil a un diamètre d'environ 0,5 mm. Advantageously, said wire has a diameter of approximately 0.5 mm.
Ces avantages et caractéristiques et d’autres de la présente invention apparaîtront plus clairement au cours de la description détaillée suivante, faite en référence aux dessins joints, donnés à titre d’exemples non limitatifs, et sur lesquels : These advantages and characteristics and others of the present invention will appear more clearly during the following detailed description, made with reference to the attached drawings, given by way of non-limiting examples, and in which:
La figure 1 est une vue schématique d'un dispositif électrochirurgical selon un mode de réalisation avantageux, Figure 1 is a schematic view of an electrosurgical device according to an advantageous embodiment,
La figure 2 est une vue agrandie du détail A de la figure 1 , et Figure 2 is an enlarged view of detail A of Figure 1, and
La figure 3 est une illustration schématique globale de l'utilisation d'un dispositif électrochirurgical selon l'invention. Figure 3 is an overall schematic illustration of the use of an electrosurgical device according to the invention.
En référence à la figure 3, qui illustre une intervention transurétrale, il est représenté un résectoscope 10 relié à un dispositif d'alimentation haute fréquence 20. Une pédale de commande 30 peut être connectée au dispositif d'alimentation haute fréquence 20. Referring to Figure 3, which illustrates a transurethral procedure, there is shown a resectoscope 10 connected to a high frequency power supply device 20. A foot control 30 can be connected to the high frequency power supply device 20.
Le résectoscope 10 comprend une chemise externe creuse 11 formant endoscope à travers lequel un dispositif électrochirurgical 40, visible sur la figure 1 , peut être inséré dans le corps du patient. The resectoscope 10 comprises a hollow outer jacket 11 forming an endoscope through which an electrosurgical device 40, visible in FIG. 1, can be inserted into the patient's body.
Le dispositif électrochirurgical 40 comprend un tube principal 41 et une partie distale opérationnelle 42, faisant saillie hors du tube principal 41 , et illustrée plus en détail sur la figure 2. Cette partie distale 42 comprend un fil 43 qui forme environ un U comportant deux parties parallèles 47 reliées par une partie centrale 49.The electrosurgical device 40 includes a main tube 41 and a distal operative part 42, projecting out of the main tube 41, and illustrated in more detail in Figure 2. This distal part 42 comprises a wire 43 which forms approximately a U comprising two parallel parts 47 connected by a central part 49.
Le fil 43 est avantageusement réalisé en un matériau électriquement conducteur suffisamment rigide, tel que le tungstène ou l'acier inoxydable. Le tungstène présente notamment l'avantage de ne pas ou peu se déformer lorsqu'il est chauffé. De plus, il est plus rigide que les matériaux généralement utilisés dans ce type de dispositif électrochirurgical, tel que les alliages d'iridium et de platine. The wire 43 is advantageously made of a sufficiently rigid electrically conductive material, such as tungsten or stainless steel. Tungsten has the particular advantage of not deforming or only slightly deforming when it is heated. In addition, it is more rigid than the materials generally used in this type of electrosurgical device, such as iridium and platinum alloys.
Les deux parties parallèles 47 du U peuvent être disposées dans des manchons respectifs 45. The two parallel parts 47 of the U can be arranged in respective sleeves 45.
La partie centrale 49 reliant les deux parties parallèles du U est recourbée vers le bas, avantageusement d'un angle compris entre 30° et 90°. The central part 49 connecting the two parallel parts of the U is curved downwards, advantageously by an angle comprised between 30° and 90°.
Cette partie centrale recourbée 49 forme elle-même environ un U, avec deux branches latérales 44 reliées par une branche centrale 48. Il est à noter que toute forme avec deux branches latérales reliées par une branche centrale est envisageable, par exemple un V arrondi. This curved central part 49 itself forms approximately a U, with two lateral branches 44 connected by a central branch 48. It should be noted that any shape with two lateral branches connected by a central branch is possible, for example a rounded V.
Les deux branches latérales 44 ne sont pas forcément parallèles. En effet, dans le mode de réalisation décrit, la partie centrale 49 est en forme de demi-cercle, comme visible sur la figure 2, et de ce fait chaque branche latérale 44 et la branche centrale 48 forment chacune un arc de cercle. The two side branches 44 are not necessarily parallel. Indeed, in the embodiment described, the central part 49 is in the shape of a semicircle, as shown in Figure 2, and therefore each side branch 44 and the central branch 48 each form an arc of a circle.
La partie centrale recourbée 49 est utilisée d'une part pour réaliser une action mécanique, pour décoller et détacher les tissus, et d'autre part pour réaliser deux actions électriques, à savoir une action de coupe lorsque les tissus résistent à l'action mécanique, et une action de coagulation lorsque les tissus détachés mécaniquement ont provoqué des saignements. De manière connue, le dispositif d'alimentation haute fréquence 20 fournit un courant de coupe ou un courant de coagulation à ladite partie centrale recourbée 49, selon la demande du chirurgien. The curved central part 49 is used on the one hand to carry out a mechanical action, to unstick and detach the tissues, and on the other hand to carry out two electrical actions, namely a cutting action when the tissues resist the mechanical action. , and a clotting action when the mechanically detached tissues caused bleeding. In a known manner, the high frequency power supply device 20 supplies a cutting current or a coagulation current to said curved central part 49, according to the request of the surgeon.
Selon l'invention, les deux branches latérales 44 sont recouvertes d'une gaine de protection isolante, en ne laissant non recouverte que la branche centrale 48 du fil 43, pour former l'électrode électriquement active qui génère le plasma de coupe et/ou de coagulation. La gaine de protection isolante peut être formée en tout matériau isolant approprié, tel que du polytétrafluoroéthylène (PTFE) ou du silicone. According to the invention, the two lateral branches 44 are covered with an insulating protective sheath, leaving only the central branch 48 of the wire 43 uncovered, to form the electrically active electrode which generates the cutting plasma and/or of clotting. The insulating protective sheath can be formed from any suitable insulating material, such as polytetrafluoroethylene (PTFE) or silicone.
Avantageusement, le fil 43 a un diamètre supérieur à 0,25 mm, avantageusement supérieur à 0,4 mm. Advantageously, wire 43 has a diameter greater than 0.25 mm, advantageously greater than 0.4 mm.
Avantageusement, le fil 43 a un diamètre inférieur à 0,6 mm. Advantageously, wire 43 has a diameter of less than 0.6 mm.
De préférence, le fil 43 a un diamètre d'environ 0,5 mm. Preferably, wire 43 has a diameter of about 0.5 mm.
Avantageusement, la branche centrale 48 non recouverte forme un arc de cercle ayant une longueur comprise entre 1 et 5 mm, avantageusement comprise entre 2 et 4 mm, de préférence environ 3 mm. Advantageously, the uncovered central branch 48 forms an arc of a circle having a length comprised between 1 and 5 mm, advantageously comprised between 2 and 4 mm, preferably approximately 3 mm.
Ainsi, avec un matériau approprié, tel que le tungstène, un diamètre suffisant, par exemple 0,5 mm, et une longueur appropriée, par exemple environ 3 mm, l'électrode est suffisamment rigide pour servir à la fois pour l'action mécanique de décollement des tissus et pour l'action électrique de coupe et/ou de coagulation des tissus. Cette rigidité suffisante permet donc de supprimer le bouclier avant imposé par le document EP1974683, ce qui permet de réaliser l'action mécanique et l'action électrique exactement au même endroit. Ceci permet notamment de coaguler un éventuel saignement sans aucun délai dès son apparition, et notamment sans avoir à déplacer l'électrode sur le saignement. La visibilité du chirurgien est ainsi fortement améliorée en comparaison au dispositif du document EP1974683. Thus, with a suitable material, such as tungsten, a sufficient diameter, for example 0.5 mm, and a suitable length, for example about 3 mm, the electrode is rigid enough to serve both for the mechanical action tissue detachment and for the electrical action of tissue cutting and/or coagulation. This sufficient rigidity therefore makes it possible to eliminate the front shield imposed by the document EP1974683, which makes it possible to carry out the mechanical action and the electrical action at exactly the same place. This makes it possible in particular to coagulate any bleeding without any delay as soon as it appears, and in particular without having to move the electrode over the bleeding. The surgeon's visibility is thus greatly improved compared to the device of document EP1974683.
De plus, avec une gaine de protection qui recouvre la majeure partie de la partie centrale recourbée 49 à l'exception de la branche centrale 48, la hauteur du plasma généré par ladite branche centrale 48 est réduite, réduisant ainsi la profondeur de coupe de l'électrode selon l'invention. Ceci permet de mieux maîtriser l'action de couper, sans risquer de perforer les tissus, par exemple dans le cas d'une vessie. Moreover, with a protective sheath that covers most of the curved central part 49 with the exception of the central leg 48, the height of the plasma generated by said central leg 48 is reduced, thus reducing the depth of cut of the electrode according to the invention. This makes it possible to better control the cutting action, without the risk of perforating the tissues, for example in the case of a bladder.
Dans le mode de réalisation avantageux dans lequel la partie centrale recourbée 49 est de forme semi-circulaire, la branche centrale 48 active électriquement forme un arc de cercle de faible longueur entouré par des branches latérales 44 gainées, de sorte que le plasma se forme uniquement sur la branche centrale 48. Ceci permet une action de coupe tangentielle et une action de coagulation particulièrement précise et efficace. La présente invention fournit donc un dispositif électrochirurgical qui comporte une partie centrale recourbée 49, avantageusement de forme semi- circulaire, avec l'action mécanique de poussée qui est réalisée avec la totalité de cette partie centrale recourbée pour décoller et détacher les tissus. Si des tissus résistent à cette action mécanique, seule la branche centrale 48 non recouverte d'une gaine génère un plasma de coupe localisé et de faible hauteur pour couper ces tissus, avec une maitrise de la profondeur de coupe. En cas de saignements provoqués par l'action mécanique ou par l'action de coupe, seule la branche centrale 48 non recouverte d'une gaine génère un plasma de coagulation localisé et de faible hauteur pour coaguler ces saignements, avec ici aussi une maitrise de la profondeur d'action de coagulation. In the advantageous embodiment in which the curved central part 49 is of semi-circular shape, the electrically active central branch 48 forms an arc of a circle of short length surrounded by side branches 44 sheathed, so that the plasma is formed only on the central branch 48. This allows a tangential cutting action and a particularly precise and efficient coagulating action. The present invention therefore provides an electrosurgical device which comprises a curved central part 49, advantageously of semi-circular shape, with the mechanical pushing action which is carried out with the whole of this curved central part to take off and detach the tissues. If tissues resist this mechanical action, only the central branch 48 not covered with a sheath generates a localized cutting plasma and of low height to cut these tissues, with control of the depth of cut. In the event of bleeding caused by the mechanical action or by the cutting action, only the central branch 48 not covered with a sheath generates a localized coagulation plasma and of low height to coagulate this bleeding, with here also a control of the depth of coagulation action.
Bien que la présente invention ait été décrite en référence à un mode de réalisation avantageux de celle-ci, il est entendu qu'un homme du métier peut y apporter toutes modifications utiles, sans sortir du cadre de la présente invention tel que défini par les revendications annexées. Although the present invention has been described with reference to an advantageous embodiment thereof, it is understood that a person skilled in the art can make any useful modifications thereto, without departing from the scope of the present invention as defined by the appended claims.

Claims

Revendications Claims
1.- Dispositif électrochirurgical (40) comprenant un tube principal (41 ) et une partie distale opérationnelle (42), faisant saillie hors dudit tube principal (41 ), ladite partie distale opérationnelle (42) comprenant un fil (43) qui forme environ un U comportant deux parties parallèles (47) reliées par une partie centrale (49), ladite partie centrale (49) étant recourbée vers le bas, notamment d'un angle compris entre 30° et 90°, ladite partie centrale recourbée (49) étant environ en forme de U, avec deux branches latérales (44) reliées par une branche centrale (48), caractérisé en ce que lesdites deux branches latérales (44) sont recouvertes d'une gaine de protection isolante, avec seulement ladite branche centrale (48) dudit fil (43) non recouverte pour former une électrode électriquement active pour générer un plasma de coupe et/ou de coagulation. 1.- Electrosurgical device (40) comprising a main tube (41) and a distal operative part (42), protruding from said main tube (41), said distal operative part (42) comprising a wire (43) which forms approximately a U comprising two parallel parts (47) connected by a central part (49), said central part (49) being curved downwards, in particular by an angle comprised between 30° and 90°, said curved central part (49) being approximately U-shaped, with two lateral branches (44) connected by a central branch (48), characterized in that the said two lateral branches (44) are covered with an insulating protective sheath, with only the said central branch ( 48) of said uncovered wire (43) to form an electrically active electrode for generating a cutting and/or coagulation plasma.
2.- Dispositif selon la revendication 1 , dans lequel ladite branche centrale (48) dudit fil (43) est en forme d'arc de cercle. 2.- Device according to claim 1, wherein said central branch (48) of said wire (43) is in the form of an arc of a circle.
3.- Dispositif selon la revendication 1 ou 2, dans lequel ledit fil (43) est en tungstène. 3.- Device according to claim 1 or 2, wherein said wire (43) is tungsten.
4.- Dispositif selon l'une quelconque des revendications précédentes, dans lequel ladite branche centrale (48) non recouverte a une longueur comprise entre 1 et 5 mm, avantageusement entre 2 et 4 mm, de préférence environ 3 mm. 4.- Device according to any one of the preceding claims, wherein said uncovered central branch (48) has a length of between 1 and 5 mm, advantageously between 2 and 4 mm, preferably about 3 mm.
5.- Dispositif selon l’une quelconque des revendications précédentes, dans lequel ledit fil (43) a un diamètre supérieur à 0,25 mm, avantageusement supérieur à 0,4 mm. 5.- Device according to any one of the preceding claims, wherein said wire (43) has a diameter greater than 0.25 mm, advantageously greater than 0.4 mm.
6.- Dispositif selon l’une quelconque des revendications précédentes, dans lequel ledit fil (43) a un diamètre inférieur à 0,6 mm. 6.- Device according to any one of the preceding claims, wherein said wire (43) has a diameter less than 0.6 mm.
7.- Dispositif selon l’une quelconque des revendications précédentes, dans lequel ledit fil (43) a un diamètre d'environ 0,5 mm. 7.- Device according to any one of the preceding claims, in which the said wire (43) has a diameter of approximately 0.5 mm.
PCT/FR2021/051787 2021-10-14 2021-10-14 Electrosurgical device WO2023062289A1 (en)

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6032673A (en) * 1994-10-13 2000-03-07 Femrx, Inc. Methods and devices for tissue removal
US6113597A (en) * 1992-01-07 2000-09-05 Arthrocare Corporation Electrosurgical systems and methods for urological and gynecological procedures
US20030130653A1 (en) * 1997-09-30 2003-07-10 Scimed Life Systems, Inc. Electrosurgical tissue removal with a selectively insulated electrode
US20050245927A1 (en) * 2004-05-03 2005-11-03 Snay James P Bipolar resectoscope electrode
EP1974683A1 (en) 2007-03-30 2008-10-01 Olympus Medical Systems Corp. Ablation therapeutic device, resectoscope

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6113597A (en) * 1992-01-07 2000-09-05 Arthrocare Corporation Electrosurgical systems and methods for urological and gynecological procedures
US6032673A (en) * 1994-10-13 2000-03-07 Femrx, Inc. Methods and devices for tissue removal
US20030130653A1 (en) * 1997-09-30 2003-07-10 Scimed Life Systems, Inc. Electrosurgical tissue removal with a selectively insulated electrode
US20050245927A1 (en) * 2004-05-03 2005-11-03 Snay James P Bipolar resectoscope electrode
EP1974683A1 (en) 2007-03-30 2008-10-01 Olympus Medical Systems Corp. Ablation therapeutic device, resectoscope

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