WO2024156800A1 - Sonde bipolaire, système de sonde, et procédé pour une procédure électrochirurgicale - Google Patents

Sonde bipolaire, système de sonde, et procédé pour une procédure électrochirurgicale Download PDF

Info

Publication number
WO2024156800A1
WO2024156800A1 PCT/EP2024/051757 EP2024051757W WO2024156800A1 WO 2024156800 A1 WO2024156800 A1 WO 2024156800A1 EP 2024051757 W EP2024051757 W EP 2024051757W WO 2024156800 A1 WO2024156800 A1 WO 2024156800A1
Authority
WO
WIPO (PCT)
Prior art keywords
probe
handle
region
electrode
distal end
Prior art date
Application number
PCT/EP2024/051757
Other languages
German (de)
English (en)
Inventor
Wolfgang Ries
Rainer Steegmüller
Renate Daschner
Original Assignee
Joimax Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Joimax Gmbh filed Critical Joimax Gmbh
Publication of WO2024156800A1 publication Critical patent/WO2024156800A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/148—Probes or electrodes therefor having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
    • 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
    • A61B18/1477—Needle-like probes
    • 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
    • A61B2018/00172—Connectors and adapters therefor
    • A61B2018/00178—Electrical connectors
    • 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
    • A61B2018/00339—Spine, e.g. intervertebral disc
    • 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
    • A61B2018/0044—Spinal cord
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577—Ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00589—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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00607—Coagulation and cutting with the same instrument
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/0091—Handpieces of the surgical instrument or device
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • 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
    • A61B18/1206—Generators therefor
    • A61B2018/1246—Generators therefor characterised by the output polarity
    • A61B2018/126—Generators therefor characterised by the output polarity bipolar
    • 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
    • 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
    • A61B2018/1497—Electrodes covering only part of the probe circumference
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002—Irrigation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/007—Aspiration

Definitions

  • Bipolar probe, probe system and method for an electrosurgical procedure The invention relates to a bipolar probe, a probe system and a method for an electrosurgical procedure.
  • Bipolar probes are known from electrosurgery, which is also referred to as high-frequency or HF surgery, the front side of which has two mutually insulated electrodes which, in the application case, are arranged near the tissue to be treated and are supplied with high-frequency alternating current.
  • tissue to be treated This creates an (alternating) current flow between the electrodes, which is passed through the tissue to be treated.
  • different interactions occur: For example, intracellular water in the tissue to be treated can be stimulated by the current signals in such a way that it evaporates, so that the tissue to be treated is treated in a targeted manner, while the surrounding tissue not to be treated is spared.
  • the well-known probes are used, for example, to stop bleeding and remove scar tissue.
  • the known probes can be used to shrink tissue, particularly in the annulus disc, so that tears in the annulus disc can be closed. By controlling the probe accordingly, unintentional carbonization of the tissue to be treated can be avoided.
  • the tissue to be treated can be coagulated in a targeted manner without causing unwanted tissue damage.
  • An example of a high desired temperature input is the treatment of the facet joints of the spine, which ensure the joint connection of neighboring vertebral bodies. Due to physiological overload and/or old age, a facet joint can show signs of closure in the form of arthrosis, which is very painful and, as things stand, cannot be completely treated (spondylarthrosis).
  • the pain-conducting nerve pathways that serve to transmit stimuli from the arthritic facet joint are specifically cauterized, i.e. denervated, by treatment with the bipolar probe.
  • the cauterization is carried out by heating the tissue with high-frequency (alternating) current. This effect is therefore also referred to as thermocoagulation and the entire procedure as facet joint denervation.
  • Known designs of the bipolar probes provide for the electrodes to be placed on the distal end of the probe. body. This is disadvantageous because it only allows tissue immediately distal to the bipolar probe to be treated. Large-scale tissue treatment is therefore not possible because there is no possibility of any movement of the probe at the site of the intervention, i.e. within the human body.
  • bipolar probes provide for the electrodes to be designed as cylindrical sections of the probe body that are electrically insulated from one another. This does indeed enable tissue to be treated over a relatively large area; however, the treatment is no longer targeted because tissue in the entire area surrounding the electrodes is usually treated.
  • tissue that should not be treated under any circumstances, for example nerve tracts or blood vessels that are not to be treated, is not located in the immediate vicinity of the probe. This limits the applicability of these designs. It is therefore the object of the invention to create a bipolar probe with improved usability while avoiding the disadvantages of the prior art. The same applies to the above-mentioned probe system and the above-mentioned method.
  • the object is achieved by a bipolar probe with the features of claim 1. Furthermore, the object is achieved by a probe system according to claim 12 and by a method according to claim 24.
  • the bipolar probe according to the invention for an electrochi- The probe system according to the invention has a probe body with a distal end part, the distal end part having on its outer surface two electrodes which are electrically insulated from one another, at least a first electrode extending over at least part of its axial length and not over the entire circumference of the distal end part, and the electrodes are each connected to an electrical contact of the probe body via an electrical line.
  • the probe system according to the invention has a handle and a bipolar probe according to the invention, the probe being connectable to the handle.
  • the method according to the invention provides a bipolar probe according to the invention, in particular a probe system according to the invention, the probe being moved to an intervention site in such a way that the tissue to be treated is arranged adjacent to the electrodes and the electrodes of the probe are then supplied with an electrical current in such a way that the tissue is treated in a particularly local and/or directed manner.
  • the invention is based on the basic idea that the current emitted by the electrodes, which is intended to effect the desired processing of the tissue, flows from one electrode through the tissue to the other electrode. The path of the current in the tissue and thus indirectly also the location where the processing of the tissue is to take place are thus determined by the positions of the electrodes. This is one of the reasons for the disadvantages of the known probes mentioned.
  • the probe according to the invention has a first electrode which does not extend over the entire circumference of the distal end part over at least part of its axial length, the extent of the electrical field which forms in the circumferential direction and in the tissue is limited. be limited in the circumferential direction of the current that develops at the intervention site.
  • the electric field that develops with the probe according to the invention is neither homogeneous nor isotropic over the circumferential direction; rather, an increased current flow only takes place in the area in the circumferential direction where the first electrode is provided. This allows more targeted and ultimately less risky processing of the tissue at the intervention site. In this respect, the applicability of the electrode according to the invention is improved.
  • a further advantageous effect of the directed electric field that develops with the probe according to the invention, or directed current flow through the tissue to be treated at the intervention site, compared to known probes, is that a greater spatial energy density is achieved by limiting it in the circumferential direction. This also improves the applicability of the probe according to the invention, since on the one hand the risk of processing tissue that is not to be treated is reduced and on the other hand less total energy is required for the procedure.
  • a distal direction refers to a direction towards the patient, while a proximal direction points to the surgeon as the user of the probe.
  • an axial direction points from proximal to distal or vice versa and a circumferential direction is perpendicular to the axial direction.
  • a radial direction points radially outwards from an axis, for example the extension axis of the probe. and is therefore perpendicular to the axial direction and the circumferential direction.
  • the electrosurgical procedure can include an intervention on the spine and/or in its surroundings.
  • the procedure can provide for cutting, coagulation, shrinking and/or removal of soft tissue.
  • the procedure comprises denervation, in particular surface denervation.
  • the probe can have or be connectable to an electrical generator which is designed to generate current signals, in particular to generate alternating current in the high frequency range, which in the sense of the invention particularly covers a range between 100 kHz to 5 MHz, in particular between 300 kHz to 4 MHz, in order to avoid unwanted muscle and/or nerve stimulation in the vicinity of the tissue to be treated.
  • This current is also referred to as RF/HF current, whereby the correspondingly designed probe is also referred to as RF/HF probe.
  • the first electrode does not extend over the entire circumference of the distal end part over its entire axial length in order to generate an anisotropic electric field and, in the application, a directed (alternating) current flow.
  • the first electrode can have an axial length between 0.5 mm and 10 mm, in particular between 0.5 mm and 5 mm.
  • the first electrode extends over an angular range of equal to or less than 355°, in particular equal to or less than 270°, preferably equal to or less than 180°, in particular equal to or less than 90°, most preferably between 90° and 180°, but equal to or more than 5° over the circumference of the distal end part.
  • the first electrode extends over an angular range between 5° and 355°, in particular over an angular range of substantially 30°, most preferably over an angular range of substantially 45°.
  • the current flow when the probe according to the invention is used is essentially limited to the circumferential region on which the first electrode is provided, so that in particular in a region of the probe which faces away from the first electrode in the cross section, significantly lower field strengths and no significant current flow is generated in the application.
  • the first electrode extends at least over part of the distal end face of the probe body, wherein it is particularly provided that at least part of the distal end face has an electrically non-conductive region.
  • the electrically non-conductive part is provided with electrical insulation, for example, and is also referred to as the (electrical) insulation area in accordance with the invention.
  • the electrically non-conductive part of the distal front side corresponds to the part that does not include the first electrode. Accordingly, the distal front side consists of the first electrode and the non-conductive part. It is preferably provided that the first electrode is at least partially spherical, in particular quarter-spherical, in some areas.
  • the partially spherical design of the first electrode in particular in the area of the distal end face of the probe body in the distal end area of the probe, results in homogeneous radiation of the electric field near the surface, whereby local field peaks are avoided in this area, so that the surrounding tissue is processed in a controlled manner and at the same time a direction of the electric field is ensured on a larger scale in the sense of the invention.
  • This effect is particularly pronounced with a quarter-spherical first electrode.
  • the diameter of the partially spherical area of the first electrode is, for example, between 1.5 mm and 6 mm.
  • the partially spherical area of the first electrode comprises a distal area of the first electrode.
  • the first electrode is at least partially cylindrical in shape, which is structurally simple to manufacture.
  • the cylinder jacket-shaped region of the first electrode comprises a proximal region of the first electrode.
  • the first electrode has a partially spherical region, which is arranged distally, and a cylinder jacket-shaped region, which is arranged proximally, in particular.
  • the first electrode is arranged on the surface of the distal end part is surrounded in the proximal direction and in the circumferential direction by an electrically non-conductive region. In particular, the first electrode is surrounded in the proximal direction and in the circumferential direction by an electrically non-conductive region.
  • the electrically non-conductive region which is also referred to as the insulation region, can extend in the circumferential direction over an angular range of 5° to 355°.
  • the electrically non-conductive region is designed as a covering and/or coating at least in some regions. It is preferably provided that the electrically non-conductive region surrounding the first electrode extends over the entire circumference of the distal end part at least over part of its axial length, in particular in a region proximal to the first electrode.
  • the electrically non-conductive region can extend at least over the entire axial length of the first electrode.
  • the axial length of the entire electrically non-conductive region can be between 0.5 mm and 11 mm, in particular between 1 mm and 9 mm, in particular essentially 4.7 mm. In a further embodiment of the invention, it is provided that the axial length of that part of the electrically non-conductive region that extends over the entire circumference of the distal end part is at least 2 mm. It is preferably provided that the non-conductive region surrounding the first electrode is made of plastic, in particular of a thermoplastic material, preferably of polyetheretherketone (PEEK), and/or has a different color than the region of the first electrode.
  • PEEK polyetheretherketone
  • the second electrode is arranged proximal to the first electrode, in particular axially offset from it.
  • the second electrode is arranged distal to the first electrode.
  • the diameter of the second electrode can be between 1.5 mm and 6 mm, in particular essentially 3.5 mm.
  • the second electrode can have an axial length between 1 mm and 10 mm, in particular between 1 mm and 3 mm, most preferably essentially 3 mm.
  • the second electrode is arranged at a distance, in particular an axial distance, of at least 2 mm from the first electrode.
  • An electrically non-conductive region can be formed between the electrodes, by means of which the electrodes are electrically insulated from one another.
  • the second electrode extends over the entire circumference of the distal end part, in particular over its entire axial length.
  • the second electrode can be designed in the shape of a cylinder jacket, in particular as an electrically conductive sleeve. In one embodiment of the invention, it can be provided that the second electrode extends only over part of the circumference of the probe body, with this part of the circumference essentially corresponding to the angular range of the first electrode.
  • An electrically non-conductive region can be formed proximally adjacent to the second electrode, which extends in particular over the entire circumference of the probe body.
  • the electrically non-conductive region can be designed as an insulating sleeve and/or comprise a thermoplastic material, in particular polyetheretherketone (PEEK). It can also be provided that the electrically non-conductive region arranged proximally adjacent to the second electrode has essentially the same color design as the electrically non-conductive region arranged adjacent to the first electrode.
  • the electrically non-conductive region arranged adjacent to the second electrode can have a diameter of between 1.5 mm and 6 mm, in particular essentially 3.5 mm, with a manufacturing tolerance of usually 0.1 mm being taken into account in particular.
  • the distal end part of the probe body in particular its distal end region, has an atraumatic rounding, which is in particular partially spherical in shape, in order to prevent unwanted tissue damage when the probe is moved to and at the site of intervention.
  • the atraumatic rounding is most preferably hemispherical and can also have a radius that corresponds to half the diameter of the distal end part in order to form a flush transition and reduce the risk of injury.
  • the first electrode at least partially comprises the atraumatic rounding.
  • the distal end part of the probe can have an axial length of 120 mm to 420 mm, in particular of essentially 320 mm.
  • the electrical contacts are arranged on a proximal end part of the probe body.
  • the electrical lines assigned to the electrodes can be arranged inside the probe body and/or electrically insulated from one another in order to avoid short circuits. It is preferably provided that the electrical lines are each provided with an electrically non-conductive coating, in particular with a hose. At least one of the electrical lines, in particular two electrical lines, can each be surrounded by a shrink hose that serves for electrical insulation. It is preferably provided that at least one electrical contact for one of the electrodes is arranged on the outer surface of the probe body and/or that at least one electrical contact for one of the electrodes is designed as a contact pin protruding on the proximal end face of the probe body.
  • the arrangement of the at least one electrical contact on the outer surface of the probe body enables particularly simple electrical contacting of the electrodes, for example by means of a plug solution that can be quickly assembled and disassembled.
  • Each electrode can in particular be assigned a contact.
  • the contact formed on the outer surface is preferably assigned to the distal electrode and/or can be designed as a contact sleeve, which in particular has an axial length of 3 mm to 20 mm, in particular 5 mm.
  • all contacts are arranged on the outer surface of the probe body.
  • the contact pin is preferably assigned to the proximal electrode and/or can have an axial length of 3 mm to 20 mm, in particular 6 mm, and/or can have a diameter of 0.5 mm to 6 mm, in particular 2 mm.
  • the design of the electrical contact as a contact pin ensures secure contacting of the electrode. In the event that a contact is arranged on the outer surface of the probe body and that another contact for one of the electrodes is designed as a contact pin protruding from the proximal end face of the probe body, a secure type of contacting of the electrodes is achieved, since the risk of confusion is avoided due to the structurally differently designed contacts.
  • the contact on the outer surface of the probe body can be assigned to the proximal electrode and the contact pin to the distal electrode.
  • the at least one contact on the outer surface of the probe body can be surrounded distally and/or proximally by an electrically non-conductive sleeve in the sense of an insulating sleeve, which preferably comprises polyamide.
  • the insulating sleeve can have a color design that differs from that of the electrically non-conductive areas of the distal end part. It is preferably provided that the probe body has a stop for a handle, which is designed in particular as a radial elevation.
  • the elevation can have an axial length of 5 mm to 100 mm, in particular of 17 mm, and/or a diameter between 2 mm and 10 mm, in particular a diameter of approximately 4.5 mm.
  • the stop is preferably not designed to be rotationally symmetrical, at least over an axial partial area. and/or has a flattened portion to prevent it from rolling away and/or twisting.
  • the stop can be used to ensure that the probe body and a handle to be connected to it can only be connected to one another in a specific relative position in the circumferential direction, so that a secure and at the same time quick connection of the probe body to the handle is possible.
  • the flattened portion can be arranged in the circumferential direction flush with the first electrode to ensure that it is precisely aligned.
  • the at least two electrical lines can be arranged in a common, in particular horizontal, plane that is aligned normal to the surface of the flattened portion, wherein the plane can also be arranged eccentrically, in particular offset in the direction of the flattened portion.
  • the first electrode can have at least one opening, particularly in the distal end region, which is preferably connected to an interior of the probe body for rinsing and/or suction.
  • all openings are arranged in the partially spherical region of the first electrode and/or all run radially in the sense of a three-dimensional spherical coordinate system, the origin of which corresponds to the center of curvature of the partially spherical region of the first electrode, in order to optimize the removal of the processed tissue from the procedure site.
  • the interior of the probe body can extend axially from the height of the first electrode at least to the proximal end face of the probe body and/or can be provided with a
  • the rinsing device can in particular be connected in such a way that processed tissue at the intervention site can be removed by rinsing via the at least one opening and via the interior from the intervention site.
  • the probe body can be connected to the rinsing device in order to clean the interior of the probe body, in particular after the electrosurgical procedure.
  • the interior of the probe body can be designed so that it does not communicate with the electrodes and/or with the electrical contacts. In this way, it is impossible for processed tissue and/or rinsing fluid to come into contact with the electrodes and/or with the electrical contacts.
  • the probe is designed as a sterile single-use product, which is also referred to as a "single-use" product. Since in this embodiment the probe is disposed of after use, there is no need to clean it.
  • the interior is preferably surrounded by a radial outer wall and can be associated with a hollow cylinder which is arranged inside the probe body and is designed, for example, as a rinsing cylinder.
  • the hollow cylinder can protrude proximally from the probe body, whereby the proximal end face of the hollow cylinder can be provided with a cleaning connection for a suction and/or for the rinsing device.
  • This connection can be designed as a Luer-Lock connection.
  • the lateral extension of the interior of the probe body is preferably 60% to 80%, in particular approximately 70% of the diameter of the probe body.
  • the interior of the probe body can be arranged radially eccentrically to the probe body.
  • the probe body has a particularly annular recess, with particular provision being made for the recess to be arranged proximal to the stop.
  • the particularly annular recess of the probe body can serve as a connection option with the handle, for example as part of a locking connection, with the recess interacting with a corresponding projection of the handle.
  • the recess of the probe body has an axial length of between 1 mm and 5 mm, preferably 2 mm, and/or can be designed as an annular groove.
  • the probe of the probe system can be detachably and/or positively connected to the handle.
  • connection between the handle and the probe means that the probe can be reused.
  • the formation of a positive connection between the probe and the handle increases the safety in use of the probe system according to the invention.
  • An advantageous development of the invention provides that the connection between the probe and the handle is designed as a locking connection, wherein it is provided in particular that the handle has a movable pin, in particular one that is spring-loaded.
  • the movement component of the pin can have at least one directional component that is aligned perpendicular to the rotational symmetry axis of the probe body, which is in particular normal to the surface of the probe body and/or parallel to a radial is aligned in the axial direction.
  • the pin is movable in the direction of the in particular annular recess of the probe, the pin being designed for positive engagement in the recess of the probe body.
  • the pin preferably has an axial opening which is designed to receive the probe body.
  • the pin can have at least one projection on a side facing the spring, which is in particular designed to be partially circular.
  • the projection is designed for at least partial engagement in the annular recess of the probe body in order to lock the probe body not only in an axial but also in a radial position relative to the handle part.
  • the handle has a push button which is designed to establish and/or in particular to easily release the connection of the handle to the probe.
  • the push button can be designed as a raised area and in this respect serves as a roll-away protection.
  • the push button is connected to the pin, in particular designed as one piece with it.
  • the handle has, in particular in a distal area on a radial inner side, a raised portion that is complementary to the flattening of the probe body and corresponds to a reduction in the cross-sectional area, so that the handle can be connected to the probe body in a form-fitting manner, in particular in the circumferential direction, and the probe system therefore has an anti-twist device that prevents unwanted relative rotation between the probe body and the handle during use of the probe system. In addition, this always ensures a correct directional alignment between the probe and the handle is ensured.
  • the surface of the handle in particular in a distal area, has at least two, in particular three recesses, which can be arranged distributed over the circumference of the handle, in particular at the same axial height.
  • the recesses of the handle are particularly preferably arranged evenly distributed over its circumference. The recesses create defined storage options for the user's fingers, which enables longer, fatigue-free use and ergonomic handling of the probe system.
  • the recesses in the handle can be arranged in such a way that a tridigital grip, also referred to as a tridigital fingertip grip, of the handle and thus also of the probe connected to it is possible, in which the handle is grasped by the pollex, the index and the digitus maxims of the user during use, with the balanced weight of the probe system resting primarily on the digitus medius.
  • a tridigital grip also referred to as a tridigital fingertip grip
  • the handle has four recesses arranged next to one another, extending at least over part of the circumference of the handle, so that the handle can be grasped in the sense of a tetradactyl grip, i.e.
  • the handle preferably has a flushing connection, particularly in a proximal area, which is designed in particular as a Luer-Lock connection, so that the probe system, in particular its handle, can be cleaned easily and reliably.
  • the flushing connection can be arranged on a proximal end face of the handle.
  • the proximal, in particular radially tapering area of the handle can be designed to accommodate the hollow cylinder protruding proximally from the probe body, in particular the flushing cylinder.
  • the handle preferably has a flushing insert, particularly in the proximal area, with a flushing connection, in particular a proximal one, wherein the flushing connection can be connected in particular to a flushing and/or suction device.
  • the flushing insert can be connected to the outer surface of the handle.
  • the flushing connection is designed as a Luer-Lock connection.
  • the flushing insert can be connected to the handle in a form-fitting manner, in particular by means of a radial elevation that can be brought into engagement with a recess in the handle in its proximal region.
  • the handle can have a contact insert that is arranged in particular proximal to the flushing insert and connected to it in particular via a seal, which is preferably designed to be essentially cylindrical and/or two electrically has conductive areas that are separated by an insulating area arranged between them in order to avoid electrical short circuits.
  • the contact insert can be arranged completely inside the handle.
  • the two electrically conductive areas of the contact insert can each be arranged at the axial height of the contacts of the probe body when a probe is connected to the handle in order to electrically connect the contacts of the probe to the contact insert of the handle.
  • the contact insert and the flushing insert of the handle preferably each have a lumen, which can in particular be designed to be aligned and communicate with the lumen of the handle.
  • the contact insert can be arranged at an axial distance from the flushing insert, wherein the axial distance can correspond approximately to the axial length of the contact insert.
  • the handle in particular together with the rinsing insert and/or with the contacting insert, has a lumen that extends over the entire axial length of the handle and wherein the diameter of the lumen is in particular larger than the largest radial extent of the probe body.
  • the lumen of the handle can serve as a cleaning channel so that the handle can be reprocessed.
  • the probe system preferably has a plug connection for a plug that can be detachably connected to the handle for electrically contacting the contacts of the probe.
  • the plug is designed in particular to connect the electrically conductive areas of the contact insert to a voltage source that can be connected to the plug via the plug connection in order to ultimately apply electrical voltage to the contacts of the probe arranged inside the handle.
  • the plug connection can have an electrical contact that is in particular radially centered and is designed in particular as a contact pin, wherein the contact pin can protrude beyond the plug connection in the distal direction and/or in the proximal direction.
  • the contact pin can be surrounded at least in regions by an electrically insulating layer in order to insulate an electrically conductive surface arranged radially outside the electrically insulating layer, which can serve as the second contact of the plug connection, from its radially centered contact.
  • the electrically conductive surface as the second contact of the plug connection is preferably itself surrounded by an electrically insulating surface.
  • the radially centered contact of the plug connection can be connected to the distal electrically conductive region of the contact insert of the handle and the electrically conductive surface of the plug connection can be connected to the proximal electrically conductive region of the contact insert of the handle.
  • the plug connection can be arranged in some areas inside the handle and/or in some areas outside the handle.
  • the plug connection preferably projects beyond the handle in a radially outward and/or proximally direction.
  • the plug connection is completely accommodated in the handle.
  • the plug can be designed to complement the proximal area of the plug connection.
  • the plug can have a radially centered recess on its distal end face to accommodate the contact pin.
  • the plug can have an electrically conductive outer surface that is arranged at the same radial height as the electrically conductive outer surface of the plug connection.
  • the plug can be detachably connected to the plug connection.
  • the plug connection can be designed as a recess in the handle, which is directed radially inwards and/or distally and is preferably tapered in the distal direction.
  • the dimensions of the recess are selected such that the plug can be accommodated in the recess at least in part.
  • the recess is arranged, for example, in a region of the handle facing away from the push button and/or can have a length that is selected such that the plug can be accommodated in the handle part for at least 50% of its length, in particular completely.
  • the plug has a radially centered electrically conductive region for contacting the distal electrically conductive region of the handle and a radially outer electrically conductive region for contacting the proximal electrically conductive region of the handle.
  • the radially centered electrically conductive region of the plug can be designed as a contact pin and/or electrically insulated from the radially outer electrically conductive region of the plug.
  • the radially outer electrically conductive region is designed in particular as an electrically conductive outer surface of the plug and can in particular have electrical insulation in some areas radially outside.
  • the contact pin of the plug can be accommodated in particular in the tapered region of the recess as a plug connection of the handle.
  • the plug connection is arranged at an angle of not equal to 0° relative to the direction of extension of the handle and/or relative to the direction of extension of the flush connection of the handle.
  • the plug connection is arranged at an angle of not 0° relative to the axial direction of the handle.
  • the plug connection can be arranged relative to the direction of extension of the handle and/or relative to the direction of extension of the flushing connection at an angle of between 10° and 40°, in particular at an angle of between 20° and 30°, preferably at an angle of approximately 25°.
  • the handle can have a conically shaped outer surface at least over an axial partial area, in particular over its entire axial length, wherein the handle has a concavely shaped outer surface over an axial partial area, in particular in an area of 80% of its axial length, the contour of which is preferably parabolic. This improves the ergonomics of the handle and also reduces its weight.
  • a proximal end area and/or a distal end area of the handle can have a tapered outer surface.
  • the handle has a gripping area, the center of gravity of the handle connected to the probe being arranged within the gripping area, in particular in an area at the axial height of the recesses, in order to enable working with the probe system to be as fatigue-free as possible.
  • the gripping area thus corresponds to a holding area of the probe system.
  • the arrangement of the center of gravity in the gripping area of the handle can also be carried out in particular taking into account the geometric design and the material of the probe as well as the position of the handle relative to the probe connected to it.
  • the surface of the handle is at least partially roughened to improve the grip of the handle.
  • the roughened area can be done by plasma treatment, a mechanical surface treatment, in particular sand and/or glass bead blasting.
  • the handle can be manufactured by an additive manufacturing process, for example by 3D printing.
  • the probe system and/or one of its components, in particular the handle can be reprocessable.
  • the probe system or one of its components, in particular the probe can be designed as a disposable piece.
  • the probe system can comprise an endoscope with a working channel, wherein the probe system can be inserted into the working channel.
  • the probe system can comprise a generator for generating electrical alternating current signals with which the electrodes of the probe can be activated.
  • the method according to the invention preferably provides for a particularly local and/or directed processing of the tissue, in particular tissue in the area of the spine.
  • the method is particularly preferably designed as a minimally invasive method.
  • Fig. 1 shows a first embodiment of the probe according to the invention in a schematic side view
  • Fig. 2 shows the probe according to Fig. 1 in a schematic longitudinal section along the section line AA according to Fig. 3
  • Fig. 3 shows the probe according to Fig. 1 in a side view rotated by 90° about its axis of extension
  • Fig. 4 shows a first embodiment of a handle of a probe system according to the invention in a schematic side view
  • Fig. 5 shows the handle according to Fig. 4 in a side view rotated by 90° about its direction of extension
  • Fig. 1 shows a first embodiment of the probe according to the invention in a schematic side view
  • Fig. 2 shows the probe according to Fig. 1 in a schematic longitudinal section along the section line AA according to Fig. 3
  • Fig. 3 shows the probe according to Fig. 1 in a side view rotated by 90° about its axis of extension
  • Fig. 4 shows a first embodiment of a handle of a
  • FIG. 6 shows the handle according to Fig. 4 in a schematic longitudinal section through the section line AA according to Fig. 5
  • Fig. 7 shows the handle according to Fig. 4 in a view from distal
  • Fig. 8 shows an enlarged view of detail B according to Fig. 6
  • Fig. 9 shows a further embodiment of a probe according to the invention in a schematic side view
  • Fig. 10 the probe according to Fig. 8 in a schematic longitudinal section through the section line AA
  • Fig. 11 the probe according to Fig. 9 in a view from distal
  • Fig. 12 the probe according to Fig. 9 in a schematic cross section through the section line B-B
  • Fig. 13 the probe according to Fig. 9 in a side view rotated about its direction of extension
  • Fig. 10 shows the handle according to Fig. 4 in a schematic longitudinal section through the section line AA according to Fig. 5
  • Fig. 8 shows an enlarged view of detail B according to Fig. 6
  • Fig. 14 a longitudinal section through the probe according to Fig. 13 along the section line CC
  • Fig. 15 a further embodiment of a handle of a probe system according to the invention in a schematic side view
  • Fig. 16 the handle according to Fig. 15 in a side view rotated about its direction of extension
  • Fig. 17 the handle according to Fig. 16 in a longitudinal section through the section line CC
  • Fig. 18 the handle according to Fig. 14 in a schematic cross section through the section line F.F.
  • Fig. 19 an enlarged view of the detail A according to Fig. 17, Fig. 20 an enlarged view of the detail B according to Fig. 17, Fig. 21 a further embodiment of a handle of a probe system according to the invention in a schematic side view
  • Fig. 16 the handle according to Fig. 15 in a side view rotated about its direction of extension
  • Fig. 17 the handle according to Fig. 16 in a longitudinal section through the section line CC
  • Fig. 18 the
  • Fig. 22 the handle according to Fig. 21 in a side view rotated about its direction of extension
  • Fig. 23 the handle according to Fig. 22 in a longitudinal section through the section line AA
  • Fig. 24 the handle according to Fig. 21 in a schematic cross section through the section line EE
  • Fig. 25 an enlarged view of the detail B according to Fig. 23
  • Fig. 26 an enlarged view of the detail C according to Fig. 23
  • Fig. 27 a further embodiment of a handle of a probe system according to the invention in a schematic side view
  • Fig. 28 shows the handle according to Fig. 27 in a side view rotated about its direction of extension
  • Fig. 29 shows the handle according to Fig. 28 in a longitudinal section through the section line BB
  • Fig. 1 shows a first embodiment of a bipolar probe 10 according to the invention with a probe body 11 in a schematic side view. In the sense of the invention, a distal direction is directed towards a patient, while a proximal direction points towards the user of the probe 10.
  • a distal end part 19 of the probe body 11 has a distal end region 12 with an atraumatic rounding 13, which in the embodiment shown is approximately hemispherical in shape in order to prevent unwanted tissue damage during the processing of tissue by means of the bipolar probe 10.
  • the distal end part 19 of the probe body 11 partially has a first electrode 14, which is arranged on the outer surface 15 of the probe body 11 and which is approximately quarter-spherical in shape, i.e. extends over an angular range of 180° in the circumferential direction, which also includes this area of the rounding 13 as the distal end face 13 of the probe body 11.
  • the first electrode 14 Proximal to the rounding 13, the first electrode 14 is semi-cylindrical in shape.
  • the first electrode 14 extends over its entire axial length, not over the entire circumference of the outer surface 15 of the probe body 11, in order to specifically treat only tissue in the area of the first electrode 14 when using the probe 10 according to the invention.
  • the first electrode 14 has an axial length of 2.7 mm in the embodiment shown.
  • the first electrode 14 is completely surrounded both circumferentially and axially by a first electrically non-conductive region 16, which is also referred to as the first insulation region.
  • the first insulation region 16 also includes a region of the rounding 13 that is not assigned to the first electrode 14, is also made of polyetheretherketone (PEEK) and has a different color design than the first electrode 14.
  • PEEK polyetheretherketone
  • the first insulation region 16 has a partially spherical shape and in a region proximal to the first electrode 14 it has a cylindrical shape.
  • the first insulation region 16 extends proximal to the first electrode 14 and has an axial length of 4.7 mm.
  • a second electrode 17 in the form of an electrically conductive sleeve is attached. which extends over the entire circumference of the outer surface 15 of the probe body 11.
  • the second electrode 17 has an axial length of 3.0 mm and a diameter of 3.3 mm.
  • a second electrically non-conductive region 18 Proximal to the second electrode 17 there is a second electrically non-conductive region 18, thus a second insulation region in the sense of the invention, which, like the first insulation region 16, is made of polyetheretherketone (PEEK) and has the same color design as the latter.
  • the second insulation region 18 has a diameter of 3.5 mm and an axial length of 7.0 mm and extends over the entire circumference of the outer surface 15 of the probe body 11.
  • the second insulation region 18 is designed as an insulating sleeve.
  • the probe body 11 also has a diameter of 3.5 mm, so that a flush transition is formed between the probe body 11 and the second insulation region 18.
  • the probe body 11 has a distal end region 19 which extends from the distal rounding 13 of the probe body 11 to a radial elevation 20 of the probe body 11 arranged proximal to the second insulation region 18 and having a diameter of 4.5 mm, wherein the radial elevation 20 is designed as a stop for a handle 21 (not shown in Fig. 1) in order to limit its axial movement.
  • the distal end part 19 has a total axial length of 320.0 mm.
  • the area of the probe body 11 provided with the radial elevation 20 has a flattening 23 at a proximal end area 22, so that the stop 20, at least in the proximal end region 22, is not rotationally symmetrical.
  • the probe body 11 has an annular recess 24 in the form of an annular groove, which is designed as part of a locking connection with the handle 21.
  • a proximal end part 25 of the probe body 11 has a first electrically conductive contact 26 on its outer surface 15, which is surrounded distally and proximally by an electrically non-conductive insulating sleeve 27, 28 made of polyamide.
  • an electrically conductive contact pin 29 protrudes as a second electrically conductive contact - radially centered - from the proximal end face 30 of the probe body 11.
  • the first contact 26 arranged on the outer surface 15 of the probe body 11 is electrically insulated from the contact pin 29 as the second contact.
  • the first electrode 14 is electrically connected to the first contact 26 arranged on the outer surface 15 via a first electrical line 31, while the second electrode 17 is electrically connected to the contact pin 29 via a second electrical line 32.
  • the electrical lines 31, 32 are each arranged as wires inside the probe body 11 and each with a shrink tube made of polytetrafluoroethylene (PTFE) as electrically non-conductive coating 33, 34 so that the lines 31, 32 are electrically insulated from one another.
  • PTFE polytetrafluoroethylene
  • FIG. 2 shows that the lines 31, 32 are arranged in a common horizontal plane which is offset eccentrically in the direction of the flattened portion 23.
  • the electrodes 14, 17 arranged in the distal end part 19 of the probe body 11 can be supplied with electrical alternating current signals in order to treat tissue which is located at the surgical intervention site in the vicinity of the electrodes 14, 17, in particular in the vicinity of the first electrode 14, which does not extend over the entire circumference of the probe body 11. This protects tissue which is located in the area of the probe body 11 facing away from the first electrode 14.
  • Fig. 3 shows a view rotated by 90° around the direction of extension of the probe body 11 compared to Fig.
  • Fig. 4 shows a handle 21 corresponding to the probe according to Fig. 1 in a schematic side view, wherein the handle 21 together with the probe 10 forms a probe system according to the invention.
  • the outer surface 37 of the handle 21 is designed to be rotationally symmetrical and has a concave curvature in an axially central region 38, with a distal end region 39 and a proximal end region 40 of the handle each having a convex design with a taper.
  • the distal end region 39 of the handle 21 is provided with the aforementioned push button 36, which is designed as an elevation and serves in particular to prevent the handle from rolling away.
  • evenly distributed recesses 35 are formed over the circumference of the handle 21, which extend essentially parallel to the axial direction and serve as a support for the fingers of the user of the handle 21.
  • the outer surface 37 of the handle 21 is roughened at least proximally to its axial center up to and including the entire proximal end region 40 in order to improve the grip of the handle 21.
  • the grip region of the handle 21 shown extends from the recesses 35 proximally up to and including the proximal end region 40.
  • the shape, the material and the recesses 35 of the handle 21 are selected such that the center of gravity of the handle 21 together with the probe 10 connected to it is arranged essentially in the region of the recesses 35.
  • Fig. 5 shows the handle 21 according to Fig. 4 in a schematic view which, starting from Fig. 4, corresponds to a view rotated by 90° around the direction of extension of the handle 21.
  • FIG. 6 shows the handle 21 according to Fig. 5 in a schematic longitudinal section through the section line AA, from which it can be seen that the handle 21 has a lumen 41 formed over its entire axial extent and essentially radially centered as a through opening, the diameter of the lumen 41 being larger than the outer diameter of the probe 10 according to Fig. 1 in order to accommodate the probe 10 in the lumen 41 of the handle 21.
  • the diameter of the lumen 41 is selected such that, when the probe 10 is accommodated, a radial gap is formed between the probe body 11 and the handle 21.
  • the lumen 41 can serve as a flushing channel in order to be able to reprocess the handle 21 after one use for the next use.
  • the push button 36 of the distal end region 39 is provided with a radially movable pin 42 which is formed in one piece with the push button 36 and which is subjected to a force directed upwards in Fig. 6 by means of a spring 43.
  • the pin 42 has an axial opening 44 which, in the position shown in Fig. 6, is aligned with the longitudinal axis of the handle 21 in order to accommodate the probe 10.
  • the radial extent of the opening 44 therefore corresponds essentially to the outer diameter of the probe 10.
  • the handle 21 has on its radial inner side 46 a raised portion 47 (not shown in Fig. 6) which is designed to complement the flattening 23 of the probe body 11 and which results in a reduction in the cross-sectional area.
  • the flattening 23 serves to connect the handle 21 with the probe body 11 in a form-fitting manner and to lock it in the axial direction.
  • the flattening 23 serves as a functional anti-twist device.
  • An area of the pin 42 facing the spring 43 has a projection 45 directed radially towards the center, upwards in Fig. 6, the axial length of which essentially corresponds to the axial length of the annular recess 42 of the probe body 10 according to Fig.
  • the projection 45 is designed in the shape of a part circle and extends in the circumferential direction over an area of more than 180°. In particular, the orientation of the projection 45 also results from the distal view of the handle 21 according to Fig. 7.
  • the push button 36 is then released and the probe body 11 is pushed further through the lumen 41 of the handle 21 until the projection 45 of the pin 42 engages in the annular recess 24 of the probe body 11 due to the force of the spring 43, so that further axial movement of the probe body 11 relative to the handle 21 is avoided, and as a result the probe body 11 is connected to the handle 21 by means of a locking connection.
  • the flattening 23 of the probe body 11 engages in the elevation 47 of the handle, so that further axial movement of the probe 10 is prevented.
  • the push button 36 is actuated so that the projection 45 is disengaged from the annular recess 24 of the probe body and the probe body 11 can be pulled out of the handle 21 distally.
  • the handle 21 has on its proximal end face 48 a recess 49 which is cylindrical in section and in which a cleaning connection 50 is arranged which is designed as a Luer-Lock connection in the embodiment of Fig. 6 and by means of which the lumen 41 of the handle 21 can be flushed for reprocessing using a flushing device (not shown).
  • the cleaning connection 50 serves to remove impurities in the lumen 41 of the handle.
  • Fig. 7 shows the handle 21 of the probe system in a distal view, in particular the position of the push button 36, the radial centering of the lumen 41 and the projection 45 of the pin 42 being visible.
  • the elevation 47 of the handle 21, which is designed to complement the flattening 23 of the probe 19, is also visible.
  • the probe system according to the invention which for example has the handle 21 according to Fig. 4 and the probe 10 according to Fig. 1 inserted into it and connected to it, is guided to the location of the tissue to be treated, which corresponds to the site of the procedure in the sense of the invention.
  • the electrodes 14, 17 are thus arranged adjacent to the tissue to be treated.
  • the electrodes 14, 17 are arranged adjacent to the tissue to be treated.
  • Fig. 9 shows a further embodiment of the probe 10 in a schematic side view, similar to Fig. 1. Since the probe 10 according to Fig. 9 has many features of the probe 10 according to Fig. 1, a further mention of this will be refrained from and, to avoid repetition, reference will be made to the explanations in connection with the figures explained so far.
  • the probe 10 according to Fig. 9 has in the area of the - distal - first electrode 14, in particular in the distal end part 19 of the probe body 11, several openings 51 with a substantially round cross-section, which are distributed over the peripheral area of the first electrode 14.
  • the radial elevation 20 and the flattening 23 arranged proximally therefrom in the proximal end area of the elevation 20 can also be seen.
  • both contacts 26, 29 are formed on the outer surface 15 of the probe body 11.
  • a hollow cylinder 52 arranged within the probe body 11 projects beyond the probe body 11, in particular its proximal end face 30, which will be discussed further below.
  • Fig. 10 shows a longitudinal section through the probe body 11 according to Fig. 9 at the level of the lines 31, 32, illustrated in Fig. 9 by the section line AA. The openings 51 do not open to the lines 31, 32.
  • first line 31, arranged at the top in Fig. 10 electrically connects the first electrode 14 to the first distal contact 26, while the second line 32, arranged at the bottom in Fig. 10, electrically connects the second electrode 17 to the second proximal contact 29.
  • Both lines 31, 32 are located in a common horizontal plane, which is arranged eccentrically offset in the direction of the elevation 20 according to Fig. 9.
  • both lines 31, 32 are each provided with an electrically insulating coating 33, 34 in order to avoid unwanted contact or short circuits.
  • the lines 31, 32 are insulated from one another both in the area of the electrodes 14, 17 and in the area of the contacts 26, 29.
  • Fig. 11 shows a distal view of the probe 10 according to Fig. 9, from which in particular the arrangement of the openings 51 in the area of the first electrode 14, which extends over a circumferential area of 180°, and the first insulation area 16, which also extends over a circumferential area of 180°, can be seen.
  • Fig. 11 shows the radial elevation 20 of the probe body 11.
  • Fig. 12 is a schematic cross section through the probe 10 according to Fig.
  • Fig. 13 shows the probe 10 according to Fig. 8 in a view rotated by 90° around its direction of extension, from which it can be seen that the arrangement of the openings 51 and that of the first electrode 14 face the elevation 20 in the circumferential direction. Due to the already explained anti-twist device of the probe 10 when it is connected to the handle 21, this ensures that the surgeon always knows where the area of the first electrode 14 is located, and thus also the area in which tissue is to be treated during the electrosurgical procedure.
  • Fig. 14 is a schematic longitudinal section through the probe 10 according to Fig.
  • the openings 51 in the area of the first electrode 14 are designed to communicate with an interior 53 of the already mentioned hollow cylinder 52 arranged within the probe body 11.
  • the openings 51 each have essentially a radial orientation in the sense of a of a three-dimensional spherical coordinate system, the center of which corresponds to the center of curvature of the partially spherical atraumatic rounding 13.
  • the hollow cylinder 52 separates its interior 53 from the lines 31, 32, so that in particular tissue in the interior 53 cannot reach the lines 31, 32, thus avoiding short circuits and contamination.
  • electrical contact of the hollow cylinder 52 with both the electrodes 14, 17 and the contacts 26, 29 is avoided.
  • the interior 53 of the hollow cylinder 52 can be connected at least indirectly to a cleaning or rinsing device (not shown) via the proximal end region in order to rinse through the openings 51 at the surgical intervention site and/or to suction off tissue residues from it.
  • the hollow cylinder 52 is designed as a rinsing cylinder.
  • Fig. 15 shows a further embodiment of the handle 21 of the probe system according to the invention in a side view, wherein the handle 21 is designed for use with the probe 10 according to Figs. 9 to 14, for example.
  • the radially tapering proximal region 40 of the handle 21 is provided with an electrically non-conductive flushing insert 55 with a flushing connection 56, which in the embodiment shown is designed as a Luer-Lock connection in order to be able to connect the flushing connection 56 to a flushing device, for example.
  • Fig. 16 is a view rotated by 90° around the direction of extension of the handle 21 compared to Fig. 15, from which the position of the push button 36 and the recesses 35 for the surgeon's fingers can be seen.
  • Fig. 17 corresponds to a schematic longitudinal section through the handle 21 according to Fig. 16 along the section line C-C and shows in particular the already mentioned elevation 47 on the radial inner side 46 in the distal region 38 of the handle 21.
  • the designs of the push button 36 and the pin 42 correspond to those of the handle 21 according to Fig. 6, so that reference is made to the above explanations in this regard.
  • the flushing insert 55 enables the contact insert 58 to be mounted more easily within the handle 21.
  • the contact insert 58 is electrically connected to a plug connection 63 inserted into the opening 62 via an opening 62 in the handle 21 that runs radially outward and proximally in Fig.
  • the plug connection 63 has an angle of not equal to 0° relative to the axial extension direction of the handle 21, approximately 25° in Fig. 17.
  • the length of the opening 62 is selected such that the plug connection 63 can be inserted into the handle 21 for at least 50% of its length.
  • the probe 10 connected to the handle 21 can be in contact with its contacts 26, 29 with the electrically conductive areas 59, 60 of the contacting insert 58, which in turn can be connected via the plug connection 63 and a plug connected thereto (not shown in Fig.
  • the handle 21 according to Fig. 17, with the contact insert 58 and rinsing insert 55, has a lumen 41 extending over its entire axial length.
  • Fig. 18 shows the handle according to Fig. 15 in a schematic cross section along the section line FF from the distal view. This shows that the contact insert 58 is arranged within the handle 21 with a tight fit.
  • Fig. 18 also shows at least part of the pin 42, which in the embodiment shown has the partially circular projection 45, which extends in the circumferential direction over an angular range of more than 180° in order to engage in the annular recess 24 of the probe body 11 in the locked state, as already described.
  • FIG. 19 shows the detail A shown in Fig. 17 in the distal area 39 of the handle 21 in an enlarged view with the pin 42 arranged there with the axial opening 44.
  • Fig. 20 shows the detail B shown in Fig. 17 in the proximal region 39 of the handle 21 in an enlarged view, in particular with the plug connection 63 arranged in the opening 62.
  • the plug connection 63 has the already mentioned distally protruding contact pin 64, which is itself surrounded by an electrically insulating layer 65.
  • an electrically conductive surface 66 is provided in order to electrically connect the proximal electrically conductive region 60 of the contacting insert 58.
  • the electrically conductive surface 66 is surrounded by an electrically insulating surface 67 in order to electrically insulate the former radially outwards.
  • the contact pin 64, the electrically insulating layer 65, the electrically conductive surface 66 and the electrically insulating surface 67 are each aligned coaxially to the longitudinal axis of the plug connection 63, which is aligned radially outwards from distal to proximal.
  • the radially centered contact pin 64 of the plug connection 63 also protrudes from this in the proximal direction.
  • the plug connection is connected to a plug (not shown in Fig. 20), the plug having a radially centered recess for receiving the contact pin 64 and an electrically conductive surface arranged radially outside the recess for contacting the electrically conductive surface 64 of the plug connection 63.
  • the plug is designed to be complementary to the proximal region of the plug connection 63.
  • Figs. 21 to 26 show a further embodiment of the handle 21 with a handle that is larger than the handle in Fig. 15 radially widened proximal region 40, which, however, also has the previously explained flushing insert 55 and the contacting insert 58.
  • Fig. 22 shows a view rotated by 90° about the direction of extension of the handle 21 compared to Fig.
  • Fig. 23 shows a longitudinal section through the section line AA of Fig. 22. This shows that the contacting insert 58 is arranged axially spaced from the flushing insert 55.
  • the handle 21 according to Fig. 23 also has an opening 62 for inserting the plug connection 63, but the length of the plug connection 63 is selected here such that the plug connection 63 is arranged completely within the opening 62 in the fully inserted position and is therefore accommodated in the handle 21.
  • the design of the plug connection 63 and the contacting insert 58 essentially correspond to the already explained Fig. 17.
  • Fig. 24 is a schematic cross section through the section line EE according to Fig.
  • Fig. 24 is essentially similar to Fig. 18.
  • Fig. 25 shows, similar to Fig. 19, an enlarged view of detail B of Fig. 23.
  • Fig. 26 is an enlarged view of detail C of Fig. 22 and shows the plug connection 63 arranged in the opening 62, the structure of which is similar to that of the plug connection 63 according to Fig. 19 with the exception of its already described, now changed length.
  • Fig. 27 to Fig. 33 show a further embodiment of the handle 21 which is similar to the handle 21 of Fig.
  • Fig. 28 shows a view of the handle 21 rotated by 90° around the longitudinal axis of the handle compared to Fig. 27, and Fig. 29 shows a longitudinal section through the handle 21 according to Fig. 28 along the section line B-B.
  • a significant difference to the handle 21 according to Fig. 15 to Fig. 20 concerns the contacting of the contact insert 58.
  • a recess 68 is now formed as a plug connection 63.
  • the recess 68 is directed radially inwards from proximal to distal and has a tapered region 69 distally, at the axial height of the distal electrically conductive region 59 of the contact insert 58.
  • the dimensions of the recess 68 are selected such that the plug 70, also shown in Fig. 29, can be received therein, the plug 70 being described further below in connection with Figs. 32 and 33.
  • Fig. 30 is a schematic cross section through the section line AA of Fig. 27, so that this illustration, in contrast to Fig. 18, does not show the recess 68.
  • Fig. 31 is an enlarged view of detail C of Fig. 29 and largely corresponds to the illustration according to Fig. 19. Fig.
  • FIG. 32 shows in an enlarged view of detail D of Fig. 29 the recess 68 of the handle 21 as a plug connection 63 for receiving the plug 70. Accordingly, the distally arranged, tapered area 69 of the recess 68 is arranged at the axial height of the distal electrically conductive region 59, while the remaining region of the recess 68 is arranged essentially at the axial height of the proximal electrically conductive region 69 of the contact insert 58.
  • Fig. 33 shows an enlarged view of detail E of Fig. 29 of the structure of the plug 70 for explanation in a partial section.
  • the plug 70 has, radially centered, a distally protruding, electrically conductive contact pin 71, the lateral extent of which is selected such that the contact pin 71 can be received by the tapered region 69 of the recess 68 and can thereby electrically contact the distal electrically conductive region 59.
  • the contact pin 71 is electrically insulated by an electrically insulating layer 72 as a lateral surface from an electrically conductive region 73 arranged radially outside the same, which is also designed as a lateral surface. To avoid short circuits, the electrically conductive lateral surface 73 is shielded by an insulation 74 arranged radially outside the same.
  • the contact pin 71, the electrically insulating layer 72, the electrically conductive lateral surface 73 and the insulation 74 are arranged coaxially.
  • the contact pin 71 of the plug 70 contacts the first electrode 14 of the probe 10.
  • the electrically conductive lateral surface 73 is designed in such a way that when the plug 70 is inserted in the recess 68, it can contact the proximal electrically conductive region 60 of the contact insert 58 and, via this, finally the second electrode 17 of the probe 10.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Otolaryngology (AREA)
  • Neurology (AREA)
  • Surgical Instruments (AREA)
  • Neurosurgery (AREA)
  • Plasma & Fusion (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)

Abstract

L'invention concerne une sonde bipolaire pour une procédure électrochirurgicale. La sonde comprend un corps de sonde ayant une partie d'extrémité distale et la partie d'extrémité distale comprend sur sa surface latérale deux électrodes qui sont isolées électriquement l'une de l'autre, au moins une première électrode, sur au moins une partie de sa longueur axiale, ne s'étendant pas sur toute la circonférence de la partie d'extrémité distale, et les électrodes étant chacune connectées par l'intermédiaire d'une ligne électrique à un contact électrique du corps de sonde. L'invention concerne également un système de sonde comprenant une poignée et la sonde bipolaire pouvant être connectée à la poignée. Enfin, l'invention concerne un procédé pour une procédure électrochirurgicale utilisant la sonde bipolaire, la sonde pouvant être déplacée vers un emplacement de procédure de sorte que le tissu à traiter est situé de manière adjacente aux électrodes, et un courant électrique étant ensuite appliqué aux électrodes de la sonde de sorte que le traitement du tissu est effectué.
PCT/EP2024/051757 2023-01-27 2024-01-25 Sonde bipolaire, système de sonde, et procédé pour une procédure électrochirurgicale WO2024156800A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102023102049.8 2023-01-27
DE102023102049.8A DE102023102049A1 (de) 2023-01-27 2023-01-27 Bipolare Sonde, Sondensystem und Verfahren für einen elektrochirurgischen Eingriff

Publications (1)

Publication Number Publication Date
WO2024156800A1 true WO2024156800A1 (fr) 2024-08-02

Family

ID=89767697

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2024/051757 WO2024156800A1 (fr) 2023-01-27 2024-01-25 Sonde bipolaire, système de sonde, et procédé pour une procédure électrochirurgicale

Country Status (2)

Country Link
DE (1) DE102023102049A1 (fr)
WO (1) WO2024156800A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060259026A1 (en) * 2005-05-05 2006-11-16 Baylis Medical Company Inc. Electrosurgical treatment method and device
US20070027449A1 (en) * 2002-03-05 2007-02-01 Baylis Medical Company Inc. Electrosurgical device and methods
US20140236144A1 (en) * 2013-02-21 2014-08-21 Carefusion 2200, Inc. Intravertebral tissue ablation device and method
US20200390496A1 (en) * 2019-06-14 2020-12-17 Avolt, Llc Electromagnetic radiation ablation tips made of magnetic materials

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080234673A1 (en) 2007-03-20 2008-09-25 Arthrocare Corporation Multi-electrode instruments
DE202008004064U1 (de) 2008-03-25 2008-07-17 ArthroCare Corporation, Austin Ablationsgerät mit reduzierter Nervenstimulation
GB2479582B (en) 2010-04-15 2016-05-04 Gyrus Medical Ltd A surgical instrument
DE102012007650A1 (de) 2012-04-18 2013-10-24 Karl Storz Gmbh & Co. Kg Handhabungseinrichtung für ein medizinisches Instrument
DE102020130716A1 (de) 2020-11-20 2022-05-25 Karl Storz SE & Co. KG Intellectual Property Verbindungsvorrichtung und monopolares Kabel für monopolar und bipolar betreibbare chirurgische Instrumente, chirurgisches Instrument und chirurgisches System
CN112914721A (zh) 2021-03-23 2021-06-08 上海微创电生理医疗科技股份有限公司 电极装置、医疗导管和消融系统

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20070027449A1 (en) * 2002-03-05 2007-02-01 Baylis Medical Company Inc. Electrosurgical device and methods
US20060259026A1 (en) * 2005-05-05 2006-11-16 Baylis Medical Company Inc. Electrosurgical treatment method and device
US20140236144A1 (en) * 2013-02-21 2014-08-21 Carefusion 2200, Inc. Intravertebral tissue ablation device and method
US20200390496A1 (en) * 2019-06-14 2020-12-17 Avolt, Llc Electromagnetic radiation ablation tips made of magnetic materials

Also Published As

Publication number Publication date
DE102023102049A1 (de) 2024-08-01

Similar Documents

Publication Publication Date Title
DE60024877T2 (de) Elektrokauterisationskatheter
DE4414807C2 (de) Elektrochirurgisches Instrument zur Therapie von Varizen
EP1044654B1 (fr) Système de traitement électrothermique du corps humain ou animal
DE112011101324B4 (de) Chirurgisches Instrument
DE102008048616B4 (de) Urologischer Ballonkatheter
DE602005001776T2 (de) Bipolare elektrochirurgische Schlinge
EP2243437B1 (fr) Appareil d'hystérectomie doté d'un manipulateur d'utérus
DE2513868A1 (de) Elektrische vorrichtung zum behandeln von erkranktem gewebe durch hindurchleiten eines hochfrequenten stroms
EP0536440A1 (fr) Appareil de chirurgie à H.F. pour couper et coaguler
EP1868520A1 (fr) Instrument chirurgical d'endoscopie
EP2558017A1 (fr) Ensemble d'électrodes
EP1151724B1 (fr) Applicateur à ultrason pour la désintegration de tissus
DE3738429C2 (fr)
AT411013B (de) Venenstripper
EP3372183B1 (fr) Instrument d'ablation
EP3471642B1 (fr) Instrument chirurgical pour la diathermie chirurgicale et accessoire pour celui-ci
WO2024156800A1 (fr) Sonde bipolaire, système de sonde, et procédé pour une procédure électrochirurgicale
DE102004042998A1 (de) Elektrochirurgische Sonde
EP2405845A2 (fr) Procédé et dispositif pour faire fonctionner un système chirurgical hf
DE102009053438B4 (de) Resektoskop
DE102018122010B4 (de) Resektoskop mit Betätigungselement zur Stromunterbrechung
WO2001034046A1 (fr) Dispositif pour prelever delicatement du tissu humain ou animal
WO2003079915A2 (fr) Instrument medical pour traiter des tissus au moyen de courant haute frequence et systeme medical comportant un instrument medical de ce type
EP3158960B1 (fr) Électrode ayant un etranglement destine a empecher des combustions induites par un courant de fuite hf
DE102013210960A1 (de) Elektrochirurgisches Instrument

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 24702299

Country of ref document: EP

Kind code of ref document: A1