The present invention relates to electrosurgical instruments. More specifically, the present invention relates to an end effector for an electrosurgical instrument, the end effector comprising an electrode assembly.
Surgical instruments, including radio frequency (RF) electrosurgical instruments, have become widely used in surgical procedures where access to the surgical site is restricted to a narrow passage, for example, in minimally invasive “keyhole” surgeries.
RF electrosurgical instruments typically include an active electrode which forms a distal RF tip of the instrument, and a return electrode. The distal RF tip provides tissue ablation and/or coagulation effects at a surgical site when a RF power signal is delivered to the electrodes.
In prior art RF bi-polar electrode assemblies, the return electrode is often configured as an outer steel shaft that is mechanically coupled to the handle of the instrument. In order to limit the exposed return electrode to just the distal end of instrument assembly, an insulating material is usually provided over the return electrode. This is typically a heat-shrink style material such as polyvinylidene fluoride (PVDF), or a rigid lumen configured to tightly slide over the outer shaft.
As such, there is a need to further improve the configuration of the return electrode and its definition at the distal end of the device.
In known RF electrosurgical instruments that implement a return electrode in the form of an outer shaft, the insulating sleeve used to define the end region of the return electrode typically leaves a blunt edge that can catch on other surfaces during use. This can result in damage to the entry site on the patient, and if the material erodes a sufficient amount, can lead to material being left in the patient after the instrument is removed, or an increase in the RF current density if pinholes are created in the insulating sleeve. The present disclosure therefore seeks to address this problem by providing a lead-in feature on the electrode assembly, to gradually increase the diameter of the outer shaft to that of the insulation sleeve. This would prevent a user catching this edge on the cannula, and therefore reduce the force needed to insert the device, and reduce the risk of damaging the insulation or hurting the patient.
A first aspect of the present disclosure provides an end effector for an electrosurgical instrument, comprising an electrode assembly for delivering a radio-frequency (RF) power signal to a surgical site, the electrode assembly comprising an active electrode and a return electrode, wherein the electrode assembly comprises at least a first portion having a first outer diameter and a second portion having a second outer diameter, the first outer diameter being larger than the second outer diameter; and an insulating sleeve configured to be received by the second portion of the electrode assembly, the insulating sleeve having an outer diameter substantially the same as the first outer diameter.
For example, the return electrode may comprise the first portion having the first outer diameter and the second portion having the second diameter. As such, when the insulating sleeve is placed around the second portion of the return electrode, the outer surface of the insulating sleeve lies substantially level with the outer surface of the first portion of the return electrode, thereby forming a smooth outer surface at the junction between the first portion and the insulating sleeve. As such, there is no lip or edge formed by the end of the insulating sleeve on which things may catch, thus reducing the force needed to insert the device.
The return electrode may comprise a lead-in feature between the first portion and the second portion to thereby provide a difference in outer diameter. That is to say, the return electrode comprises a feature that creates the difference in diameter between the first portion and the second potion.
For example, the return electrode may comprise a protruding edge formed between the first portion and the second portion. The protruding edge may extend around at least a portion of a circumference of the return electrode. For example, the protruding edge may extend around up to about 75% of the circumference of the return electrode. The remaining circumference of the return electrode may then provide a surface for receiving the active electrode or a ceramic insulator.
An end of the insulating sleeve may be configured to mate with a surface of the protruding edge. That is to say, edge may comprise a surface pointing in the proximal direction (i.e., away from the active electrode and towards the handle of the instrument); when the insulating sleeve is formed around the second portion of the return electrode, the end of that insulating sleeve abuts the surface of the protruding edge.
In some arrangements, the first portion of the return electrode may comprise a sloped surface, the sloped surface forming the protruding edge. That is to say, the outer diameter of the first portion gradually increases, such that the outer diameter in the region of the protruding edge substantially matches the outer diameter of the insulating sleeve.
It will of course be appreciated that the first and second portions may be provided by different parts of the electrode assembly. For example, the return electrode may provide the second portion, whilst the first portion with the larger diameter may be provided by a separate lead in component arranged on the electrode assembly, for example, on a ceramic insulating component. That is, the electrode assembly may further comprise an insulating element arranged between the active electrode and the return electrode, wherein the insulating element comprises the first portion having the first outer diameter and the return electrode comprises the second portion having the second outer diameter.
The insulating element may be formed of a ceramic or a polymer.
The end effector may also comprise a rotary shaver arrangement. In such cases, the rotary shaving arrangement may be operably connected to drive componentry to drive the rotary shaver to operate in use.
The insulating sleeve may be heat-shrink wrapped around the second portion of the electrode assembly. The insulating sleeve may comprise a polymer material. For example, the polymer material may comprise polyvinylidene fluoride.
The return electrode may be manufactured by a process of metal injection moulding. This allows the lead-in feature (e.g., the protruding edge) to be easily moulded into the return electrode component without adding significant cost to the return electrode or overall assembly of the end effector.
The active electrode may comprise an aperture for providing access to a suction channel extending through the insulating element to a lumen configured to carry fluid from the surgical site. The lumen may be connectable to a suction tube for connecting to a suction source.
The active electrode and/or return electrode may be formed from a metal. For example, the metal may be any one of copper, stainless steel, tungsten or an alloy of tungsten and platinum.
The active electrode and the return electrode may be connectable to a RF power source.
A further aspect provides an electrosurgical instrument, comprising a hand-piece, one or more user-operable buttons on the handpiece for operably controlling the instrument, and an operative shaft, having RF electrical connections, and drive componentry for an end effector, the electrosurgical instrument further comprising an end effector as described above, the active electrode and the return electrode being connected to the RF electrical connections.
Another aspect provides an electrosurgical system, comprising an RF electrosurgical generator, a suction source, and an electrosurgical instrument as described above, the arrangement being such that in use the RF electrosurgical generator supplies an RF coagulation or ablation signal via the RF electrical connections to the active electrode and the return electrode.
Yet a further aspect of the present invention may provide a method for processing an instrument for surgery, the method comprising obtaining an electrosurgical instrument and/or end effector described herein, sterilizing the electrosurgical instrument and/or end effector, and storing the electrosurgical instrument and/or end effector in a sterile container.
Embodiments of the invention will now be further described by way of example only and with reference to the accompanying drawings, wherein like reference numerals refer to like parts, and wherein:
As described above, the electrosurgical instrument 3 may be a dual sided (or an opposite sided) RF shaver device. In this respect, the main RF componentry and the manual shaving/cutting componentry of the instrument 3 can be provided on opposite sides of a distal end portion of the instrument 3. The structure of the distal end of the instrument is described in more detail below.
In known RF electrosurgical instruments that implement a return electrode in the form of an outer shaft, the insulating sleeve used to define the RF return area typically leaves a blunt edge that can catch on other surfaces during use. This can result in damage to the entry site on the patient, and if the material erodes a sufficient amount, can lead to material being left in the patient after the instrument is removed. The present disclosure therefore seeks to address this problem by providing a lead-in feature on the electrode assembly, to gradually increase the diameter of the outer shaft to that of the insulation diameter. This would prevent a user catching this edge on the cannula, and therefore reduce the force needed to insert the device, and reduce the risk of damaging the insulation or hurting the patient.
The return electrode component 106 is shown in more detail in
The shaft 108 comprises a lumen 112 that provides a hollow space for receiving an inner blade arrangement 132, as shown in more detail in
The distal end region 114 of the return electrode component 106 is further provided with lead-in feature in the form of a sloped surface 124 around at least portion of its circumference, for example, approximately 75% of its circumference extending from one side 120a of the mating surface 120 to the opposing side 120b, such that the profile of the distal end region 114 extends beyond that of the shaft 108, and such that it forms an edge 126 facing in the proximal direction (i.e., towards the shaft 108). In this respect, the protruding edge 126 also extends around at least portion of the circumference of the return electrode component, for example, approximately 75% of the circumference. When the insulating sleeve 110 is assembled, as shown in
The return electrode component 106 may be manufactured by any suitable means. One particularly advantageous manufacturing method is Metal Injection Moulding (MIM), which would allow the lead-in feature (e.g., the sloped surface 124) to be easily moulded into the return electrode component 106 without adding significant cost to the return electrode 106 or overall assembly of the end effector 100. Alternatively, the return electrode component 106 may be machined or 3D printed.
Whilst the example described with reference to
As another example, a separate lead-in component may be assembled onto the return shaft or insulating casing, and then welded or bonded in place,
Various further modifications to the above-described embodiments, whether by way of addition, deletion or substitution, will be apparent to the skilled person to provide additional embodiments, any and all of which are intended to be encompassed by the appended claims.
The electrosurgical instrument and/or end effector disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, the electrosurgical instrument and/or end effector can be reconditioned for reuse after at least one use. Reconditioning can include a combination of the steps of disassembly of the electrosurgical instrument, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the electrosurgical instrument can be disassembled, and any number of particular pieces or parts of the device (such as the end effector) can be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, the electrosurgical instrument can be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure.
Those of ordinary skill in the art will appreciate that the reconditioning of an electrosurgical instrument can utilize a variety of different techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned electrosurgical instrument, are all within the scope of the present application.
Preferably, the invention described herein will be processed before surgery. First a new or used instrument is obtained and, if necessary, cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK® bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or higher energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility. The electrosurgical instrument may also be sterilized using any other technique known in the art, including but limited to beta or gamma radiation, ethylene oxide, or steam.
There follows a set of numbered features describing particular embodiments of the invention. Where a feature refers to another numbered feature then those features may be considered in combination.
1. An end effector for an electrosurgical instrument, comprising:
2. An end effector according to feature 1, wherein the return electrode comprises the first portion having the first outer diameter and the second portion having the second diameter.
3. An end effector according to feature 2, wherein the return electrode comprises a lead-in feature between the first portion and the second portion to thereby provide a difference in outer diameter.
4. An end effector according to features 2 or 3, wherein the return electrode comprises a protruding edge formed between the first portion and the second portion.
5. An end effector according to feature 4, wherein the protruding edge extends around at least a portion of a circumference of the return electrode.
6. An end effector according to features 4 or 5, wherein the protruding edge extends around up to about 75% of the circumference of the return electrode.
7. An end effector according to any of features 4 to 6, wherein an end of the insulating sleeve is configured to mate with a surface of the protruding edge.
8. An end effector according to any of features 4 to 7, wherein the first portion of the return electrode comprises a sloped surface, the sloped surface forming the protruding edge.
9. An end effector according to feature 1, wherein the electrode assembly further comprises an insulating element arranged between the active electrode and the return electrode, wherein the insulating element comprises the first portion having the first outer diameter and the return electrode comprises the second portion having the second outer diameter.
10. An end effector according to any of features 2 to 8, wherein the electrode assembly further comprises an insulating element arranged between the active electrode and the return electrode.
11. An end effector according to features 9 or 10, wherein the insulating element is formed of a ceramic or a polymer.
12. An end effector according to any preceding feature, further comprising a rotatory shaver arrangement.
13. An end effector according to any preceding feature, wherein the insulating sleeve is heat-shrink wrapped around the second portion of the electrode assembly.
14. An end effector according to any preceding feature, wherein the insulating sleeve comprises a polymer material.
15. An end effector according to feature 14, wherein the polymer material comprising polyvinylidene fluoride.
16. An end effector according to any preceding feature, wherein the return electrode is manufactured by a process of metal injection moulding.
17. An end effector according to any preceding feature, wherein the active electrode comprises an aperture for providing access to a suction channel extending through the insulating element to a lumen configured to carry fluid from the surgical site.
18. An end effector according to feature 17, wherein the lumen is connectable to a suction tube for connecting to a suction source.
19. An electrosurgical instrument, comprising:
20. An electrosurgical system, comprising:
Number | Date | Country | |
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63340108 | May 2022 | US |