The present invention relates to forceps for use in deep body cavity surgery, and more particularly to a forceps for use in division of tissues of haemostasis in such surgeries.
It is a common practice in some surgical techniques to utilize electrical current for the cauterization or electro-coagulation of small blood vessels and the like. While foot switches operated by the surgeon have been used to operate such devices, the shortcomings of this arrangement have led to the development of alternate devices that provide safer and more sophisticated control of the cauterization instrument. For example, in the 1960s, relay operated electrosurgical forceps were developed, such as disclosed in U.S. Pat. No. 3,100,489 to Bagley. In the forceps of Bagley, closure of the forceps itself closes a switching means to provide radio frequency electrical energy to a site to be treated.
In this type of arrangement, typically, the contacts of the switch on the forceps are exposed to permit engagement thereof when the forceps are closed. Inasmuch as the potentials on these exposed contacts can be substantial, however, there is a certain degree of danger associated therewith. The danger of inadvertently burning unintended tissue is magnified in deep body cavity type surgery, particularly where the surgeon is operating through a relatively small incision. Further, in surgeries where excessive moisture is present, such fluid can cause inadvertent electrical contact and activation of electrical energy.
In an attempt to remedy these shortcomings, hand-switch operated electrosurgical forceps were developed. Such an arrangement is disclosed, for example in U.S. Pat. No. 4,041,952 to Morrison, Jr. In hand-switch forceps, a switching member is disposed on only one tine of the forceps, and is operated independently of the closing of the forceps. This type of arrangement, however, likewise has its shortcomings. Most notably, the operation of the switching member is sometimes cumbersome. Moreover, it requires the extra step of actuating the switch, rather than the automatic operation upon closure of the forceps.
As a result, it is desirable to provide an electrosurgical forceps arrangement that overcomes the shortcomings and maintains the advantages associated with the various arrangements known in the art.
The invention provides an electromechanical forceps arrangement that includes a switch in the form of an insulated pin and an insulated cylinder block to receive the pin midway along the respective tines. The insulated pin and insulated cylinder block contain respective contacts. Except for the contacts themselves, the switch is fully enclosed and fully insulated so that when it is activated, there is no leakage of high frequency electrosurgical current in the surrounding area. The distal end of the pin is normally disposed within the opening in the cylinder block such that they are not in contact with the closing of the tips of the tines. The gap between the contacts is sized such that there is no uninsulated part of the switch that is exposed when the instrument tips are open. As a result, the electrosurgical hand-switching device allows the instrument to be in close proximity to tissue or with the pocket of the surgical site without the danger of burning the surrounding areas around the switch with unintended spark or contact. When the switch contacts are touching each other, however, it activates the flow of high frequency current from an energy source, such as an electrosurgical generator to the surgical site.
In use, the surgeon brings the tines of the forceps together to touch the tips to the desired surgical site. Additional force is required, however, to bring the midsections of the tines further toward each other in order to touch the switch contacts. Thus, once in such proper position, the surgeon squeezes the central portions of the tines slightly further to cause the uninsulated contact at the distal tip of the pin to engage the second contact at the uninsulated base of the cylinder block to activate electrical current to the tips of the tines.
In a monopolar application, the instrument comprises an active electrode (+), while the dispersive electrode is remotely attached to the patient body, which is the ground (−). Conversely, in a bipolar application, both poles are contained within the instrument, either tip of the respective tine being the active electrode or the ground. In both monopolar and bipolar application, the switch is attached to the forceps, which is connected to the electrosurgical generator by a cable. Accordingly, the surgeon may remotely and instantaneously activate the electrosurgical generator by closing or touching the switch contacts together.
The switch contacts can be made from any conductive and biocompatible material. Inasmuch as the device is preferably reusable, the switch insulation or shielding can be any biocompatible material that withstands high frequency electrosurgical voltage at elevated levels, and can be sterilized in any manner of hospital sterilization process.
These and other objects and advantages of the invention will be apparent to those skilled in the art upon reading the following detailed description and upon reference to the drawings.
Turning now to the drawings, there is shown in
In use, as the tips 30, 32 of the forceps 22 are closed around tissue (not shown), electrosurgical current is passed to through the tines 24, 26 to the tips 30, 32 such that it is applied to the grasped tissue to cauterize or electro-coagulate small blood vessels at a surgical site. Power is typically supplied to the surgical forceps 22 from a power source (not shown) by way of a cable 40 that may be coupled to the power source by ajack or plug or other appropriate fitting arrangement 42. While the illustrated embodiment includes a two-prong jack 42, the fitting arrangement 42 could alternately include a three-prong jack, for example, as is known in the industry. The illustrated embodiment comprises a monopolar cable 40 comprising two wires 44, 46. It will be appreciated, however that a bipolar arrangement may alternately be utilized in keeping with the invention. The wires 44, 46 are electrically coupled to the respective tines 24, 26 such that when the tips 30, 32 are closed around the tissue and upon closing of a switching assembly (indicated generally as 48), power is supplied to one or both of the tips 30, 32. The arrangement for electrically coupling the wires 44, 46 to the tines 24, 26 will be explained in greater detail below.
As may best be seen in
In accordance with the invention, the switching assembly 48 is fully enclosed and insulated such that electrosurgical current may be accurately, selectively provided to the surgical site, substantially eliminating undesirable arcing that may result in an unintended spark or flow of power. More specifically, and as shown in more detail in
In a currently preferred embodiment of the invention, the pin 54 comprises an enlarged head 61 and a probe portion 68. The proximal end 62 of the pin 54, here, a portion of the head 61, is preferably received in a first bore 64 in one of the tines 24, while the cylinder block 56 is received in a bore 66 in the other tine 26. In this way, the pin 54 and cylinder block 56 extend toward one another between the tines 24, 26, the probe portion 68 of the pin 54 being disposed within the channel 55 of the cylinder block 56 with the contact 58 at the distal end 70 of the pin 54 being spaced slightly apart from the contact 60 at the base 57 of the cylinder block 56 in the free position (see
The switch 48 is connected to the power supply by the wires 44, 46, which are preferably jacketed. As shown in
According to another important feature of the invention, the switching assembly 48, and, more particularly, the pin 54 and cylinder block 56 are insulated to prevent inadvertent closing of the switch 48 and supply of current to the tips 30, 32. In the currently preferred embodiment, sleeves 72, 74 of insulation are disposed about the wire 44 and the tines 24, 26, with the insulative sleeves 72, 74 substantially covering all of pin 54 and cylinder block 56 except the probe portion 68 of the pin 54 and the channel 55 of the cylinder block 56. While the insulative sleeves 72, 74 may be of any appropriate material, in the currently preferred embodiment, a polymeric material such as Kynar is utilized. As with the primary insulative sleeves, the secondary insulative sleeves 72, 74 must by formed of a biocompatible material that withstands high frequency electrosurgical voltage at elevated levels, as well as the rigors of autoclaving. Further, while the insulative sleeves 72, 74 may be applied in any appropriate manner, in the currently preferred embodiment, the insulative sleeves 72, 74 are overwraps that are then heat shrunk to the tines 24, 26. It will be appreciated, however, that alternate materials, arrangements or assembly methods may be utilized within the scope of the present invention.
Preferably, the forceps 22 may be repeatedly autoclaved or otherwise sterilized for repeated use. Alternately, the forceps assembly 20 may be utilized and discarded thereafter.
While this invention has been described with an emphasis upon preferred embodiments, variations of the preferred embodiments can be used, and it is intended that the invention can be practiced otherwise than as specifically described herein. Accordingly, this invention includes all modifications encompassed within the spirit and scope of the invention as defined by the following claims.
All of the references cited herein, including patents, patent applications, and publications, are hereby incorporated in their entireties by reference.
Number | Date | Country | |
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60565294 | Apr 2004 | US |