The present disclosure relates to electrosurgical instruments, and more particularly, to electrosurgical loop instruments for resecting tissue.
Electrosurgical instruments and techniques are widely used in surgical procedures because they generally reduce patient bleeding and trauma associated with cutting operations. One such electrosurgical instrument is an electrosurgical loop instrument. Generally, electrosurgical loop instruments include a handle, a shaft extending from the handle, and an electrosurgical loop disposed at a distal end portion of the shaft. The electrosurgical loop may be extended and retracted to ensnare tissue to resect tissue. The resection may be performed within a specimen bag or, alternatively, the resected tissue may be placed into a specimen bag after resection, to keep the resected tissue away from healthy tissue.
However, electrosurgical loops can lack structural rigidity and therefore limit user control over their placement around tissue. Moreover, external surfaces (e.g., specimen bags) risk exposure to electrical energy and/or heat from the electrosurgical loop during the course of a procedure, even when the electrosurgical loop is not receiving electrical energy.
Accordingly, a need exists for an electrosurgical loop that provides for improved user control and that can protect external surfaces from exposure to electrical energy and/or heat from electrosurgical loops during the course of a surgical procedure.
According to an aspect of the present disclosure, an electrosurgical instrument is provided including a handle assembly having an actuator and a shaft extending distally from the handle assembly. An electrosurgical loop is adapted to connect to a source of energy and is operably supported at a distal end portion of the shaft. The electrosurgical loop is movable relative to the shaft between a first retracted state and a first expanded state. A support structure is operably supported at the distal end portion of the shaft and is disposed about the electrosurgical loop. The support structure is movable relative to the shaft between a second retracted state and a second expanded state. Actuation of the actuator moves at least one of the electrosurgical loop or the support structure from the retracted state to the expanded state. The electrosurgical loop and the support structure are movable relative to each other.
In embodiments, the support structure includes an inner surface and an outer surface. The inner surface is configured for contact with the electrosurgical loop and the outer surface is configured for contact with an external surface. The support structure is configured to shield the external surface from heat and energy from the electrosurgical loop.
In some embodiments, the support structure is a band disposed about an outer periphery of the electrosurgical loop. The band defines a width that is greater than a width of the electrosurgical loop.
In certain embodiments, the electrosurgical loop includes a metal selected from the group consisting of copper, copper alloy, stainless steel, tungsten, platinum, niobium, and molybdenum.
In embodiments, the actuator is a movable trigger movable relative to a fixed handle of the handle assembly.
In some embodiments, a second actuator is coupled to the handle assembly and is configured to move the electrosurgical loop relative to the shaft and is configured to move the support structure relative to the shaft.
In certain embodiments, the electrosurgical loop is connected to a source of electrical energy to energize the electrosurgical loop for resection of tissue therewith.
In embodiments, the electrosurgical loop includes a sleeve surrounding a portion of the electrosurgical loop.
In some embodiments, the support structure is configured to provide structural reinforcement to the electrosurgical loop.
In certain embodiments, the support structure includes an insulative material.
According to another aspect of the present disclosure, an electrosurgical instrument is provided, including a handle assembly having at least one actuator and a shaft extending distally from the handle assembly. An electrosurgical loop is operably supported at a distal end portion of the shaft. The electrosurgical loop includes first and second arms pivotably connected to each other at distal end portions thereof. The first and second arms are pivotable relative to one another to move the electrosurgical loop between a retracted state and an expanded state. A first stiffening sleeve is disposed partially about the first arm and a second stiffening sleeve is disposed partially about the second arm. The first and second stiffening sleeves are configured to provide structural reinforcement to the electrosurgical loop.
In embodiments, a pivot pin pivotably connects the first and second arms to each other.
In some embodiments, the pivot pin is formed from an electrically conductive material configured to permit electrical energy transmission between the first and second arms.
In certain embodiments, the first and second stiffening sleeves are formed from a spring steel configured to enable the electrosurgical loop to move between a non-deflected position and a deflected position.
In embodiments, a band is disposed about an outer periphery of the electrosurgical loop and defines a width that is greater than a width of the electrosurgical loop.
In some embodiments, the band includes an inner surface and an outer surface. The inner surface is configured for contact with the electrosurgical loop and the outer surface is configured for contact with an external surface. The band is configured to shield the external surface from heat and energy from the electrosurgical loop.
In certain embodiments, the at least one actuator includes a first trigger and a second trigger. The first trigger is configured to move the electrosurgical loop and the second actuator is configured to move the band about the electrosurgical loop. The electrosurgical loop and the band are movable relative to each other.
In embodiments, the electrosurgical loop is connected to a source of electrical energy to energize the electrosurgical loop for resection of tissue therewith.
In some embodiments, the electrosurgical loop includes a metal selected from the group consisting of copper, copper alloy, stainless steel, tungsten, platinum, niobium, and molybdenum.
Objects and features of the present disclosure will become apparent to those of ordinary skill in the art when descriptions thereof are read with reference to the accompanying drawings, of which:
Embodiments of the present disclosure are described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “distal” refers to that portion of structure farther from the user, while the term “proximal” refers to that portion of structure closer to the user. As used herein, the term “clinician” refers to a doctor, nurse, or other care provider and may include support personnel. In the following description, well-known functions or constructions are not described in detail to avoid obscuring the present disclosure in unnecessary detail.
Referring initially to
Handle assembly 110 is configured for gripping and/or using electro surgical instrument 100 and generally includes a fixed handle 111 depending from a housing 112, a first squeezable trigger 113 pivotably attached to fixed handle 111, and a second squeezable trigger 115 pivotably attached to housing 112. Handle assembly 110 may further include a switch 117. First trigger 113 is operatively connected to electrosurgical loop 130 to move electrosurgical loop 130, and second trigger 115 is operatively connected to support structure 140 to move support structure 140, as will be described below, although a single trigger, e.g., first trigger 113, may alternatively be configured to move both electrosurgical loop 130 and support structure 140. Handle assembly 110 may further include a switch 117 that is selectively activatable to energize electrosurgical loop 130. It should be appreciated that handle assembly 110 may include alternative configurations to move one of electrosurgical loop 130 and support structure 140, such as the handle assemblies of commonly owned U.S. Pat. Nos. 8,734,464 and 9,370,341, the entire contents of each of which is hereby incorporated by reference.
Shaft 120 extends distally from handle assembly 110 and is generally an elongated tube configured for insertion into a body cavity, e.g., an abdominopelvic cavity. Shaft 120 includes first and second cables or drive assemblies 121, 123 disposed therein. First drive assembly 121 is connected to first trigger 113 at a proximal end portion thereof and to electrosurgical loop 130 at a distal end portion thereof. Second drive assembly 123 is connected to second trigger 115 at a proximal end portion thereof and to support structure 140 at a distal end portion thereof. Pivoting of first trigger 113 relative to fixed handle 111 thus moves first drive assembly 121 through shaft 120 to move electrosurgical loop 130, and movement of second trigger 115 relative to housing 112 moves second drive assembly 123 to move support structure 140.
With additional reference to
With reference to
Electrosurgical loop 130 may be formed from or include any material having suitable electrical conductivity. For example, electrosurgical loop 130 may be formed from metal, such as, e.g., copper, copper alloy, stainless steel, tungsten, platinum, niobium, molybdenum, etc. Electrosurgical loop 130 may be coated with a conductive material, such as an epoxy coating, fluoropolymer, or the like, to improve the concentration of an electrical field around electrosurgical loop 130 and/or to provide an enhanced electrosurgical effect during a surgical procedure. Electrosurgical loop 130 may be formed as a wire having any suitable cross-sectional configuration, e.g., circular, oval, polygonal, etc.
With continued reference to
Support structure 140 generally defines an inner peripheral surface 141 and an outer peripheral surface 143. Inner peripheral surface 141 of support structure 140 is configured for contact with outer peripheral surface 133 of electrosurgical loop 130, although outer peripheral surface 133 of electrosurgical loop 130 may separate from inner peripheral surface 141 of support structure 140, e.g., where electrosurgical loop 130 is retracted while support structure 140 is maintained in position. Tissue may also be grasped between outer peripheral surface 133 of electrosurgical loop 130 and inner peripheral surface 141 of support structure 140 to provide greater control in maneuvering tissue and resecting tissue. Outer surface 143 of support structure 140 is configured for contact with external surfaces, e.g., healthy tissue, specimen bags, or the like, to shield external structures from heat or energy from electrosurgical loop 130. Support structure 140 generally envelopes or surrounds outer peripheral surface 133 of electrosurgical loop 130.
Movement of second trigger 115 causes support structure 140 to move between an expanded state (
Electrosurgical loop 130 and support structure 140 are movable together with each other, as illustrated in
It should be appreciated that electrosurgical loop 130 and support structure 140 may be moved into any desired position, and are not limited to those described above. For example, electrosurgical loop 130 and support structure 140 may be extended further outwardly than as shown, and/or may be retracted further inwardly than as shown (e.g., completely within shaft 120). Electrosurgical loop 130 may be fixedly attached to at least a portion of support structure 140 such that e.g., movement of electrosurgical loop 130 causes movement of support structure 140, and/or movement of support structure 140 causes movement of electrosurgical loop 130. For example, support structure 140 may flex or move inwardly into a “V” shape, which may cause a corresponding flexing or movement of electrosurgical loop 130, e.g., to allow for easier separation of tissue during tissue resection.
In use, with reference to
A specimen retrieval device 150 having a specimen bag 151 may be disposed within the body cavity “BC” to enable electrosurgical loop 130 to resect tissue disposed therein. For example, the specimen bag 151 may completely surround the target tissue, and electrosurgical loop 130 may resect the tissue (e.g., morcellate the tissue to reduce tissue size) within specimen bag 151 such that the resected tissue is fully isolated from the body cavity. Alternatively, previously resected tissue may be placed into specimen bag 151 such that the resected tissue is kept separate from healthy tissue. As support structure 140 surrounds electrosurgical loop 130, support structure 140 prevents exposure of specimen bag 151 to heat or energy from electrosurgical loop 130 when resecting tissue therein and/or placing resected tissue therein during a procedure. It is contemplated that electrosurgical loop 130 and support structure 140 may be integrated or attached to inside of specimen bag 151, e.g., such as the mouth or opening of specimen bag 151. In this regard, as tissue is pulled through the mouth of specimen bag 151 (e.g., with a grasper), electrosurgical loop 130 resects the tissue while support structure 140 prevents exposure of specimen bag 151 to heat or energy from electrosurgical loop 130. After completion of the procedure, electrosurgical instrument 100 and specimen retrieval device 150 may be removed from the body cavity “BC.”
With reference to
Electrosurgical loop 230 is operatively supported at a distal end portion of shaft 120 and is selectively connected to a source of electrical energy (not shown) to energize electrosurgical loop 230 for resecting tissue therewith. Electrosurgical loop 230 includes a first arm 231 and a second arm 233 that is pivotably connected to first arm 231 via a pivot joint 235 at a distal end portion of electrosurgical loop 230.
Pivot joint 235 may include a pivot pin 236 to pivotably connect first and second arms 231, 233. Pivot pin 236 may be formed from an electrically conductive material, e.g., metal, such that electrical energy can flow between first and second arms 231, 233. Alternatively, first and second arms may be integrally and/or monolithically formed (e.g., from a single piece of wire) wherein pivot joint 235 connects first and second arms 231, 233 and includes a coiled, bent, or curved portion that acts as a living hinge to permit first and second arms 231, 233 to move relative to each other.
First and second arms 231, 233 define an inner peripheral surface 237 and an outer peripheral surface 239. Inner peripheral surface 237 of electrosurgical loop 230 is configured for encircling tissue (e.g., snaring or grasping tissue) to resect tissue at a target site. Outer surface 239 of electrosurgical loop 230 is configured for resecting tissue and may be used to move or displace tissue. Electrosurgical instrument 100 (
A first stiffening member 241 may be disposed on at least a portion of first arm 231. Likewise, a second stiffening member 243 may be disposed on at least a portion of second arm 233. First and second stiffening members 241, 243 of respective first and second arms 231, 233 are configured to provide structural reinforcement to electrosurgical loop 230 to aid electrosurgical loop 230 in maneuvering through tissue for resecting tissue, and for moving between a rest or non-deflected position (
First and second stiffening members 241, 243 may be formed from a pliable, shape-memory material that returns electrosurgical loop 230 to the rest or non-deflected position from the deflected position. The shape-memory material may be spring steel, an alloy such as copper-aluminum-nickel or nickel-titanium, or a combination of at least two of zinc, copper, gold, or iron. First and second stiffening members 241, 243 may be conductive or alternatively, non-conductive (e.g. insulative). Other suitable materials and/or configurations of stiffening members 241, 243 are also contemplated.
Electrosurgical loop 230 may be used with support structure 140 (
In use, with additional reference to
Persons skilled in the art will understand that the structures and methods specifically described herein and shown in the accompanying figures are non-limiting exemplary embodiments, and that the description, disclosure, and figures should be construed merely as exemplary of particular embodiments. It is to be understood, therefore, that the present disclosure is not limited to the precise embodiments described, and that various other changes and modifications may be effected by one skilled in the art without departing from the scope or spirit of the disclosure. Additionally, the elements and features shown or described in connection with certain embodiments may be combined with the elements and features of certain other embodiments without departing from the scope of the present disclosure, and that such modifications and variations are also included within the scope of the present disclosure. Accordingly, the subject matter of the present disclosure is not limited by what has been particularly shown and described.
The present application claims the benefit of and priority to U.S. Provisional Application Ser. No. 62/561,241, filed on Sep. 21, 2017 the entire contents of which are incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 62561241 | Sep 2017 | US |