This invention relates to an electrosurgical apparatus and system and in particular to the non-contact coagulation of tissue using an ionisable gas such as argon.
Argon beam coagulators have been known for many years, and examples are given in U.S. Pat. Nos. 4,040,426, 5,720,745, 6,039,736 and 6,197,026. The first example is an end-effect instrument, in which the ionised gas exits through the end of the instrument, while the latter two examples are directed at side-effect instruments, in which the ionised gas exits the instrument though an aperture in the side of the instrument. Such instruments are often referred to as APC instruments (Argon Plasma Coagulation).
Embodiments of the invention attempt to provide an instrument which is more versatile than any of the instruments in the prior art, and accordingly one aspect of the invention resides in an electrosurgical apparatus for coagulating tissue, comprising an elongated tube having a tubular wall and a proximal end and a distal end,
a conduit though which ionisable gas can be supplied to the distal end of the tube, the tube including one or more apertures in the tube such that the ionisable gas is capable of exiting the tube in the region of the distal end of the tube,
a braided tubular component associated with the wall of the tube, and
a connector for connecting the braided tubular component to a source of electrical energy, such that the braided tubular component can form part of an electrode assembly for ionising the ionisable gas exiting the one or more apertures.
The braided tubular component forms part of an electrode assembly in that it can either constitute a lead forming an electrical path between the connector and an electrode element, or may alternatively itself constitute an electrode element. In the first alternative, the electrode assembly constitutes the braided tubular component plus a separate electrode element, whereas in the second alternative the electrode assembly merely constitutes the braided tubular component.
The braided tubular component may be “associated” with the wall of the tube in that the tubular wall comprises an inner surface and an outer surface, and the braided tubular component is located adjacent the inner surface of the tubular wall. Alternatively, the braided tubular component may be “associated” with the wall of the tube in that the braided tubular component is embedded in the tubular wall. In one convenient construction, the braided tubular component is an inner layer in a laminate structure comprising the braided tubular component and a plurality of layers of electrically insulating material. Whichever arrangement is employed, the braided component is a tubular component extending around the circumference of the elongated tube, as oppose to a braided wire which runs along a single path in or adjacent the elongated tube. In this way, the braided tubular component is present around 360° with respect to the elongated tube, so as to be able to provide an electrical presence in whichever radial direction is required.
An insulative sleeve may be provided arranged to insulate the braided tubular component from the conduit other than in regions where the braided tubular component is to ionise the ionisable gas. In this respect, in some embodiments the insulative sleeve does not extend about or around the apertures to allow the braided tubular component to form part of the electrode assembly for ionising the ionisable gas exiting the one or more apertures.
According to one convenient arrangement, the one or more apertures includes an aperture at the distal end of the tube. This may be provided by the tube having an open end face constituting the aperture at the distal end of the tube, or alternatively by the tube having a distal end face, the aperture at the distal end of the tube being formed in the distal end face. With either construction, the braided tubular component is preferably exposed at the distal end of the tube so as to form the electrode element for ionising the ionisable gas exiting the aperture.
Where the braided tubular component does not constitute the electrode itself, but merely a lead for a separate electrode element, the electrode element is conveniently a separate annular ring positioned at the distal end of the tube and electrically connected to the braided tubular component. This allows the provision of a solid annular ring as an electrode, which may provide more resistance to wear and erosion from the ionisation of the gas, as compared to the braided component. Other electrode elements of different shapes can be envisaged as alternatives to an annular ring.
According to an alternative arrangement, the one or more apertures conveniently includes one or more side apertures in the wall of the tube. In this arrangement, the braided tubular component is conveniently exposed in the region of the one or more side apertures so as to form the electrode element for ionising the ionisable gas exiting the aperture. Due to the tubular nature of the braided component, it is ensured that a portion of the braided component will always be available to provide the electrode element regardless of the number of apertures or their radial positioning.
In another aspect the invention further resides in an electrosurgical system including an electrosurgical generator, a source of ionisable gas, and an electrosurgical apparatus as described above. The electrosurgical generator provides an electrical RF signal, as is known in the art. In one arrangement, the system also includes a patient return electrode connected to the electrosurgical generator, such that the electrosurgical apparatus is effectively a monopolar apparatus. Alternatively, the electrosurgical apparatus also includes a return electrode connected to the electrosurgical generator, such that the electrosurgical apparatus is effectively a bipolar apparatus. In this bipolar arrangement, the return electrode conveniently also comprises a braided tubular component. In such a system, the return electrode is preferably a layer in a laminate structure comprising the braided tubular component and a plurality of layers of electrically insulating material.
In another aspect the invention further resides in an electrosurgical apparatus for coagulating tissue, comprising:
an elongated tube having a tubular wall and a proximal end and a distal end,
a conduit though which ionisable gas can be supplied to the distal end of the tube, the tube including one or more apertures in the tube such that the ionisable gas is capable of exiting the tube in the region of the distal end of the tube,
a first braided tubular component associated with the wall of the tube,
a second braided tubular component associated with the wall of the tube, and
a connector for connecting the first and second braided tubular components to a source of electrical energy, such that the first and second braided tubular components can form part of a bipolar electrode assembly for ionising the ionisable gas exiting the one or more apertures.
Embodiments of the invention will now be further described, by way of example only, with reference to the accompanying drawings, in which:
Referring to
The tube 6 has an open distal end forming the aperture 15 for the argon gas to exit the tube 6. In use, the gas is supplied along the conduit 11, and a high voltage radio frequency waveform is supplied to the tubular braid 14. The braid 14 acts as an electrode to ionise the argon gas as it exits the aperture 15. Due to the insulative sleeve 75 stopping short of the distal end of the tube 6, ionisation occurs in the region of the aperture, where the tubular braid is exposed to the gas conduit 11 in the region where the insulative sleeve 75 does not extend.
Finally,
Those skilled in the art will appreciate that other constructions can be envisaged without departing from the scope of the present invention. For example, the number, location and shape of the apertures can be varied, as can the shape of the electrode element, if one is used in addition to the tubular braid. The instrument can be made rigid or flexible, depending on the intended use, and different versions of the system can be envisaged for endoscopic, laparoscopic or open surgical use.
Number | Date | Country | Kind |
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1217781.2 | Oct 2012 | GB | national |
Filing Document | Filing Date | Country | Kind |
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PCT/GB2013/052582 | 10/3/2013 | WO | 00 |