Patent Application
20140142568
The present invention relates to an elongated electrosurgical instrument comprising
Most conventional electrosurgical instruments have either an integral tapering suction channel of fixed length or has a detachable suction shroud with a tapering snout of fixed length. The surgeon has no way of controlling how much of the electrosurgical electrode he/she wants that protrudes from the suction tip.
In electrosurgery high frequency (radio-frequency) current is applied by an active electrosurgical electrode to cause a cutting action, hemostasis, or coagulation of bleeding tissue. This procedure produces smoke and coagula resulting in a decreased visibility of the operative field. Electrosurgical smoke plume in high concentrations is considered hazardous and causes health care problems. Thus the reasons for facilitating effective and instantaneously evacuation of such side products are numerous and various approaches have been suggested to remedy the problems.
Thus there remains a need within the art for effective suction properties when using electrosurgical instruments during surgery.
From British patent application no. GB 2311225 is known an electrode and nozzle combination for transporting and delivering ionizable gas, such as argon, to a tip on an electrosurgical instrument for gas-enhanced electrosurgery. The nozzle has a shroud that surrounds the electrode along its length and leaves the proximal and distal ends of the electrode exposed. The volume of the chamber in which gas is ionised and the position where the gas is supplied for ionising in relation to the electrode must remain substantially unchanged during surgery so that the ionising process can be kept under control. The position of the suction tip is therefore fixed.
U.S. Pat. No. 5,496,314 discloses an endoscopic probe with a tubular shroud slidably disposed on it. An indexing sleeve extends from in front of a bonnet on the probe shaft opposite the probe tip and surrounds the tubular shroud in frictional engagement so that the shroud can be extended in the distal direction to encircle and cover more or less of the probe tip, and so as to enable the surgeon to position and manipulate the probe at the surgical site to provide suction or irrigation without concern that the probe tip might inadvertently snag or cut the tissue. The advancing and withdrawal of the shroud is cumbersome and course due to the frictional engagement and the technology is merely intended used between the extreme positions of the shroud and thus does not avail the surgeon the possibility fine adjustment of suction tip position.
Thus there remains a need within the art for improving suction properties for electrosurgical cutting instruments and for more versatile and flexible adjustment of electrode tip position in relation to the tip of a co-operating electrosurgical electrode.
The present invention aims to provide such electrosurgical instrument and suction tip.
Accordingly, it is a main aspect of the present invention to provide an electrosurgical instrument of the kind mentioned in the opening paragraph, which has versatile, flexible and effective suction and evacuation properties for both smoke, liquid and/or more or less homogeneous suspensions of liquid/solid matter.
It is a second aspect of the present invention to provide an inexpensive electrosurgical instrument of the kind mentioned in the opening paragraph.
It is a third aspect of the present invention to provide an electrosurgical instrument of the kind mentioned in the opening paragraph, which electrosurgical instrument has an ergonomic design, and does not require use of a detachable suction channel for evacuation of matter from a surgical site.
It is a fourth aspect of the present invention to provide an electrosurgical instrument of the kind mentioned in the opening paragraph, which allows the user a high degree of freedom to adjust the axial position of a suction opening distance in relation to a conductive electrode means first means.
It is a fifth aspect of the present invention to provide an electrosurgical instrument with high flow rate through the entire suction channel.
It is a sixth aspect of the present invention to provide a suction tip for an electrosurgical instrument, including but not limited to an electrosurgical instrument of the kind mentioned in the opening paragraph, which suction tip contributes in achieving the above aspects.
The novel and unique features whereby these and other aspects are achieved according to the present invention consist in that the suction tip has a coupling end part opposite a suction opening, said coupling end part has a first engagement means for engagement with a second engagement means provided on the hollow elongated main body, which first engagement means and second engagement means are configured so that an axial position of the suction tip in relation to the first means is adjustable in response to movement of the suction tip about and/or along a longitudinal axis of said suction tip.
Depending on how much of the first means that is beneficial to expose from the suction tip for various patients, under various surgical conditions and for various circumstances and situations, the surgeon may benefit from a means to adjust the longitudinal position of the suction tip in relation to the longitudinal axis of the hollow elongated main body, and thus in relation to the first means that is arranged in a substantially fixed axial position, e.g. in a holder of the hollow elongated main body. The first and second engagement means confer this option to the surgeon, who e.g. can choose an initial rough adjusting of the axial position of the suction opening of the suction tip in relation to the first means, simply by displacing the first engagement means axially on the second engagement means. If desired, subsequently a fine adjusting of said position can be made by slightly rotating the suction tip a fraction of a turn or as many turns as desired about the longitudinal axes of the suction tip until the position of the tip opening is exactly as desired. Fine adjusting can be done during the actual surgery without removing the electrosurgical instrument from the surgical site. The surgeon only needs to rotate the suction tip slightly using e.g. the index finger and thumb to grasp said suction tip and rotate as much as desired.
The second engagement means may advantageously be provided on the first end of the hollow elongated main body proximal to the first suction port to ensure that the suction tip can be mounted to cover said first suction port completely and in a manner so that the high level of adjustability of axial position of the suction tip is not reduced or compromised, and so that as much of the axial lengths of the first engagement means and the second engagement means remain at the surgeon's full disposal.
The second engagement means may advantageously be an exterior thread, or at least one bead or projection provided on the first end of the hollow elongated main body proximal to the first suction port, optionally several circumferential beads or projections.
In a preferred embodiment the first suction port can thus be located distal to the second engagement means and proximal to the first opening of the hollow elongated main body. In this embodiment it is always ensured that both the first means, that extends inside the suction tip, and the first suction port can maintain encircled by the suction tip in a manner that still offers adjustability without the suction tip tends to fall off and uncover the first suction port.
Safe and reliable attachment of the suction tip on the hollow elongated main body to cover the first suction port can be obtained by providing the first suction port closer to the second engagement means than to the first opening of the hollow elongated main body. The second engagement means can for example have an axial length corresponding to at least half the axial length of the coupling end part.
The first engagement means may advantageously be provided on an interior side of a circumferential coupling wall of the coupling end part and protrude inside the bore of the coupling end part. In a length-adjustable embodiment of the suction tip, the suction tip may e.g. be provided with a first engagement means in form of an internally radiating means for adjusting the longitudinal position of a suction opening of the suction tip in relation to the longitudinal axes of the hollow elongated main body and the first means, which internally radiating means may engage complementary shaped second engagement means on the exterior surface of the hollow elongated main body.
The first engagement means can e.g. be selected from the group comprising an interior thread, at least one annular bead, one or more spaced apart engagement elements, or combinations of the aforementioned.
Irrespective of what shape and design the first engagement means has, the second engagement means must have a suitable complementary shape so that firm, as well as adjustable, engagement can take place.
The first engagement means may, if expediently, be configured as the second engagement means and vice versa.
The engagement of the first engagement means and the second engagement means can in an advantageous embodiment be tactile and/or audible to further aid the surgeon when displacing the suction tube. The surgeon is also able to ascertain that the chosen position is secured and that the suction tip is not pushed too much forward so that it drop off. Tactile and audible properties can e.g. be due to the shape, location and dimension of the first engagement means and the second engagement means.
The coupling end part of the suction tip may extend into a suction end part including the suction opening, which suction opening encircles the tip of the first means to ensure instant suction from the surgical site close to where the first means is being operated and produces side product.
If at least a section of the suction end part tapers towards the suction opening the suction tip may serve as a nozzle with increased suction rate and flow rate, however to avoid clotting of the suction tip it may be preferred that the suction tip taper more at the most distal end of the suction end part than at an intermediate suction part of the suction tip and than at the coupling end.
In one preferred embodiment the suction end part of the suction tip has a tubular, non-tapering mouth. This design has turned out to create even greater suction properties. The tubular mouth serves as a nozzle that provides a high suction capacity at the suction opening and the increasing diameter of the suction provides high flow velocity. A steady but fast straight flow can be obtained through the tubular, non-tapering mouth, which straight flow may turn more or less into a more turbulent flow, depending on e.g. the composition of sucked matter, once such sucked matter exits the tubular, non-tapering mouth and passes further into the suction tip towards its coupling end. The straight flow may in one flow situation be substantially laminar.
By providing the suction opening of the suction tip with a flared skirt part, the suction opening is given a trumpet-shape and can provide suction from a larger area than if no flared skirt part is provided. Moreover, the flared skirt part serves as a guide surface into the suction tip for matter that needs to be aspirated. A further advantage is that the enlarged area of the flared skirt part serves as a small shield towards the surgeon's field of vision when the cells burst during the electrosurgical cutting.
The elongated hollow main body may have a stop element for stopping axial displacement beyond said stop element of the suction tip towards the second end of the hollow elongated main body. The stop element expediently serves to keep the suction tip positioned correctly in order not to be pushed against the actuator and the switch means, at the risk that the actuator gets actuated unintentionally and energy supplied to the patient at moments where it should not have been.
Suction tips of different designs and of preference for a given surgical procedure can be mounted covering the first suction port if the suction tip is detachable mounted on the first end of the hollow elongated main body of the electrosurgical instrument.
More or less of the suction tip may be made of a transparent material so that the surgeon better can monitor the effect of voltage application by the first means as well see if and how waste is evacuated from the surgical site.
Preferably, at least a tip part of the suction end part is transparent, however more preferred the entire suction end part, including an intermediate suction part, could be transparent.
Another advantageous feature, which the suction tip can have, is exterior tactile means, so that the surgeon can locate, confirm and adjust the suction tip as well as relate to its position on the hollow elongated main body without actually seeing the suction tip. When doing so it is important that the first means is firmly positioned and secured to the hollow elongated main body so that the first means does not detach or gets loose if it is accidentally hit during manipulation of the suction tip.
The first engagement means, the second engagement means, the stop element, the transparency and the exterior tactile means may all contribute to ensure the correct position of the suction tip both angularly and axially in relation to the first means and the hollow elongated main body. The first means can be kept with its suction opening surrounding, e.g. substantially concentric, the first means, and mounted sealingly over the suction port of the suction channel of the hollow elongated main body. Thus, also the risk that a heated first means accidentally hits the circumferential wall of the suction tip, which wall could become damaged due to spots on said wall melts, can be avoided even though the suction tip not is an integral part of the hollow elongated main body.
The invention also relates to a suction tip adapted to be mounted on an electrosurgical instrument and the advantages and properties are the same as described above.
The suction tip is particularly suited for use with an electrosurgical instrument of the kind that comprises
Emphasise is made that the suction tip is not solely for use with an electrosurgical instrument of the above kind. It can be used on any suction instrument, provided said suction instrument has suitable second engagement means. A tubular tip mouth and/or a flared skirt can be provided at the suction opening of any terminal free end of a suction channel.
The first engagement means may advantageously be provided on an interior side of a circumferential coupling wall of the coupling end part and protrude inside the bore of said coupling end part to facilitate prompt and effective engagement.
Suitable first engagement means can be selected from the group comprising an interior thread, at least one annular bead, one or more spaced apart engagement element, or combinations of the aforementioned, but this list should not be seen as exhaustive and other kinds of first engagement means are contemplated within the scope of the present invention.
As described above in relation to the electrosurgical instrument the first engagement means can be configured for engaging a second engagement means provided on the first end of the hollow elongated main body of the electrosurgical instrument proximal to the first suction port.
The second engagement means can e.g. be an exterior thread, circumferential beads or projections provided on the first end of the hollow elongated main body proximal to the first suction port.
The first engagement means can be configured as the second engagement means and vice versa. The main and most important criteria for design of the first engagement means and the second engagement means is that the first engagement means and the second engagement means are designed so that they can mate firmly, and that engagement is reliable while it still remains possible to move the suction tip about and/or along a longitudinal axis of said suction tip without hindrances.
The coupling end part of the suction tip may extend into a suction end part including the suction opening, which suction end part may include a part that is seen as an intermediate suction part in immediate extension of the coupling end part.
It is preferred that least a section of the suction end part tapers towards the suction opening, preferably at least the section of the suction end part distal to the intermediate suction part tapers.
Experiments have shown that a tubular, non-tapering mouth at the free end of the suction end part of the suction tip confers enhanced suction properties, including a straight flow through the mouth. Suction velocity through the tubular, non-tapering mouth is higher than through the remaining part of the suction tip, and because the mouth opens into an increasingly larger diameter of the suction end part, where suction pressure becomes increasingly higher, more or less solid matter such as clots and tissue fragments does not gets stucked at the mouth.
In a second embodiment of the suction tip according to the present invention the suction opening of the suction tip has a flared skirt part. The flared skirt part may be in extension of a tubular, non-tapering mouth, if preferred. The flow velocity at the larger diameter of the flared skirt part is lower than through the restriction constituted by the suction opening and optionally also through the tubular, non-tapering mouth. By using an embodiment with a flared skirt part the surgeon is able to cover a very large suction area around the tip of the first means.
For some surgical procedures the surgeon may prefer that the suction opening is very close to the tip of the first means and for other surgical procedures remoter from the tip of the first means. To that aspect the axial displacement made possible by the provision of the first engagement means and the second engagement means may be sufficient, but the surgeon may prefer in addition to use a longer or shorter suction tip or use no suction tip at all. To that aspect the suction tip can be detachable mounted on the first end of the hollow elongated main body of the electrosurgical instrument, and suction tips be available with various lengths and cross-sections.
Accordingly, an electrosurgical instrument may be provided by the manufacturer with more than one suction tip, such as suction tips with different lengths, degree of tapering, transparent sections and designs of mouths and flared skirts.
For example at least a tip part of the suction end part can be made transparent, but preferably the entire suction end part is transparent to allow the surgeon better to monitor the suction progress and process.
In a preferred embodiment the coupling end part of the suction tip has exterior tactile means so that the surgeon easily can locate the suction tip when the axial position needs adjusting.
The invention further relates to a method of adjusting the axial position of a suction tip as defined above on an electrosurgical instrument as defined above. The method comprises an initial step of placing the first means through the suction tip and mounting the coupling end part on the first end of the hollow elongated main body to cover the suction port of the suction channel.
The method may further comprise at least one of the steps of
If the obtained axial position of the suction tip on the hollow elongated main body turns out not to be exactly as the surgeon wishes, the surgeon may need to modify and adjust the position during surgery by subsequent application of the axial force or by rotating the suction tip, or both. These movements can just be repeated until the axial position of the suction opening is as desired. By doing so the axial position of the suction opening can be adjusted in relation to the tip of the first means, so that the electrosurgical instrument can perform optimal at a given surgical operation. The suction tip can even be extended to completely cover the tip of the first means, in which case the electrosurgical instrument can be used just for aspirating and evacuation of matter from the surgical site.
The invention further relates to an assembly kit for an electrosurgical instrument according to any of the preceding claims, the kit comprises at least
The hollow elongated main body may include the switch means and an actuator as described below.
A switch means suited for use in the electrosurgical instrument according to the present invention is disclosed in the applicant's co-pending international patent application entitled “An elongated electrosurgical instrument and a switch means for said instrument”.
A first means suited for use in the electrosurgical instrument according to the present invention is disclosed in the applicant's co-pending international patent application entitled “An electrosurgical instrument and electrosurgical conductive electrode for use with the instrument”.
A click-in coupling means and various kit assemblies suited for use in the electrosurgical instrument according to the present invention is disclosed in the applicant's co-pending international patent application entitled “A coupling means connecting an electrosurgical instrument to a vacuum source, an electrosurgical instrument provided with the coupling means, a kit including the coupling means and their uses”.
The disclosures of the switch means, the first means, and the click-in coupling means made in the above international patent applications, including their special design features, functions and uses, are contemplated used in the present invention and incorporated by references.
The electrosurgical instrument and switch means according to the present invention is described in more details below by way of exemplary embodiments. The electrosurgical instrument and switch means are versatile and the components of the electrosurgical instrument and switch means can be combined into a plurality of electrosurgical instrument having different properties, functionalities and designs.
Below selected embodiments are described as examples only, of the many ways the components can be combined into various electrosurgical instruments for various purposes. Functionality and design of the electrosurgical instrument can be changed either at the manufacturing stage or by the surgeon in advance of or in relation to the surgical procedure, as will be understood by the following description. Thus electrosurgical instruments comprising other combinations and arrangements of the inventive components, such as e.g. actuators, first and second coupling parts, providing the cable for connecting to the electrosurgical generator outside and/or inside the suction tubing, kinds of electrodes, and shapes of the elongated main body, and how these components are combined are also intended within the scope of the present invention.
Thus the electrosurgical instrument according to the present invention may be provided to the consumer as a kit including various components to be assembled as desired, e.g. various electrosurgical electrodes, first and/or second coupling parts and tubings of various lengths and properties, to be mounted to the elongated main body according to the surgeons choice and surgical requirements for a given surgical procedure. The surgeon is able to modify the inventive electrosurgical instrument when desired and to compose exactly the instrument he/she prefers for a given surgical patient and medical condition.
The electrosurgical instrument 1 comprises a hollow elongated main body 2, a first means 3 in the form of a blade electrode 3, an actuator 4 for manual application of a force to a switch means 5 below the actuator 4, which switch means 5 is incorporated inside the elongated main body 2 and thus not visible in
In the present embodiment of the electrosurgical instrument 1 the cable 12 extends inside the suction tubing 11 towards a second end 13 of the suction tubing 11, at which second end 13 a second coupling part 14 is mounted in order for said suction tubing 11 to be appropriately coupled to a vacuum source (not shown). In other embodiments the cable 12 can extend exterior to the suction tubing 11.
The structure and design of the elongated main body 2 is seen more clearly in the exploded, perspective, enlarged scale view of
The first end 7 of the elongated main body 2 has a first opening 15 into which the first means 3, in the present case the blade electrode 3, can pass, to be mounted to the elongated main body 2, thus the combined tubular part 16 and cover part 17, in conductive communication with the switch means 5, optionally in a replaceable manner, so that the surgeon can arrange the angle of the blade electrode 3 in relation to the main body 2, as desired, or replace the blade electrode 3 with another kind of electrosurgical electrode.
The elongated main body 2 includes two main components, a tubular part 16 and a cover part 17 respectively, which parts 16,17 preferably are manufactured as individual parts which are joined, e.g. by heat sealing, in order to create the elongated main body 2, once all electrosurgical components relevant for the instrument's performance, such as switch means and wires, are mounted appropriately. The tubular part 16 and the cover part 17 may be manufactured by any suitable kind of moulding method and subsequently joined.
A wall 18 of the cover part 17 has a substantially semicircular cross-section for, inside the elongated main body 2, providing space for accommodating both the switch means 5 and at least the part of the actuator 4 that serves to engage said switch means 5. The actuator 4 protrudes only to a minimum extent beyond the outermost circumference of the wall 18 of the cover part 17, but sufficiently for the surgeon to be able to actuate the switch means 5 by using the actuator 4. The actuator 4 does not extend into the tubular part 16, which as will be described in further details later, defines a suction channel 27. In this way the overall exterior appearance of the first embodiment of the electrosurgical instrument 1 is kept elegant and slim in order not only to be easy to handle, but also to preserve a design of the electrosurgical instrument that allows said instrument to be introduced through a very small surgical incision, while at the same time obtaining an electrosurgical instrument with high suction efficiency. Other cross-sections of cover parts 17 may be appropriate too. The cover part 17 may thus be made without a perfect semicircular cross-section, e.g. be made more flat.
The wall 18 of the cover part 17 also has a first aperture part 19, through which a first actuator button 20 for application of a cutting voltage can pass in order to actuate the cutting mode of the switch means 5, and a second aperture part 21 through which a second actuator button 22 for application of a coagulation voltage can pass in order to actuate the switch means 5 in a coagulation mode of the switch means 5. An exterior side 23 of the wall 18 of the cover part 17 has protruding ribs 24, barbs or other tactile means adjacent the first aperture part 19 and the second aperture part 21. The ribs 24 extend along the longitudinal axis of the cover part 17 on both longitudinal sides of the actuator 4 in order for, on the one hand providing guidance to the surgeon for locating the actuator buttons 20,22, and on the other hand helping the surgeon to get a good hold on the elongated main body 2 during operating the electrosurgical instrument 1. Although preferred, grasping ribs 24, barbs or tactile means at the actuator's position on the main body 2 are optional.
At the first end 7 of the elongated main body 2, both the cover part 17 and the tubular part 16 have opposite facing similar circumferential engagement means 25, e.g. an external thread or spaced apart circumferentially protruding beads, for securing the suction tip 6 in adjustable manner in selected suction position in relation to the longitudinal axis of the elongated main body 2, as shown in
The tubular part 16 constitutes a second elongated compartment 27 of the hollow elongated main body when the tubular part 16 is assembled with the cover part 17. The tubular part 16 has a substantially semi-circular exterior wall part 28, which circumferentially merges into an elongated wall part 29 having a substantially flat base 30. The base 30 of the wall part 29 becomes the partition wall 30 of the elongated main body 2 when assembled with the cover part 17. The wall part 29 seals the second compartment 27 from the surroundings to allow the second compartment 27 to serve as the suction channel 27.
The partition wall 30 has guide pins 31 projecting away from the suction channel 27, for arranging the switch means 5 in the correct position in relation to the elongated main body 2, e.g. as shown in
Between the guide pins 31 and the first end 7 of the elongated main body 2 the tubular part 16 has a holder 33 for securing the blade electrode 3, which blade electrode 3 has a conductive coupling rod 34 that extends into a conductive electrode tip part 35 via a conductive securing part 36. The conductive securing part 36 includes a first engagement part 37 of first pentagonal cross-section, which first engagement part 37 is provided opposite a coupling end 39 of the coupling rod 34. An insulation sleeve 36a may extend axially over at least the part of the length of the securing part not including the first engagement part 37, but can also extend over the first engagement part 37, in which case the pentagonal circumference and thus the first pentagonal cross-section of the first engagement part is due to shaping of the insulation sleeve 36a. Furthermore the securing part 36 may, as shown in
The tubular part 16 can advantageously be moulded as a unit piece including a.o. the exterior wall 28, partition wall 30, protruding guide pins 31, holder 33, exterior ribs 25, and cable trap 32.
As is seen more clearly in
A switch means 5 to be provided on the partition wall 30 of the tubular part 16 of the elongated main body 2 is arranged for supplying the electrical energy to the first means 3 in response to operating the actuator 4 above the switch means 5.
The switch means 5 has a first electrical contact 42, another first electrical contact 43 out of physical contact with the first electrical contact 42, and a second electrical contact 44 superjacent the first electrical contacts 42,43. Thus there is a very small distance between the plane of the first electrical contacts 42,43 and the plan of the second electrical contact 44 in the assembled state of the switch means 5, which distance defines a gap into which an insulating insert 45 is provided to prevent unintended closure of circuits and diverted current flow.
The first electrical contact 42 is activated for application of a cutting voltage by means of the first actuator button 20, and the other first electrical contact 43 is activated for application of a coagulation voltage by means of the second actuator button 21. Both first electrical contacts 42,43, the second electrical contact 44, and the insulating insert 45 has holes 46 for receiving the protruding, confronting guide pin 31 on the partition wall 30.
In this way the switch means 5 can in a very simple and fast manner be built on the partition wall 30 by stacking the very few individual components of the switch means on top of each other on the partition wall 30, connecting the cable 12 appropriately to put the switch means 5 into electrical contact with the first means 3, and enclose the switch means 5 by putting the cover part 17 on top of the tubular part 16 to define a first compartment 59a, as seen in
By proper dimensioning of the holes 46 in the electrical contacts 42,43,44 and the diameter of the guide pins 31 on the partition wall 30, individual distances between the first electrical contacts 42,43, and well-defined gaps between any of the first electrical contacts 42,43 and the second electrical contact 44 can be defined in a simple manner. Tapered guide pins 31 can e.g. only pass through the hole 46 just to the extent where the tapered guide pin's 31 diameter's and the hole's diameter's are the same. Simply by making larger holes 46 in the second electrical contact 44, said second electrical contact 44 is able to receive e.g. the full length of the guide pins 31, while smaller holes 46 in the first electrical contacts 42,43 serve to preserve the required insulation distance between any of the first electrical contacts 42,43 and the second electrical contact 44 without the absolute requirement of inserting the insulating insert 45, although such an insulation insert 45 is preferred in most embodiments. The lateral distance between the two first electrical contacts 42,43 is obtained by corresponding suitable allocation of the guide pins 31 across the partition wall 30.
The first electrical contact 42 has a first main body part 47 configured as a first conductive sheet component 47, the other first electrical contact 43, i.e. the second first electrical contact 43 has a second first main body part 48 configured as a second first conductive sheet component 48. The second electrical contact 44 has a second main body part 50 configured as a second conductive sheet component 50. The second conductive sheet component 50 has an electrode contacting end 51 with an electrode connection terminal 52 for securing the first means 3, and an opposite cable connection end 53 with a third wire connection terminal 54. The electrode connection terminal 52 is configured as a clamp 52 to fittingly engage the conductive coupling rod 34 of the blade electrode 3. The conductive coupling rod 34 is inserted into the electrode connection terminal 52 of the second conductive sheet component to establish electrical contact to the conductive blade electrode tip 35. In the present embodiment the electrode connection terminal 52 is illustrated as a clamp, however other designs are foreseen within the scope of the present invention.
The third wire connection terminal 54 is used for securing a third 12c of three wires of the cable 12 so that the correct voltage can be supplied to the first means 3 from an electrosurgical generator in response to a measurement of an electrical parameter representing an identification of which actuator buttons 20,22 that have been actuated. To that aspect the first 42 of the first electrical contacts 42,43 has a first wire connection terminal 55 for securing a first 12a of three wires of the cable 12, and the second 43 of the first electrical contacts 42,43 has a second wire connection terminal 56 for securing a second 12b of three wires of the cable 12. In the present case the cable 12 is a Schneider cable, where the conductor insulation is penetrated once the wire is introduced in a respective wire connection terminal.
The first conductive sheet component 47 of the first 42 of the first electrical contacts 42,43 has a raised or projecting contact part 57, and the second first conductive sheet component 48 of the second 43 of the first electrical contacts 42,43 has a raised or projecting contact part 58. The insulating insert 45 has actuating apertures 49a,49b, to allow passage of the aligned selected raised or projecting contact part 57,58 of the respective first electrical contacts 42,43 towards the second conductive sheet component 50 in response to a force application on the similarly aligned respective actuator button 20,21. When a raised or projecting contact part 57,58 touch the second conductive sheet component 50, a circuit is closed so that current of a voltage level related to the actuated actuator buttons 20,21 can flow from the electrosurgical generator to the conductive blade electrode 3 via the cable 12. No expensive optical switches or thick and complex PCB's are required. The use of simple, thin, substantially flat stacked conductive sheet components makes it possible to create a switch means 5 that appear considerable flatter than known switch means used in conventional electrosurgical instruments for similar purposes. The conductive sheets components 47,48,50 used in the inventive switch means 5 can easily be stamped, punched or cut from of thin plate, e.g. of metal. The holes for the guide pins and cutting of slits to make the raised parts can be made in the same process step. Wire connection terminals and the terminal for the first means can be made by subsequent or simultaneous bending or folding.
In the exemplary embodiment of the switch means 5 shown in
In
The cavity 59 of the cover part 17 has a first cable guide member 63 disposed a short distance from the second end 9 of the cover part 17 of the elongated main body 2. Proximal to the first cable guide member 63 said second end 9 is designed to receive the first coupling part 8 for providing communication to the vacuum source. In order for the cable 12 to pass smoothly without kinks inside the cover part 17 a second cable guide member 64 is made integral with the wall of the cover part 17 proximal to the first cable guide member 63. One or both of the cable guide members 63,64 can be left out if expedient or more cable guide members be included if necessary.
The elongated edges of the circumferential wall 18 of the cover part 17 has respective coupling webs 65a,66a to mate with complementary coupling webs 65b,66b, as seen in
An alternative method of joining the tubular part 16 and the cover part 17 could be gluing, however combinations of methods are within the scope of the present invention. Glue can be applied if considered expedient at any surfaces, such as e.g. at any of the coupling webs 65a,66a, the complementary coupling webs 65b,66b and the distance members 67.
In the view of the cover part 17 seen in
The first means 3 needs to be mounted or be mountable to the elongated main body in a safe manner. Longitudinal displacement or accidentally dropping out must be avoided, and the correct angular position in relation to the location of the actuator may be important to the surgeon. A hook electrode bent as an L must e.g. be positioned so that operating tip of the hook electrode faces towards the tissue when the surgeon holds the instrument in a manner that enables him/her also to operate the actuator, and thus to operate the switch means.
These problems are solved according to the present invention by providing a specially designed holder 33 at the first end 7 of the elongated main body 2.
The holder 33 has a holder body with a channel 71 for accommodating the blade electrode 3, and securing both the angular and axial position of said blade electrode 3 to the elongated main body 2. The second engagement part 38 of the holder 33 has an interior section crosswise the longitudinal axis of the channel of the holder. The second engagement part 38 has a second pentagonal cross-section sized to intimately engage the first pentagonal cross-section of the first engagement part 37 of the blade electrode 3. In case the electrosurgical instrument 1 is intended for use with replaceable first means 3, said first means 3 can advantageously be detachably mounted in the holder 33, thus also be detachably coupled to the switch means 5.
Each of the pentagonal cross-sections of blade electrode 3 and second engagement part 38 of holder 33, respectively, have five engaging edges thereby providing five potentially different positions and angular orientations into which a first means 3 can be placed and arranged. Conventionally first means 3 has first engagement parts 37 with hexagonal cross-section, and if the electrode tip 35 has a symmetrical design, such a conventional electrode tip can only be positioned and orientated in three different angular positions. Thus a pentagonal cross-section of the first engagement part confers more versatile positioning of in particular a first means with a symmetrical electrode tip, i.e. a symmetrical electrode tip part for cutting and coagulation of tissue.
Thus, the first engagement part 37 and the second engagement part 38 engage intimately so that the orientation of a first means 3, in this case the blade electrode 3, maintains firmly fixed during operation of the instrument. In contrast most engagement parts on conventional electrosurgical electrodes have six edges, thus they have hexagonal cross-sections. However, the more edges the more circular the cross-section becomes and the higher the risk that the electrosurgical electrode be dislocated during use, or is not placed correct during the assembling process, in particular gets angular dislocated. Engagement parts with less than five edges, e.g. having squared cross-sections, are less preferred due to the limited number of possible angular positions.
The conductive securing part 36 of the first means 3 includes the enveloping insulation sleeve 36a that improves sealing and engagement at the first opening 15 of the tubular part when the conductive securing part 36 is fitted into the hollow socket 72 of the holder 33 distal to said second engagement part 38. The conductive securing part 36 with enveloping insulation sleeve 36a has a larger cross-section or is wider than the second pentagonal cross-section of the second engagement part 38 of the holder 33, so that the securing part 36 with enveloping insulation sleeve 36a can serve as a plug or stop in a socket to thereby prevent displacement of the first means 3 in relation to the longitudinal axis of the elongated main body 2 towards the second end 9 of said elongated main body 2 so that the switch means 5 gets damaged. In summary the arrangement of the securing part 36 with enveloping insulation sleeve 36a and the socket 72 ensures the axial position and engagement of pentagonal part 37 of first means 3 and pentagonal part 38 of holder 33 in relation to each other. The pentagonal parts 38,37 of the holder 33 and first means 3, respectively, with pentagonal cross-sections serve to prevent any unintended angular dislocation or repositioning while still offering the possibility of deliberate, preselected, angular positioning of the first means 3. The holder 33 has an annular collar part 73 proximal to the pentagonal second engagement part 38 of holder and a hollow connection piece 74 proximal to the annular collar part 73. The hollow connection piece 74 extends with the bore of the hollow connection piece 74 on both sides of the annular collar part 73, through said annular collar part 73, into the pentagonal second engagement part 38 of holder 33, and ends in hollow socket 72 thereby creating channel 71, with the first opening 15 at the first end 7 of the elongated main body 2 and an opposite channel entry 75, through which the coupling rod 34 of the first means 3 protrudes for engaging the electrode connection terminal 52 of the switch means 5. The first end 7 of the elongated main body 2 tapers towards the hollow socket 72 and the holder 33 can be configured to extend above the plane of the partition wall 30 to an extent that allows the first means to protrude from the opening 15 substantially concentric with the suction opening 77, as seen in
The suction tip 6 is seen in perspective view in
The suction tip 6 has a coupling end part 76 opposite the suction opening 77. The coupling end part 76 is dimensioned to fit sealingly over the first end 7 of the elongated main body 2 to cover the first suction port 40, optionally in detachable manner. The coupling end part 76 of the suction tip 6 has a first engagement means 78 for engagement with the second engagement means 25, the circumferential second engagement means 25, as an example in form of an exterior thread, on the first end 7 of the elongated main body 2 proximal to the first suction port 40. The first engagement means 78 and the second engagement means 25 are configured so that an axial position of the suction tip 6 in relation to the first means 3 is adjustable in response to movement of the suction tip 6 about and/or along a longitudinal axis A of said suction tip 6. In a preferred embodiment the suction tip 6 is transparent to allow the surgeon to monitor, not only adjusting axial location of suction tip 6 in relation to the blade electrode 3, but also to see composition of sucked matter at any convenient point of time during surgery.
The first engagement means 78 is provided on an interior side of a circumferential coupling wall 79 of the coupling end part 76 and protrudes radially inside a bore 80 of suction tip 6 at the coupling end part 76 in order to engage the second engagement means 25 of the elongated main body 2, as is seen more clearly in
The coupling end part 76 of the suction tip 6 extends via an intermediate, optionally tapering, suction part 81 into a suction end part 82 part with a tubular, non-tapering mouth 83 that ends in the suction opening 77. Other designs or modifications of the mouth 83 are intended within the scope of the present invention. The mouth 83 can e.g. have a flared skirt part (not shown) to further improve turbulence at the suction opening 77 and through the suction channel 27 out of the second end 9 of the elongated main body 2. Regarding transparency, it is most preferred that at least the suction end part 82, the intermediate suction part 81 and the mouth 83 are made of a transparent material, e.g. a plastic material that can be recycled.
The coupling end part 76 of the suction tip 6 has exterior tactile means 84 to allow the surgeon to actually feel operation of the suction tip 6 when manipulating the axial position of the suction tip 6, should he/she suddenly discover that it would be better to expose more or less of the blade electrode part 35 from the suction opening 77 at a given moment during the surgical procedure, e.g. in order to change distance of mouth 83 to the wound created by the voltage applied by the blade electrode tip part 35. Thus, not only can the surgeon operate the actuator 4 with his/hers fingers without looking at the electrosurgical instrument 1, he/she can also make a qualified adjustment of the axial position of the suction tip 6 without actually being able to see what he/she is doing because he/she knows the position of the tactile means 84, e.g. one or more ribs, beads, corrugations, indents or other uneven surface topography.
In the present exemplary embodiment the first engagement means is achieved by five spaced apart engagement elements 78a,78b,78c,78d,78e in the form of radial webs provided close to the opening at the coupling end 76 of the suction tip, as can be seen in the end view of the suction tip 6 seen in
The interaction of the first engagement means 78 and the second engagement means 25 creates a further tactile means for adjusting and fine tuning axial position of suction tip 6 on the first end 7 of the elongated main body 2. In the present embodiment adjusting of mutual axial position between first engagement means 78 and second engagement means 25 can, as an example, be done by screwing or rotating the coupling end part 76 of the suction tip 6 onto the second engagements means 25, or by application of a small axial force to the suction tip 6, e.g. by pushing the suction tip 6 towards and away from the stop element in form of a stop web 26 on the cover part 17 of the elongated main body 2. When webs 78a,78b,78c,78d,78e snaps into valleys 85 between ribs 86 of the thread or other circumferential projections of the second engagement means 25 the surgeon can easily feel it. So the surgeon easily experiences displacement or adjusting actions. Pushing the suction tip 6 may be preferred in preference to or in combination with rotation for initial adjusting and fine adjustment, but it is up to the surgeon to decide if rotation or axial force application are most preferred, e.g. in dependency of the surgical condition and spatial limitations and requirements. Embodiments including just on radial web are contemplated within the scope of the present invention.
The enlarged scale view of
The second end 9 of the elongated main body 2 could, as conventional electrosurgical instruments be adapted to be directly coupled to the vacuum source. It is however intended that the electrosurgical instrument 1 can be used with the cable outside the suction tubing, the cable inside the suction tubing or without the suction tubing.
To that aspect the electrosurgical instrument or the assembly kit for the electrosurgical instrument may, e.g. as an accessories comprise one or more different first coupling parts designed for fitting into the second coupling end 9 of the elongated main body 2, which second coupling end 9 is seen in
The first plug end part 89 has a first end-closed click-in part for engaging, e.g. by force-fitting into frictional engagement, and closing off the first click-in opening 87 of the elongated first compartment 59a. Below the first end-closed click-in part 90 the first plug end part 89 has a hollow second click-in part 91 for engaging the second click-in opening 88 of the suction channel 27, to thereby allow suction from the surgical site to a waste receptacle.
The first plug end part 89 extends via a circumferential collar 92 into a bevelled second plug end part 93 that fits into the first end 10 of the suction tubing 11. Coupling barbs 94 is provided on the exterior side of the second plug end part 93 to prevent unintended detachment of the suction tubing 11 once connected.
The circumferential collar 92 has substantially the same outline as or slightly larger than the outline of the second end 9 of the elongated main body 2. The collar 92 serves to end fit said elongated main body 2, as well as a stop for the suction tubing 11.
The hollow second click-in part 91 has a suction inlet 95 that extends into the bore 96 of the second plug end part 93 towards a suction outlet 97 thereby allowing passage of sucked matter from the elongated main body 2, through the first coupling part 8, and into the suction tubing 11.
A first cable groove 98 is provided in the first plug end part 89 to receive the cable 12 when the first end-closed click-in part 90 is mounted inside the first click-in opening 87. The first cable groove 98 becomes substantially axially aligned with a corresponding cable groove of at least any of the first and second cable guide members 63,64 of the cover part 17, to allow the cable 12 to pass in recessed manner and the suction tubing 11 to be mounted to surround the cable 12. When using the first embodiment of a first coupling part 8 the cable 12 passes inside the suction tubing 11, as is seen more clearly in
The second embodiment of a first coupling parts 8′ is modified in that the circumferential collar 92′ is thicker, i.e. has a longer axial extent, and that the first cable groove 98′ ends blind in the circumferential collar 92′ to enable exit of the cable 12 at this location, as illustrated in
The first plug end part 89″ has a first end-closed click-in part 90″ for engaging, e.g. by force-fitting into frictional engagement, and closing off the first click-in opening 87 of the elongated first compartment 59a. Below the first end-closed click-in part 90″ the first plug end part 89″ has a blind second click-in part 99 for engaging the second click-in opening 88 of the suction channel 27, to thereby close the suction channel 27 and allow the electrosurgical instrument 1 to be used without suction, thus as a simple electrosurgical pencil if desired.
In a manner similar to the first cable groove 98 of the first embodiment of the first end-closed click-in part 90, the first cable groove 98″ extends into the first end-closed click-in part 90″ through the circumferential collar 92″ where the first cable groove 98″ exits into a bevelled second plug end part 93″ that is end capped by base surface, wall part or cap 100.
The vacuum source coupling end part 101 has two concentric tubes, an inner tube 102 and an outer tube 103 of larger internal diameter than the inner tube 102. Due to the different diameters of the tubes 102,103 the second coupling part 14 can be connected to vacuum sources having vacuum connection pieces of two different sizes. Use of the second coupling part therefore facilitates use of the electrosurgical instrument according to the present invention, as well as other medical devices that requires connection to a vacuum source, using one and the same second coupling part 14. Accordingly, often it is not necessary to invest in new vacuum sources or adapters for being able to make use of suction from a conventional vacuum source.
The vacuum source coupling end part 101 extends into the suction tubing end part 104 defined by an annular wall 105 with a second cable groove 106 and serrations 107. The cable groove 105 is provided in a manner similar to the first cable groove 98 of the first coupling end part 8 to allow the cable 12 to exit the suction tubing 11 just in form of vacuum source coupling end part 101, i.e. close to the vacuum source. A evacuation channel 108 extends via the inner tube 102 and into suction tubing end part 104, as seen in
In a modified embodiment of the second coupling part 14 no second cable groove 105 is provided. The modified second coupling part 14 without second cable groove 106 is suited for use with for example the second embodiment of the first coupling part 8″.
A modification of a second coupling part is shown in
The second coupling parts according to the present invention thus fit standard connection pieces of many different diameters.
A second embodiment of an actuator 4′ is seen in
The first embodiment of an actuator 4′ is configured as a rocker with opposite rocker arms merging into each other. In contrast the second embodiment of an actuator 4′ has no rocker arm. Instead the actuator buttons 20′,22′ is provided as separate parts with respective stem 68′,69′. The buttons 20′,22′ has different height and surface texture and/or surface to enable the surgeon to identify the relevant button, as seen more clear in the view of
The suction tip according to the present invention is one unit component with a simple design and is simple to operate. The axial position of the suction tip remains fixed once set by the surgeon and until the surgeon deliberately chooses to adjust the position again, in which case the surgeon may apply an axial force to displace the suction tip in a translatory movement in the selected direction, or rotate the suction tip more or less clockwise or counter-clockwise until the position is as desired. Both a translatory and rotational movement may be required to set the position of the suction tip into a new position, and the translatory movement and the rotational movement can be done in any order.
Thus the present invention allows for a substantially stepless and continuous adjustment of the suction tip on the hollow elongated main body, and provide the surgeon with a high degree of freedom to select how much of the first means the surgeon prefers to expose before, during and after surgery.
The exchangeable components of the electrosurgical instrument according to the present invention makes it possible for the surgeon to tailor exactly the instrument that is best for a given surgery, at a given moment.
The hollow elongated main body, which incorporates the switch means, the actuator and any suitable wirings and cable, constitutes the base component of a kit for building numerous different electrosurgical instruments.
The kit may comprise all or just some of the following components
The invention provides the possibility of combining separate components into plural different electrosurgical instruments and thus offers the surgeon a hitherto unknown possibility of creating his/her favourite tool with excellent suction properties.
| Number | Date | Country | Kind |
|---|---|---|---|
| PA 2011 00482 | Jun 2011 | DK | national |
| Filing Document | Filing Date | Country | Kind | 371c Date |
|---|---|---|---|---|
| PCT/DK2011/050299 | 8/1/2011 | WO | 00 | 12/27/2013 |
