Patent Application
20180333195
This disclosure relates to hand-held instruments. More particularly, the disclosure relates to swivel components and functionality of hand-held instruments.
As is known to those skilled in the art, modern surgical techniques typically employ radio frequency (RF) power to cut tissue and coagulate bleeding encountered in performing surgical procedures. For a historical perspective and details of such techniques, reference is made to U.S. Pat. No. 4,936,842, issued to D'Amelio et al., and entitled “Electroprobe Apparatus,” the disclosure of which is incorporated by this reference.
As is known to those skilled in the medical arts, electrosurgery is widely used and offers many advantages including the use of a single surgical instrument for both cutting and coagulation. A monopolar electrosurgical generator system has an active electrode, such as in the form of an electro surgical instrument having a hand piece and a conductive electrode or tip, which is applied by the surgeon to the patient at the surgical site to perform surgery and a return electrode to connect the patient back to the generator.
The electrode or tip of the electrosurgical instrument is small at the point of contact with the patient to produce an RF current with a high current density in order to produce a surgical effect of cutting or coagulating tissue. The return electrode carries the same RF signal provided to the electrode or tip of the electrosurgical instrument, after it passes through the patient, thus providing a path back to the electrosurgical generator. To make the electrical connection for the RF current between the electrosurgical generator and the electrosurgical instrument, a cable having an electrically conductive core typically extends from the electrosurgical generator to the electrosurgical instrument.
Electrosurgical procedures often require precise movement and control of the electrosurgical instrument in order to properly treat the targeted tissue with the electrosurgical instrument. In particular, the manner in which the electrode tip is oriented and positioned relative to the targeted tissue can affect the way in which the tissue interacts with the delivered electrical energy.
In some instances, an operator may desire to readjust or reorient an electrosurgical instrument relative to the targeted tissue during an electrosurgical procedure. Using a typical electrosurgical instrument, such adjustments can increase the procedure time and typically require an operator to readjust his/her grip on the instrument, thereby increasing the risk of accidental contact between the instrument and non-targeted patient tissues.
In addition, moving and reorienting the electrosurgical instrument during a procedure typically requires moving the attached power cable and/or other hoses/connections as well. This leads to changes in the drag, torque, and torsional moment force distribution at the electrosurgical instrument, thereby altering the manner in which the instrument sits in the user's hand, making the instrument more difficult to consistently manipulate and control, and further increasing the risk of accident or procedural mistakes.
Further, changes in the way in which the instrument needs to be held or gripped as well as changes to the force distributions of the instrument against a user's hand can reduce user comfort during use of the instrument and can lead to faster hand fatigue.
The subject matter claimed herein is not limited to embodiments that solve any disadvantages or that operate only in environments such as those described above. Rather, this background is only provided to illustrate one exemplary technology area where some embodiments described herein may be practiced.
To further clarify the above and other advantages and features of the present invention, a more particular description of the invention will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. It is appreciated that these drawings depict only illustrated embodiments of the invention and are therefore not to be considered limiting of its scope. The invention will be described and explained with additional specificity and detail through the use of the accompanying drawings in which:
The present disclosure relates to electrosurgical instruments and other hand-held instruments having a swivel body enabling precision control and fine adjustment of the instrument during a procedure, such as during an electrosurgical procedure. In some embodiments, an electrosurgical or other hand-held instrument includes a hand piece having a proximal section and a distal section, the proximal section and distal section being rotationally decoupled to enable the distal section to be rotated independently of the proximal section, or vice versa.
One or more embodiments beneficially enable an electrosurgical instrument to be manipulated and reoriented without disrupting the grip position of the electrosurgical instrument in a user's hand. For example, during an electrosurgical procedure, a user may hold a hand piece by positioning a proximal section of the hand piece in the crook of his/her hand while gripping a distal section of the hand piece between the thumb and index and/or middle finger. The electrosurgical instrument enables the user to independently rotate the distal section relative to the proximal section, allowing the thumb and/or fingers to control the rotational manipulation of the distal section while the proximal section remains seated in the crook of the hand.
The structure and function of such embodiments can allow a user to adjust the electrosurgical instrument while minimizing or reducing changes in the force distribution (e.g., torque and drag effects) on the user's hand. Such benefits reduce or eliminate operator discomfort and fatigue, and help maintain consistent grip dynamics, thereby reducing or eliminating associated patient and equipment risks.
Generally, electrosurgical instrument 104 includes a hand piece or pencil 114 and an electrode tip 116. Electrosurgical instrument 104 communicates electrical energy to a target tissue of a patient to cut the tissue and/or cauterize blood vessels within and/or near the target tissue. Specifically, an electrical discharge is delivered from electrode tip 116 to the patient in order to cause heating of cellular matter of the patient that is in close contact with electrode tip 116. The tissue heating takes place at an appropriately high temperature to allow electrosurgical instrument 104 to be used to perform electrosurgery. Return electrode 106 is connected to generator 102 by a cable 118 in order to complete the circuit and provide a return electrical path to wave generator 102 for energy that passes into the patient's body.
As explained in greater detail below, some embodiments of electrosurgical or other hand-held instruments according to the present disclosure enable efficient capture of smoke generated during a procedure, such that smoke that is not immediately captured near the site of smoke generation (e.g., at the tissue/electrode tip interface) can still be captured and evacuated away from the operating environment. It will be appreciated, however, that smoke capture/evacuation is not required. Rather, for instance, some embodiments may include a hand piece with a swivel body as described herein but may not be equipped with smoke capture/evacuation features. Accordingly, even embodiments that are described and illustrated as including smoke capture/evacuation features are not so limited.
Illustrated in
Electrosurgical instruments, such as electrosurgical instrument 120, are commonly referred to as electrosurgical pencils or pens because in use they are often held in the same manner that a pencil or pen is held when writing.
The extendable section 228 is preferably configured as a conduit (e.g., tube or other shape having a hollow or partially hollow cross-section). The conduit of the extendable section 228 is configured to pass at least partially into an internal chamber of the hand piece 222 and to be in fluid communication with the utility conduit 240 (and/or with a vacuum hose attached/disposed in the utility conduit 240). The extendable section 228 also includes a distal end opening providing fluid communication between the interior of the extendable section and the atmosphere exterior to the extendable section 228. As shown, the electrode tip 230 can be coupled to the extendable section 228 (e.g., via adhesive, welding, mechanical fastening, notches, slots, and/or friction fitting, or through integral formation of a single piece) in a manner that leaves one or more aperture spaces for smoke capture into the interior of the extendable section 228.
The illustrated embodiment can also include a front piece 250 having an opening for the extendable section 228 to pass through. In this embodiment, the front piece 250 is formed with a tapered profile that tapers inwardly in the distal direction. In other embodiments, the front piece 250 is formed without a tapered shape (e.g., a squared or straight edge profile), or with a different taper or curved profile.
The illustrated front piece 250 includes one or more supports 252 configured to hold or stabilize the extendable section 228 in position relative to the front piece 250. In some embodiments, the one or more supports 252 are configured to maintain the rotational relationship between the front piece 250 and the extendable section 228, such that rotation of the front piece 250 causes rotation of the extendable section 228 (and attached electrode tip 230) as well. Additionally, or alternatively, the extendable section 228 can be rotationally coupled to the front piece 250 and/or other rotatable portions of the hand piece 222 through other linking means, such as a key and keyway system, friction fitting system, or other configuration that maintains the translatability of the extendable section 228 while also rotationally coupling the extendable section 228 with the front piece 250.
The one or more supports 252 can be configured to frictionally maintain the position of the extendable section 228 relative to the front piece 250. For example, the one or more supports 252 can be configured to allow a user to adjust the extendable section 228 when desired, while otherwise maintaining the position of the extendable section 228 during normal operation of the instrument (e.g., securing against movement caused by gravity or other relatively minor forces).
The illustrated front piece 250 includes supports 252 formed as radial extensions. Other embodiments can include one or more legs, braces, helical extrusions, and/or other support structures. As shown, the front piece 250 includes an opening 256 to enable fluid communication between the atmosphere exterior to the hand piece 222 and the interior of the hand piece 222.
The embodiment shown in
The illustrated embodiment also includes one or more controls 238 enabling a user to adjust one or more parameters of the electrosurgical instrument 220, such as increasing or decreasing electrical power delivery through the instrument, turning the instrument on and off, adjusting the instrument for different operating modes (cut, coagulate, cut-coagulate blend), etc. For example, the controls 238 can provide a connection for transmitting control signals from the electrosurgical instrument 220 to an electrosurgical generator and/or other controller.
On the other hand, by rotating the electrode tip 230 relative to the targeted tissue to position a side face 236 of the electrode tip 230, which has a relatively higher surface area, near the targeted tissue, the density of the current passing from the electrode tip 230 to the targeted tissue is distributed across a greater area and is relatively lower (e.g., for use in a more dispersed spray-type coagulation mode). Rotation of the electrode tip 230 can therefore allow a user to perform different types of procedures and/or to dynamically adjust the operation of the electrosurgical instrument 220 during an electrosurgical procedure (e.g., by adjusting the level of pinpoint-type operation relative to spray-type operation and vice versa).
In some embodiments, the electrosurgical instrument 220 includes a back stop 244 positioned to limit proximal translation of the extendable section 228 within the interior conduit 242. For example, the back stop 244 can be disposed at a position such that when the extendable section 228 is fully retracted, the electrode tip 230 is at or near the distal portion of the hand piece 222 but is not retracted into the interior of the hand piece 222. The illustrated back stop 244 is formed as a crosspiece to prevent proximal movement of the extendable section 228 past the back stop 244. Alternatively, the back stop 244 can be formed as a wall, rib, detent, abutment, catch, brace, and/or other means of preventing relative movement.
The illustrated electrosurgical instrument 220 also includes a connector 246 coupled to the extendable section 228 at the proximal end of the extendable section 228. As shown, the connector 246 has one or more projections extending radially outwardly to the wall of the interior conduit 242. In some embodiments, the one or more projections function as friction fitting components for maintaining the position of the extendable section 228 relative to the interior conduit 242 (e.g., in addition to, or as an alternative to, frictional securement through engagement between the supports 252 shown in
In some embodiments, the connector 246 is electrically conductive and is configured to pass electrical current to the extendable section 228. In some embodiments, the extendable section 228 is also electrically conductive and is able to pass electrical current to the electrode tip 230. For example, a power cable can extend into the interior of the hand piece 222 (e.g., through a utility conduit) to be coupled to the connector 246 and/or extendable section 228. Alternatively, the connector 246 and/or extendable section 228 can be formed of a non-conductive material, and a power cable or other conductive member can extend to the electrode tip 230 or to other intermediate components in order to deliver electrical current to the electrode tip 230. In some embodiments, the extendable section 228 and/or connector 246 may be formed from a conductive material that is at least partially coated with a non-conductive material to prevent the transfer of current from the extendable section 228 to patient tissue during an electrosurgical procedure.
As shown, the extendable section 228 can be formed with a length (measured along the proximal-distal axis) to be about the same length (e.g., within 99% of, 95% of, 90% of, 80% of, or 75%) of the hand piece 222 in which it can selectively translate within. In other embodiments, the extendable section 228 may be shorter or longer, such as about 0.75 times or 0.5 times the length of the hand piece 222, or about 1.25, 1.5, 2, or 2.5 times longer than the length of the hand piece 222.
In other embodiments, movement of the extendable section 228 can be limited in other ways. For example, the extendable section 228 can include a key or keyway matched to a corresponding keyway or key of the hand piece 222 and/or front piece 250, and the key/keyway system can be formed to limit translation of the extendable section 228 to a desired range. In such embodiments, the key/keyway system can also function to lock the rotational relationship between the extendable section 228 and the front piece 250.
For example, during an electrosurgical procedure, a user can rotate the distal section 260 to alter the orientation of the electrode tip 230 relative to a targeted tissue. This can beneficially enable a user to dynamically adjust the operational characteristics of the electrosurgical instrument, such as by altering the angle at which the electrode tip 230 interacts with the tissue (e.g., by adjusting which portion of the electrode is brought nearest the tissue). For example, the user can rotate the distal section 260 to angle the electrode edge nearer or farther from the target tissue, according to the user's preferences and/or patient needs. In addition, the electrosurgical instrument 220 allows a user to make dynamic adjustments during a procedure, such as by rotating the distal section 260 to adjust the angle of the electrode tip 230 to account for changing tissue geometries (e.g., curves, bumps, etc.) along a cutting or treatment path.
In a typical manner in which the hand piece 222 is held (see
Further, by joining the utility conduit 240 to the proximal section 270, rotational movement of the distal section 260 is mechanically decoupled from the utility conduit 240, allowing rotational adjustments to be made without changing the force distribution on the hand piece 222 and without altering the drag, torque, or torsional moment forces resulting from connection of the utility conduit 240. This further allows the user's grip position to be maintained and provides more consistent controllability of the electrosurgical instrument 220 by keeping drag, torque, torsional moment forces, and other forces applied to the user's hand consistent throughout a procedure. For example, the utility conduit 240 can aid in anchoring the hand piece 222 in the user's hand in a stable manner, and by decoupling rotation of the distal section 260 from the proximal section 270 and utility conduit 240, this stable anchoring function can be maintained without swivel-induced fluctuation or change.
The illustrated attachment piece 280 is formed as a ring having a channeled section 282 and a rim 284 disposed proximal to the channeled section. The structure of the attachment piece 280 allows components of the instrument to be passed from the distal section 260 to the proximal section 270, and vice versa, through the opening of the ring structure. For example, this allows the extendable section 228 to be translatable within the interiors of both the distal section 260 and the proximal section 270.
In the illustrated embodiments, the channeled section 282 of the attachment piece 280 is disposed between the rim 284 and the proximal edge 286 of the front piece 250. As shown, the rim 284 and the proximal edge of the front piece 250 have diameters that are larger than the diameter of the attachment piece 280 at the channeled section 282. This enables the proximal section 270 to be linked to the distal section 260 through insertion of an inward radial extension 272 (disposed at the distal edge of the proximal section 270) into the channeled section 282 of the attachment piece 280, placing the extension 272 between the rim 284 and the proximal edge of the front piece 250. Proximal or distal separation of the distal section 260 from the proximal section 270 is therefore prevented, while independent rotational movement of the distal section relative to the proximal section is maintained.
In the illustrated embodiment, the attachment piece 280 also includes a catch 286 projecting further proximally relative to the remaining proximal surface of the attachment piece 280. The proximal section 270 also includes a swivel stop 274 disposed at or near the proximal surface of the attachment piece 280. Rotation of the distal section 260 causes the attachment piece 280 to correspondingly rotate. Rotation can be continued until the catch 286 abuts against the swivel stop 274. The range of rotation can therefore be limited according to the position of the catch 286 and/or swivel stop 274.
Other embodiments omit swivel-limiting means, allowing a full 360 degree rotation of the distal section 260 relative to the proximal section 270. In some embodiments, rotation is limited to a range of about 45 to 315 degrees, or about 60 to 300 degrees, or about 90 to 270 degrees, for example.
In the embodiment illustrated in
The illustrated embodiment provides a smooth interface between the channeled section 282 and the extension 272, allowing free rotation of the distal section 260 throughout the range of rotation. In other embodiments, rotation may be confined to discrete positions (e.g., in increments of 5, 10, 15, 20, 25, 30, 45, 60 degrees), such as by forming the grooved or sectioned interface between the channeled section 282 and the extension 272.
While the embodiments described herein have been directed to electrosurgical instruments, the present disclosure is not intended to be so limited. Rather, the present disclosure is broadly directed to any hand-held instrument that includes a hand piece with a swivel body. Thus, for instance, a hand-held instrument according to the present disclosure need not include smoke capture/evacuation features. Similarly, a hand-held instrument for use in non-electrosurgical environments may include a functional implement other than an electrode tip for performing a desired function. Thus, reference herein to an electrode tip or tip is not limited to implements used to perform electrosurgical procedures. Rather, reference to an electrode tip or tip is intended to broadly refer to any functional implement that is or can be associated with a hand piece and which is usable to perform a desired function.
By way of non-limiting example, hand-held instruments according to the present disclosure may include dental instruments (e.g., drills, polishing tools, scalers, compressed air tools, suction tools, irrigation tools, carries detection tools, water flossing tool (e.g., waterpik)), soldering tools (e.g., heated tools, smoke collection tools, de-soldering tools), high speed grinding and polishing tools (e.g., Dremel tools, carving tools, manicure tools, dental lab grinders/polishers), laser treatment instruments, laser surgical instruments, light probes, suction handles (e.g., Yankauer), blasting tools (e.g., sandblast, gritblast), shockwave therapy tools, ultrasonic therapy tools, ultrasonic probe tools, ultrasonic surgical tools, adhesive application instruments, glue guns, pneumatic pipettes, welding tools, RF wrinkle therapy hand pieces, phaco hand pieces, shears, shaver, or razor hand pieces, micro drill hand pieces, vacuum hand pieces, small parts handling hand pieces, tattoo needle handles, small torch hand pieces, electrology hand pieces, low speed grinding, polishing and carving tools, permanent makeup hand pieces, electrical probe hand pieces, ferromagnetic surgical hand pieces, surgical plasma hand pieces, argon beam surgical hand pieces, surgical laser hand pieces, surgical suction instruments (e.g., liposuction cannulas), surgical suction cannulas, microdermabrasion hand pieces, fiberoptic camera handles, microcamera hand pieces, pH probe hand pieces, fiberoptic and LED light source hand pieces, hydrosurgery hand pieces, orthopedic shaver, cutter, burr hand pieces, wood burning tools, electric screwdrivers, electronic pad styluses, and the like.
The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the invention is, therefore, indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.
This application claims priority to and the benefit of U.S. Provisional Patent Application No. 62/351,809, filed Jun. 17, 2016, and entitled HAND-HELD INSTRUMENT WITH BODY-SWIVEL, the entirety of which in incorporated herein.
