CN1968657A - 外科手术器械 - Google Patents
外科手术器械 Download PDFInfo
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- CN1968657A CN1968657A CNA2005800201828A CN200580020182A CN1968657A CN 1968657 A CN1968657 A CN 1968657A CN A2005800201828 A CNA2005800201828 A CN A2005800201828A CN 200580020182 A CN200580020182 A CN 200580020182A CN 1968657 A CN1968657 A CN 1968657A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1402—Probes for open surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00607—Coagulation and cutting with the same instrument
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
- A61B2018/1246—Generators therefor characterised by the output polarity
- A61B2018/126—Generators therefor characterised by the output polarity bipolar
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1412—Blade
Abstract
公开了一种包括刀片形电极组件(12)的双极凝固器械,电极组件包括由绝缘材料的中间部分(28)分隔的上侧平坦面(14)和下侧平坦面(15)。上侧平坦面(14)包括由第一绝缘构件(18)分隔的第一和第二电极(16,17),而下侧平坦面(15)包括由第二绝缘构件(24)分隔的第三和第四电极(22,23)。第一和第二绝缘构件(18,24)彼此相互没有关联,以使得,设有至少一个区域,其中第一电极(16)重叠第三电极(22)上,并设有至少一个附加的区域,其中第一电极(16)重叠第四电极(23)。切削电极(30)位于上侧平坦面(14)与下侧平坦面(15)之间,边界延伸超出其周边。
Description
本发明涉及诸如手术刀的双极电手术器械。
这种器械通常被用于外科手术中组织的凝固(凝结)和/或切除,最常用于“锁孔(keyhole)”或微创外科手术中,而且还被用于“开放(open)”外科手术中。
电手术装置大致分成两类,单极装置和双极装置。在单极装置中,射频信号被提供给有源电极,其用于治疗目标部位的组织,电路通过接地垫而实现,所述接地垫大体为较大区域的垫,其在远离目标部位的位置连接至患者。相反,在双极装置中,有源电极和回路电极这两者都设置在器械上,并且电流从有源电极流向回路电极。本发明涉及双极装置。
在微创外科手术中,重要的是能够凝固组织,以阻止或防止流血。通常,手术在受限的空间中完成,并且通常很难或很不方便地必须反复重新定位手术器械,以完成这种凝固。本发明提供了一种适于凝固组织的手术器械,所述器械提供有多个可以实现凝固的区域。
因此,提供了一种包括刀片形电极组件的双极凝固器械(bipolar coagulating instrument),该组件包括由绝缘材料的中间层分隔的上侧平坦面和下侧平坦面,上侧平坦面包括由第一绝缘构件分隔的第一和第二电极,而下侧平坦面包括由第二绝缘构件分隔的第三和第四电极,第一和第二绝缘构件彼此相互没有关联,以使得,设有至少一个区域,其中第一电极重叠第三电极,并且设有至少一个附加的区域,其中第一电极重叠第四电极。
术语“刀片形”是指这样一种器械,其中电极组件的厚度显著小于其宽度。大体上,电极组件的厚度小于5mm,并优选小于3mm。电极组件的宽厚比值至少为1.5,也就是说,电极组件的宽度至少是其厚度的1.5倍。优选地,宽厚比值至少为2。
通过设置第一电极重叠第四电极的至少一个附加的区域,器械提供给使用者位于电极组件上的三个不同的区域,利用它们可完成凝固。首先,凝固可以利用上侧平坦面而完成,凝固电流在第一与第二电极之间流动。其次,凝固可以利用下侧平坦面而完成,凝固电流在第三与第四电极之间流动。最后,凝固可以在电极组件的上侧平坦面与下侧平坦面之间来完成,凝固电流在第一与第四电极之间流动,在该区域它们彼此重叠。
在一种方便的结构中,第一电极与第三电极电连通。大体上,第一电极与第三电极一体形成。相似地,第二电极与第四电极方便地电连通,并且大体上一体形成。
优选地,所述至少一个附加的区域邻近刀片形电极组件的边缘,并且方便地邻近其尖端。在这种方式中,可由其而完成凝固的第三区域包括电极组件的尖端。
在所述至少一个附加的区域中,有多种方式使得第一和第四电极可彼此相互重叠。在一种结构中,第一和第二绝缘构件是纵向延伸的构件,它们彼此成角度设置。可选地或附加地,第一和第二绝缘构件具有彼此各不相同的结构。在另一种可选的结构中,第一和第二绝缘构件具有相似的形状,但是彼此位于不同的方位。一个实例是使得第一和第二绝缘构件分别包括两个区段,它们彼此成锐角设置。无论采用哪种结构,重要的是,电极组件的上侧平坦面上的第一绝缘构件与电极组件的下侧平坦面上的第二绝缘构件在某种情况下互不相关联,从而确保,设有至少一个区域,其中,上侧平坦面上的电极并不与下侧平坦面上的相应的电极对应。
大体上,第一绝缘构件或第二绝缘构件与绝缘材料的中间层一体形成。可想象的是,第一绝缘构件和第二绝缘构件这两者与中间层一体形成。
在优选的结构中,附加地设有切削电极,切削电极分别与第一至第四电极中的每一个电极绝缘。在这种方式中,大体上,在诸如腹腔镜下子宫次全切除术(laparoscopic supracervicalhysterectomy,LSH)的手术中,器械可被用于切除和凝固组织。方便地,切削电极位于上侧平坦面与下侧平坦面之间。大体上,绝缘材料的中间层为两个部分,而切削电极位于它们之间。优选地,切削电极从刀片形电极组件的边缘突出。这样,电极组件的边缘可以被用来切除组织,并且如前所述,可在器械的任何区域中完成凝固。在这种方式中,切除和凝固这两者可仅仅通过必要的器械的最小运动和重新定位而完成,如在微创外科手术中所需要的。
附图说明
现在将参看附图仅仅以实例的方式说明本发明,其中:
图1是包括根据本发明构造的电手术器械的电手术系统的示意图;
图2是根据本发明构造的电手术器械的示意性透视图;并且
图3是从下面看到的、图2的器械的示意性透视图。
具体实施方式
参看图1,发生器1具有输出插座2,其经由连接缆线4为器械3提供射频(RF)输出信号。发生器1的激活可以从器械3经由电缆4内的连接而实现,或依靠脚踏开关单元5而实现,如图所示,其通过脚踏开关连接缆线6被连接至发生器的后部。在所示的实施例中,脚踏开关单元5具有两个脚踏开关5A和5B,用于相应地选择发生器1的凝固模式和切除模式。发生器前面板设有按钮7和8,用于相应地设定凝固和切除的功率级别,其在显示器9上被显示出来。按钮10被设置为用于在凝固与切除模式之间选择的变更装置。
参看图2和3,器械3被示出具有纵向延伸的轴11和刀片形电极组件12。电极组件12的形式为压舌板(spatula)13,其相对于轴11的轴线倾斜大约20度的角度,并且具有宽阔的上侧面14,宽阔的下侧面15,以及相对较薄的截面。上侧面14由第一电极16(被指定为上左电极),和第二电极17(被指定为上右电极)构成。第一和第二电极16和17是由铜形成,覆有硬质镍底镀金(hardgold over nickel)。
在第一电极16与第二电极17之间是第一绝缘构件18,其是由陶瓷形成。第一绝缘构件18具有“双折”形状,带有纵向延伸的茎部19,弯头部分20,和以大约45度的角度延伸的端部部分21。端部部分21向第二电极17斜角,以使第一电极16具有比第二电极更大的表面面积。
下侧面15是由第三电极22(被指定为下左电极),和第四电极23(被指定为下右电极)构成,所述电极也由铜形成,像之前那样电镀。在第三电极22与第四电极23之间是第二绝缘构件24,其也是由陶瓷形成。第二绝缘构件24也具有“双折”形状,并具有纵向延伸的茎部25,弯头部分26,和端部部分27。端部部分27也被类似地斜角大约45度,但是是沿与第一绝缘构件18相反的方向,以使第四电极23具有比第三电极22更大的表面面积。沿电极组件12的一侧,第一电极16重叠第三电极22。沿电极组件12的相反侧,第二电极17重叠第四电极23。然而,第一绝缘构件18和第二绝缘构件24的不同方位意味着,朝向电极组件12的尖端,第一电极16重叠第四电极23。这是重要的,下面将更详细地解释。
在上侧面14与下侧面15之间是中间部分28,其包括由上侧陶瓷层29、平坦的切削电极30、和下侧陶瓷层31构成的三层结构。上侧陶瓷层29和下侧陶瓷层31用于将切削电极30分别与上述从第一至第四电极16、17、22和23绝缘。切削电极30是由不锈钢形成,并边界延伸超出电极组件12的其余部分的周边。
第一电极16和第三电极22(上左电极和下左电极)是由一体的金属构件形成,并经由引线(未示出)连接至电手术发生器1的一个输出端。类似地,第二电极17和第四电极23(上右电极和下右电极)也是由一体的金属构件形成,并且经由引线(未示出)连接至发生器1的另一个输出端。切削电极30也经由引线(未示出)连接至发生器1的输出端。发生器1具有可切换的输出,如申请人的未决欧洲专利申请EP 1287788中所述。
现在说明器械3的操作。器械3通过手术套管针(未示出)被引导入患者体内。当外科医生希望使用器械3切除组织时,脚踏开关5B被压下以将电手术切除信号传送给器械。这个切除信号被提供给切削电极30,而第一至第四电极16、17、22和23被共同连接,并在切除手术中用作为回路电极。在申请人的PCT专利申请WO 03/055402中更加详细地说明了这种电手术切除。
当外科医生希望凝固组织时,脚踏开关5A被压下以传送凝固信号给器械3。该凝固信号在一方面被提供到左侧电极16和22,和而在另一侧面被提供给右侧电极17和23。这为外科医生提供了三种不同的凝固选择。首先,外科医生可以使用电极组件12的上侧面,横跨第一绝缘构件18凝固第一电极16与第二电极17之间的组织。其次,外科医生可以使用电极组件12的下侧面,横跨第二绝缘构件24凝固第三电极22与第四电极23之间的组织。最后,外科医生可以使用电极组件12的尖端,横跨中间部分28凝固第一电极16与第四电极23之间的组织。这只可以提供第一绝缘构件18和第二绝缘构件24不同的方位,允许第一电极16和第四电极23在电极组件12的尖端区域内彼此重叠。这样,外科医生可以使用电极组件12的三个不同部分凝固组织,因此最小化对于器械3的移动和重新定位的需求。而且,器械3的上侧面14和下侧面15的使用适于大面积凝固,而器械的尖端区域的使用则更适于点凝固。当然,用于凝固的电极组件12的三个不同的部分可以组合使用。例如,上述尖端凝固可通过第一电极16与第二电极17之间的、和/或第三电极22与第四电极23之间的凝固的贡献而被增强。如果需要,在使用尖端区域时,这提供了更大的凝固面积。
应该清楚的是,绝缘构件18和24的其它结构和形状也是可行的,而同时仍提供至少一个区域,其中第一电极16重叠第四电极23。例如,第一绝缘构件18和第二绝缘构件24可以大致相同,而相对于轴11的纵向轴线以不同的角度延伸。可选地,绝缘构件18和24分别具有不同的形状。不论采用何种结构,绝缘构件18与24之间的非相关联用于提供附加的凝固区域,其中第一电极16重叠第四电极23。
Claims (17)
1.一种双极凝固器械,其包括刀片形电极组件,所述刀片形电极组件包含上侧平坦面以及下侧平坦面,所述上侧平坦面与所述下侧平坦面由它们之间的绝缘材料的中间层分隔,所述上侧平坦面包括由第一绝缘构件分隔的第一电极和第二电极,而所述下侧平坦面包括由第二绝缘构件分隔的第三电极和第四电极,所述第一绝缘构件与所述第二绝缘构件彼此并不相互关联,以使得设有至少一个区域,在其中所述第一电极重叠所述第三电极;并设有至少一个附加的区域,在其中所述第一电极重叠所述第四电极。
2.根据权利要求1所述的双极凝固器械,其特征在于,所述第一电极与所述第三电极电连通。
3.根据权利要求2所述的双极凝固器械,其特征在于,所述第一电极所述第三电极一体形成。
4.根据权利要求1至3任一所述的双极凝固器械,其特征在于,所述第二电极与所述第四电极电连通。
5.根据权利要求4所述的双极凝固器械,其特征在于,所述第二电极与所述第四电极一体形成。
6.根据前述权利要求任一所述的双极凝固器械,其特征在于,所述至少一个附加的区域邻近所述刀片形电极组件的边缘。
7.根据权利要求6所述的双极凝固器械,其特征在于,所述至少一个附加的区域邻近所述刀片形电极组件的尖端。
8.根据前述权利要求任一所述的双极凝固器械,其特征在于,所述第一和第二绝缘构件为纵向延伸的构件,它们彼此成角度设置。
9.根据权利要求1至7任一所述的双极凝固器械,其特征在于,所述第一绝缘构件和第二绝缘构件具有彼此各不相同的形状。
10.根据权利要求1至7任一所述的双极凝固器械,其特征在于,所述第一和第二绝缘构件具有类似的形状,但是它们彼此位于不同的方位。
11.根据权利要求10所述的双极凝固器械,其特征在于,所述第一和第二绝缘构件分别包括两个区段,所述区段相互以锐角设置。
12.根据前述权利要求任一所述的双极凝固器械,其特征在于,所述第一绝缘构件与所述绝缘材料的中间层一体形成。
13.根据前述权利要求任一所述的双极凝固器械,其特征在于,所述第二绝缘构件与所述绝缘材料的中间层一体形成。
14.根据前述权利要求任一所述的双极凝固器械,其特征在于,还包括切削电极,所述切削电极分别与所述第一电极至所述第四电极中的每一个电极绝缘。
15.根据权利要求14所述的双极凝固器械,其特征在于,所述切削电极位于所述上侧平坦面与所述下侧平坦面之间。
16.根据权利要求15所述的双极凝固器械,其特征在于,所述绝缘材料的中间层具有两个部分,而所述切削电极位于所述部分之间。
17.根据权利要求14至16任一所述的双极凝固器械,其特征在于,所述切削电极从所述刀片形电极组件的边缘突出。
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GB0413705.5 | 2004-06-18 | ||
GB0413705A GB2415140A (en) | 2004-06-18 | 2004-06-18 | A surgical instrument |
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CN1968657A true CN1968657A (zh) | 2007-05-23 |
CN100443062C CN100443062C (zh) | 2008-12-17 |
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US (1) | US7150748B2 (zh) |
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-
2004
- 2004-06-18 GB GB0413705A patent/GB2415140A/en not_active Withdrawn
- 2004-08-25 US US10/924,953 patent/US7150748B2/en active Active
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- 2005-05-31 WO PCT/GB2005/002143 patent/WO2005122936A1/en not_active Application Discontinuation
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- 2005-05-31 CN CNB2005800201828A patent/CN100443062C/zh active Active
- 2005-05-31 AU AU2005253762A patent/AU2005253762C1/en active Active
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WO2005122936A1 (en) | 2005-12-29 |
US20050283151A1 (en) | 2005-12-22 |
GB2415140A (en) | 2005-12-21 |
EP1755475A1 (en) | 2007-02-28 |
DE602005019158D1 (de) | 2010-03-18 |
EP1755475B1 (en) | 2010-01-27 |
CN100443062C (zh) | 2008-12-17 |
ATE456331T1 (de) | 2010-02-15 |
AU2005253762B2 (en) | 2011-03-31 |
ES2339952T3 (es) | 2010-05-27 |
AU2005253762A1 (en) | 2005-12-29 |
AU2005253762C1 (en) | 2011-08-11 |
GB0413705D0 (en) | 2004-07-21 |
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