U.S. patent number 3,901,242 [Application Number 05/474,614] was granted by the patent office on 1975-08-26 for electric surgical instrument.
This patent grant is currently assigned to Storz-Endoskop GmbH. Invention is credited to Karl Storz.
United States Patent |
3,901,242 |
Storz |
August 26, 1975 |
Electric surgical instrument
Abstract
An electric surgical instrument includes a pair of laterally
spaced, hollow tubes the distal ends of which are interconnected by
a transverse electrical insulating member upon which are helically
wound a pair of spaced electrodes having electrical conductors
which extend through the tubes for connection to a source of high
frequency current. This assembly is adapted for use with an
endoscope or other similar type of instrument.
Inventors: |
Storz; Karl (Tuttlingen,
DT) |
Assignee: |
Storz-Endoskop GmbH
(Schaffhausen, CH)
|
Family
ID: |
23884296 |
Appl.
No.: |
05/474,614 |
Filed: |
May 30, 1974 |
Current U.S.
Class: |
606/46;
606/48 |
Current CPC
Class: |
A61B
1/307 (20130101); A61B 18/149 (20130101); A61B
18/1485 (20130101); A61B 1/12 (20130101); A61M
3/0283 (20130101); A61B 18/1402 (20130101) |
Current International
Class: |
A61B
18/14 (20060101); A61B 1/12 (20060101); A61B
1/307 (20060101); A61M 3/00 (20060101); A61M
3/02 (20060101); A61b 017/32 () |
Field of
Search: |
;128/303.15,303.16,303.17,303.18,303.13,303.14,404,407-409 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Pinkham; Richard C.
Assistant Examiner: Cohen; Lee S.
Attorney, Agent or Firm: Olson; Oliver D.
Claims
Having now described my invention and the manner in which it may be
used, I claim:
1. An electric surgical instrument, comprising:
a. a pair of elongated, laterally spaced and substantially parallel
hollow tubes,
b. an electrode support of electrically non-conductive material
secured to and extending transversely between the tubes at one end
thereof,
c. a pair of electrodes mounted upon the electrode support in
spaced-apart relation and extending transversely between the tubes,
and
d. an electrical conductor connected to each electrode and
extending through one of said tubes for connection to a source of
high frequency current.
2. The electric surgical instrument of claim 1 wherein the
electrode support has a pair of helical threads of equal pitch
spaced apart a predetermined distance and each mounting one of the
pair of electrodes, with a substantial portion of the cross
sectional thickness of the electrodes projecting outwardly from the
threads.
3. The electric surgical instrument of claim 2 wherein the
predetermined distance between the electrodes is substantially
one-half the pitch of the threads.
4. The electric surgical instrument of claim 1 in combination with
an endoscope having a hollow shaft, wherein the electrode support
is curved to correspond with the internal diameter of the endoscope
shaft, the tubes and electrode support being mounted within the
hollow shaft.
Description
BACKGROUND OF THE INVENTION
This invention relates to surgical instruments, and more
particularly to a surgical operating instrument for electric
cutting by means of high frequency current, particularly in the
bladder.
Operating instruments of this type presently known are constructed
as unipolar operating members, i.e. the instrument has an operating
member which as only one electrode (e.g. German Gebrauchsmuster
1,980,836). However, the patient must be brought into contact with
a so-called inactive plate-like electrode. As a result, the
complete body of the patient serves as a conductor for the high
frequency current whilst the loop-like electrode of the instrument,
which is for example mounted in an endoscope, is constructed as the
active electrode by means of which the cuts for removing diseased
tissue are performed. For this purpose the current potentials must
be comparatively high because on the one hand the whole body of the
patient serves as a conductor and on the other hand sparking must
occur on the loop-like active electrode. It is possible for burns
to occur at the inactive electrode if contact with the patient's
body has not been completely satisfactory.
In order to avoid the foregoing disadvantages of unipolar operation
in hemostatic coagulation, bipolar coagulation recently has been
used in surgical operations. For this purpose, high frequency
current is supplied to each of the two legs of the forceps which
are insulated relative to one another. The tissue between the legs
of the forceps is coagulated as soon as these legs are at the
necessary limited distance from one another. As a result of such
bipolar operation, the advantage obtained is that the high
frequency current can be a multiple smaller than with unipolar
operation. Accordingly, the danger of burns is eliminated.
However, operating instruments for use with endoscopes and other
similar instruments heretofore have not been provided with a pair
of electrodes for bipolar operation in such organs as the
bladder.
SUMMARY OF THE INVENTION
In its basic concept, this invention provides an electric surgical
instrument which may be used with endoscopes and similar
instruments for bladder and other operations, wherein the
instrument is provided with a pair of electrodes.
It is by virtue of the foregoing basic concept that the principal
objective of this invention is achieved; namely, to overcome the
aforementioned disadvantages of prior electric surgical instrument
for these types of operations.
Another object of this invention is to provide an electric surgical
instrument of the class described in which the pair of electrodes
are maintained in accurate spaced-apart arrangement.
A further object of this invention is the provision of an electric
surgical instrument of the class described in which the support for
the electrodes may be shaped to accommodate use with endoscopes and
other similar types of instruments.
Still another object of this invention is the provision of an
electric surgical instrument of the class described in which the
pair of electrodes are supported to provide maximum surface areas
facing one another.
A still further object of this invention is the provision of an
electric surgical instrument of the class described which is of
simplified construction for economical manufacture, which is
capable of being cleaned with speed and facility and which is
operable with precision and maximum safety.
The foregoing and other objects and advantages of this invention
will appear from the following detailed description, taken in
connection with the accompanying drawings of preferred
embodiments.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a foreshortened front view, partly in section, of an
endoscope having associated therewith an electric surgical
instrument embodying the features of this invention.
FIG. 2 is a foreshortened side view of the electrical surgical
instrument shown in FIG. 1.
FIG. 3 is a view in transverse section taken on the line III--III
in FIG. 2 on a greatly increased scale.
FIG. 4 is a transverse sectional view of an electrode support in a
further embodiment.
FIG. 5 is a fragmentary section taken in the longitudinal direction
through the electrode support of FIG. 3.
FIG. 6 is a fragmentary plan view of a lathe tool for producing the
electrode support of FIGS. 3 and 5.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
FIG. 1 shows an endoscope shaft 16 in which is arranged the viewing
tube with the eyepiece 18 and the lens 13. This can be of
conventional design and is known to those skilled in the art. The
electrode support carrier, commonly known as a loop carrier, and
the appropriate guide block 17 also are fundamentally known.
The viewing tube is non-displaceably but interchangeably connected
with the endoscope shaft 16 and a considerable portion of its
length projects above the head 19 of the endoscope shaft. In the
area of eyepiece 18 is articulated a lever 20 whose free end is
hinged in shear-like manner with arm 21 of a hand lever 22 which,
in turn, is articulated to guide block 17 and is constructed in the
form of a control handle 23. Upon operating hand lever 22, relative
to the attachment 24 on the eyepiece, the guide block 17 is moved
in the longitudinal direction of the viewing tube.
The loop carrier comprises two parallel tubular rods 10 and 11
which are interconnected and guided on the viewing tube 15 and
which at their distal ends carry and are interconnected by a
transverse electrode support 12. In the embodiment illustrated,
this support is in the form of an open loop (FIG. 3).
According to the invention, the left hand tubular rod 11 contains
an insulated electrode wire 1 and the right hand rod 10 contains an
insulated electrode wire 2.
In the area of the distal end of the viewing tube 15, the loop
carrier is provided with a guidance member 14 in the form of a
sleeve which surrounds the viewing tube and is supported on the
inner wall of the endoscope shaft 16. The remaining inner area
within the endoscope shaft serves as a washing passage. Guidance
member 14 is provided with a nozzle-like constriction 24 (FIG. 2)
through which a washing agent can be sprayed onto the loop 12 in
order to clean the same. In head 19 of endoscope 16 is provided a
pair of pipe connections, one being provided with a tap 26, the
other with a tap 28, for the supply and discharge of the washing
agent.
The insulated electrode wires 1 and 2, which are not shown in FIGS.
1 and 2 and which are for example 0.5 mm. thick, are located in
tubes 10 and 11 and terminate at the top in plug 25 for connection
to a source of high frequency current, not shown.
FIG. 3 shows a preferred embodiment of electrode support loop 12 on
a greatly enlarged scale. It is curved according to the internal
diameter of the endoscope shaft 16. The loop is made of electrical
insulating material 4, preferably synthetic thermoplastic resin
having appropriate strength and elasticity. Such plastics are well
known to those skilled in the art. The support must be constructed
in such a way that maximum surface areas of the two electrodes 1
and 2 face one another across the predetermined limited spacing
between them. This means that particularly between the closest
points of the two electrodes there will be no insulating material,
because here the cutting process according to this invention takes
place by spark-over.
Referring particularly to FIG. 5 of the drawing, which shows FIG. 3
on a greatly enlarged scale, the insulating support 12 is provided
externally with two parallel helical threads 5 and 6 which are of
the same pitch and which are axially spaced relative to one another
by a desired limited spacing. In this way, the two electrodes,
whose diameter, for example, may be 0.5 mm., can be reliably kept
at the desired limited spacing a from one another in the two
parallel threads so that most of the surface thereof projects
outward above the threads. As a result, the length of the
electrodes which are in this way distributed over the loop is much
greater than that of the loop itself, so that the total cutting
surface is increased. The diameter of the insulator 4 is also kept
small and can be, for example, 1 mm. It is particularly preferred
that the limited spacing between the two electrodes be half as
large as the pitch of the threads. In this way, a uniform
construction of the threads over the insulator length is
achieved.
The uninsulated portions of the electrodes 1 and 2 are wound onto
the two parallel threads 5 and 6 of insulator 4 in the manner
clearly shown in FIG. 5. Therefore, the left hand electrode 1
terminates at the right hand end of the insulator adjacent tube 10
and, conversely, the right hand electrode 2 terminates at the left
hand end of the insulator adjacent tube 11.
The diameter d of insulator 4 can be, for example, 1 mm., whilst
the diameter of electrode wires 1 and 2 can be, for example, 0.5
mm. The two parallel threads 5 and 6 have the same pitch h because
otherwise the threads would run into one an other. The axial
spacing a thereof relative to one another corresponds to the
desired limited spacing between electrodes 1 and 2. This relates to
the centers of the electrode wires. As can be seen, the closest
points of the electrode surfaces are much closer together. In this
way, very limited spacings of electrodes 1 and 2 can be reliably
obtained because the electrode wires are securely held in threads 5
and 6 and cannot become displaced.
FIG. 5 only shows a short portion of loop 12 which, according to
FIG. 3 is at least partly curved, corresponding to the inner
diameter of endoscope shaft 16. The insulating plastic material
from which insulator 4 is made has the necessary strength, but at
least when warm can be brought into the form of FIG. 3. Insulator 4
not only has the function of keeping the thin electrode wires 1 and
2 at a particular spacing relative to one another and insulating
the same relative to one another, but also insures the necessary
stability of the structure. In this connection, wires 1 and 2 can
be considerably thinner, for example 0.1 mm. thick. As a result, a
good cut is insured and also a high degree of stability in the case
of clamp cuts, gripping pieces of tissue and currentless
shaving.
In FIG. 5, the two threads 5 and 6 preferably are constructed as
buttress threads, in order to leave freely exposed the maximum
portion of electrode wires 1 and 2.
The threads 5 and 6 can be produced by conventional means. In
accordance with this invention there is provided a recessing lathe
tool having two cutting tips spaced apart relative to one another
by the desired limited spacing corresponding to the cross section
of the two threads. By means of this lathe tool, the indicated
construction of the threads can be obtained in simple manner by
turning the insulator 4.
FIG. 6 shows a lathe tool 7 which can be used to cut threads 5 and
6 in insulator 4 according to FIG. 5. This takes place on a small
lathe, such as is conventionally used in the watch industry. A feed
of h=2a must be selected to give a completely uniform arrangement
of the two separate threads 5 and 6 for receiving the two electrode
wires 1 and 2. To this end, the two cutting tips 8 and 9 must be at
the spacing a from one another and contoured to produce the desired
shape of threads.
Although the electrode support 12 of FIGS. 3 and 5 is circular in
cross section, it may have various other cross sectional shapes.
For example, it may be fork-shaped in cross section, as illustrated
in FIG. 4. This embodiment keeps the two electrodes 1 and 2 at a
distance a and partly surrounds the same, but leaves free for
sparking the area where the two electrodes 1 and 2 are closest
together. Insulator 3 and electrodes 1 and 2 therefore together
form a loop 12 as in the embodiment according to FIG. 3.
Whatever shape is selected for the insulators 3 and 4, it is
important that the electrodes 1 and 2 be kept at the desired
limited spacing a from one another by the insulator, in order to
achieve efficient bipolar cutting.
It will be apparent to those skilled in the art that various
changes may be made in the size, shape, type, number and
arrangement of parts described hereinbefore, without departing from
the spirit of this invention.
* * * * *