U.S. patent number 3,920,021 [Application Number 05/470,010] was granted by the patent office on 1975-11-18 for coagulating devices.
Invention is credited to Siegfried Hiltebrandt.
United States Patent |
3,920,021 |
Hiltebrandt |
November 18, 1975 |
**Please see images for:
( Certificate of Correction ) ** |
Coagulating devices
Abstract
This invention relates to devices for coagulating animal tissue
by means of high frequency current. Such devices are known to
include two electrodes connectable to sources of high frequency
alternating current at different potentials, and the coagulating
current flows between these electrodes after they have been applied
to the body tissue. Such devices also further consist of a barrel
with a coagulator fitting provided at the distal end thereof. In
accordance with the invention the coagulator fitting in a device of
the kind just described utilizes two electrodes which are separated
from one another by an insulator, and these are arranged at the
distal end of the barrel.
Inventors: |
Hiltebrandt; Siegfried (7134
Knittlingen, DT) |
Family
ID: |
5881058 |
Appl.
No.: |
05/470,010 |
Filed: |
May 15, 1974 |
Current U.S.
Class: |
606/50;
606/51 |
Current CPC
Class: |
A61B
18/1485 (20130101); A61B 18/1442 (20130101); A61B
17/29 (20130101); A61B 18/1402 (20130101); A61B
17/30 (20130101); A61B 2018/00196 (20130101) |
Current International
Class: |
A61B
18/14 (20060101); A61B 17/30 (20060101); A61B
17/28 (20060101); A61B 18/00 (20060101); A61B
017/40 (); A61N 003/06 () |
Field of
Search: |
;128/303.17,303.13,303.14,407-409,404,405,303.18,303.19 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Michell; Robert W.
Assistant Examiner: Cohen; Lee S.
Claims
I claim:
1. A high frequency alternating electric current tissue-coagulating
device having an elongated means supporting two separate and spaced
apart electrodes, and electrical insulator spacer means for
insulating the electrodes from each other, and circuit means for
connecting the electrodes to opposite poles of a source of high
frequency alternating current, the improvement being: said
electrical insulator spacer means being axially elongated along a
longitudinal axis thereof, the electrical insulator spacer means
having a first step defined therein at a distal end thereof and
having a second step defined therein at an interconnected and
opposite proximal end thereof; the elongated means being further
for positioning the electrodes at the distal end thereof, and said
insulator spacer means being further for spacing the electrodes at
said distal end of the elongated means; said electrodes including a
first annular electrode mounted in juxtaposition to the second step
onto said electrical insulator spacer means, and a second
hemispherically shaped terminal-end electrode mounted on said first
step onto said electrical insulator spacer means, and said
electrical insulator spacer means and said electrodes being mounted
on said distal end of the elongated means at said proximal end of
the electrical insulator spacer means, each of the first annular
electrode and the second hemispherically shaped terminal-end
electrode in a mounted state having predetermined amounts of
exterior exposed surface area, respectively for each, whereby
tissue in contact with both the first annular electrode and the
second hemispherically shaped terminal-end electrode becomes
coagulated when the high frequency alternating electric current is
passed through the contacted tissue between the electrodes.
2. A high frequency alternating electric current tissue-coagulating
device of claim 1, in which said first annular electrode defines a
step on its outer periphery, and in which said elongated means
defines a hollow distal end fitted securedly onto the step of the
first annular electrode.
3. A high frequency alternating electric current tissue-coagulating
device of claim 1, in which one of the second hemispherically
shaped terminal-end electrode and the electrical insulator spacer
means defines a male member, and in which the remaining other one
of the second hemispherically shaped terminal-end electrode and the
electrical insulator spacer means defines a female member, the male
member being mounted matedly in the female member.
4. A high frequency alternating electric current tissue-coagulating
device of claim 3, in which said first annular electrode defines a
step on its outer periphery, and in which said elongated means
defines a hollow distal end fitted securedly onto the step of the
first annular electrode.
5. A high frequency alternating electric current tissue-coagulating
device of claim 1, in which said elongated means defines a hollow
distal end fitted securedly onto said second step.
6. A high frequency alternating electric current tissue-coagulating
device of claim 5, in which one of the second hemispherically
shaped terminal-end electrode and the electrical insulator spacer
means defines a male member, and in which the remaining other one
of the second hemispherically shaped terminal-end electrode and the
electrical insulator spacer means defines a female member, the male
member being mounted matedly in the female member.
Description
BACKGROUND OF THE INVENTION
The present invention relates to devices for coagulating animal
tissue by means of high frequency current, of the kind which
comprise two electrodes connectable to sources of high frequency
alternating current at different potentials, and between which the
coagulating current flows after they have been applied to the body
tissue, and which further consists of a barrel, at the distal end
of which a coagulator fitting is provided. Hereinafter such devices
will be referred to as "devices of the kind described".
In known devices of the kind described, the coagulator fitting
consists of an electrode representing one pole, which is
connectable to a potential different from earth via a lead
extending through the barrel. The second electrode used is
generally an earth pole in the form of a plate, which is applied to
the appropriate portion of the anatomy of the person being
treated.
During the coagulation process, the electrode situated at the end
of the barrel is applied to the tissue so as, for example, to
coagulate the tissue and perform a stypic operation, which may be
necessary after a biopsy has been performed.
The basis of this process is that, due to the difference of
potential between the electrodes (which are supplied from a source
of high frequency alternations current energy, usually referred to
as an HF supply apparatus) there is a flow of current through the
body tissue which, if suitably regulated, causes the tissue to be
dried out or parched in the vicinity of the electrode situated on
the device itself, due to the fact that the latter is smaller than
the earth electrode and therefore generates higher current
densities at the point of transition between it and the tissue.
In known devices of the kind described, the distance between the
electrodes, and thus the distance to be traversed by the current,
is relatively large, which naturally leads to a considerable loss
in power and, as a consequence, to resultant coagulation which is
often unsatisfactory. It might be desirable in such cases to
increase the operating voltage, but this is not always possible
because of the danger to the patient which it involves.
A further disadvantage which is particularly apparent is that the
plate-like earth electrode often does not lie completely flat
against the patient's body but only has part of its conductive
surface in contact. It is therefore possible in use for the current
density to increase locally and cause burns in the vicinity of the
earth electrode.
OBJECT OF THE INVENTION
It is an object of the invention to remove or minimise these
drawbacks and to provide a reliable coagulating device.
SUMMARY OF THE INVENTION
The invention consists in a tissue-coagulating device of the kind
described, wherein said two electrodes are separated from one
another by an insulator, and are arranged at the distal end of the
barrel.
In a particular embodiment, the two electrodes can be applied to
the tissue to be coagulated cojointly, the advantage of this being
that there is a shorter current path between the electrodes and
that only a small power loss is encountered. In addition the large
electrode which otherwise has to be handled separately is dispensed
with and this prevents undesirable burns and other injuries,
especially since the doctor performing the treatment is now able to
guide the electrodes while they are both in his field of
vision.
By making the conductive areas of the electrodes which are applied
to the tissue of suitable size, the possibility also exists of
deciding precisely which of the two electrodes is to play a greater
or lesser part in the coagulation process. This fact may be of
importance in cases where it is desired that a given electrode
should operate particularly and preferentially on a special area of
tissue. In view of the high current density required the effective
area of the electrode in question would be made smaller than that
of the other electrode.
SHORT DESCRIPTION OF THE DRAWINGS
In order that the invention may be more clearly understood,
reference will now be made to the accompanying drawings which show
certain embodiments thereof by way of example only and in
which:
FIG. 1 shows an axial section through a first embodiment of
coagulator device according to the invention,
FIG. 2 shows an axial-section through the distal end of a second
embodiment,
FIG. 3 shows an axial-section through the distal end of a third
embodiment,
FIG. 4a shows an end-on view of the distal end of a fourth
embodiment which employs concentric electrodes,
FIG. 4b shows a longitudinal section through the embodiment shown
in FIG. 4a,
FIG. 5a shows an end-on view of the distal end of a fifth
embodiment of coagulator device having a modified form of
electrode,
FIG. 5b shows an axial section through the distal end of the
embodiment shown in FIG. 5a and,
FIGS. 6 to 8 show three further embodiments in which the electrodes
are in the form of adjustable forceps.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
Referring now to the drawings in which like reference numerals
refer to like parts, in general, the device in all embodiments
comprises a barrel 1 which may be either flexible or rigid, and
through which extend two electrical supply leads 2, 3, these being
connected at the distal end to the two electrodes and at the
proximal end to two metal plug-terminals 4 and 5 by soldering or in
any other desired way. Between the plug-terminals is a bush 6 made
of insulating plastics material. The barrel 1 fits tightly over a
shoulder on the outer plug terminal 4 and may be joined to the
latter by bonding, shrinking or in any other desired manner. The
parts 4, 5 and 6 of the plug are screwed tightly together by means
of the threads indicated in the drawing and form a plug which can
be inserted in an appropriate connection on the HF supply apparatus
(not shown) or in a socket coming from this equipment. If the
method of connection requires it, the plug may be modified from the
form shown in FIG. 1 and may be a female socket connection.
Corresponding plug and socket members may be used with the devices
shown in the other views and there is therefore no need for further
description or drawings in this respect.
In FIG. 1 the part 7 of the device at the extreme distal end, which
is made of plastics material, is rounded to prevent injury to the
tissue amongst other things. The two electrodes 8 and 9 are in the
form of annular bodies which are held apart by a spacer 10 made of
insulating material. Furthermore, the spacer and the two
electrodes, as shown, have inter-engaging shoulders and projections
which support one another and by means of which the spacer and
electrodes are located in their fitted positions relative to the
longitudinal axis 11 of the device. The end-part 7 is screwed into
a threaded bore in spacer 10 by means of a threaded projection 7a,
while the spacer in turn is screwed into a threaded bore in
electrode 9 by means of a threaded projection 10a. Electrode 9 has
a step on its periphery so that the hollow distal end of the barrel
1 can be fitted over the step. A secure connection between parts 1
and 9 may be ensured by additionally using a bonding agent.
The respective areas of electrodes 8 and 9 which are to be applied
to the body tissue to be coagulated take the form of cylindrical
surfaces 8a, 9a the axis of which coincides with the axis 11 of the
device. It can be seen that the distance between the electrodes,
which is dictated by the dimensions of the spacer 10, is short,
which gives the advantages mentioned above. As an example, when the
device is used as a probe in conjunction with an endoscope, the
diameter of its nose at the distal end, and thus the diameter of
the electrodes, may be 2 to 5 mm, although this statement should
not be taken as representing a limitation to the size mentioned.
Clearly all that this is intended to show is that the working gap
between the electrode surfaces 8a and 9a may be made extremely
small if this is desired.
In the embodiments shown in FIGS. 2 and 3 the one (12 or 13) of the
electrodes which forms the distal end of the device is in the form
of a rounded nose or is substantially hemispherical, while the
other electrode 14 or 15 is once again represented by an annular
body of which the area applied to the body tissue is, as in the
embodiment in FIG. 1, the surface of a cylinder whose axis
coincides with the longitudinal axis 11 of the device. The pairs of
electrodes 12, 14 or 13, 15 are held apart by spacers 16 or 17 made
of insulating material and are connected to the spacers via engaged
threads which can be seen in the drawings.
In FIG. 2 the rounded electrode 12 is screwed into the threaded
bore in the spacer 16 by means of a threaded projection, while the
annular electrode 14 fits onto a step on the spacer. The spacer is
screwed into an insulating piece 18 which is joined to the barrel 1
by fitting the hollow distal end of the barrel over a step on the
insulating piece 18 and connecting it thereto by means of an
adhesive or the like.
In the embodiment shown in FIG. 3 the electrode 15, which is in the
form of an annular body, has a step on the periphery and the distal
end of the barrel is fitted over this step and fixed in position
there by means of a bonding agent.
As shown in FIGS. 4a and 4b, it is also possible for one of the two
electrodes to be formed by a metal rod 19 and the other electrode
by a sleeve or tube 20 which surrounds this rod and is insulated
from it. In this case also the distal end of the device is
rounded.
The same applies to the device shown schematically in FIGS. 5a and
5b, in which the two electrodes 21 and 22 are substantially in the
form of quarter spheres which are arranged at the distal end of the
device so as to be symmetrical to the longitudinal axis 11 and to
form mirror images of each other and which, in conjunction with an
insulator 23 situated between them, form a hemisphere.
In the case of the embodiments shown in FIGS. 6 to 8, the
coagulator electrodes are mounted at the ends of forceps arms in
the form of wires the relative position of which can be adjusted by
means of a handle which is operated from the proximal end.
The instrument shown in FIG. 6 has a barrel 24 in which a
guide-piece 25 can be slidably displaced axially in either
direction. In this guide-piece 25 is inserted a holder 26 made of
insulating material. The two electrodes 27, 28 are mounted at one
end of electrically conductive wires 29 and 30 in the form of
plates, the other ends of the wires being inserted in different
longitudinal holes in the holder 26. Via leads of conventional kind
(not shown) the electrodes have a conductive connection to a plug
31 fitted to the proximal end of the instrument.
In this case the electrodes thus form a kind of forceps the arms of
which are the spring wires 29, 30. The possibility also exists of
making the circular plates shown from an insulating material,
resulting in the electrodes being formed directly by the ends of
wires 29 and 30.
The plug 31 is mounted in a holder part 32 which is joined to the
guide-piece 25 via an actuating rod 33. A handle in the form of a
folded grip 34 made of resilient material is rigidly connected at
34a to the rod 33 and at 34b to the barrel 24. Near the point 34b
where the grip 34 is attached, the actuating rod 33 is a clearance
fit in the limb of the grip situated at this point.
When the limbs of the grip 34 are moved towards one another, the
guide-piece 25 slides to the left of the Figure in the barrel 24
and the wire arms 29, 30, which are sprung-loaded radially
outwards, emerge from the distal end of the barrel and open out in
contact with a cylindrical part 24a made of insulating material, as
a result of which the gap between the electrodes increases. it will
be apparent that the gap between the electrodes will be dictated by
the position of the limbs of the grip 34 at any given time. Thus,
when the limbs of the grip are released or opened, guide-piece 25
slides back to the right in barrel 24 and the gap between the
electrodes is reduced again.
In the case of the embodiment shown in FIG. 7, a projection on the
upper metal electrode 35 can engage in an appropriate recess in the
lower metal electrode 36. The same applies to the embodiment shown
in FIG. 8 in which the upper electrode 37 is able to engage in a
V-shaped recess in the lower electrode 38. In this case also the
electrodes are actuated or adjusted in the same way as was
explained in connection with FIG. 6.
It should also be mentioned that on the one hand the device, which
is suitable for the treatment both of human beings and of animals,
can be used as a probe in conjunction with an endoscope. For this
purpose the endoscope has a probe passage by means of which the
probe can be inserted from the proximal end and can be passed
through the barrel of the endoscope and up to the area of
treatment. On the other hand the device may, of course, also be so
formed as to be capable of use separately from endoscopes, in which
case its distal end is applied directly to the area of treatment.
In this case the barrel of the device may be made relatively rigid.
Doing this does not of course preclude the possibility of observing
the coagulation process with an endoscope which has been inserted
in the body cavity through a second incision.
Finally, it should be mentioned that any other desired types of
connection may be considered in addition to the connections in
thread form shown and described. The possibility may also be
considered of applying a cement, such as red-lead putty, between
the parts to be screwed together so as to ensure that the
connection is absolutely solid and secure.
* * * * *