CN104224308A - 电外科手术器械 - Google Patents

电外科手术器械 Download PDF

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CN104224308A
CN104224308A CN201410363021.XA CN201410363021A CN104224308A CN 104224308 A CN104224308 A CN 104224308A CN 201410363021 A CN201410363021 A CN 201410363021A CN 104224308 A CN104224308 A CN 104224308A
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CN104224308B (zh
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R·J·霍德赖斯
R·J·基奥
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Gyrus Medical Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1485Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
    • BPERFORMING OPERATIONS; TRANSPORTING
    • B23MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23PMETAL-WORKING NOT OTHERWISE PROVIDED FOR; COMBINED OPERATIONS; UNIVERSAL MACHINE TOOLS
    • B23P17/00Metal-working operations, not covered by a single other subclass or another group in this subclass
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00526Methods of manufacturing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1467Probes or electrodes therefor using more than two electrodes on a single probe
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1472Probes or electrodes therefor for use with liquid electrolyte, e.g. virtual electrodes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/16Indifferent or passive electrodes for grounding
    • A61B2018/162Indifferent or passive electrodes for grounding located on the probe body
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10TTECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T29/00Metal working
    • Y10T29/49Method of mechanical manufacture
    • Y10T29/49002Electrical device making
    • Y10T29/49117Conductor or circuit manufacturing

Abstract

电外科手术器械。一种用于治疗组织的电外科手术器械,该器械(3)包括轴(14)和位于所述轴的远端的包括至少一个电极(16)的末端部。流体不可渗透的套(25)覆盖轴的至少一部分并且延伸到该套在远端部(26)终止的末端部。设置金属罩(29),其包括圆环部(30)和向后延伸的圆柱部(31)。该圆环部(30)连接到该末端部,且该圆柱部(31)盖在该套(25)的该远端部(26)上以防止流体在该套的该远端部进入。

Description

电外科手术器械
技术领域
本发明涉及用于治疗组织的电外科手术器械。这样的系统通常用于手术干预中组织的汽化和/或凝固,更普遍的用于“锁孔”或微创手术,但是也用于“开放”手术。
背景技术
一种类型的电外科手术方法被称为“水下”电外科手术,其中,器械被操作浸没在导电流体,例如普通的生理盐水中。即使是在干燥场合的电外科手术中,由于血液或冲洗液的存在,手术部位往往是湿的。因此电外科手术器械通常需要是密封的,使得流体不会渗入器械并且到达内部元件。流体进入会导致元件之间不必要的电弧放电,并且由于这个原因,电外科手术器械经常覆盖有流体不可渗透的套。但是,即使有这样的套,依然会发生不希望的流体进入。
发明内容
为了解决上面的问题,本发明的实施方式给出了一种具有改进的阻止流体进入的电外科手术器械。因此,从一个方面,提供一种用于治疗组织的电外科手术器械,该器械包括:
a)具有纵轴线的轴,该纵轴线定义近端和远端方向,
b)位于所述轴的远端的末端部,该末端部包括至少一个电极,
c)流体不可渗透的套,其覆盖该轴的至少一部分并且延伸到该套在远端部终止的末端部,以及
d)金属罩,其包括圆环部和向后延伸的圆柱部,
布局是该圆环部连接到该末端部,该圆柱部分盖在该套的远端部上以防止流体在该套的该远端部分进入。
该金属罩覆盖所述流体不可渗透的套的远端并且防止流体在该套与该器械的该末端部分汇合的点侵蚀。方便的是,在远离所述套在远端部中终止的点的位置,该金属罩的圆环部连接到末端部。这样,向后延伸的圆柱部盖在该套终止的点上,以保护它防止流体进入。
该圆环部优选地通过加热该圆环部的过程来连接到所述末端部,通常通过焊接到该末端部。方便的是,该圆环部激光焊接到该末端部。优选的是,加热过程是使得流体不可渗透的套在该金属罩的圆柱部区域中熔化以紧贴所述圆柱部密封。这样,该罩不仅可以覆盖套的远端部,也将该套熔化使得紧贴该罩密封。通过在所述圆柱部区域使该套熔化,改善了对流体进入的障碍。
通常,该末端部包括双极电极组件,该双极电极组件包括至少一个作用电极和至少一个返回电极。在这种结构中,该圆环部优选地连接到该返回电极。这意味着该金属罩电连接到该返回电极,并且形成返回电极的延伸以传导从作用电极流出的电流。
该电外科手术器械优选地为内窥镜外科手术器械。在微创方法中,该器械典型地与内窥镜或其他可视器械一起用于关节、腹腔或妇科手术。
本发明的实施方式还包括一种电外科手术器械的制造方法,该方法包括以下步骤:
a)提供轴、包括至少一个电极的末端部,流体不可渗入的套、包括圆环部和向后延伸的圆柱部的金属罩,
b)在该轴的远端固定该末端部,
c)将流体不可渗入的套设置于该轴,使得该流体不可的套覆盖该轴的至少一部分并延伸到该流体不可的套在远端部终止的末端部,
d)设置金属罩,使得该圆柱部盖在该套的远端部上,以及
e)按照使来自焊接过程的热量也加热圆柱部并使在该圆柱部的位置的该流体不可渗入的套熔化以将它密封到该圆柱部的方式,将该圆环部焊接到该末端部使得该圆环部被固定到该末端部。
附图说明
下面将通过示例的方式参考附图进一步描述本发明的实施方式,其中:
图1是使用根据本发明的实施方式的电外科手术器械的电外科手术系统的示意图,以及
图2是根据本发明的实施方式的电外科手术器械的末端的截面侧视图。
具体实施方式
参照附图,图1示出了电外科手术设备,其包括具有输出插座2的发生器1,该输出插座2经由连接线4提供用于电外科手术器械3的射频(RF)输出。发生器1的激活可以经由器械3上的手动开关(未示出)从器械3实现,或通过脚踏开关连接线6利用单独连接到发生器1后面的脚踏开关单元5来实现。在所例示的实施方式中,脚踏开关单元5具有分别用于选择该发生器1的干燥模式和蒸发模式的两个脚踏开关7和8。发生器前面板具有分别用于设定干燥和蒸发功率水平的按钮9和10,该水平在显示器11中显示。提供按钮12作为用于在干燥和蒸发模式之间选择的另选手段。
如将在下面描述,电外科手术器械3包括具有细长轴14的壳体13和在该轴的远端的组织治疗电极。与该壳体相关联的可移动的把手15可以被致动以使该轴弯曲。该器械特别适用于髋关节的治疗,该治疗需要具有关节功能的相对长的轴来进入要治疗的区域。
图2示出了电外科手术器械3的末端,并包括作用组织治疗电极16,该作用组织治疗电极16包括半球端面17和圆柱侧面18。该电极典型地由钨(或钨和铂的合金)形成,并且可以由单个整体部件形成或由两个彼此焊接的部件形成。端面17设置有在其中心的单个开孔19,而侧面18设置有沿着其圆周等距离间隔的多个开孔20。该组织治疗电极位于陶瓷部件21上,并由通过激光焊接固定的开口环护圈22保持固定。电极16和陶瓷部件21这两者都是中空的以形成吸入腔23,并且还容纳引线24以向组织治疗电极16提供射频能量。
轴14的大部分由流体不可渗入的绝缘套25覆盖,该绝缘套具有端部26,以使该轴的一部分不被覆盖,以形成返回电极27。该返回电极27由该陶瓷部件的一部分与该组织治疗电极16分开,以形成绝缘件28。在该套25的端部的上方设置有金属罩29,该罩包括圆环部30和向后延伸的圆柱部31。该圆环部30激光焊接到该轴14的露出部分,在该部分形成返回电极27。圆柱部31盖在该套的端部26上,并且来自圆环部30的激光焊接的热量导致套材料熔化并形成紧贴圆柱部31的密封。
在使用中,该器械3进入病人身体中并且操纵到位,通常邻近髋关节。RF能量提供给组织治疗电极16,其用于依赖于从发生器1提供的RF能量的类型蒸发或凝固组织。该器械典型地用于浸没在导电流体(诸如生理盐水)中,RF能量从组织治疗电极16.通过导电液体流到返回电极27,依赖于环境,进入组织治疗电极16的区域的任何组织被蒸发或凝固。
通过将圆环部30激光焊接到轴14,防止了盐水在点A进入器械3的内部。相似地,通过将套25的端部26密封到罩29的圆柱部31,防止了盐水在点B进入。盐水能够流入器械内部的唯一点是通过孔19和孔20,这将通往控制盐水流动的密封的吸入腔23。这样,盐水不会进入器械的其他区域,因此防止了不希望的电弧放电。
在不脱离本发明的范围的情况下,本领域技术人员可以想到另选的实施方式。例如,电外科手术器械也可被用作单极器械,仅将电极16与远程病人返回板(未示出)一起连接到发生器1。不论采用何种类型的器械,该罩29有助于防止盐水进入器械内部,防止不希望的部件的发热和部件之间的电弧放电。

Claims (10)

1.一种电外科手术器械,该电外科手术器械包括:
a)具有纵轴线的轴,该纵轴线限定近端和远端方向,
b)位于所述轴的远端的末端部,该末端部包括至少一个电极,
c)流体不可渗入的套,其覆盖了所述轴的至少一部分并且延伸到所述套在远端部分终止的末端部,以及
d)金属罩,其包括圆环部和向后延伸的圆柱部,
布局是该圆环部连接到该末端部,该圆柱部盖在所述套的远端部上以防止流体在所述套的远端部分进入。
2.根据权利要求1所述的电外科手术器械,其中,在远离所述套在远端部中终止的点的位置,所述圆环部连接到所述末端部。
3.根据权利要求1或2所述的电外科手术器械,其中,通过涉及加热所述圆环部的处理,所述圆环部接到所述末端部。
4.根据权利要求3所述的电外科手术器械,其中,所述圆环部焊接到所述末端部。
5.根据权利要求4所述的电外科手术器械,其中,所述圆环部激光焊接到所述末端部。
6.根据权利要求3到5中任一权利要求所述的电外科手术器械,其中,流体不可渗入的套在所述金属罩的圆柱部的区域中熔化以紧贴所述圆柱部密封。
7.如前述任一权利要求所述的电外科手术器械,其中,所述末端部包括双极电极组件,所述双极电极组件包括至少一个作用电极和至少一个返回电极。
8.根据权利要求7所述的电外科手术器械,其中,所述圆环部连接到所述返回电极。
9.如前述任一权利要求所述的电外科手术器械,其中,所述电外科手术器械为内窥镜外科手术器械。
10.一种电外科手术器械的制造方法,包括以下步骤:
a)提供轴、包括至少一个电极的末端部、流体不可渗入的套、以及包括圆环部和向后延伸的圆柱部的金属罩,
b)在所述轴的远端固定所述末端部,
c)将所述流体不可渗入的套设置于所述轴,使得所述流体不可渗入的套覆盖所述轴的至少一部分并延伸到所述流体不可渗入的套在远端部终止的所述末端部,
d)设置所述金属罩使得所述圆柱部盖在所述套的远端部上,以及
e)按照使来自焊接过程的热量也加热所述圆柱部并使在所述圆柱部的位置上的所述流体不可渗入的套熔化以将所述流体不可渗入的套密封到所述圆柱部的方式,将所述圆环部焊接到所述末端部使得所述圆环部固定到所述末端部。
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CN104224308B (zh) 2018-10-16
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CA2854378A1 (en) 2014-12-24
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GB2515493A (en) 2014-12-31
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US9820809B2 (en) 2017-11-21

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