WO2016124612A1

WO2016124612A1 - Electrosurgical applicator with capillary supply of fluid

Info

Publication number: WO2016124612A1
Application number: PCT/EP2016/052206
Authority: WO
Inventors: German Klink; Andreas HÖRLLE; Torben Schüttfort; Dana WILLFROTH
Original assignee: Olympus Winter & Ibe Gmbh
Priority date: 2015-02-02
Filing date: 2016-02-02
Publication date: 2016-08-11
Also published as: DE102015201786A1

Abstract

The invention relates to an electrosurgical applicator for an electrosurgical instrument for the treatment of human or animal tissue, to a system, and to a method for operating an electrosurgical instrument. The electrosurgical applicator comprises an elongate shaft (5), at least one unit for discharging therapeutic energy, which unit can be connected to an output of a high-frequency generator, and at least one outlet (30; 32; 34; 82, 87; 130; 132) for humidifying medium, designed for the emergence of a humidifying medium (40) guided in the applicator, wherein the outlet (30; 32; 34; 82; 87; 130; 132) for humidifying medium is designed to allow the humidifying medium to emerge by capillary flow.

Description

ELECTRO-SURGICAL APPLICATOR WITH CAPILLARY

FLUID SUPPLY

The invention relates to an electrosurgical applicator for an electrosurgical instrument for treating human or animal tissue comprising an elongated shaft, at least one therapeutic energy delivery unit connectable to an output of a high frequency generator, and at least one humidifying medium exit which is designed for the exit of a guided in the applicator moistening medium. The invention further relates to an electrosurgical system and a method for operating an electrosurgical instrument.

Electrosurgical applicators, instruments, systems and methods for operating the same are known, for example from EP 0 608 609 A2 and WO 2006/003216 A1. EP 0 608 609 A2 describes a catheter for radiofrequency ablation with an electrode formed by a round tip at a distal end of the catheter. The electrode has openings through which cooled liquid can escape. WO 2006/003216 A1 describes a bipolar coagulation probe with a proximal and a distal end. The coagulation probe comprises a tempering unit, which is designed to temper the coagulation probe in the region of its distal end by means of a tempering medium. Holes are provided at one end face of the coagulation probe through which the temperature control medium can emerge.

The existing applicators, systems and methods for operating such applicators and systems offer several advantages, but further improvements are desirable.

Therefore, it is an object of the present invention to provide an electrosurgical applicator for an electrosurgical instrument, an electrosurgical system and a method for operating an electrosurgical instrument, which are improved over existing applicators, systems and methods.

This object is achieved by an electrosurgical applicator for an electrosurgical instrument for treating human or animal tissue, comprising an elongate shaft, at least one unit for delivering a therapeutic energy, which is connectable to an output of a high-frequency generator, and at least one humidifying medium. Outlet, which is formed for the exit of a guided in the applicator humidifying medium, wherein the humidifying medium outlet is adapted to allow the humidifying medium to escape by capillary flow.

Among other things, the electrosurgical applicator according to the invention is based on the recognition that improvements can be achieved if a moistening medium is dispensed in controlled small amounts in the area of the tissue to be treated during operation of the electrosurgical applicator. In this way, the delivery of an uncontrolled high amount of moistening medium and a concomitant uncontrolled outflow of the medium, for example in a not intended for the treatment tissue area, prevented. At the same time, a higher energy input into the intended tissue area is made possible without this tissue area drying out unintentionally. Consequently, the treatment times can be shortened by the solution according to the invention. In particular, in the treatment of lung tissue which tends to rapidly dry out upon treatment with radiofrequency energy, larger volumes per unit time can be treated according to the invention. But even in the treatment of other tissue types, such as liver tissue, the invention is advantageously used. At a high temperature of the tissue or moistening medium at the outlet, at comparatively low pressures in the region of the outlet and / or with small amounts of moistened moisturizing medium, the controlled release can become a Evaporate the humidifying medium when it comes out. This results in additional cooling of the tissue.

The electrosurgical applicator according to the invention achieves these advantages in particular by controlling the moistening medium, in particular exiting the applicator in small quantities. In this case, a capillary effect, which acts on the moistening medium, exploited. For this purpose, the applicator and in particular the outlet preferably has dimensions which allow a controlled outlet of the humidifying medium by capillary flow.

The therapeutic energy delivery unit may be an electrode or a microwave antenna, as discussed further below.

The moistening medium preferably comprises or consists of a liquid, for example a sterile, pyrogen-free saline solution. Alternatively, preferably, the humidifying medium comprises or consists of deionized water.

The term "capillary flow" in the context of the present invention is to be understood as a flow of humidifying medium, in particular humidifying fluid, out of the humidifying medium outlet, whereby the flow is based on the capillarity of the humidifying medium The capillarity of a medium is the ability to operate in confined spaces without the flow is caused by the surface tension of the medium and the interfacial tension between the medium and the solid surface of the narrow space, for example, a narrow tube, a narrow space A corresponding effect occurs in the fiber space in textile fabrics or the cell gap in biological tissues, in which case the term "wicking" is also used. d A controlled flow of humidifying medium from the applicator is achieved independently of the pressure at the tip of the applicator.

In addition to the capillary action, further effects, such as contact effects, as well as effects based on the incompressibility and / or surface tension of the humidifying medium, preferably promote the escape of the humidifying medium from the applicator. Further preferably, the provision of the moistening medium to the applicator is carried out in a controlled manner. For this purpose, the moistening medium is provided to the applicator, for example, at a predetermined pressure and in a predetermined amount per unit of time. In this case, it is advantageous if the material forming the moistening medium outlet is incompressible or hardly compressible, eg glass, quartz or steel.

The applicator is preferably configured to permit leakage of the humidifying medium in the region of the therapeutic energy delivery unit, particularly for applicators having radio frequency energy provided to the unit. As a result, drying out of the tissue which is in contact with the unit is prevented.

The electrosurgical applicator according to the invention preferably forms part of an electrosurgical instrument, in particular a hand instrument for the treatment of human or animal tissue. In the context of the present invention, the term "applicator" is to be understood in particular as a section of the instrument which makes contact with the tissue for treatment of the tissue.Furthermore, radiofrequency energy and / or ultrasound vibration are introduced into the tissue via the applicator For the understanding of the invention, the applicator of the present invention will be described below with reference to a system comprising a high frequency generator and an electrosurgical instrument powered by the generator comprising the applicator The generator for operating the electrosurgical instrument preferably comprises a radio frequency generator for providing radio frequency energy to two output contacts of the generator In addition, the generator may also include an ultrasonic generator having a generating unit for providing an excitation signal with which an ultrasonic transducer can generate an ultrasonic vibration of the applicator. For the operation of the electrosurgical instrument, the generator provides at its output contacts an operating signal which is processed by the electrosurgical instrument. The transmission of the operating signal to the Instrument takes place for example via a cable connection of the instrument. The cable connection preferably comprises a plug which can be plugged into the output contacts. The operating signal preferably comprises the radio frequency energy and more preferably the excitation signal. The excitation signal is converted by means of an ultrasonic transducer present in the instrument into an ultrasonic vibration of the applicator, which can be used to treat the tissue of a patient.

The high frequency energy may be provided according to the present invention for monopolar and / or bipolar applications. That The applicator according to the invention may be formed by a monopolar applicator (for example with a single electrode) or preferably by a bipolar applicator (for example with two electrodes).

The applicator may alternatively be embodied as a microwave applicator with a microwave antenna. For monopolar applications, the applicator preferably has a (single) electrode connected to one of the output contacts to which the radio frequency energy is provided. At the same time, the system includes a patient electrode connected to another of the two output contacts to which radio frequency energy is supplied. During operation of the electrosurgical instrument, the electrode is brought into contact with the tissue to be treated. For example, the patient electrode is connected to a portion of the patient's skin. In this way, the high frequency energy generates a current that flows back and forth through a part of the body from the electrode to the patient electrode. In bipolar applications, the applicator has at least two electrodes, each electrode being connected to one of the two output contacts to which the radio frequency energy is supplied. In such a bipolar application, the electrical current flows through the tissue which lies between and in contact with the two electrodes of the applicator. The two electrodes are preferably arranged spaced apart in the axial direction along the shaft.

The applicator according to the invention is preferably formed with a distal end and a proximal end. The applicator continues in the area of the distal end preferably a rounded free end. The applicator is preferably cylindrical in shape between the distal and proximal ends. The moistening medium exit is preferably formed by an opening in the shaft.

The applicator is preferably designed as a disposable applicator. A preferred embodiment of the electrosurgical applicator provides that the moistening medium outlet comprises or consists of a capillary tube in a jacket of the shaft. The capillary tube is preferably provided through a bore. The capillary tube thus forms an opening in the shaft. The opening preferably has a diameter at which the moistening medium is excited by utilizing the capillarity to exit the shaft. The capillary tube is preferably produced in the manufacturing process by means of laser drilling. Further preferably, the capillary tube is oriented substantially radially (towards the interior of the shaft) and / or parallel to the longitudinal axis of the shaft (towards the proximal end of the shaft). The jacket is preferably formed by an outer wall of the shaft and / or by an applicator housing.

According to a further preferred embodiment of the electrosurgical applicator, the moistening medium outlet comprises or consists of a nonwoven fabric, a textile fabric and / or a porous material.

Preferably, the shaft is at least partially surrounded by the nonwoven fabric, textile fabric and / or porous material. This is to be understood such that an outer surface of the shaft is at least partially covered by the textile fabric. Further preferably, an outer wall of the shaft consists essentially of the nonwoven fabric, the textile fabric and / or of the porous material. Further preferably, the outer wall of the shaft and / or the applicator housing of the porous material and is at the same time at least partially surrounded by the textile fabric.

More preferably, the entire shaft is essentially formed by the nonwoven fabric, textile fabric and / or the porous material. Thereafter, preferably also an interior of the shaft is substantially filled with nonwoven fabric, textile fabric and / or porous material or consists thereof, wherein at the same time form a high-frequency energy acted upon conductor and a humidifying medium access elements of the shaft. Also in this embodiment, among other things, capillary effects within the nonwoven, textile fabric and / or the porous material are exploited, which excite a distribution of the moistening medium in the nonwoven, textile fabric and / or porous material. Consequently, an advantage of this embodiment is that the dampening medium spreads during emergence in the nonwoven fabric, textile fabric and / or porous material and thus is evenly distributed on the surface of the applicator. This results in a uniform exit of the wetting medium from the applicator distributed over the surface of the applicator. This further doses and thus controls the delivery of the wetting medium to the environment of the applicator with respect to the delivery of wetting medium per unit surface area of the applicator housing. A further advantage of this embodiment results from the fact that the distribution of the moistening medium over the surface of the applicator leads to a cooling of the applicator. An additional cooling circuit is therefore no longer required or can be supported by the humidification. This achieves a simplification of the construction and / or an improvement in the cooling of the applicator.

In a further preferred embodiment, the moistening medium outlet comprises or consists of a capillary tube, the capillary tube preferably extending substantially parallel to a longitudinal axis of the applicator. The capillary tube preferably provides an additional tube for access of the wetting medium to the applicator as well as for the exit of a wetting medium from the applicator. The capillary tube preferably further extends outwardly along the shaft or substantially in an interior of the shaft.

According to a further preferred embodiment, the unit for delivering therapeutic energy is a microwave antenna, wherein the humidifying medium outlet is arranged in the vicinity of the microwave antenna.

According to a further preferred embodiment, the therapeutic energy delivery unit comprises at least a first electrode, wherein the humidifying medium outlet is arranged in the vicinity of the first electrode. A preferred embodiment of the applicator comprises a second electrode, wherein at least one moistening medium outlet is arranged in a region between the first electrode and the second electrode and / or in a region of the first and / or second electrode. More preferably, the two electrodes are along the Longitudinal extension of the applicator spaced from each other on an outer surface of the shaft. Further preferably, the electrodes are each annular and surround the shaft.

This embodiment preferably relates to the case of bipolar application where the high frequency energy is provided between the first and second electrodes of the applicator. In this application, the problem of drying of the tissue to be treated occurs, in particular in the region between the first and second electrode. In this respect, it is advantageous if the moistening medium emerges in this area between the first electrode and the second electrode. The arrangement "between" the electrodes is to be understood as an arrangement in a region which lies in the longitudinal direction of the shaft between the electrodes - in particular when the electrodes are formed as annular elements surrounding the shaft, which are arranged spaced apart from one another in the longitudinal direction of the shaft.

Consequently, this embodiment is to be understood such that at least a part of the humidifying medium outlet is arranged between the first and second electrodes. In the case of capillary tubes, the outlet end is preferably arranged between the first and second electrodes. In the case of a nonwoven fabric, textile fabric and / or porous material, at least one fabric or material region is preferably arranged between the first and second electrodes. Further preferably, the moistening medium outlet or a region of the outlet is arranged in the region of the first and / or second electrode, in particular below the electrode. Thus, the moistening medium outlet preferably has a plurality of capillary tubes, the outlet ends of which are arranged partially between and partly below the first and / or second electrode. In an embodiment of the outlet as nonwoven fabric, textile fabric and / or porous material, a region thereof is preferably arranged below the first and / or second electrode.

The arrangement of the exit "below" the electrode is to be understood as an arrangement radially further inward compared to the electrode - in particular when the electrodes are designed as an annular element surrounding the shaft Opening with a diameter, in particular transversely to the flow direction of the humidifying medium, of less than 100 μιτι, in particular special about 90 μητι, preferably in a range of 5 μιτι to 20 μιτι, on. Preferably, the diameters described above are provided in the Kapillarbohrung. It has been found that the capillary effect can be used particularly effectively with a diameter in the above-mentioned range, while the amount of the exiting humidifying medium is at the same time kept low. The formulation of the diameter transverse to the flow direction of the humidifying medium is to be understood on the assumption of a laminar flow of the humidifying medium through the opening, wherein the flow direction is substantially parallel to the opening surfaces bounding the inner surfaces. A diameter of less than 100 μιτι, in particular about 90 μητι, is preferred when the moistening medium is provided by a moistening unit (as described below). More preferably, the diameter is less than 80 μιτι, 70 μιτι, 60 μιτι, 50 μιτι, 40 μιτι, 30 μιτι and / or is in a range of 10 μιτι to 15 μιτι.

According to another preferred embodiment of the electrosurgical applicator, the humidifying medium outlet is designed to provide a volume flow of humidifying medium of less than 0.25 ml / min, in particular of about 0.1 ml / min.

According to a further preferred embodiment, the moistening medium outlet, in particular the capillary tube, is designed to transport the moistening medium from a moistening unit to the moistening medium outlet. The capillary tube preferably runs at least partially parallel to a longitudinal axis of the applicator starting from the moistening unit to a capillary tube end which forms the outlet for the moistening medium.

In a further preferred embodiment, the electrosurgical applicator has a channel for the passage of a tempering medium.

According to a preferred further development, the channel is in fluid communication with the humidifying medium outlet for the passage of a tempering medium.

According to a further preferred embodiment of the applicator of the humidifying medium outlet for the outlet of the tempering medium, which preferably serves as a wetting medium, is formed. This embodiment represents a particularly expedient and simplified construction variant of an electrosurgical applicator, in which a temperature control medium preferably has an additional function, namely, wetting of the applicator environment. The tempering medium preferably comprises or consists of a liquid, for example a sterile, pyrogen-free saline solution. Alternatively, preferably, the tempering medium comprises or consists of deionized water. The tempering medium is also preferably used for cooling the applicator.

According to a further preferred embodiment of the applicator, the humidification medium outlet is designed to transport the temperature control medium from an interior of the applicator, in particular the shaft, to the outside.

According to a further aspect of the invention, the object mentioned is achieved by a system comprising an electrosurgical instrument with an applicator of the type described above and a generator, which is designed to operate the electrosurgical instrument.

According to a preferred embodiment of the electrosurgical system, a control unit, which is designed to control the provision of the humidifying medium as a function of a tissue temperature or a tissue impedance between the first electrode and the second electrode, is formed on the generator. Another preferred embodiment of the electrosurgical system includes a moistening unit configured to provide the moistening medium for exiting the moistening medium exit. An advantage of this embodiment is that, in addition to the capillary flow, a further control of the moistening preferably takes place through the moistening unit, by controlling the supply of the moistening medium to the applicator. Preferably, the moistening unit merely provides replenishment for the capillary flow. Alternatively preferably, the moistening unit provides the moistening medium at a pressure which additionally excites the capillary flow.

Preferably, the humidifying medium is provided in addition to and separately from a tempering medium in the applicator. More preferably, the temperature control medium only has the function of tempering, wherein the humidification th the environment of the applicator is done only by means of the humidifying medium. In other words, the temperature control medium is preferably provided in a temperature control circuit, namely the applicator by means of a temperature control unit (as further explained below) initially supplied and discharged for reuse to the temperature control unit. The moistening medium is provided to the applicator by means of a moistening unit and exits the applicator at the moistening medium exit.

A further preferred refinement of the electrosurgical system comprises a control unit which is designed to control a conveying device of the moistening unit for providing a volume flow of the moistening medium. In this way, further control of the discharge of the humidifying medium is provided by controlling the amount of humidifying medium which passes to the humidifying medium outlet by means of the conveying device. The conveying device preferably comprises a pump. The control unit is preferably designed to control the supply flow of the humidifying medium into the applicator. Further preferably, the control unit is designed to control the supply pressure of the humidifying medium in the applicator. The control unit preferably forms part of the applicator. Further preferably, the control unit is formed on the generator. Further preferably, the control unit forms a separate element in addition to the applicator, instrument and / or generator.

The instrument and / or the generator preferably comprise a control element by means of which the user can carry out a manual control of the conveying device, preferably during operation. As a result, the user is provided with an opportunity to completely control or adjust the discharge of the moistening medium on the applicator.

In a further preferred embodiment of this embodiment, the control unit is designed to determine a tissue impedance in the region of the unit for delivering therapeutic energy and to control the provision of the humidifying medium as a function of the impedance. This training is based on the finding that the impedance depends on the degree of humidity between the first electrode and the second electrode. Thus, the real part of the impedance (resistance) generally increases with decreasing moisture level. As the degree of humidity increases, the real part of the impedance falls usually. An advantage of this development is that in the systems known from the prior art, the impedance between the two electrodes of the applicator is already determined anyway. Thus, for example, the provision of a so-called resistance-controlled automatic power of high-frequency energy (RCAP: Resistance Controlled Automatic Power) is known. In this respect, the humidification of the environment of the applicator can be controlled by means of signals or values which are already determined by the system according to the prior art. A redesign of an impedance measuring probe and the signal transmission is not required, at least in this regard. This leads to an increase in acceptance of the solution according to the invention.

In a further preferred embodiment of the electrosurgical system, the applicator comprises a sensor for determining a tissue temperature in the region of the unit for delivering therapeutic energy, wherein the control unit is designed to control the provision of the humidifying medium as a function of the tissue temperature.

A further preferred embodiment of the electrosurgical system comprises a tempering unit, which is designed to temper the shaft by means of a tempering medium.

The temperature control unit is preferably designed to control the supply and removal flow of the temperature control medium into the applicator and out of the applicator. Further preferably, the temperature control unit is designed to control the supply and discharge pressure of the temperature control medium in the applicator and out of the applicator out. The simultaneous control of feed and discharge flow has the advantage that a leak rate, i. the amount of humidifying medium delivered to the humidifying medium outlet per unit of time can be controlled.

The control of the supply and discharge flow or the supply and discharge pressure is preferably carried out by means of a control unit and / or conveying device described above.

The system of the invention and its teachings have features which make them particularly suitable for use with an electrosurgical instrument applicator according to the invention for the treatment of human or animal tissue. For advantages, design variants and implementation For details of the system and its developments refer to the previous description of the corresponding device features of the applicator.

According to a further aspect of the invention, the object mentioned at the outset is achieved by a method for operating an electrosurgical instrument, comprising:

5 - operating an electrosurgical instrument, in particular with a previously described electrosurgical applicator, by means of a generator, the electrosurgical instrument having on the applicator a unit for delivering a therapeutic energy,

- Determining an impedance and / or a temperature in the region of the unit to the Abgalt) be therapeutic energy, and

- Providing a humidifying medium at a humidifying medium outlet depending on the impedance and / or temperature.

The method according to the invention and its further developments have features which make them particularly suitable for being carried out in an electrosurgical applicator according to the invention and a system according to the invention and its further developments. For advantages, embodiments and details of execution of the method and its training reference is made to the preceding description of the corresponding device and system features.

Preferred embodiments of the invention will be described by way of example with reference to the accompanying figures. Show it:

1 shows a first embodiment of an applicator according to the invention in a partial cross-sectional view,

2 shows a second embodiment of an applicator according to the invention in a partial cross-sectional view,

FIG. 3 shows a third exemplary embodiment of an applicator according to the invention in a partial cross-sectional view,

FIG. 4 shows a fourth exemplary embodiment of an applicator according to the invention in a partial cross-sectional view, 5 shows a fifth embodiment of an applicator according to the invention in a schematic partial cross-sectional view,

6 shows a sixth embodiment of an applicator according to the invention in a schematic partial cross-sectional view,

FIG. 7 shows a seventh exemplary embodiment of an applicator according to the invention in a schematic partial cross-sectional view,

8 shows an eighth embodiment of an applicator according to the invention in a schematic partial cross-sectional view, and

Figure 9: a first embodiment of a system according to the invention in a schematic representation.

The embodiments of an applicator according to the invention according to FIGS 1-8 and the embodiment of a system according to the invention are described below in connection with an embodiment of a method according to the invention.

1 shows a partial section (section line in the viewing direction right) of an electrosurgical applicator 1 according to the invention for an electrosurgical instrument for the treatment of human or animal tissue (not shown). The applicator 1 has a shaft 5 with a distal end 10 and a proximal end 12. Starting from the proximal end 12, the shaft 5 extends in a longitudinal direction as far as the distal end 10. In the region of the distal end, the applicator has a rounded head attachment 14. Between the distal end 10 and the proximal end 12, an outer surface of the applicator is substantially formed by an applicator housing 15. Furthermore, the applicator 1 is partially surrounded by a first electrode 20 and a second electrode 25, wherein a high-frequency energy is provided between the first electrode 20 and the second electrode 25 during operation of the applicator 1 (method step A). For operation of the applicator, a generator (not shown) provides an operating signal that includes the radio frequency energy.

Instead of the electrodes 20, 25, the applicator may comprise a microwave antenna, not shown. In the shaft 5 a plurality of humidifying medium outlets 30, 32 are formed in the form of openings, which were produced by means of laser drilling. The humidifying medium outlets 30 are arranged in a region 27 between the first electrode 20 and the second electrode 25. The humidifying medium outlets 32 are arranged in a region 28 below the second electrode 25.

A moistening medium 40 passes via an interior 17 of the applicator to the moistening medium outlets 30, 32, where it emerges from the applicator housing for moistening the surroundings 19 of the applicator 1.

Figures 2 to 8 show further embodiments of an applicator according to the invention, which are similar to the first embodiment shown in Figure 1 constructed. The same or substantially functionally identical elements are provided with the same reference numerals.

FIG. 2 shows a second exemplary embodiment of an applicator 1 according to the invention having a first electrode 20 and a second electrode 25, wherein the shaft 5, in particular also in the interior 17 of the applicator 1, essentially consists of a porous material 60. The porous material 60 forms a moistening medium outlet 34 through which the moistening medium 40 exits the applicator for moistening the surroundings 19 of the applicator 1.

FIG. 3 shows a third exemplary embodiment of an applicator 1 according to the invention in which the moistening medium outlet 34 is formed by a textile fabric 50 so that the moistening medium 40 exits through the textile fabric 50 into the environment 19 of the applicator. Here, the shaft 5 consists essentially of the textile fabric 50, or is covered with the textile fabric 50.

FIG. 4 shows a fourth exemplary embodiment of an applicator 1 according to the invention, in which the applicator is cooled by means of a tempering medium 145. A tempering unit 140 leads the tempering medium 145 via an access 147 into an interior 170 of the applicator. The moistening of the surroundings 19 of the applicator 1 takes place by means of a moistening medium 40, which is provided by a moistening unit 45, which has a conveying device 95 in the form of an injection pump, via a capillary tube 80 and a capillary tube 85. An exit end of the capillary tube 80 is disposed longitudinally of the applicator between the first electrode 20 and the second electrode 25 and forms a humidifying medium exit 82. A control unit 75 controls the injection pump of the humidification unit 45 such that a volume flow of the humidifying medium 40 through the capillary tube 80 and 85 to the humidifying medium outlet 82 and 82, respectively. 87 arrives.

In this embodiment, the humidifying medium 40 and the tempering medium 145 form separate media, each of which has a function, namely humidifying or tempering, in particular cooling.

FIG. 5 shows a fifth exemplary embodiment of an electrosurgical applicator 101 according to the invention, in which the moistening medium 40 is formed by the temperature-controlling medium 145. The tempering unit 140 supplies the interior space 170 with the temperature control medium 145 which is delivered to the surroundings 19 of the applicator 101 at humidifying medium outlets 130 and 132. The humidifying medium outlets 130 are located between the first electrode 20 and the second electrode 25. The humidifying medium outlets 132 are located below the first electrode 20.

The humidifying medium outlets 132 each include a glass capillary tube 135 which is inserted into the applicator housing 15.

FIG. 6 shows a sixth exemplary embodiment of an applicator 101 according to the invention. The humidifying medium 40 is formed by the tempering medium 145, which is supplied to the interior 170 of the applicator 101 by means of the tempering unit 140. The humidifying medium outlet 34 is formed by an area of the housing itself, namely a housing wall 90, which partially consists of a porous material 160. The region of the porous material 160 extends longitudinally below and between the two electrodes 20 and 25.

FIG. 7 shows a seventh exemplary embodiment of an applicator 101 according to the invention. This applicator 101 is constructed similarly to the applicator shown in FIG. In the case of the applicator 101 shown in FIG. 7, the housing wall 90 is partially surrounded by a textile fabric 150. In the eighth exemplary embodiment of an applicator 101 according to the invention shown in FIG. 8, the applicator housing 15 is likewise made of a textile fabric 150 surround. In contrast to the applicators shown in FIGS. 6 and 7, the applicator housing 15 shown in FIG. 8 has capillary bores 152 and 154, which together with the textile fabric 150 form a wetting medium outlet 34.

FIG. 9 schematically shows the structure of a system according to the invention with a generator 202, a conveying device and an applicator 201. During operation of the applicator 201, the conveying device 95 provides a moistening medium 40 which exits at a moistening medium outlet 30, 32, 34, 82, 87, 130 and / or 132 of the applicator 201. The arrow from the generator 202 to the conveyor 95 stands for the flow rate control, the arrow from the conveyor 95 to the fluid delivery applicator 201, and the arrow from the applicator 201 to the humidification degree information generator 202.

In a method step B, a degree of moisture in the region of the first electrode 20 of the applicator 201 is determined. This is done by an impedance measurement between the first electrode 20 and the second electrode 25. The generator 202 receives a signal from the applicator 201, which represents the measured impedance as information about the degree of moisture in the region of the electrodes 20 and 25.

In a method step C, the humidifying medium 40 is provided at the humidifying medium exit 30, 32, 34, 82, 87, 130 and / or 132 depending on the impedance. For this purpose, the generator 202 controls the conveying device 95 such that a desired volume flow of moistening medium 40 is provided to the applicator 201.

Attributes, 101, 201 Applicator

shaft

0 distal end

2 proximal end

4 head attachment

5 applicator housings

7 interior

9 environment

0 first electrode

5 second electrode

7 area

8 area

0, 32, 34, 82, 87, 130, 132 Moistening medium outlet 0 Moistening medium 5 Moistening unit 0, 150 Textile fabric

0, 160 porous material

5 control unit

0, 85 capillary tube

0 housing wall

5 conveyor

35 Glass capillary tube40 Tempering unit45 Temperature control medium 147 access

152, 154 Capillary bore 170 Interior 202 Generator A, B, C Process steps

Claims

claims

An electrosurgical applicator for an electrosurgical instrument for the treatment of human or animal tissue, comprising:

an elongate shaft (5),

at least one therapeutic energy delivery unit connectable to an output of a high frequency generator and at least one humidifying medium exit (30; 32; 34; 82; 87; 130; 132) for the exit of a humidifying medium carried in the applicator (40) is formed

wherein the humidifying medium outlet (30; 32; 34; 82; 87; 130; 132) is adapted to allow the humidifying medium (40) to escape by capillary flow.

Electrosurgical applicator according to claim 1,

wherein the moistening medium exit (30; 32; 34; 130; 132) comprises or consists of a capillary tube in a jacket of the shaft (5).

An electrosurgical applicator as claimed in any preceding claim 1 or 2, wherein the moistening medium exit (34) comprises or consists of a nonwoven web, a textile web (50; 150) and / or a porous web (60; 160).

An electrosurgical applicator according to any one of the preceding claims, wherein the moistening medium exit (30; 32; 34; 130; 132) comprises or consists of a capillary tube (80; 85), the capillary tube preferably being substantially parallel to a longitudinal axis of the applicator ,

An electrosurgical applicator according to any one of the preceding claims, wherein the therapeutic energy delivery unit is a microwave antenna, and wherein the humidifying medium exit is located near the microwave antenna.

Electrosurgical applicator according to one of claims 1-4,

wherein the therapeutic energy delivery unit comprises at least a first electrode, and wherein the humidifying medium exit is located near the first electrode. An electrosurgical applicator according to claim 6, comprising a second electrode (25),

at least one moistening medium exit (30; 32; 34; 82; 130; 132) in a region (27) between the first electrode (20) and the second electrode (25) and / or

in a region (28) of the first (20) and / or second electrode (25) is arranged.

Electrosurgical applicator according to one of the preceding claims, wherein the humidifying medium outlet (30; 32; 82; 87; 130; 132) has an opening with a diameter of less than 100 μιτι, in particular about 90 μιτι, preferably in a range of 5 μιτι to 20 μιτι, has.

An electrosurgical applicator according to any one of the preceding claims, wherein the humidifying medium outlet (30; 32; 82; 87; 130; 132) is designed to have a humidifying medium volume flow of less than 0.25 ml / min, in particular about 0.1 ml / min, to provide. An electrosurgical applicator according to any one of the preceding claims, wherein the moistening medium exit, in particular the capillary tube (80; 85), is adapted to transport the moistening medium (40) from a moistening unit (45) to the moistening medium exit (82; 87) , 1 1. Electrosurgical applicator according to one of the preceding claims,

wherein the electrosurgical applicator has a channel for the passage of a tempering medium.

12. An electrosurgical applicator according to claim 1 1,

wherein the channel is in fluid communication for the passage of a tempering medium with the humidifying medium outlet.

13. Electrosurgical applicator according to one of the preceding claims 1 1 or 12,

wherein the humidifying medium outlet (34; 130; 132) for the exit of the

Tempering medium (145), which preferably serves as Befeuchtungsmedium (40) is formed. Electrosurgical system comprising

an electrosurgical instrument with an electrosurgical Applika gate according to one of the preceding claims, and

a generator (202) adapted to operate the electrosurgical instrument.

Electrosurgical system according to claim 14,

wherein a control unit configured to control the provision of the humidifying medium (40) in response to a tissue temperature or tissue impedance between the first electrode (20) and the second electrode (25) is formed on the generator (202).

An electrosurgical system as claimed in any one of claims 14 or 15, comprising:

a moistening unit (45) configured to provide the moistening medium (40) for exiting the moistening medium exit (30; 32; 82; 87). 17. An electrosurgical system according to claim 16, comprising

a control unit (75) configured to control a conveying device (95) of the moistening unit (45) for providing a volume flow of the moistening medium (40). 18. An electrosurgical system according to claim 17,

wherein the control unit (75) is formed

to determine a tissue impedance in the region of the therapeutic energy delivery unit, and

- To control the provision of the humidifying medium (40) in dependence of the impedance.

An electrosurgical system according to any of the preceding claims 14-18, wherein the applicator comprises a sensor for determining a tissue temperature in the region of the therapeutic energy unit, and wherein the control unit (75) is arranged to control the provision of the humidifying medium in dependence on the tissue temperature ,

20. An electrosurgical system according to any one of the preceding claims 14-19, comprising

a tempering unit (140), which is designed to temper the shaft (5) by means of a tempering medium (145).

21. A method of operating an electrosurgical instrument, comprising:

Operating (A) an electrosurgical instrument, in particular with an electrosurgical applicator according to one of the preceding claims 1-12, by means of a generator (202), the electrosurgical instrument having on the applicator (201) a unit for delivering a therapeutic energy,

Determining (B) an impedance and / or a temperature in the region of the therapeutic energy delivery unit, and

Providing (C) a humidifying medium (40) at a humidifying medium exit (30; 32; 34; 82; 87; 130; 132) as a function of the impedance and / or temperature.