Surgery – Instruments – Electrical application
Patent
1996-08-26
1999-12-21
Peffley, Michael
Surgery
Instruments
Electrical application
606 41, 604 22, A61B 1736
Patent
active
060043199
DESCRIPTION:
BRIEF SUMMARY
This invention relates to an electrosurgical instrument for the treatment of tissue in the presence of an electrically conductive fluid medium, and to an electrosurgical system apparatus including such an instrument.
Endoscopic electrosurgery is useful for treating tissue in cavities of the body, and is normally performed in the presence of a distension medium. When the distension medium is a liquid, this is commonly referred to as underwater electrosurgery, this term denoting electrosurgery in which living tissue is treated using an electrosurgical instrument with a treatment electrode or electrodes immersed in liquid at the operation site. A gaseous medium is commonly employed when endoscopic surgery is performed in a distensible body cavity of larger potential volume in which a liquid medium would be unsuitable, as is often the case in laparoscopic or gastroenterological surgery.
Underwater surgery is commonly performed using endoscopic techniques, in which the endoscope itself may provide a conduit (commonly referred to as a working channel) for the passage of an electrode. Alternatively, the endoscope may be specifically adapted (as in a resectoscope) to include means for mounting an electrode, or the electrode may be introduced into a body cavity via a separate access means at an angle with respect to the endoscope--a technique commonly referred to as triangulation. These variations in technique can be subdivided by surgical speciality, where one or other of the techniques has particular advantages given the access route to the specific body cavity. Endoscopes with integral working channels, or those characterised as resectoscopes, are generally employed when the body cavity may be accessed through a natural body opening--such as the cervical canal to access the endometrial cavity of the uterus, or the urethra to access the prostate gland and the bladder. Endoscopes specifically designed for use in the endometrial cavity are referred to as hysteroscopes, and those designed for use in the urinary tract include cystoscopes, urethroscopes and resectoscopes. The procedures of transurethal resection or vaporisation of the prostate gland are known as TURP and EVAP respectively. When there is no natural body opening through which an endoscope may be passed, the technique of triangulation is commonly employed. Triangulation is commonly used during underwater endoscopic surgery on joint cavities such as the knee and the shoulder. The endoscope used in these procedures is commonly referred to as an arthroscope.
Electrosurgery is usually carried out using either a monopolar instrument or a bipolar instrument. With monopolar electrosurgery, an active electrode is used in the operating region, and a conductive return plate is secured to the patient's skin. With this arrangement, current passes from the active electrode through the patient's tissues to the external return plate. Since the patient represents a significant portion of the circuit, input power levels have to be high (typically 150 to 250 watts), to compensate for the resistive current limiting of the patient's tissues and, in the case of underwater electrosurgery, power losses due to the fluid medium which is rendered partially conductive by the presence of blood or other body fluids. Using high power with a monopolar arrangement is also hazardous, due to the tissue heating that occurs at the return plate, which can cause severe skin burns. There is also the risk of capacitive coupling between the instrument and patient tissues at the entry point into the body cavity.
With bipolar electrosurgery, a pair of electrodes (an active electrode and a return electrode) are used together at the tissue application site. This arrangement has advantages from the safety standpoint, due to the relative proximity of the two electrodes so that radio frequency currents are limited to the region between the electrodes. However, the depth of effect is directly related to the distance between the two electrodes; and, in applications requiring very small electrodes, the i
REFERENCES:
patent: Re33925 (1992-05-01), Bales et al.
patent: 164184 (1875-06-01), Kidder
patent: 1366756 (1921-01-01), Wappler
patent: 1735271 (1929-11-01), Groff
patent: 1814791 (1931-07-01), Ende
patent: 1889609 (1932-11-01), Mutscheller
patent: 1932258 (1933-10-01), Wappler
patent: 1943543 (1934-01-01), McFadden
patent: 1952617 (1934-03-01), Wappler
patent: 1983669 (1934-12-01), Kimble
patent: 2050904 (1936-08-01), Trice
patent: 2056377 (1936-10-01), Wappler
patent: 2196171 (1940-04-01), Arnesen
patent: 2888928 (1959-06-01), Seiger
patent: 3035580 (1962-05-01), Guiorguiev
patent: 3460539 (1969-08-01), Anhalt, Sr.
patent: 3595239 (1971-07-01), Petersen
patent: 3601126 (1971-08-01), Estes
patent: 3614414 (1971-10-01), Gores
patent: 3648001 (1972-03-01), Anderson et al.
patent: 3685518 (1972-08-01), Beurle et al.
patent: 3707149 (1972-12-01), Hao et al.
patent: 3801766 (1974-04-01), Morrison, Jr.
patent: 3815604 (1974-06-01), O'Malley et al.
patent: 3845771 (1974-11-01), Vise
patent: 3847153 (1974-11-01), Weissman
patent: 3901242 (1975-08-01), Storz
patent: 3902494 (1975-09-01), Haberlen et al.
patent: 3903891 (1975-09-01), Brayshaw
patent: 3920021 (1975-11-01), Hiltebrandt
patent: 3920022 (1975-11-01), Pastor
patent: 3923063 (1975-12-01), Andrews et al.
patent: 3929137 (1975-12-01), Gonser et al.
patent: 3939839 (1976-02-01), Curtiss
patent: 3945375 (1976-03-01), Banko
patent: 3963030 (1976-06-01), Newton
patent: 3964487 (1976-06-01), Judson
patent: 3970088 (1976-07-01), Morrison
patent: 3974833 (1976-08-01), Durden, III
patent: 4011872 (1977-03-01), Komiya
patent: 4016881 (1977-04-01), Rioux et al.
patent: 4024467 (1977-05-01), Andrews et al.
patent: 4033351 (1977-07-01), Hetzel
patent: 4040426 (1977-08-01), Morrison, Jr.
patent: 4043342 (1977-08-01), Morrison
patent: 4051855 (1977-10-01), Schneiderman
patent: 4060088 (1977-11-01), Morrison, Jr. et al.
patent: 4069827 (1978-01-01), Dominy
patent: 4074718 (1978-02-01), Morrison, Jr.
patent: 4092986 (1978-06-01), Schneiderman
patent: 4114623 (1978-09-01), Meinke et al.
patent: 4116198 (1978-09-01), Roos
patent: 4119102 (1978-10-01), LeVeen
patent: 4126137 (1978-11-01), Archibald
patent: 4189685 (1980-02-01), Doss
patent: 4200104 (1980-04-01), Harris
patent: 4202337 (1980-05-01), Hren et al.
patent: 4204549 (1980-05-01), Paglione
patent: 4210152 (1980-07-01), Berry
patent: 4228800 (1980-10-01), Degler, Jr. et al.
patent: 4248231 (1981-02-01), Herczog et al.
patent: 4271837 (1981-06-01), Schuler
patent: 4281373 (1981-07-01), Mabille
patent: 4301802 (1981-11-01), Poler
patent: 4326529 (1982-04-01), Doss et al.
patent: 4346332 (1982-08-01), Walden
patent: 4376263 (1983-03-01), Pittroff et al.
patent: 4381007 (1983-04-01), Doss
patent: 4416277 (1983-11-01), Newton et al.
patent: 4418692 (1983-12-01), Guay
patent: 4429698 (1984-02-01), Bentall
patent: 4448198 (1984-05-01), Turner
patent: 4474179 (1984-10-01), Koch
patent: 4476862 (1984-10-01), Pao
patent: 4492231 (1985-01-01), Auth
patent: 4494541 (1985-01-01), Archibald
patent: 4512338 (1985-04-01), Balko et al.
patent: 4524770 (1985-06-01), Orandi
patent: 4532924 (1985-08-01), Auth et al.
patent: 4534347 (1985-08-01), Taylor
patent: 4548207 (1985-10-01), Reimels
patent: 4559943 (1985-12-01), Bowers
patent: 4559951 (1985-12-01), Dahl et al.
patent: 4562838 (1986-01-01), Walker
patent: 4565200 (1986-01-01), Cosman
patent: 4567890 (1986-02-01), Ohta et al.
patent: 4580557 (1986-04-01), Hertzmann
patent: 4590934 (1986-05-01), Malis et al.
patent: 4593691 (1986-06-01), Lindstrom et al.
patent: 4617927 (1986-10-01), Manes
patent: 4657015 (1987-04-01), Irnich
patent: 4658819 (1987-04-01), Harris et al.
patent: 4658820 (1987-04-01), Klicek
patent: 4669468 (1987-06-01), Cartmell et al.
patent: 4674499 (1987-06-01), Pao
patent: 4681122 (1987-07-01), Winters et al.
patent: 4682596 (1987-07-01), Bales et al.
patent: 4688569 (1987-08-01), Rabinowitz
patent: 4696668 (1987-09-01), Wilcox
patent: 4706667 (1987-11-01), Roos
patent: 4709698 (1987-12-01), Johnston et al.
paten
Goble Colin Charles Owen
Goble Nigel Mark
Gyrus Medical Limited
Peffley Michael
LandOfFree
Electrosurgical instrument does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Electrosurgical instrument, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Electrosurgical instrument will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-500865