Surgery – Instruments – Electrical application
Patent
1998-05-20
2000-05-09
Dvorak, Linda C. M.
Surgery
Instruments
Electrical application
606 51, A61B 1818
Patent
active
060597828
DESCRIPTION:
BRIEF SUMMARY
DESCRIPTION
1. Technical Field
The present invention relates to a high frequency surgical instrument.
High-frequency surgical instruments of this type are utilized, in particular, as bipolar instruments.
2. State of the Art
To cut or coagulate tissue using high-frequency currents, whose frequency lies by way of illustration in the range between 500 kHz and 1 MHz, is known. Fundamentally one differentiates between monopolar and bipolar types of operation:
In monopolar operation, the current flows between one large area neutral electrode and a small operation electrode, also called an active electrode. The active electrode can, in particular, have the shape of a pointed tip or a small ball. Due to the high current density at the tip of the active electrode, only the tissue in the vicinity of this tip desiccates or burns, with cutting results or intensified coagulation occurring corresponding to the current shape (sinus, sinus with interruptions respectively impulse shape).
In bipolar operation, the flow of current occurs between two small electrodes enclosing a piece of tissue. In the past, this type of operation has been used for coagulation and in practice only to a small extent for cutting.
Contrary to bipolar operation, in monopolar operation, the current flows through large areas of the human body. Thus there is a danger that, particularly if not applied 100% properly, not only the tissue in the immediate vicinity of the active electrode is influenced in the desired manner by the flow of current, but by way of illustration a disturbance in heart function may occur due to a flow of current in the vicinity of the heart. Moreover, coagulation may also occur in tissue fibers, etc. which are located quite far from the actual coagulating site.
For this reason, for some time attempts have been made to obtain results even in bipolar type operation.
By way of illustration, the use of a "triode" is known in which the shape of the two electrodes of which the one is a pointed tip and the other a hemisphere, the conditions under which the monopolar type of operation are copied. On the basis of this form, cutting results are obtained only at the tip of the electrodes so that cutting is very precise. This shape of the electrodes however does not permit gripping the tissue to be cut.
A bipolar coagulation pair of tongs is known from German utility patent 92 15 590. These coagulation tongs are provided with two electrodes which are designed as the jaws of the tongs and therefore can serve as clamping electrodes between which the tissue to be cut is held respectively clamped. Tissue coagulation is performed by applying a HF current from a HF generator.
These known bipolar coagulation tongs are solely suited for coagulating tissue, however not for cutting it. Moreover, these coagulation tongs possess no channel which could serve as a rinsing and/or vacuum off channel by means of which, by way of illustration pieces of tissue could be vacuumed off.
Another bipolar coagulation pair of tongs are known from EP 0 589 453 A2. These bipolar coagulation tongs. Too. are neither suited for cutting tissue nor possess a channel which could be used for rinsing or vacuuming off.
The same applies to the bipolar tongs respectively instruments known from U.S. Pat. Nos. 5,269,782, 5,282,799, 5,258,006 and 5,290,285 as well as EP-A-0 596 436.
Another bipolar coagulation instrument is known from EP 0536 440. Although this instrument for high-frequency surgery is suited selectively for cutting or coagulating, it possesses neither a rinsing and/or vacuuming-off channel nor is it of optimum design for both types of operation.
Therefore the bipolar arrangement described in the printed publications mentioned in the preceding, to which, moreover, explicitly reference is made for the explanation of all details not explained more closely herein, have the disadvantage that they possess no rinsing and/or vacuuming-off channel. Furthermore, these bipolar electrodes cannot be employed in combination with conventional high-frequency surgical instruments
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Novak Pavel
Wattiez Arnaud
Dvorak Linda C. M.
Gibson Roy
Storz Endoskop GmbH
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