Surgery – Endoscope – With guide means for body insertion
Reexamination Certificate
2001-03-16
2003-07-01
Jeffery, John A. (Department: 3742)
Surgery
Endoscope
With guide means for body insertion
C606S041000
Reexamination Certificate
active
06585638
ABSTRACT:
FIELD OF THE INVENTION
This invention relates to an endoscope power supplying appliance, and in particular to an endoscope power supplying appliance capable of endoscopic surgical operation with a single skin incision. Further this invention relates to a power supplying appliance suitable for blocking operation of nerve fibers such as sympathetic nerves and parasympathetic nerves, and in particular, blocking operation of sympathetic nerves in thoracic part under thoracoscope.
BACKGROUND TECHNOLOGY
In conventional so called endoscopic operations, surgical operations using endoscope, an endoscope and operational devices such as electric knives and electrodes for cautery are inserted from different skin incisions. Consequently at least two skin incisions and in some cases more than three incisions are necessary in such operations. And bar shaped devices with no cavities are used for the operation devices such as electric knives and electrodes for cautery for perfect sterilization and prevention of pollution. Consequently cylindrical shaped devices are not used.
However to reduce patients' load and to facilitate earlier recovery after surgical operations, it is preferred to reduce the number of skin incisions and the size thereof. It is necessary to insert an endoscope and power supplying appliance from a same incision to finish off the operation with only one cut. Further it is necessary to make endoscope and power supplying appliance as thin as possible so as to minimize the size of incision. Conventionally there was no endoscope power supplying appliance that satisfies above requirements.
DISCLOSURE OF THE INVENTION
The present invention relates to an endoscope power supplying appliance of which an endoscope and an operational device can be inserted into a body from a same skin incision and procedures such as electric cautery, electrocoagulation and electro scission can be performed while observing an operation site through the endoscope to resolve above said problems. More specifically, this invention relates to an endoscope power supplying appliance in a cylindrical shape having an electrode for electric coagulation and electro scission at a distal end of the cylinder in which an endoscope can be inserted and moved minutely along the cylinder. Further the present invention relates to an endoscope power supplying appliance having a slit at the distal end of the appliance.
The power supplying appliance of this invention used while an endoscope is inserted therein is composed of a control unit, a cylinder unit and an electrode, where the electrode is set at the distal end of the cylinder unit, the control unit at the other end of the cylinder unit, the optical lens of the endoscope inserted in the power supplying appliance can protrude beyond the distal end of the power supplying appliance and the endoscope can move in the axial direction of the power supplying appliance. The endoscope is composed of a bar-shaped insert part in diameter of 2 mm to 3 mm having an optical lens at the distal end thereof and a display unit attached thereto such as TV monitor. Commercial endoscopes for surgery operation under endoscope may be optionally used for the endoscope of the present invention. The insert part having an optical lens inserted into the power supplying appliance of this invention must be inserted while nearly contacting inside wall of the hard power supplying appliance, and should be a linear shape or a curved shape with a constant radius having a constant sectional shape so that the insert part can move minutely in the axial direction of the cylinder unit. Although the sectional shape of the insert part is optional, a round shape conforming to the optical system of the endoscope is generally preferred.
The power supplying appliance is formed of a hard and tough material such as metals, for example, stainless steal and ceramics. The appliance has an electrode at the distal end of the cylinder unit where the electrode is electrically connected to the control unit. When the cylinder unit of the appliance is made of an electroconductive material such as metal, the outside wall and inside wall of the cylinder unit except for the electrode must be insulated from the outside in order not to connect to the endoscope. The insulation treatment may be performed by coating treatment, coating and hardening, baking finish of an insulation material. Although the electrode may be monopolar or bipolar, monopolar is preferred when performing a micro-structural operation because the monopolar electrode is capable of concentrating electric power in a comparatively narrow area.
When the distal end of the power supplying appliance is used for incision, it is preferred to make the distal end sharp as a blade. Further it is preferred to arrange the optical lens of the endoscope close to the distal end of the cylinder unit so as not to form a too broad gap between the lens and the distal end. In case too broad gap is formed between the optical lens and the distal end, body liquid such as blood, fat, body tissue fragments formed during the incision will intrude the gap during the operation, which will contaminate other parts in the body or raise troubles to the endoscopic observation by narrowing the view through the endoscope.
The optical lens of the endoscope of the endoscope power supplying appliance of this invention can protrude beyond the distal end of the cylinder unit, and the endoscope may be moved minutely in the axial direction of the cylinder unit to a specific position. Endoscopic observation is facilitated by protruding beyond the distal end of the cylinder unit because the endoscopic view is not disturbed by the cylinder unit. Further since the lens is capable of moving a specific position in the axial direction of the cylinder unit, an operator can observe an operation site in the body with a wide view to specify the target area of the operation by protruding the endoscope beyond the distal end of the cylinder unit when looking for an operation site, and when performing the operation, it is possible to focus both on the subject area and on the electrode concurrently by pulling it in the cylinder unit. The distance of the movement is very short and generally 5 mm to 7 mm is sufficient. By adopting above said configurations, it is possible for the operator to keep the electrode always in his/her view when performing the treatment with the electrode because the electrode and the endoscope move along the same axial line, and further the operator is capable of performing a cautery while precisely approaching the electrode to the operation site specified by the search. The movement of the endoscope may be done manually or electrically by linear motor and the like. In the case of electric-motor driven devices, the linear motor may be controlled by dials, levers and the like on the control unit, which is capable of moving the lens to a desired position through one-touch operation and facilitates the control during operation. It is not necessary to take the endoscope out of the body each time during operation. Further it eliminates the need for procedures such as checking on the direction of the view and focusing each time the endoscope or electrode is moved, the operation is facilitated and may be proceeded promptly because the moving direction of the endoscope and the power supplying appliance and viewing direction of the endoscope become all concentric.
The electrode at the distal end of the cylinder unit must have a shape which does not block the movement of the endoscope so that the endoscope can protrude beyond the distal end of the cylinder unit in order that the electrode or the distal end of the cylinder unit may not get in the view of endoscope. Consequently when the insert part of the endoscope has a circular section, it is preferred that the electrode also has a circular shape or an arc shape constituting a part of the circular shape conforming to the sectional shape of the endoscope. When adopting bipolar electrode, in particular, it is preferred to configure an arc shape. The e
Jeffery John A.
Simpson & Simpson PLLC
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