Surgery – Instruments – Electrical application
Reexamination Certificate
1999-09-28
2001-12-11
Cohen, Lee (Department: 3739)
Surgery
Instruments
Electrical application
C606S046000
Reexamination Certificate
active
06328734
ABSTRACT:
FIELD OF THE INVENTION
This invention relates to endoscopes and more specifically to an endoscope which can be used as a diagnostic instrument and a therapeutic device.
BACKGROUND OF THE INVENTION
Endoscopes, which accommodate a bipolar energy source and which deliver the electrosurgical radiofrequency within a saline medium, are known in the art. However, interruption of the irrigation flow in such endoscopes may cause severe thermal injury to the surrounding tissues. Moreover, utilization of the preferred irrigating media, physiologic 0.9N saline, with an endoscope using a standard monopolar energy source is not feasible because a substantial portion of the radiofrequency energy from an electrosurgical generator unit, (ESU), to the endoscope, is dissipated within the ionic nature of the sodium chloride. To avoid dissipation, more non-conducting irrigation solutions are used such as water, glycine or sorbitol. However, these latter solutions may cause hyponatremia. Thus, use of monopolar energy has fallen out of favor with most endoscopic surgeons, whether they are performing urologic, gynecologic, arthroscopic or laparoscopic procedures.
In addition, endoscopes to date are not adapted to act as combined diagnostic and therapeutic instruments, and endoscopes that utilize a radiofrequency energy source generally require a ground-dispersive pad. These ground pads increase costs and may cause flesh burns.
SUMMARY OF THE INVENTION
It is therefore a primary object of this invention to provide an endoscope which provides bipolar capabilities without the risk of thermal injury.
It is a further object of this invention to provide an endoscope which enables a physician to use a physiological saline solution as the irrigant without problems associated with dissipating electrosurgical energy.
It is a further object of this invention to provide an endoscope which can be used for both diagnostic and therapeutic procedures.
It is a further object of this invention to provide an endoscope with a bipolar return electrode and a working channel.
It is a further object of this invention to provide an endoscope with a coaxial electrode which does not require a ground-dispersive pad.
It is a further object of this invention to provide an endoscope with a bipolar return electrode and a working channel through which items such as grasping and biopsy forceps, radiofrequency energy or injectables may be passed.
It is a further object of this invention to provide an endoscope in which the outflowing irrigant is used to cool the coaxial cable of a bipolar resecting device.
It is a further object of this invention to provide an endoscope which provides more energy to a cutting loop and thus more heat, which in turn provides quicker and more efficient tissue removal and improved cauterization.
It is a further object of this invention to provide an endoscope with a bipolar return electrode and a working channel with which conductive physiologic irrigation solution may be used.
The preferred embodiment of the endoscopic device of the invention adapted for use in diagnostic and therapeutic procedures, comprises: one or more sheaths; one or more endoscopes disposed within the sheath; one or more return electrodes disposed within the sheath; and one or more working channels disposed within the sheath. The endoscopic device may further comprise one or more irrigation channels disposed within the sheath capable of transporting one or more irrigation fluids through the channel; and a coaxial cable, disposed within the sheath, in which one or more of the return electrodes is disposed so that one or more of the electrodes surrounds one or more of the irrigation channels so that the irrigation fluid is capable of cooling the return electrode. The endoscopic device also preferably comprises an electrical conductor disposed within the working channel, one or more light source channels, and/or a means for steering.
Another preferred embodiment of the endoscopic device of the invention that is capable of use as both a diagnostic instrument and a therapeutic device, wherein at least a portion of the device is disposed within a sheath, comprises: one or more lenses, one or more internal working channels; and one or more internal bipolar return electrodes. Similarly, this embodiment may also comprise a coaxial cable comprising at least one irrigation channel, wherein at least one of the return electrodes is disposed within the cable and wherein the irrigation channel is capable of cooling the return electrode. Further, at least one of the working channels may carry one or more items selected from a group consisting of forceps, one or more electrical conductors and one or more injectables.
The invention may utilize any type or size endoscope used to perform urologic, gynecologic, arthroscopic or laparoscopic procedures, including but not limited to cystoscopes, gastroscopes, colonoscopes, hysteroscopes and choledocoscopes.
REFERENCES:
patent: 4116198 (1978-09-01), Roos
patent: 4184492 (1980-01-01), Meinke et al.
patent: 4311144 (1982-01-01), Harada
patent: 4606331 (1986-08-01), Shene
patent: 5885277 (1999-03-01), Korth
Cohen Lee
Mirick O'Connell DeMallie & Lougee LLP
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