Surgery: kinesitherapy – Kinesitherapy – Ultrasonic
Reexamination Certificate
1998-11-30
2001-01-09
Dvorak, Linda C. M. (Department: 3739)
Surgery: kinesitherapy
Kinesitherapy
Ultrasonic
C606S039000, C606S040000, C606S041000, C606S169000, C607S101000
Reexamination Certificate
active
06171265
ABSTRACT:
FIELD OF THE INVENTION
The invention relates to a handpiece for a multifunctional instrument for endoscopic surgery, comprising a sonotrode for ultrasonic applications, in accordance with the introductory clause of Patent claim
1
.
PRIOR ART
The wording of the introductory clause of the independent patent claims starts out, for instance, from the U.S. Pat. No. 5,391,144, which discloses various devices for ultrasonic treatment, or from the document WO-A-91/07917.
These references disclose handpieces for multifunctional devices for endoscopic surgery, which comprise a case, port means disposed on the case and adapted for connection to connecting lines such as electrical lines, lines for supply and discharge of liquids, etc., at least one ultrasonic transducer mounted in the case, one ultrasonic sonotrode for transmitting the ultrasonic energy to the distal end, and at least one switching means for control of the handpiece functions.
As far as the structure and the mode of operation of a sonotrode is concerned, reference is made specifically to the document WO-A-91/07917 to the extent to which it is assumed to be known within the scope of the present application.
As far as other aspects are concerned reference is made to the prior art documents identified above and mentioned in the following, as far as the explanation of all the terms is concerned which are not described here in details.
From the U.S. Pat. No. 5,391,144 instruments have become known which present the following features:
endoscopic application,
ultrasonic function,
high-frequency coagulation,
suction function,
irrigation and flushing
several ports in the rear zone of the handpiece,
switch on the handpiece, and
vapour sterilisability.
A similar device is described in the U.S. Pat. No. 5,312,329. In that ultrasonic and electro-surgical handpiece switches are mounted on the handpiece and provided with a separate supply line.
The devices known from the U.S. Pat. Nos. 5,391,144 and 5,312,329 present, however, a number of disadvantages:
For instance, switches are mounted on an existing handpiece or clamped on the outside of the case with a separate supply line. The switches used there present the following disadvantages:
The surgeon is disturbed by the switch mounted on the case and by the separate supply line. Moreover, the separate supply line is frequently damaged in application.
When switches are integrated often a cable lead-in is provided which involves an expenditure in terms of structure and which is a leak risk in autoclaving. For this reason it were desirable to avoid lead-in penetrations as far as possible.
When high frequency is activated (commonly at 5000 Vpp and 500 kHz) there is a breakdown or puncture risk. When common high-frequency wires and further wires are provided in a single cable the further wires are equally subjected to a high-frequency potential on account of capacitive coupling. It is necessary for this reason to insulate switches reliably from high frequencies from the outside. Even though this is feasible with a suitable structure comparatively big and bulky switches ought to be employed as a matter of fact. Small, less bulky switches such as foil push-buttons mounted on the envelope are not suitable for application in prior art.
For each function to be performed with the surgical device a separate line each is required for transmission and control.
Moreover, the devices known from the U.S. Pat. Nos. 5,312,329 and 5,391,144 display an insufficient insulation between the high-frequency and the ultrasonic supply in the handpiece, if an insulation is provided at all, so that high-frequency cross-talk to the ultrasonic supply will inevitably occur in the handpiece.
As a result even a high-frequency transmission to the ultrasonic generator may occur, which involves the risk of damage to the generator.
Another disadvantage of the describes described in the above-identified documents is the fact that a vibration-compatible design of the case and/or the sonotrode has not been considered.
BRIEF DESCRIPTION OF THE INVENTION
The present invention is based on the problem of defining a compact handpiece which is safe for the user and for the patient treated, which avoids the disadvantages of prior art and is easy to handle and yet stable.
The invention is moreover based on the problem of defining a handpiece for a surgical instrument which is functionally operable over a sufficient period despite the simultaneous integration of the ultrasonic function and the high-frequency application in one handpiece.
Another problem consists in the definition of a sonotrode which is simple to manufacture and presents a long service life.
Inventive solutions to these problems are defined in the independent claims. Improvements of the invention are the subject matter of the dependent claims.
The service life of the known sonotrodes is comparatively short, specifically in the case of long probe elements, because they are normally made of steel wire.
Even though the use of titanium or titanium alloys as probe material could be remedial the production of passages in such materials is possible only by boring, however. Deep-drilling with an acceptable reject rate is possible only up to roughly 200 to 300 mm.
In an approach to provide yet long probe elements a sonotrode is employed in accordance with the invention which comprises a long and thin probe section with a passage consisting of several segments welded together. The weld points may be located in particular in the antinodes of the ultrasonic wave. With this provision it is possible to produce probes of titanium or titanium alloys such as Ti6A14V where the passage diameter amounts to roughly 2 mm, the thickness of the probe section is less than 4 mm, and the length is more than 30 cm. The bored tubular segments are preferably formed or faced in such a way that they may be self-centred and welded.
The probe may specifically present a bulge which is welded on the probe section and screwed to the case. Regarding more details of the design reference is made to the document WO-A-91/07917 identified by way of introduction.
It is moreover expedient to probe a single connecting means and to mount all handpiece ports of the connecting lines in this single connecting means. A handpiece presenting these features saves additional cables outside the handpiece. All the ports are connected to the single connecting means which is disposed on one end of the handpiece or the case, respectively.
All the connecting lines which are of a design other than one-way lines—one-way lines are typically fluid lines—are expediently inserted into a cable sheath. This provision allows for a particularly simple handling of the handpiece.
Piezo transducers may preferably be used as ultrasonic transducers. With the inertial mass of prior art piezo transducers being normally connected to the electrical mass, it is common to use an ever number of piezo disks and hence an odd number of electrode surfaces.
For a minimisation of the current derived from the patient, by contrast, all the piezo disks should be expediently insulated from the inertial mass. With an even number of electrode surfaces, i.e. with the same number of positive and negative surfaces the positive and negative currents are substantially compensated, which result in a capacitive coupling with the inertial mass and may therefore arrive at the patient by contact.
It is moreover expedient to provide the ultrasonic generator with a floating symmetrical output so as to achieve that the currents which are capacitively coupled to the patient on account of the even number of electrode surfaces for reasons of symmetry will balance each other and form a minimum derivation current.
In another preferred embodiment the switching means includes at least one switching sensor and at least one actuator element which does not include any part which may be mechanically contacted with the switching sensor directly. In particular, this design does not establish an electrical connection so that high-frequency coupling will be avoided substantially as early
Gminder Frank
Henes Rudolf
Irion Klaus
Krattiger Beat
Novak Pavel
Dvorak Linda C. M.
Ruddy David M.
St. Onge Steward Johnston & Reens LLC
Storz Endoskop GmbH
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