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DE2514501A1 - Bipolar coagulation instrument for endoscopes - has two high frequency electrodes looped over central insulating piece - Google Patents

Bipolar coagulation instrument for endoscopes - has two high frequency electrodes looped over central insulating piece

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Publication number
DE2514501A1
DE2514501A1 DE19752514501 DE2514501A DE2514501A1 DE 2514501 A1 DE2514501 A1 DE 2514501A1 DE 19752514501 DE19752514501 DE 19752514501 DE 2514501 A DE2514501 A DE 2514501A DE 2514501 A1 DE2514501 A1 DE 2514501A1
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DE
Germany
Prior art keywords
electrodes
bipolar coagulation
coagulation instrument
loop
endoscopes
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
DE19752514501
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German (de)
Inventor
Karl Storz
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Individual
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Individual
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Priority to DE19752514501 priority Critical patent/DE2514501A1/en
Publication of DE2514501A1 publication Critical patent/DE2514501A1/en
Pending legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1402—Probes for open surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • A61B2018/141—Snare

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The bipolar coagulation cauterisation instrument for endoscopes is for removal of polyps from the stomach, duodenum, rectum, larynx or nose and has two high frequency electrode for staunching the blood flow, whereby both electrodes (1, 2) form a loop coupled together by an insulated section (3). Pref., the electrodes (1, 2) are coated with insulating material over their entire length with the exception of a region (4, 5) adjacent to the insulated connector (3) and facing each other. The loop (1-3) is slid into an inner sleeve (7) on the end of a shaft (6) and the free proximal ends encompassed in a sheath (8). The method enables use of a much lower current than the unipolar system but does not required an additional inactive electrode.

Description

Bipolares Coagulationsinstrument für Endoskope Die Erfindung bezieht sich auf ein bipolares Coagulationsinstrument für Endoskope zum Abtragen von Polypen z.B. Bipolar coagulation instrument for endoscopes The invention relates to on a bipolar coagulation instrument for endoscopes to remove polyps e.g.

im Magen, Duodenum, Rektum, im Larynx oder Nasenraum, dessen Elektroden ein Hochfrequenzstrom zur Blutstillung zugeleitet wird.in the stomach, duodenum, rectum, larynx or nasal cavity, its electrodes a high-frequency current is supplied to stop the bleeding.

Bei chirurgischen Operationen kommt in neuerer Zeit das bipolare Coagulieren zur Anwendung. Hierbei wird z.B.Bipolar coagulation has recently been used in surgical operations to use. Here, e.g.

jedem der beiden gegeneinander isolierten Schenkel einer Pinzette, die hier als Elektroden dienen, der Hochfrequenzstrom zugeführt. Das zwischen den Schenkeln liegende Gewebe wird coaguliert, sobald sich die Schenkel in dem erforderlichen geringen Abstand voneinander befinden.each of the two mutually isolated legs of a pair of tweezers, which serve as electrodes here, the high-frequency current is supplied. That between the Thighs lying Tissue is coagulated as soon as the thighs expand are at the required small distance from each other.

Dadurch ergibt sich der Vorteil, daß durch die bipolare Arbeitsweise der Hochfrequenzstrom um ein vielfaches geringer sein kann als bei der unipolaren Technik. Es ist auch die Gefahr von Verbrennungen aus diesem Grunde beseitigt.This has the advantage that the bipolar mode of operation the high-frequency current can be many times less than with the unipolar one Technology. It also eliminates the risk of burns for this reason.

Es sind weiter unipolare Coagulations-Schlingen zum Abtragen von Polypen und dgl. bekannt (USA-PS 3 805 791), wobei sich aber der schwere Nachteil ergibt, daß das Anlegen einer inaktiven Patientin-Elektrode erforderlich ist. Hierbei muß der Strom zwischen der inaktiven Patienten-Elektrode und der aktiven Elektrode der Coagulations-Schlinge und daher durch den Körper des Patienten fließen. Dabei können u.a. unkontrollierte Nebenströme auftreten, die an ungewollten Stellen Gewebe schädigungen verursachen.There are also unipolar coagulation loops for removing polyps and the like known (USA-PS 3 805 791), but there is the serious disadvantage that the application of an inactive patient electrode is necessary. Here must the current between the inactive patient electrode and the active electrode of the Coagulation loop and therefore flow through the patient's body. Here you can Among other things, uncontrolled side currents occur that damage tissue in unwanted places cause.

Der Erfindung liegt deshalb die Aufgabe zugrunde, das bipolare Coagulationsinstrument der eingangs erwähnten Art so zu verbessern, daß es bei den bekannten Schlingen der erwähnten Art Anwendung finden kann, um sich dieser wähnten großen Vorteile der bipolaren Arbeitsweise nutzbar zu machen.The invention is therefore based on the object of the bipolar coagulation instrument of the type mentioned at the beginning to improve so that it is with the known Loops of the type mentioned can be used to protect these supposedly large ones To harness the advantages of the bipolar way of working.

Die Lösung dieser Aufgabe durch die Erfindung besteht darin, daß die beiden Elektroden eine Schlinge bilden, indem sie an ihren Enden mittels eines Isolierstückes miteinander verbunden sind.The solution to this problem by the invention is that the Both electrodes form a loop by using an insulating piece at their ends are connected to each other.

Dadurch kann die bipolare Arbeitsweise zur Anwendung gelangen, ohne daß die eingangs erwähnten Nachteile auftreten.This allows the bipolar mode of operation to be used without that the disadvantages mentioned occur.

In weiterer Ausgestaltung der Erfindung ist vorgesehen, daß die Elektroden auf ihrer ganzen Länge mit Ausnahme eines Bereiches in der Nähe des Isolierstückes mit einer Isolierschicht versehen sind. Auf diese Weise arbeitet nur der distale Bereich der Schlinge als bipolares Coagulationsinstrument, weil die beiden Schenkel im übrigen voneinander isoliert sind und somit als aktive und inaktive Elektrode wirken. Hierbei fließt der Strom nur unmittelbar zwischen den beiden Schenkeln der Schlinge und kann nur auf das von der Schlinge unter optischer Kontrolle erfaßte Gewebestück wirken. Der Strom fließt also nicht mehr durch den Körper des Patienten, und ungewollte Gewebeschäden sind ausgeschlossen.In a further embodiment of the invention it is provided that the electrodes along their entire length with the exception of an area near the insulating piece are provided with an insulating layer. This way, only the distal one works Area of the loop as a bipolar coagulation instrument because the two legs are otherwise isolated from each other and thus as active and inactive Electrode act. The current only flows directly between the two legs the loop and can only access what is detected by the loop under optical control Work piece of tissue. The current no longer flows through the patient's body, and unwanted tissue damage are excluded.

Dadurch, daß bei der bevorzugten Ausführungsform der Schlingendraht nur am distalen Ende nicht isoliert und somit wirksam ist, ist ein Kontakt der beiden Elektroden auch bei zusammengezogener Schlinge verhindert. Die beiden Elektroden sind nämlich im übrigen auf ihrer gesamten Länge isoliert.Because in the preferred embodiment the noose wire Only at the distal end is not isolated and therefore effective, is a contact between the two Electrodes prevented even when the loop is pulled together. The two electrodes that is to say they are insulated over their entire length.

Hierbei kann vorteilhaft sein, daß die Elektroden nur im Bereich der einander zugewandten Hälften nicht mit der Isolierschicht versehen sind. Dadurch wird erreicht, daß eine unerwünschte Berührung selbst des distalen arbeitenden Endes der beiden Elektroden mit dem Endoskopschaft auch im zusammengezogenen Zustand vermieden ist.It can be advantageous that the electrodes are only in the area of the facing halves are not provided with the insulating layer. Through this it achieves undesirable contact even of the distal working end of the two electrodes with the endoscope shaft avoided even in the contracted state is.

Hierzu ist noch zweckmäßig, daß die Schlinge in das Ende eines Schaftes einschiebbar ist. Dadurch können zangenartige Bewegungen der Schlinge erzeugt werden. Um die beiden Elektroden hierbei möglichst nahe aneinander zu bringen, kann noch vorgesehen sein, daß am Ende des Schaftes eine Innenhülse angeordnet ist.For this purpose, it is also useful that the loop is in the end of a shaft is retractable. This can generate pincer-like movements of the loop. In order to bring the two electrodes as close as possible to one another, it is still possible be provided that an inner sleeve is arranged at the end of the shaft.

Schließlich ist nach einem anderen Merkmal der Erfindung auth noch zweckmäßig, daß die beiden Elektroden in ihrem der Schlinge abgewandten proximalen Bereich von einer Hülse ummantelt sind. Dadurch werden die beiden Elektroden in diesem Bereich zusammengehalten und können auch durch die Hülse gemeinsam betätigt werden.Finally, according to another feature of the invention, auth is still expedient that the two electrodes in their proximal electrodes facing away from the loop Area are encased by a sleeve. This will put the two electrodes in this area held together and can also be operated jointly by the sleeve will.

Weitere Vorteile und Einzelheiten der Erfindung ergeben sich aus der nun folgenden Beschreibung eines Ausführungsbeispiels unter Hinweis auf die Zeichnung. In dieser zeigen: Fig. 1 eine teilweise geschnittene Seitenansicht auf das distale Ende des Erfindungsgegenstandes und Fig. 2 das gleiche wie Fig. 1, jedoch in der zusammengezogenen Lage.Further advantages and details of the invention emerge from the now the following description of an embodiment with reference to the drawing. These show: FIG. 1 a partially sectioned side view of the distal End of the subject matter of the invention and Fig. 2 is the same as Fig. 1, but in the contracted position.

In Fig. 1 sieht man den Instrumentenschaft 6, wobei es sich auch um den Endoskopschaft handeln kann, andernfalls um eine Hülse, die in einem nicht weiter dargestellten Endoskop angeordnet ist. Derartige Endoskope mit ähnlichen Instrumenten sind bereits bekannt und müssen daher nicht im einzelnen dargestellt werden.In Fig. 1 you can see the instrument shaft 6, which is also the endoscope shaft can act, otherwise a sleeve that does not continue in one shown endoscope is arranged. Such endoscopes with similar instruments are already known and therefore do not have to be presented in detail.

In dem Schaft 6 sind zwei Elektroden 1 und 2 am distalen Ende schlingenförmig angeordnet und am distalen Ende mittels eines Isolierstückes 3 zusammengehalten, in dem die Elektroden 1 und 2 voneinander getrennt gehalten sind, so daß ein Kurzschluß nicht entstehen kann. Mittels der unterbrochenen Linien 9 und 10 ist die Lage der Elektroden innerhalb des Isolierstückes 3 getrennt voneinander angegeben.In the shaft 6, two electrodes 1 and 2 are looped at the distal end arranged and held together at the distal end by means of an insulating piece 3, in which the electrodes 1 and 2 are kept separate from each other, so that a short circuit cannot arise. By means of the broken lines 9 and 10, the position of the Electrodes indicated separately from one another within the insulating piece 3.

Die Elektroden 1 und 2 sind nahezu über ihre gesamte Länge vollständig mit einer Isolierschicht versehen. Lediglich in der Nähe des Isolierstückes 3 ist die Isolierung an den einander zugewandten Hälften der Elektroden 1 und 2 im Bereich 4 und 5 nicht vorhanden. Wie man der Fig. 1 deutlich entnehmen kann, ist die Isolierung hier im Außenbereich 11 und 12 ebenfalls noch vorhanden, lediglich innen sind die Elektrodenhälften 4 und 5 blank, das heißt ohne die Isolierung Nur dieser Bereich bildet daher die aktiven oder arbeitenden Elektroden.The electrodes 1 and 2 are almost complete over their entire length provided with an insulating layer. Only in the vicinity of the insulating piece 3 is the insulation on the facing halves of the electrodes 1 and 2 not available in areas 4 and 5. As can be clearly seen in FIG. 1 the insulation is still present here in the outer area 11 and 12, the electrode halves 4 and 5 are bare only on the inside, that is to say without the insulation Only this area therefore forms the active or working electrodes.

Die erwähnte Schlinge ist in Fig. 1 vollständig ausgefahren.The loop mentioned is fully extended in FIG.

Sie wird innerhalb des Schaftes 6 durch die Hülse 7 zusammengedrückt, und im proximalen Bereich sind die beiden Elektroden 1 und 2 von einer weiteren Hülse 8 ummantelt, die einen sehr viel kleineren Durchmesser hat als der Schaft 6 und die beiden Elektroden zusammenhält. Diese Hülse 8 kann auch zur Betätigung, das heißt zur Verschiebung der Elektroden in Richtung des Pfeiles 13 und in Gegenrichtung dienen.It is compressed within the shaft 6 by the sleeve 7, and in the proximal area the two electrodes 1 and 2 are from another Sheathed sleeve 8, which has a much smaller diameter than the shaft 6 and holds the two electrodes together. This sleeve 8 can also be used to operate that is, to move the electrodes in the direction of arrow 13 and in the opposite direction to serve.

In Fig. 2 sind die Elektroden mittels der Hülse 8 in Richtung des Pfeiles 13 in den Schaft oder die Hülse 6 hineingezogen, so daß hierdurch die beiden distalen aktiven Enden 4 und 5 der Elektroden 1 und 2 einander genähert worden sind.In Fig. 2, the electrodes are by means of the sleeve 8 in the direction of Arrow 13 drawn into the shaft or the sleeve 6, so that thereby the two distal active ends 4 and 5 of electrodes 1 and 2 have been brought closer to each other.

Sie haben dadurch eine zangenförmige Bewegung ausgeführt und dazwischen vorhandenes Gewebe oder dgl. abgetrennt.You have performed a pincer-shaped movement and between Existing tissue or the like. Separated.

Durch die Erfindung ist dabei die erwähnte Coagulations-Wirkung der aktiven Teile der Elektrode eingetreten.Through the invention, the aforementioned coagulation effect is the active parts of the electrode occurred.

Die Erfindung ist nicht auf die dargestellte Ausführungsform beschränkt. Sie kann sowohl bei flexiblen Schlingen, z.B. für Gastroskope, Colonoskope als auch bei starren Schlingen, z.B. für Rektoskope oder Laryngoskope Anwendung finden.The invention is not limited to the embodiment shown. It can be used with flexible slings, e.g. for gastroscopes, colonoscopes as well as for rigid slings, e.g. for rectoscopes or laryngoscopes.

Claims (6)

AnsprücheExpectations #.) Bipolares Coagulationsinstrument für Endoskope zum Abtragen von Polypen z.B. im Magen, Duodenum, Rektum, im Larynx oder Nasenraum, dessen Elektroden ein Hochfrequenzstrom zur Blutstillung zugeleitet wird, dadurch gekennzeichnet, faß die beiden Elektroden (1, 2) eine Schlinge bil#en, indem sie an ihren Enden mittels eines Isolierstückes (3) miteinander verbunden sind.#.) Bipolar coagulation instrument for endoscopes to remove Polyps e.g. in the stomach, duodenum, rectum, larynx or nasal cavity, their electrodes a high-frequency current is supplied for hemostasis, characterized in that hold the two electrodes (1, 2) to form a loop by holding them at their ends are connected to one another by means of an insulating piece (3). 2. Bipolares Coagulationsinstrument nach Anspruch 1, dadurch gekennzeichnet, daß die Elektroden (1, 2) auf ihrer ganzen Länge mit Ausnahme eines Bereiches (4, 5) in der Nähe des Isolierstückes (3) mit einer Isolierschicht versehen sind. 2. Bipolar coagulation instrument according to claim 1, characterized in that that the electrodes (1, 2) over their entire length with the exception of an area (4, 5) are provided with an insulating layer near the insulating piece (3). 3. Bipolares Coagulationsinstrument nach Anspruch 2, dadurch gekennzeichnet, daß die Elektroden (1, 2) nur im Bereich der einander zugewandten Hälften (4, 5) nicht mit der Isolierschicht versehen sind. 3. Bipolar coagulation instrument according to claim 2, characterized in that that the electrodes (1, 2) only in the area of the mutually facing halves (4, 5) are not provided with the insulating layer. 4. Bipolares Coagulationsinstrument nach Anspruch 1, dadurch gekennzeichnet, daß die Schlinge (1-3) in das Ende eines Schaftes (6) einschiebbar ist.4. Bipolar coagulation instrument according to claim 1, characterized in that that the loop (1-3) can be pushed into the end of a shaft (6). 5. Bipolares Coagulationsinstrument nach Anspruch 4, dadurch gekennzeichnet, daß am Ende des Schaftes (6) eine Innenhülse (7) angeordnet ist.5. Bipolar coagulation instrument according to claim 4, characterized in that that an inner sleeve (7) is arranged at the end of the shaft (6). 6. Bipolares Coagulationsinstrument nach Anspruch t, dadurch gekennzeichnet, daß die beiden Elektroden (1, 2) in ihrem der Schlinge abgewandten proximalen Bereich von einer Hülse (8) ummantelt sind.6. Bipolar coagulation instrument according to claim t, characterized in that that the two electrodes (1, 2) in their proximal area facing away from the loop are encased by a sleeve (8).
DE19752514501 1975-04-03 1975-04-03 Bipolar coagulation instrument for endoscopes - has two high frequency electrodes looped over central insulating piece Pending DE2514501A1 (en)

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DE19752514501 DE2514501A1 (en) 1975-04-03 1975-04-03 Bipolar coagulation instrument for endoscopes - has two high frequency electrodes looped over central insulating piece

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DE19752514501 DE2514501A1 (en) 1975-04-03 1975-04-03 Bipolar coagulation instrument for endoscopes - has two high frequency electrodes looped over central insulating piece

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