FR2573301A1 - Pince chirurgicale et son appareillage de commande et de controle - Google Patents
Pince chirurgicale et son appareillage de commande et de controle Download PDFInfo
- Publication number
- FR2573301A1 FR2573301A1 FR8417545A FR8417545A FR2573301A1 FR 2573301 A1 FR2573301 A1 FR 2573301A1 FR 8417545 A FR8417545 A FR 8417545A FR 8417545 A FR8417545 A FR 8417545A FR 2573301 A1 FR2573301 A1 FR 2573301A1
- Authority
- FR
- France
- Prior art keywords
- thermocouple
- control means
- thermocouples
- clamp according
- rods
- Prior art date
- 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.)
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/30—Surgical pincettes, i.e. surgical tweezers without pivotal connections
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- 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
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
-
- 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
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00084—Temperature
- A61B2017/00092—Temperature using thermocouples
- A61B2017/00097—Temperature using thermocouples one of the thermometric elements being an electrode or the heating element
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (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)
- Otolaryngology (AREA)
- Plasma & Fusion (AREA)
- Physics & Mathematics (AREA)
- Surgical Instruments (AREA)
Abstract
L'INVENTION SE RAPPORTE A UNE PINCE CHIRURGICALE A COURANT HAUTE FREQUENCE - MONOPOLAIRE ET BIPOLAIRE - COMPORTANT DEUX BRANCHES METALLIQUES A EXTREMITES ACTIVES ET A SON APPAREILLAGE DE CONTROLE. CONFORMEMENT A L'INVENTION AU MOINS UNE DES DEUX EXTREMITES ACTIVES COMPORTE UN THERMOCOUPLE (1C-2C) RELIE A UN APPAREILLAGE INTERROMPANT OU REGULANT LE COURANT HAUTE FREQUENCE. CHAQUE BRANCHE 1-2 EST CONSTITUEE DE DEUX TIGES 1A-1B 2A-2B SOUDES EN EXTREMITE ACTIVE DE LA BRANCHE POUR Y FORMER LE THERMOCOUPLE 1C-2C. L'INVENTION S'APPLIQUE D'UNE FACON GENERALE A L'INSTRUMENTATION CHIRURGICALE.
Description
La présente invention se rapporte à une pince chirurgicale et à son appareillage de commande et de con trôle, considérés en soi, sans implication d'aucune méthode de traitement chirurgical du corps humain ou animal.
L'utilisation des courants de haute-fréquence pour coaguler les vaisseaux sanguins sectionnés au cours d'opération chirurgicale. s'effectue généralement à l'aide de pinces agissant soit en mode monopolaire (voir la figure 1 du dessin annexé), soit en mode bipolaire si l'instrument est approprié, cest-à-dire avec les deux branches électriquement isolées l'une de l'autre (voir la figure 2 du dessin annexe). L'effet de coagulation est contrôle par le chirurgien qui décide. lui-même, d'interrompre le passage du courant H.F. au moment qu'il juge opportun.
En prolongeant l'action au-delà de ce qui est nécessaire pour bloquer le courant sanguin et assurer l'hémostase, les tissus déshydratés se nécrosent et, par parcelles, viennent adhérer aux pinces qu'il est alors nécessaire de nettoyer en cours d'opération.
La présente invention entend empêcher le phénomène d'adhérence sur les extrémités actives de la pince et notamment éviter ainsi, à l'utilisateur, de devoir nettoyer fréquemment celle-ci.
L'invention vise une pince dont une ou les deux extrémités actives comportent un thermocouple relié à un appareillage électromécanique ou électronique interrompant ou régulant le courant de Haute-Fréquence pour une température maximale choisie.
Les moyens de mesure, de contact ou de régulation sont en principe placés en série avec un interrupteur manuel ou à pédale. commandé par le chirurgien ou son aide. Avec une pince selon l'invention les coagulations sont assurées d'être régulières et non nécrosantes par l'arrêt automatique du courant H.F. lorsque la température affichée est atteinte au point de préhension.
Une autre possibilité offerte par l'invention est de permetttre la mise sous tension Haute-Fréquence de la pince sous condition que ses extrémités actives soient à environ 37-C (température des tissus du patient quand il s'agit d'un être humain?, la pince étant alors électriquement inerte lorsqu'elle reste à la température ambiante (de 20 à 25@C par exemple) même si l'opérateur appuie sur la pédale ou l'interrupteur de commande.
Cet avantage protège le générateur H.F. contre les risques de fonctionnement inutilement prolongé si l'opérateur continue à appuyer sur la pédale alors qu'il n'utilise plus l'instrument pour coaguler.
Le ou les moyens de contrôle électromécaniques ou électroniques, appropriés et jumelés avec la pince, sont bien entendu réalisés pour la sécurité du patient et du chirurgien, en assurant les isolements et la limitation des courants de fuite B.F. et H.F. conformément aux normes de construction des appareils électro-chirurgicaux.
D'autres caractéristiques et avantages de la présente invention ressortiront de la description qui va suivre faite en regard du dessin annexé sur lequel
- Les figures 1 et 2 sont des schémas expliquant la coagulation monopolaire et la coagulation bipolaire;
t -la figure 3 est une vue schématique en pers pective d'une pince chirurgicale selon l'invention;
- la figure 4 représente l'appareillage de commande et de contrôle selon l'invention;
Les pinces électro-chirurgicales classiques - mono ou bipolaires - comportent deux branches métalliques de section rectangulaire ou similaire venant en contact à leurs extrémités sous la pression des doigts.
- Les figures 1 et 2 sont des schémas expliquant la coagulation monopolaire et la coagulation bipolaire;
t -la figure 3 est une vue schématique en pers pective d'une pince chirurgicale selon l'invention;
- la figure 4 représente l'appareillage de commande et de contrôle selon l'invention;
Les pinces électro-chirurgicales classiques - mono ou bipolaires - comportent deux branches métalliques de section rectangulaire ou similaire venant en contact à leurs extrémités sous la pression des doigts.
Dans la forme de réalisation représentée une pince selon l'invention comprend deux branches (1 et 2) constituées chacune de deux tiges (1A - 18) (2A - 2B) de section ronde (ou d'une autre section ou profil) s'amincissant vers l'extrémité active de la branche où ils se rejoignent.
Ces deux tiges de métaux différents (Acier, Inox,
Nickel, Maillechort ou Constantan par exemple) sont soudés au point de contact actif (1C) (2C) pour y former un couple thermo-électrique (lC) (2C) sensible aux variations de tem perature.
Nickel, Maillechort ou Constantan par exemple) sont soudés au point de contact actif (1C) (2C) pour y former un couple thermo-électrique (lC) (2C) sensible aux variations de tem perature.
Les deux branches (1 et 2) ainsi constituées sont immobilisées dans un bloc isolant (3) et leurs tiges peuvent dépasser vers l'arrière de celui-ci en servant de fiches de branchement sur un connecteur (4).
Les parties métalliques des branches qui sont soumises au courant de haute-fréquence, peuvent être plastifiées ou recouvertes d'un isolant (5) afin de protéger les doigts des utilisateurs des risques de brûlures par courant H.F.
Il est aussi possible de rigidifier l'instrument par un apport de matière non conductrice sur une partie ou sur la totalité des tiges constituant les branches.
Bien que les pinces droites de différentes longueurs soient les plus couramment utilisées, il est possible de réaliser, par ce mode de construction, des pinces coudées ou à baÏonnette par exemple,
Le connecteur (4) relié à un câble souple multiconducteur (6) relie la pince à un appareil de commande et de contrôle (7I et à un générateur H.F. (8? ces divers appareils pouvant éventuellement constituer un seul ensemble.
Le connecteur (4) relié à un câble souple multiconducteur (6) relie la pince à un appareil de commande et de contrôle (7I et à un générateur H.F. (8? ces divers appareils pouvant éventuellement constituer un seul ensemble.
L'appareil (7) comprend un, deux ou plusieurs moyens de contrôle (9) suivant la nature des thermocouples et leur montage;
Ainsi, la pince peut comporter un ou deux thermocouples de même nature ou de natures différentes.
Ainsi, la pince peut comporter un ou deux thermocouples de même nature ou de natures différentes.
Dans le premier cas, il existe un thermocouple et un moyen de contrôle à un ou deux seuils de température (arrêt seul ou déclenchement et arrêt).
Dans le second cas, il existe deux thermocouples et deux moyens indépendants de contrôle. l'un assurant le déclenchement, l'autre assurant l'arrêt.
Un dispositif contrôlant les deux thermocouples et des moyens de contrôle comportant des filtres H.F. et ne provoquant 1 arrêt que lorsque les deux thermocouples ont atteint un seuil préréglé. peuvent permettre le maintien d'une température plus uniforme.
Des modes de fonctionnement de l'ensemble pinceappareillage de commande et de contrôle peuvent être les suivants
Avec un thermocouple placé à l'extrémité active d'une branche de la pince, le fonctionnement du générateur H.F, . ( 8 ) peut être interrompu au seuil de température choisi et remis en service à un seuil de température minimal.
Avec un thermocouple placé à l'extrémité active d'une branche de la pince, le fonctionnement du générateur H.F, . ( 8 ) peut être interrompu au seuil de température choisi et remis en service à un seuil de température minimal.
Avec deux thermocouples, chacun étant sur l'extrémité active de l'une des branches; l'un de ces thermocouples interrompt le fonctionnement à un seuil de température maximale; l'autre thermocouple, à un seuil de température minimale, rétablit le fonctionnement. ceci en vue d'obtenir une régulation précise de la température
Suivant une autre possibilité. en intervenant sur le circuit lié au thermocouple interrompant le fonctionment à température minimale. le générateur H.F. peut être arrêté si l'utilisateur n'a pas placé la pince au contact des tissus du corps vivant humain ou animal, donc à leur température. le fonctionnement n'étant alors assuré qu'à cette température (environ 37-C par exemple).
Suivant une autre possibilité. en intervenant sur le circuit lié au thermocouple interrompant le fonctionment à température minimale. le générateur H.F. peut être arrêté si l'utilisateur n'a pas placé la pince au contact des tissus du corps vivant humain ou animal, donc à leur température. le fonctionnement n'étant alors assuré qu'à cette température (environ 37-C par exemple).
La pince peut éventuellement être pourvue d'une butée avec ou sans contact électrique pouvant avoir pour objet de commander automatiquement le fonctionnement du générateur H.F. selon l'écartement de ses branches.
Il est bien entendu, enfin, que la présente invention n'a été décrite et revendiquée qu'à titre d'exemple préférentiel et que l'on pourra apporter des équivalences dans ses éléments constitutifs sans, pour autant, sortir du cadre de l'invention,
Claims (11)
1. Pince chirurgicale à courant haute-fréquence monopolaire et bipolaire - comportant deux branches métalliques à extrémités actives, caractérisée en ce qu'au moins une des deux extrémités actives comporte un thermocouple (1C-2C) relié à un appareillage (7-8) interrompant ou régulant le courant haute-fréquence.
2. Pince selon la revendication t caractérisée en ce que chaque branche (1-2) est constituée de deux tiges (1A-1B) < 2A-28? soudés en extrémité active de la branche pour y former le thermocouple (1C-2C).
3. Pince selon l'une quelconque des revendications 1 et 2 caractérisée en ce que les deux branches (1-2) à deux tiges (1A-1B) (2A-2B) sont immobilisées dans un bloc isolant (3).
4. Pince selon la revendication 3 caractérisée en ce que les tiges (1A-1B) (2A-2B) dépassent du bloc isolant (3) pour servir de fiches de connexion.
5. Pince selon l'une quelconque des revendications 1 à 4 caractérisée en ce que, suivant la nature et le montage des thermocouples, l'appareillage comprend un, deux ou plusieurs moyens de contrôle (9).
6. Pince selon l'une quelconque des revendications 1 à 5 caractérisée en ce qu'elle comprend un thermocouple, l'appareillage comprenant un moyen de contrôle (9) à un ou deux seuils (arrêt seul ou déclenchement et arrêt).
7. Pince selon l'une quelconque des revendications 1 à 5 caractérisée en ce qu'elle comprend un thermocouple, le courant haute-fréquence étant interrompu à un seuil choisi de température et remis en service à un seuil de température minimale.
8. Pince selon l'une quelconque des revendications 1 à 5 caractérisée en ce qu'elle comprend deux thermocouples, l'appareillage comprenant deux moyens indépendants de contrôle (9) l'un assurant le déclenchement.
l'autre assurant l'arrêt.
9. Pince selon l'une quelconque des revendications 1 à 5 caractérisée en ce qu'elle comprend deux thermocouples, l'appareillage comprenant un moyen de contrôle (9) associé et des moyens de contrôle à filtres haute-fréquence ne provoquant l'arrêt que lorsque les deux thermocouples ont atteint un seuil préréglé,
10. Pince selon l'une quelconque des revendications 1 à 5 caractérisée en ce qu elle comprend un thermocouple à seuil minimal le courant haute-fréquence étant déclenché à une température correspondant à celle des tissus du corps du patient.
11. Pince selon 1 une quelconque des revendications 1 à 10 caractérisée en ce qu'elle comprend une butée avec ou sans contact électrique.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR8417545A FR2573301B3 (fr) | 1984-11-16 | 1984-11-16 | Pince chirurgicale et son appareillage de commande et de controle |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR8417545A FR2573301B3 (fr) | 1984-11-16 | 1984-11-16 | Pince chirurgicale et son appareillage de commande et de controle |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| FR2573301A1 true FR2573301A1 (fr) | 1986-05-23 |
| FR2573301B3 FR2573301B3 (fr) | 1987-04-30 |
Family
ID=9309686
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| FR8417545A Expired FR2573301B3 (fr) | 1984-11-16 | 1984-11-16 | Pince chirurgicale et son appareillage de commande et de controle |
Country Status (1)
| Country | Link |
|---|---|
| FR (1) | FR2573301B3 (fr) |
Cited By (249)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0295579A1 (fr) * | 1987-06-17 | 1988-12-21 | USSC (Deutschland) GmbH | Pince à ressort ou pincette en particulier pincette de coagulation |
| EP0386425A2 (fr) * | 1989-03-06 | 1990-09-12 | Mdt Corporation | Pince électrochirurgicale bipolaire |
| FR2647683A1 (fr) * | 1989-05-31 | 1990-12-07 | Kyocera Corp | Dispositif d'etanchement/coagulation de sang hors de vaisseaux sanguins |
| US5163937A (en) * | 1990-01-25 | 1992-11-17 | Transtech Scientific, Inc. | Waterproof body for cautery devices |
| US5443463A (en) * | 1992-05-01 | 1995-08-22 | Vesta Medical, Inc. | Coagulating forceps |
| EP0694291A1 (fr) * | 1994-07-28 | 1996-01-31 | Ethicon Endo-Surgery, Inc. | Procédé et dispositif pour le traitement électrochirurgical de tissu |
| US5496312A (en) * | 1993-10-07 | 1996-03-05 | Valleylab Inc. | Impedance and temperature generator control |
| US5558100A (en) * | 1994-12-19 | 1996-09-24 | Ballard Medical Products | Biopsy forceps for obtaining tissue specimen and optionally for coagulation |
| US5558671A (en) * | 1993-07-22 | 1996-09-24 | Yates; David C. | Impedance feedback monitor for electrosurgical instrument |
| US5562720A (en) * | 1992-05-01 | 1996-10-08 | Vesta Medical, Inc. | Bipolar/monopolar endometrial ablation device and method |
| FR2747242A1 (fr) * | 1996-02-22 | 1997-10-10 | Omega Engineering | Procede et dispositif de suppression a effet d'antenne, en particulier pour thermocouples et autres combinaisons differents de conducteurs metalliques |
| US5713942A (en) * | 1992-05-01 | 1998-02-03 | Vesta Medical, Inc. | Body cavity ablation apparatus and model |
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