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EP3160377A1 - Instrument électrochirurgical et élément d'embouchure destiné à celui-ci - Google Patents

Instrument électrochirurgical et élément d'embouchure destiné à celui-ci

Info

Publication number
EP3160377A1
EP3160377A1 EP15728866.3A EP15728866A EP3160377A1 EP 3160377 A1 EP3160377 A1 EP 3160377A1 EP 15728866 A EP15728866 A EP 15728866A EP 3160377 A1 EP3160377 A1 EP 3160377A1
Authority
EP
European Patent Office
Prior art keywords
instrument
spacer
electrode
medial
proximal
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.)
Withdrawn
Application number
EP15728866.3A
Other languages
German (de)
English (en)
Inventor
Christoph Rothweiler
Eugen Herner
Christian Huber
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Aesculap AG
Original Assignee
Aesculap AG
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Aesculap AG filed Critical Aesculap AG
Publication of EP3160377A1 publication Critical patent/EP3160377A1/fr
Withdrawn legal-status Critical Current

Links

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
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/11—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis
    • A61B17/1114—Surgical instruments, devices or methods for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
    • 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
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00059—Material properties
    • A61B2018/00071—Electrical conductivity
    • A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00482—Digestive system
    • A61B2018/00494—Stomach, intestines or bowel
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/0063—Sealing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself

Definitions

  • the present invention relates to an electrosurgical instrument
  • End portions of the instrument industry acting distal spacers and at least one acting on a medial portion of the instrument brachial medial spacers is limited.
  • the two hollow vessel sections must be reconnected at their open ends so that a continuous course is formed. This is called an end-to-end anastomosis.
  • the two opened ends are e.g. sewn together with staplers again.
  • TFT tissue Fusion Technique
  • HF high-frequency technology
  • HF high-frequency technology
  • the tissue is heated during the welding process to temperatures above the protein denaturation temperature and brought into a gel-like state together with the intracellular and extracellular matrix.
  • the liquefied tissue cools to a fused mass, causing a secure connection of the tissue.
  • tissue caught between two clamping jaws is subjected to a current which flows between electrodes on the two clamping jaws.
  • the spacers are made of electrically nonconductive material to avoid a short circuit between the RF electrodes, a so-called coagulation shadow, ie the tissue sections in the region of or under the spacers, is encapsulated in the area of these spacers, thus not or only Insufficient power is applied to it and there is no satisfactory welding of the vessel sections.
  • the object of the present invention is to provide an instrument which improves the result of an end-to-end anastomosis of hollow vessels, in particular of hollow vessels such as small and large intestine, or generally in tissue connections by means of a thermofusion technique, in particular ensures a parallel alignment of the RF electrodes without damaging the tissue and has increased reliability.
  • an electrosurgical instrument with a jaw part of mutually movable instrument branches, on whose mutually facing sides in each case one or more electrode surfaces is or are or is or are formed, wherein the movement of the instrument branches relative to each other by a proximal to End portions of the instrument industry acting proximal (first) spacers, one acting on distal end portions of the instrument branches distal (second) spacers and at least one acting on a medial portion of the instrument brachial medial (third) spacers is limited, wherein the medial spacer is formed by at one Electrode made of their electrode surface elevating stop made of electrically conductive material and is electrically connected to the electrode and connected to an electrically insulating insulating component on the Elek troden constitutional the opposite electrode cooperates and the proximal spacers and / or the distal spacer are of electrically non-conductive material.
  • An inventive coagulation instrument for surgical purposes of the pertinent genus has in one embodiment against each other (preferably scissor or mouth-like) movable instrument industries, each with one or more electrode surfaces on the respectively facing industry sides.
  • Proximal and distal spacers are formed of an electrically non-conductive material.
  • Medial spacers have at least one projection of electrically conductive material holding the opposing electrode surfaces at a distance from each other. This is preferably provided directly integrally with the electrode, for example by embossing or punching or formed or fixed thereto, for example by welding or soldering.
  • an insulating member preferably in the form of a pad or pins of electrically non-conductive material inserted into a corresponding recess or placed / glued on / to form a contact surface for a conductive medial spacer, so that this has conductive material, the
  • two opposite electrodes electrically isolated from each other.
  • the embodiment according to the invention ensures that the distance of the opposing electrode surfaces over the entire electrode surface is uniform.
  • the advantage can be exploited that due to the use of conductive spacers in the medial region of the electrodes, a uniform, homogeneous current distribution, in particular to a uniform current density, in between the electrodes clamped tissue comes while also non-conductive spacers in the distal and proximal marginal areas of the electrodes are placed where coagulation shadows are less relevant. It can be a uniform
  • Non-conductive spacers in the central region of the electrode so can be particularly well avoided, with a parallel alignment of the electrodes is always guaranteed. Furthermore, by means of the non-conductive spacers in the proximal and distal edge regions of the electrodes, relatively large-area electrically insulating bearing surfaces can be formed, so that a more uniform
  • Electrode distance can be set and the risk of short circuits in not fully covered electrodes can be reduced. Another advantage is that the size or area of the insulation component or the insulation components of the medial
  • Coagulation shadow secure tissue fusion by always parallel alignment of the electrodes to each other, secure tissue fusion through a clearly defined
  • Electrodes and prevention of short circuits in partially covered electrodes are Electrodes and prevention of short circuits in partially covered electrodes.
  • the medial spacers on the electrode surfaces can be arranged directly or fixed on it and made of an electrically conductive material, for example in one piece / soldered / welded to the relevant electrode / connected.
  • On or at the respectively opposite electrode is provided or arranged for each medial spacer a non-conductive insulating member on which the respective electrically conductive medial spacer is supported with the instrument closed.
  • the electrically conductive medial spacer is preferably knob-shaped.
  • the electrically insulating insulating components for example in the form of glued, applied, inserted or filled pads / plates / pins formed substantially flat to the electrode surface, so have no or only a slight projection to the respective electrode surface and can not or only with difficulty from the electrode surface be detached / demolished. Accordingly, each of the insulating components can be dimensioned smaller than an electrically non-conductive medial spacer according to the prior art in terms of the surface dimensions, since of the insulating component due to low to absent
  • the medial spacers themselves can be made of a material such as metal, which withstands high shear forces, so that they can also be small in size. This contributes overall to avoid coagulation and at the same time to increase the reliability.
  • insulation components in the form of pads or pins are inserted into corresponding recesses or recesses (depressions) on the surface of the respective electrode, so that they are substantially planar
  • each insulation component is designed in the form of a pin with a flat
  • the electrodes have a predetermined distance from each other over their entire length and thus preferably run parallel to one another. Due to the large distance of the spacers or their Einwirkstellen in industry longitudinal direction, the parallelism of the instrument industries and attached electrode surfaces is improved, as this possible manufacturing tolerances in the formation of the spacers only minor impact on the
  • Damage to tissue and its inhomogeneous penetration of HF energy can be further minimized in one embodiment of the invention by applying as small a number of medial spacers as possible to each electrode surface.
  • the instrument has two or three medial spacers, more preferably exactly one medial spacer.
  • Instrument industries of such a coagulation clamp thus provide an optimal compromise between maximum parallel alignment of the RF electrodes in the closed position of the branches on the one hand and homogeneous tissue fusion with minimal tissue damage on the other hand. Therefore, caused by the spacers tissue damage as a result of excessive force on the clamped tissue prevented and a secure fusion of the individual tissue components by constant force ratios, by the parallel arrangement of the electrodes, by the well-defined spacing of the electrodes and by the homogeneous current distribution in the tissue along ensures the electrodes.
  • the non-conductive proximal and distal spacers due to the special arrangement of the non-conductive proximal and distal spacers, the
  • Spacers of electrically nonconductive material are disposed only outside of an area provided for the treatment of the tissue at the proximal and distal ends of the branches.
  • non-conductive spacers act only on the proximal and distal end portions of the instrument branches and are free of non-conductive spacers in the medial area of the instrument branches, which is typically the actual treatment area of the tissue, they are typically caused by them
  • At least one spacer in particular the proximal spacer, is realized in the form of a spacer module formed separately from the instrument branches.
  • This can have at least one electrically non-conductive material tongue, which is clamped in a closed position of the instrument industries between them. The height of the material tongue therefore corresponds to a predetermined
  • a separate spacer module of this type has several advantages. On the one hand, this can be done easily and independently of the respective one
  • Instrument industries in the closed position can be varied.
  • the physical separation of instrument branches and spacers thus has the advantage that the same spacer module can be provided for different instrument branches or different spacer modules for the same instrument branches.
  • the coagulation shadow effect is less in the case of a loosely held and between the electrode surfaces in the closed position of the industries clamped material tongue, as in the case of one on the electrode surfaces fixed spacer, even if the spacer is made of electrically conductive material and cooperates with an insulating member made of electrically non-conductive material.
  • the spacer module may have a plurality of laterally or transversely of the
  • Branches spaced apart material have, for. to save a provided between two Koagulationselektroden lake electrical cutting section.
  • At least one of the instrument branches can be pivotally mounted, for example, on an instrument shaft or on the opposite branch and can be actuated via a handling mechanism (mounted in the instrument shaft and / or in the grip) in order to move the instrument sectors counter to and away from each other.
  • the spacer module can rotatably in a pivot joint of the actuated (stored)
  • At least one of the instrument branches preferably the pivotable one, may be used
  • this solution has the advantage that the spacer, at least in the proximal end portion of the branches, is completely outside the clamping area of the instrument branches, i. outside the tissue treatment area
  • Electrodes can be arranged and there is no contact between the spacer and the tissue to be treated. In this way damage to the tissue can be safely prevented.
  • a spacer in particular the distal spacer, can be formed by a (knob-shaped) projection arranged outside the electrode surfaces, in particular between two electrode surfaces, and pointing towards the other instrument branch. Consequently, if this spacer is not arranged on the electrode surfaces, but next to or in between, no coagulation shadows develop in this region, in particular because then the spacer (s) need not be made of insulating material.
  • the spacer is disposed between the electrode surfaces, particularly when it is disposed on the central axis of one of the instrument branches, without direct contact with the electrode surfaces, there is no electrical
  • One or more spacers may be formed by only one protrusion directly provided / fixed on an electrode surface or by a plurality of respectively different electrode surfaces. This ensures, on the one hand, a parallel alignment of the electrodes in the longitudinal direction and, on the other hand, keeps the number of spacers fixed on the electrode surfaces small, whereby an optimal treatment, in particular a homogeneous fusion of the
  • At least one instrument sector may additionally comprise one or more knob-shaped elevations whose height is less than the height of the spacers, in particular 10% to 75% of the height of the spacers Spacer is.
  • Fig. 1 shows an electrosurgical instrument according to a first
  • Fig. 2 shows an electrosurgical instrument according to a second
  • Embodiment of the invention shows a perspective view of two (scissor-like) pivotable instrument branches of the electrosurgical instrument with an enlarged view of a spacer module;
  • Fig. 4 shows a side view of the two instrument branches of Figure 3 in an open position.
  • Fig. 5 shows a side view of the two instrument branches of Figure 3 in a closed position.
  • Figures 6A, 6B, 6C show detail views A, B and C of Figures 4 and 5, respectively.
  • FIG. 7 shows a perspective view of two instrument sectors of an electrosurgical instrument which can be pivoted relative to one another according to the invention
  • Fig. 8 shows a side view of the two instrument branches of Fig. 7 in a closed position
  • Figs. 9A, 9B and 9C show detail views A, B and C of Fig. 8;
  • FIGS 10, 11 and 12 show medial spacers in different
  • Fig. 13 shows an electrosurgical instrument according to another
  • Fig. 14 shows the detail view of a spacer and an insulating member according to a first embodiment of the invention
  • Fig. 15 shows the detail view of a spacer and an insulating member according to a second embodiment of the invention.
  • Fig. 16 shows a detailed view of a spacer and an insulating member according to a third embodiment of the invention. Detailed description of preferred embodiments
  • Fig. 1 shows a perspective view of a laparoscopic
  • electrosurgical instrument 1 according to a first embodiment of the invention with a jaw part consisting of a pair of preferably scissor or forceps like each other moving instrument branches 2 and 3 in an open
  • an instrument shaft 4 which in turn is rotatably mounted via a manually operable shaft rotator 5 to a handle or handling part 6.
  • a manually operable shaft rotator 5 about the shaft rotator 5, the shaft 4 and arranged thereon Instrument industries 2 and 3 are rotated relative to the handling part 6 about the shaft longitudinal axis.
  • the handling part 6 has a manually operable handle or trigger guard 7, which is pivotally movable relative to a handpiece or pistol grip 8 fixedly connected to the handling part 6.
  • the instrument branches 2, 3 or at least one manually operable instrument branch 3 are connected via a (not shown)
  • Actuating mechanism e.g. a cable or a push rod within the instrument shaft 4, in operative connection with the handle e and can be brought by manual operation of the handle 8 preferably continuously from an open to a closed position (and vice versa).
  • the handling part 6 Via a line or electrical wiring 9 (only partially shown), the handling part 6 is connected to an RF energy source (not shown) in order to apply an RF voltage to the electrothermal treatment of tissue between the instrument branches 2 and 3.
  • FIG. 3 and 4 now show the distal end of the shaft 4 and the jaw part connected to the shaft 4 with the instrument branches 2 and 3 in an open position in detail.
  • Instrument industry 2 is pivotable about a transverse axis A at the distal end of the shaft 4 via a proximal pivot hinge or hinge 10 (see FIG. 4) stored.
  • the distal shaft end or jaw part connected thereto has a centrally formed passage slot or longitudinal gap 11 extending along the shaft, whose side cheeks each have a (co-axially aligned) transverse bore which defines the aforementioned transverse axis A.
  • the passage slot 1 1 further has a slot width which allows the movable / pivotable insertion of the first instrument industry 2 therein.
  • the distal shaft end or jaw part forms a half-shell or channel-shaped support projection or support 12, which is opposite the rotatable upper instrument industry and at its distal end portion has a passage transverse bore, substantially parallel to the transverse axis A.
  • cupped support projection 12 (axially) received, so that it protrudes over the remaining part length section axially beyond the support projection 12 in the distal direction.
  • the lower instrument industry 3 is pivotally articulated centrally on the support projection 12 via the distal through-cross bore in the manner of a rocker.
  • a spring mechanism not shown (see, inter alia, also WO 201 1/097469 A2) is the front or distal rocker part of the lower
  • Embodiment preferably two in the sector transverse direction from each other spaced, in industry longitudinally substantially parallel
  • Electrodes or electrode surfaces 14, 15, 16, 17, which can be acted upon with RF voltage. As a result, tissue is between the
  • Electrodes 14, 15, 16, 17, separate or welded.
  • a special electrosurgical knife (not shown) or a corresponding cutting device, which is electrically insulated from the electrode surfaces 14, 15, 16, 17, can also be arranged between the electrode surfaces 14, 15, 16, 17.
  • Electrode surfaces 14, 15, 16, 17 remain substantially evenly spaced from each other in the closed position.
  • the instrument 1 therefore has at the distal end portion of the lower instrument industry 3 (and / or the upper
  • knob-shaped projection 18 which is connected to the upper
  • Instrument industry 2 comes into abutment when closing the jaw part and so as a spacer to the distal
  • This spacer module 19 is presently a cam-shaped component with a proximal bearing portion (cam portion with through-cross bore), which with the pivot joint
  • Instrument industries 2 and 3 thus can rotate freely about the pivot axis A.
  • the movable upper (and / or the lower) sector 2 is hollowed out at its proximal end section in the region of the pivot axis A in the longitudinal direction, resulting in a type of receiving space or longitudinal groove which Dimensions for receiving therein the spacer module 19 are sufficient. That is to say, at least in the closed position of the jaw part, the spacer module 19 is accommodated between two slot cheeks of at least one actuatable instrument branch 2.
  • Fig. 3 shows an enlarged perspective view of the spacer module 19 alone.
  • the module 19 has a camshaft shape with the proximal bearing portion in which the cam has such a cam thickness / height as to be retractably movable in the proximal longitudinal groove of the one branch 2.
  • the transverse passage bore 20 is further formed. On the storage section
  • Tongue thickness / height H to be achieved minimum distance S (gap) between the opposite electrode surfaces 14 and 16 or 15 and 17 in
  • Sector transverse direction and width essentially corresponds to the parallel spacing and the width of the electrode surfaces 14, 15, 16, 17, so that the material tongues 21 at least partially come to lie on the electrode surfaces 14, 15, 16, 17.
  • a longitudinal slot 22 open at the distal end of the module 19 is formed in the cam-shaped module 19, which extends as far as the bearing section and ends immediately in front of the transverse bore 20.
  • the entire spacer module 19 or at least the material tongues 21 are in this
  • Embodiment made of electrically non-conductive material made of electrically non-conductive material.
  • Figures 4 and 5 show a side view of the jaw part or the
  • FIGS. 6A, 6B and 6C show detailed views of the jaw part according to FIGS. 4 and 5.
  • Spacer module 19 loosely rest on a proximal end portion of the electrode surfaces 16 and 17 of the lower instrument industry 3 when the jaw part in Open position is.
  • the material tongues 21 of the separate spacer module 19 become between the proximal end portions of the electrode surfaces 14, 15, 16, 17 of the two instrument branches 2 and 3 are clamped (see FIG. 6B) and the projection 18 at the distal end section of the lower instrument sector 3 comes into abutment with the distal end section of the upper instrument sector 2.
  • the proximal and distal end sections and thus also the entire electrode surfaces 14, 15 remain 16, 17 by the predetermined gap S of each other and substantially parallel to each other objected.
  • the (knob-shaped) projection 18 is interposed between the electrodes and thus comes into direct contact with the upper actuatable sector 2 (and not with the upper electrode surfaces of branch 2).
  • the proximal material tongues 21 are not fixed directly on the electrode surfaces but are only applied to them. In the first embodiment, therefore, no spacer is located directly on one of the electrode surfaces 14, 15, 16, 17 (in the sense of being fixed thereon). With that you can
  • FIG. 7 shows an embodiment of the laparoscopic electrosurgical instrument 1 in a perspective view.
  • FIG. 8 shows the distal end region of the instrument of FIG. 7 in a lateral view.
  • FIGS. 9A, 9B and 9C show enlarged cutouts, which are respectively identified in FIG. Fig. 9A shows a medial spacer, Fig. 9B a distal spacer, and Fig. 9C a proximal spacer.
  • On the electrode surface 14 of the instrument 1 at the distal end a projection 18 and on the electrode surface 17 at the distal end a projection 13 is arranged, in particular directly (ie fixed fixed) on the distal end portions of the electrode surfaces 14 and 17.
  • the projections 13 and 18 form non-conductive distal spacers according to the invention.
  • the projections 13, 18 made of an electrically non-conductive material manufactured. You can therefore either directly with the respective opposite electrode surface in contact and thus come into contact or indirectly, for example via insulation components not shown in Figure 7, in particular on the respective opposite electrode (exclusively) in the region of the respective projection (dot / pad-shaped) can be provided.
  • the projections 13, 18 as well as possibly provided insulation components can be formed by spraying, applying, filling a hardening mass or by sticking or inserting a lsolationsplättchens / -pads / -pins preferably in a recess in the respective electrode, as shown in more detail below is described.
  • Proximal spacers in the form of material tongues 21 of a spacer module 19, which has already been described with reference to FIGS. 3 to 6, to which description reference is made, are formed in the proximal end section of the instrument branches 2, 3.
  • opposite electrode surface 16 are in a corresponding position three equally spaced, electrically conductive projections 26, 27, 28 are formed.
  • In the medial portion of the electrode surface 15 are also three equally spaced, electrically conductive projections 29, 30, 31 formed, while on the opposite electrode surface 17 in
  • FIG. 13 shows an electrosurgical instrument 102 according to another embodiment, which differs from the instrument 1 described above in FIG.
  • the handle or the handle has a kind of receiving shaft from which protrude the instrument industries axially and distally. This shaft is dimensioned so that the instrument industries in their
  • Manhole opening advanced, move the instrument industries out of the shaft and open it preferably automatically, for example, due to a spring preload.
  • the shape and size of the chewers can be selected as desired, as long as all spacers are coordinated so that the distance between the electrode surfaces is always the same at all points.
  • the spacer can also be pyramid (dull), cylindrical or cube-shaped.
  • Spacer module may eventually be arranged in several juxtaposed
  • the spacers or protrusions 300 are preferably formed from an electrically conductive material (ie electrically conductive), preferably integrally with an associated, associated electrode 360.
  • the respective projection 300 can by appropriate punching and bending or by (selective) embossing / pressing out the electrode 360 itself be made.
  • an opposite electrode 370 (the other branch) are formed in the region of the projection 300 plate or disc-shaped recesses or recesses 372. These recesses 372 also have a central blind or through hole 374 in the electrode 370 extending in the thickness direction of the electrode 370. In this way, in the longitudinal section according to FIGS. 14 to 16, a kind of mushroom-shaped recess is formed in the relevant electrode 370.
  • a pin / plug or plug is used as an insulating member 350 made of electrically non-conductive material whose shape of the recess in
  • Substantially exactly adapted and defines the insulation component it is also possible to inject into the recess a potting compound of electrically non-conductive material which cures thereon.
  • the plug 350 terminates substantially flat with the surface of the respective electrode 370. In this way, the plug 350 does not form an external point of attack in order to be able to be pulled out of the recess if necessary. Furthermore, the outer surface of the plug 350 is in
  • FIG. 15 and 16 each show alternative embodiments for the plug 350 (insulating component), according to which a concave outer surface is provided on the plug 350 according to FIG. 15, which effects a better centering of the opposite projection 300 during compression of the branches or according to FIG Fig. 16 of Plug 350 is opposite the surface of the relevant electrode (slightly) reset in order to avoid a supernatant in any case.
  • the insulating component may in principle also have a different shape than the stopper 350 shown. So it is possible, the insulating component exclusively flat, i. platelet-shaped. It is also possible to make the plug 350 pyramidal or conical. As a material for the insulating component, a ceramic or a plastic offers. Also, between the insulating member (in particular the plug 350) and the
  • Electrode 370 may be provided an intermediate layer, the heat-related
  • Isolation component compensates and so breaking or swelling of the

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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

L'invention concerne un instrument électrochirurgical comprenant un élément d'embouchure constitué de branches d'instrument mobiles l'une par rapport à l'autre, sur chacune desquelles une ou plusieurs surfaces d'électrode sont disposés/configurés en vis-à-vis, le mouvement des branches de l'instrument l'une par rapport à l'autre étant limité par au moins une entretoise proximale agissant sur des parties d'extrémité proximales des branches de l'instrument, au moins une entretoise médiane agissant sur une partie médiane et au moins une entretoise distale agissant sur des parties d'extrémité distales des branches de l'instrument. Selon l'invention, l'entretoise proximale et/ou l'entretoise distale sont réalisées à partir d'une matière électriquement non-conductrice et l'entretoise médiane constituée d'au moins une électrode est fabriquée à partir d'une matière électriquement conductrice et est reliée électriquement à l'électrode. En outre, l'une entretoise médiane coopère avec un élément isolant local en matière non-conductrice qui est disposé de manière électriquement isolante sur au moins une électrode opposée.
EP15728866.3A 2014-06-25 2015-06-15 Instrument électrochirurgical et élément d'embouchure destiné à celui-ci Withdrawn EP3160377A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102014108914.6A DE102014108914A1 (de) 2014-06-25 2014-06-25 Elektrochirurgisches Instrument und Maulteil hierfür
PCT/EP2015/063284 WO2015197395A1 (fr) 2014-06-25 2015-06-15 Instrument électrochirurgical et élément d'embouchure destiné à celui-ci

Publications (1)

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US20170135751A1 (en) 2017-05-18
WO2015197395A8 (fr) 2016-02-11
JP2017518825A (ja) 2017-07-13
DE102014108914A1 (de) 2015-12-31
CN106456248A (zh) 2017-02-22
WO2015197395A1 (fr) 2015-12-30
JP6652940B2 (ja) 2020-02-26

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