RU33698U1 - Device for high-frequency electrosurgical endoscopic electro-excision of neoplasms of the gastrointestinal tract using high-frequency current in bipolar mode - Google Patents

Description

A device for conducting high-frequency electrosurgical endoscopic electro-excision of neoplasms of the gastrointestinal tract using high-frequency current in bipolar mode.

The device relates to medicine, namely to surgical endoscopy. A device is known for endoscopic electrosurgical operations on neoplasms of the gastrointestinal tract using a high frequency current in monopolar mode, which is a diathermic loop consisting of a fluoroplastic catheter with a conductive wire inside and, in fact, a loop on the distal part of the device, with the possibility of pulling the last from a catheter, for “throwing and fixing the neoplasm, followed by its removal using the monopolar high-frequency current mode ( our case, the analogy used electrosurgical loop diathermy SD-9L 11L with 2.8 mm in diameter. the OLYMPUS company, Japan). This device, in various modifications, has been used in operative endoscopy since 1970 / Tsuneoka, Uchida /, since 1973 in the USSR (Savelyev B.C. et al.). However, when working with this device, there is a danger of developing serious complications, the frequency of which reaches 7.5% of cases, mortality is up to 0.5%, and the vast majority of complications are associated with the use of high-frequency current in unipolar mode / V. S. Savelyev Guide to Clinical Endoscopy 1985, p. 272 273, K. Fastenmeier: High Frequensy Technology: Applications and Hazards. In. W. Mauermayer: Transurethral Surgery. Springer, Berlin Heidelberg New York, S. 47-60. So, up to 5.3% of cases after polypectomy there are bleeding (Savelyev BC et al., Kawai K., Moulinier B., Ottenjann R., Demling L.), up to 1% of cases - perforation of the walls of the stomach or intestines (Seifert E ., Demling L.), up to 1.3% of cases there are burns and necrosis

the mucous membrane outside the zone of polyps (Savelyev B.C. et al., Sokolov L.K. et al.). The complications caused by the use of high-frequency current in unipolar mode in endosurgery were addressed in a large section in the materials of the 18th Endourological symposium in Munich (Munchen, 18. bis 19. oktober 1990 s. 1-15). The presence of such a large number of complications of endoscopic polypectomy is directly related to the fact that in this case the current passes not only in the incision zone - coagulation, but in all directions around, damaging the surrounding tissue; this tissue is inversely proportional to their electrical resistance (K. Fasten-meier 1990 High-frequency technology in transurethral resection. 18 th Endourological Symposium in Munich s. 1-15).

The technical result is to provide the ability to conduct high-frequency electrosurgical endoscopic electro-excision of neoplasms of the gastrointestinal tract without complications caused by the use of high-frequency current in monopolar mode.

The technical result is ensured by the fact that the proposed device for conducting high-frequency electrosurgical endoscopic electroexcision of neoplasms of the gastrointestinal tract using a high-frequency current in bipolar mode contains two controllable articulated electrodes with the ability to remix | the distal part of the device by means of a longitudinal stirrer; along the axis of the device in the sagittal plane, both electrodes provided with current-insulating shells, are inside an electrically insulated Teflon housing and have electrical connectors at the proximal ends for connecting to opposite poles of a current source. Both electrodes are wire, with a cross-sectional diameter of not more than 0.08 cm., Which allows them to operate in cutting mode t at a current of up to 1000 Hz, a voltage of up to 300 Volts and a current of up to 0.5 A. and an active surface of not more than 30 mm .e. to carry out electroexcision of neoplasms by high frequency current in bipolar mode. In addition, both electrodes

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they have a distal working part free from a current-insulating sheath up to 5 cm long. They are connected at the distal end of the device with a current-insulating ball with a diameter of 3 mm, which is an obstacle to the breakdown of electric current between bipolar electrodes. In the working -extended state, the device at the distal end forms the shape of a wire loop up to 5 cm. diameter, which allows the device to be poured onto the neoplasm, with its subsequent capture and electro-excision using a high-frequency current in bipolar mode.

A device for conducting high-frequency electrosurgical endoscopic electro-excision of neoplasms of the gastrointestinal tract using a high-frequency current in a bipolar mode in combination with a bipolar high-frequency current source, equipped with two active electrodes, creating a cutting current discharge between the active electrodes, which makes it possible to perform endoscopic electro-excision of neoplasms with high accuracy the threat of damage to surrounding tissue spreading in all directions of high frequencies th current, as is the case when using a monopolar electrode.

The invention is illustrated by fnguramn: In FIG. 1 Scheme is a drawing of the proposed device. In FIG. 2 Device for conducting high-frequency electrosurgical endoscopic electro-excision of neoplasms of the gastrointestinal tract using high-frequency current in bipolar mode.

The device consists of a fluoroplastic catheter with a diameter of 2.8 mm. (H), inside of which two active electrodes (1.2) with current-insulating sheaths (4) pass, the length of the electrodes is 180 cm, the thickness is 0.08 cm. Both electrodes have proximal the ends of electrical sockets for connection to opposite poles of a current source. Both electrodes have a distal working part free of a current-insulating sheath (5,6) up to 5 cm long. They are connected at the distal end of the device with a current-insulating

3mm diameter rick. (7), which is an obstacle to the breakdown of electric current between bipolar electrodes. In the working - extended state, the device at the distal end forms the shape of a wire loop up to 5 cm. diameter. The active working part of the device is extended by means of a drive of longitudinal movement of the latch handle along the axis of the device in the sagittal plane. (see Fig. 1).

The device operates as follows:

The device through the working channel of a fibrogastroscope or fibrocolonoscope is brought to the neoplasm. A high-frequency current source is connected to the device’s handle-clamp, by means of two electrical connectors located on it. The distal part of the device is advanced by driving a longitudinal movement of the latch handle along the axis of the device in the sagittal plane, with a loop up to 5 cm in diameter, which is applied to the neoplasm using traditional methods, captures its base in the form of a stranglehold, and then the electric current is switched on in bipolar mode and electroexcision of the neoplasm is performed. Due to the fact that when using a high-frequency current in bipolar mode, the current acts between the active electrodes, and in our case the removed neoplasm is located between them, the best conditions are created for conducting electroexcision without the threat of current spreading to the surrounding tissues, therefore, without the threat of complications associated with the use of monopolar electrodes.

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Compiled by Antyuhin K.E.,

Claims (2)

1. A device for conducting high-frequency electrosurgical endoscopic electro-excision of neoplasms of the gastrointestinal tract using a high-frequency current in bipolar mode, containing two active electrodes, both of which are equipped with current-insulating shells and have electrical connectors at the proximal ends for connecting to opposite poles of the current source, characterized in that contains wire electrodes with a cross-sectional diameter of not more than 0.08 cm, with operating parameters of the current with a frequency d 1000 Hz voltage up to 300 V and current of up to 0.5 A and the active surface is not more than 50 mm. 2. The device according to claim 1, characterized in that both active electrodes at the distal end are connected by an isoelectric ball up to 0.3 cm in diameter with a loop forming up to 5 cm in diameter.