[go: up one dir, main page]

WO2004105625A1 - Ciseaux chirurgicaux isoles avec pointe de cauterisation - Google Patents

Ciseaux chirurgicaux isoles avec pointe de cauterisation Download PDF

Info

Publication number
WO2004105625A1
WO2004105625A1 PCT/US2003/014618 US0314618W WO2004105625A1 WO 2004105625 A1 WO2004105625 A1 WO 2004105625A1 US 0314618 W US0314618 W US 0314618W WO 2004105625 A1 WO2004105625 A1 WO 2004105625A1
Authority
WO
WIPO (PCT)
Prior art keywords
cutting
blades
cutting blades
electrically
pair
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.)
Ceased
Application number
PCT/US2003/014618
Other languages
English (en)
Inventor
John M. Levin
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.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Priority to PCT/US2003/014618 priority Critical patent/WO2004105625A1/fr
Priority to AU2003235482A priority patent/AU2003235482A1/en
Publication of WO2004105625A1 publication Critical patent/WO2004105625A1/fr
Anticipated expiration legal-status Critical
Ceased 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
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00107—Coatings on the energy applicator
    • 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
    • A61B2018/1412—Blade
    • A61B2018/1415—Blade multiple blades
    • 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

  • This invention relates generally to the field of insulated surgical scissors and more particularly to both monopolar and bipolar scissors constructions that can be specifically adapted for use in laparoscopic, endoscopic and open surgery surgical procedures.
  • Insulated forceps, biopsy devices and clamping devices having the capability of providing a coagulating function are known in the art. These devices provide a significantly different function and have different design considerations than insulated scissors of the type forming the subject matter of this invention.
  • forceps are principally designed to grip and hold tissue and/or organs during a surgical procedure; not to sever tissue between cooperation cutting edges of blades that move past each other to provide the severing operation, as in the operation of scissors within the scope of this invention.
  • This prior art directed to the construction and design of insulated, cauterizing forceps are not relevant to the insulated scissors of this invention.
  • Representative surgical forceps are disclosed in United States Patent Nos.
  • Biopsy instruments also provide a significantly different function, and have different design considerations than the insulated scissors of the type forming the subject matter of this invention.
  • biopsy devices are designed to separate and remove (often within a closed compartment of the device) portions of body tissue, growths, etc. from a patient's body.
  • the function of insulated scissors within the scope of this invention is to sever tissue or other body parts between relatively movable cutting blades, without necessarily having any separate capability to confine the severed tissue and/or body part and remove it from the patient's body.
  • prior art directed to the construction and design of insulated, cauterizing biopsy devices are not relevant to the insulated scissors of this invention.
  • Representative surgical biopsy devices are disclosed in the following publications: U. S. Patent No. 5,373,854 (Kolozsi); U.S. Patent No. 5,295,990 (Levin); and European Patent Application 0 593 929 A1 (United States Surgical Corporation).
  • the apparatus disclosed by Stone is a bipolar electro surgical instrument comprising jaws fabricated from an insulating material having conductive pathways. These conductive pathways permit sparking between the pathways when the jaw members are open. As the jaw members are brought together, the insulating jaw member material blocks the electrical path between the conductive pathways to terminate electrical treatment of tissue trapped between the jaw members.
  • the apparatus disclosed by the Rydell patents are surgical scissors with a bipolar coagulation feature.
  • the scissors disclosed therein comprise a pair of opposed blade members pivotally joined to one another through an insulated bushing member.
  • Each of the blade members comprises a blade support and a blade, each fabricated from a metal but yet separated by a dielectric bonding agent.
  • Cutting is performed at the blade level and cauterization occurs through the passage of electricity from one blade support and through the tissue to the other blade support. In other words, the passage of electricity is not through either of the blades that cut the tissue. Instead, electricity flows from one blade support (above and below the cut made by the blades), through the tissue trapped between the blade members, and into the other blade support.
  • the apparatus disclosed by Tidemand is a combination bipolar scissors and forceps instrument.
  • the scissors disclosed therein comprises a pair of interfacing blade surfaces.
  • Each of the interfacing blade surfaces comprises an insulative ceramic layer of approximately 0.020 inches.
  • a gap of approximately 0.040 inches is created between the interfacing scissors surfaces.
  • the apparatus disclosed by Smith, et al. is a disposable laparoscopic scissors utilizing cobalt-based alloy scissor elements that can be double acting (two movable jaws) or single acting (a single movable jaw in combination with a fixed jaw) and includes a plastic shrink wrap applied to the aluminum tube.
  • the apparatus disclosed by Smith, et al. ('256) is also a disposable laparoscopic scissors that can be double acting or single acting and includes plastic shrink wrap applied to the aluminum tube and portions of the actuation means at the working end of the instrument to electrically insulate the instrument.
  • the apparatus disclosed by Bhatta is a scissors-like surgical instrument with a cutting and cauterizing heat source such as a hot wire element or a laser transmission fiber carried in at least one of the jaws members.
  • the apparatus disclosed by Lyons, II I is a rotary cutting scissors for microsurgery that includes an internal fiber light source for illuminating the surgical area.
  • the apparatus comprises: a pair of opposing electrically conductive cutting blades pivotally connected to allow for shearing action of any tissue confined between opposed cutting edges of the cutting blades wherein the blades have blunted tips and wherein the pair of opposing cutting blades are entirely covered with an electrically and thermally insulative material except at the blunted tips; and a power source coupled to at least one of said pair of opposing cutting blades for electrically and thermally energizing at least one of said pair of blades.
  • the apparatus comprises: a pair of opposing electrically conductive cutting blades pivotally connected to allow for shearing action of any tissue confined between opposed cutting edges of the cutting blades wherein the is entirely covered with an electrically and thermally insulative material including its blunted tip and the other one of the pair of opposing cutting blades is entirely covered with an electrically and thermally insulative material except at its corresponding blunted tip; and a power source coupled to at least one of the pair of opposing cutting blades for electrically and thermally energizing at least one of the pair of blades.
  • the apparatus comprises: a pair of opposing electrically conductive cutting blades pivotally connected to allow for shearing action of any tissue confined between opposed cutting edges of the cutting blades wherein the blades have blunted tips and wherein the pair of opposing cutting blades is entirely covered with an electrically and thermally insulative material except on confronting surfaces at the blunted tips; a power source having a power side that is electrically coupled to one of the pair of opposing cutting blades and having a ground side that is electrically coupled to the other one of the pair of opposing cutting blades for generating a cauterization current that flows through tissue trapped between the confronting surfaces at the blunted tips.
  • FIG. 1 is a fragmentary, isometric view of a monopolar insulated surgical scissors of the present invention
  • Fig. 1 A is an enlarged view of the working end of the insulated surgical scissors of Fig. 1 ;
  • Fig.2 is an enlarged, cross-sectional view of the insulated surgical scissors taken along line 2-2 in Fig. 1A, but with the blades in a partially-closed position;
  • Fig.3 is an enlarged, cross-sectional view of the insulated surgical scissors taken along line 3-3 in Fig. 1A;
  • Fig.4 is an enlarged, cross-sectional view of the insulated surgical scissors taken along 4-4 in Fig. 1 A, but with the blades in a partially-closed position;
  • Fig. 5 is an enlarged, cross-sectional view of the working end of a second embodiment of the monopolar insulated surgical scissors, taken along a line corresponding to the location of line 2-2 in Fig. 1 A, whereby the blade tips do not pass when the blades are in a closed position;
  • Fig. 6 is an enlarged, cross-sectional view of the working end of a third embodiment of the monopolar insulated surgical scissors, taken along a line corresponding to the location of line 2-2 in Fig. 1A, whereby the blade tips abut each other in the closed position;
  • Fig. 7 is an enlarged, cross-sectional view, taken along line 7-7 in Fig. 9, of the working end of a fourth embodiment of the monopolar insulated surgical scissors whereby a sliver on the inside surface of each blade is exposed;
  • Fig. 8 is an enlarged, cross-sectional view of the working end of a fifth embodiment of the monopolar insulated surgical scissors, taken along a line corresponding to the location of line 2-2 in Fig. 1 A, whereby only one of the blades has an exposed tip;
  • Fig. 9 is an enlarged, partial isometric view of the working end of the fourth embodiment of the monopolar insulated surgical scissors showing the position of an exposed sliver on the inside surface of the upper blade and an exposed sliver on the inside surface of the lower blade; alternatively, these slivers could be on the outside surface of the blades, as shown in phantom in the lower blade;
  • Fig. 10 is an enlarged, cross-sectional view of the working end of the embodiment of Fig. 9 taken along line 10-10 in Fig. 9;
  • Fig. 11 is enlarged, partial isometric view of the working end of either a monopolar or a bipolar surgical scissors having the extreme tip on the inside surfaces of the blades exposed;
  • Fig. 12 is an enlarged, cross-sectional view taken along line 12-12- in Fig. 11 showing the blade tips overlapping and the scissors in a closed position;
  • Fig. 13 is an enlarged, cross-sectional view of the blades in Fig. 11 including a set-back feature at the extreme tip of the blades showing the blades in a closed position;
  • Fig. 14 is an enlarged, cross-sectional view of the connecting pivot fastener taken along line 14-14 in Fig. 15;
  • Fig. 15 is an enlarged, side view of the working end of a bipolar configuration of the insulated surgical scissors.
  • Fig. 16 is an enlarged, cross-sectional view of the of the bipolar insulated surgical scissors taken along line 16-16 in Fig. 15.
  • an insulated monopolar surgical scissors constructed in accordance with the present invention is shown generally at 320 in Fig. 1.
  • the insulated monopolar surgical scissors 320 comprises a pair of opposed cutting blades 322 and 324.
  • the insulated surgical scissors 320 is electrically energized for accomplishing the coagulation of blood vessels and/or other tissue that have been severed during the cutting operation.
  • the scissors 320 comprises a monopolar configuration, i.e., electrical energy is delivered from a power source (not shown) via a first electrical conductor (also not shown) to the scissors blades 322 and 324 (each comprising a metal such as stainless steel for conducting electricity), with both blades 322 and 324 being at the same voltage.
  • the return for the electrical energy from the scissors 320 is through the patient (not shown) to a large surface (e.g., a conducting plate, not shown) located underneath the patient and then back to the power source via a second electrical conductor (not shown) , as is well-known in the art, such as that shown in Fig. 1 of U.S. Patent No. 5,827,281 (Levin), which has already been incorporated by reference in its entirety.
  • the first electrical conductor enters the insulated surgical scissors 320 at the proximal end, i.e., adjacent an actuation/handle portion 325 of the scissors 320.
  • the first conductor is fed through the insulated surgical scissors 320 where the first conductor passes the electrical energy to the blades 322 and 324 via a conductive pivot fastener 327.
  • this pairof opposed cutting blades 322 and 324 are completely insulated, except for one or more surfaces at the distal end of the scissors 320, as will be described in greater detail hereinafter.
  • the opposed cutting blades 322 and 324 of the scissors 320 include rounded or blunted distal edges to preclude the cutting of tissue trapped between the blades at the distal end.
  • the complete insulation may be accomplished by an electrically and thermally insulative layer 329 (e.g., using a ceramic material or readily available liquid electrical insulation material) applied to each blade 322 and 324 while masking the one or more surfaces to create the selected uninsulated (i.e., conductive) surfaces.
  • the insulative layer 329 can be applied to the blades 322/324 in their entirety and then removed, e.g., by filing, grinding, etc., from the distal end regions that are intended to be conductive for providing the electrical cutting or cautery operation.
  • any or all surfaces at the distal end of one or both of the blades 322 and 324 can be made conductive to provide either an electrical cutting or cauterizing operation.
  • the inner side surface (326/328), the upper edge surface (330/332), the outer side surface (334/336), the lower edge surface (338/340), and the distal end surface (342/344) in the distal region of one or both blades 322 and 324 can be conductive to provide an electrical cutting or cauterizing operation.
  • the blades 322 and 324 are closed by the surgeon using the handle portion 325 in a conventional manner.
  • Fig. 2-partial closure the exposed tips of the blades 322 and 324 approach each other (Fig. 2-partial closure) and then overlap during full closure (not shown) so that inside surfaces 326 and 328 are adjacent each other.
  • Figs. 3-4 depict how the insulated proximal or back portion of the blades 322 and 324 approach each other and then overlap during closure. It should be understood that, alternatively, only one or more of such surfaces (i.e., the inner side surfaces 326/328, the upper edge surfaces 330/332, the outer side surfaces 334/336, the lower edge surfaces 338/340 and the distal end surfaces 342/344, collectively referred to as the "candidate" surfaces) can be selectively conductive to provide a cauterizing operation.
  • the inwardly facing surfaces (326/328) at the distal ends of the cutting blades 322/324 are electrically conductive to provide an electrical cutting or cauterizing operation, they are operated by either purchasing the tissue to be cut or cauterized between them or the cutting or cauterizing operation is carried out with the scissors 320 in an open condition.
  • the conductive region of the tip is located in a region which is no more than 5 millimeters from the distal edge of the blades 322/324 (i.e., from the distal end surfaces 342/344 back towards the conductive pivot fastener 327), and more preferably is in the forward, or most distal 1 -3 millimeters of the blades 322/324 (see Fig. 11).
  • Fig. 5 depicts a similar type of monopolar scissors as shown in Figs. 1-4 but in the embodiment of Fig. 5, the uninsulated tip regions do not pass each other when the scissors 320 is in its fully-closed position. Instead, the lower edge surface 338 of blade 322 and the lower edge surface 340 of blade 324 lie along the same plane P1 when the scissors are in a fully-closed position. As a result, the uninsulated tip regions act as a "clamp" for purchasing tissue and then, when electrically activated, the uninsulated tip region can either electrically cut or coagulate tissue.
  • any number of well-known mechanisms, or their equivalents can be used such as having the handle portion 325 comprise a stop to prevent the uninsulated tip regions from passing each other; or by configuring the proximal or back portion of each blade 322/324 to interact with each other to prevent the uninsulated tip regions from passing each other, or by configuring the tip regions so that they do not pass each other.
  • Fig. 6 depicts another monopolar scissors wherein the uninsulated tip region of each blade 322 and 324 comprises abutting, or engaging, surfaces 346 and 348, respectively.
  • the lower edge surface 338 of blade 322 and the lower edge surface 340 of blade 324 comprise abutting surfaces 346 and 348, respectively, to prevent the overlapping of the blades 322 and 324 at the tips thereof.
  • Figs. 7 and 9-10 depict an alternative monopolar embodiment of the invention in which a very small sliver 350, e.g., on the order of a millimeter, of conductive material extends along either the entire length or a fraction of the length of the inside surfaces 326 and 328 of the blades 322 and 324, respectively, or of the outside surfaces 334 and 336 of the blades 322 and 324, respectively.
  • the sliver 350 can be on the inside surface or the outside surface of only one of the blades 322 or 324.
  • the sliver 350 extends only over a fraction of the length of blade 322 and/or blade 324, it preferably extends over a distal region thereof adjacent the conductive tip but does not include the distal end surfaces 342/344.
  • the sliver 350 can be on both the inside surfaces (326 and 328) and/or the outside surfaces (334 and 336) of one or both blades 322 and 324. Preferably, however, the sliver 350 is included on the inner confronting surfaces (i.e., 326 and 328) of the blades 322 and 324 that are intended to provide a mechanical cutting operation.
  • a conductive sliver 350 is provided along an outer edge (as shown in phantom by the reference number 351 in Fig. 9) of one or both of the blades 322/324, they are generally oriented so that the surgeon can see at least one of them while providing a cutting or cauterizing operation, thereby minimizing the likelihood that an inadvertent injury will be caused to the patient.
  • Fig.8 depicts another embodiment of the monopolar scissors wherein one of the blades, (e.g., blade 322) is covered in its entirety with the insulative layer 329 whereas the tip region of the other blade 324 comprises the selective uninsulated surfaces.
  • one of the blades e.g., blade 322
  • the tip region of the other blade 324 comprises the selective uninsulated surfaces.
  • the distal tip section of blade 322 and/or 324 is provided with one or more conductive surfaces (i.e., candidate surfaces) to provide a cauterizing or cutting operation, and the variations of surfaces which can be made electrically conductive are the same as described above in connection with the earlier embodiments of this invention.
  • FIG. 11-12 an insulated surgical scissors having a pair of jaws 422 and 424 electrically coupled in a bipolar configuration.
  • a bipolar configuration means that each blade forms an electrode with one blade being at the voltage of a power source (not shown) while the other blade is electrically coupled to the ground side of the power source.
  • Actuation of the bipolar jaws by a handle portion (not shown) of the insulated surgical scissors is the same or similar to the handle portion 325 described earlier with respect to the monopolar insulated surgical scissors 320, and, as a result, is not explained any further herein.
  • the bipolar insulated surgical scissors is completely insulated (e.g., using a ceramic material or readily available liquid electrical insulation material), both electrically and thermally, on all of its exposed surfaces.
  • an insulative layer 429 covers almost the entire scissors 420.
  • the only portions of the bipolar insulated surgical scissors 420 that are not electrically and thermally insulated are confronting inner surfaces of the blades 422 and 424, discussed below.
  • One way of providing this electrical/thermal insulation at the pivot point is to fully insulate the entire periphery of the blades 422/424 in the region of the pivot point, including the inner surface of the passage for receiving the pivot pin.
  • Such an arrangement is illustrated in Fig. 14 and will be discussed in greater detail in connection with the bipolar scissors configuration of Figs. 15-16.
  • the exit flow of electrical energy in the bipolar configuration, is confined to the confronting inner surfaces of the jaws 422 and 424 of the scissors 420, the only portions of the scissors that conduct heat are these confronting inner surfaces. As such, any burning or smoking of tissue caused by the surgical scissors 420 being electrically active is restricted to tissue trapped between the confronting inner surfaces. Therefore, in the bipolar variants of this invention discussed below, the uninsulated conductive portions of the tip cannot include the entire exposed circumference since undesired shorting would occur. It is important that the cooperating conductive surfaces be "inner" conductive surfaces to avoid undesired arcing and burning of tissue.
  • a first embodiment of this bipolar surgical scissors 420 all of the surfaces of the blades 422 and 424 are insulated, except for confronting inner surfaces 480 and 482 at the distal end of the blades 422 and 424, respectively.
  • the confronting inner surfaces 480 and 482 of the blades 422 and 424, respectively preferably are configured with blunt and/or rounded surfaces to preclude the mechanical cutting of tissue disposed between them.
  • the tips of the blades 422 and 424 can be configured so that conductive surfaces 480 and 482 of adjacent tips engage the tissue (not shown) along a plane P2 obliquely oriented to the elongate axis, A, of the scissors 420 (Fig. 11).
  • the confronting inner conductive surfaces 480 and 482 at the distal end of the blades 422 and 424 in the bipolar version of this invention can either be in the form of raised inner projections (not shown) or recessed grooves (Fig. 13). If these regions are in the form of raised projections, the mechanical cutting action of the blades 422 and 424 will take place until the raised projections engage each other.
  • Fig. 13 depicts an embodiment similar to the embodiment of Fig. 11 but which includes uninsulated recessed grooves 484 and 486 (also known as "set-backs") in the distal tip regions.
  • the recessed grooves 484 and 486 form a small cavity for capturing tissue therein and wherein this tissue is exposed to the confronting inner conductive surfaces 480 and 482.
  • Figs. 15-16 depict an additional embodiment 421 of this bipolar surgical scissors invention whereby the confronting inner surfaces engage the tissue along a plane P3 (Fig. 16) that is substantially perpendicular to the pivot axis (schematically depicted as "PA" in Fig. 16) of the scissors 421.
  • a slight sliver 450 of conductive material can be provided along the inside cutting edges of the scissors 421.
  • the scissors 421 preferably is designed so that the entire length of the slivers 450 of both cutting blades 422 and 424 tend to engage each other at the same time, to thereby avoid undesired arcing.
  • the sliver 450 can extend to the distal tip of each blade 422 and 424, or can actually terminate short of the end surfaces 442 and 444. In this latter embodiment, the tips of the blades 422/424 can be completely insulated with the entire cautery or cutting operation taking place in the region where the conductive slivers 450 overlap.
  • each blade 422 and 424 is angled so that the front edge portions make contact at the same time that the rear edge portions make contact. Should the rear edge portions make contact before the front edge portions, an electrical short would occur, causing electrical energy to flow across the rear edge portions and bypass flowing through any tissue trapped between the front edge portions.
  • the bipolar embodiments of the insulated scissors of this invention can be made by first completely insulating each of the blades 422 and 424, including the passage 462 (Fig. 14) that is required to receive a screw 427 for pivotally attaching the blades 422/424 together.
  • the screw 427 is then positioned through the insulated passage 464.
  • the most desirable embodiments are those in which the exposed conductive areas are at the minimum required to provide the desired electrical cutting and/or cauterizing functions.
  • minimizing the conductive area of the blades reduces the amount of current that is necessary to effect an electrical cutting or cauterizing operation.
  • minimizing the conductive areas on the cutting blades provides the additional benefit of effectively controlling the flow of current through the tissue being electrically cut and/or cauterized.

Landscapes

  • 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 des ciseaux chirurgicaux isolés pourvus d'une pointe de cautérisation qui permet au chirurgien de couper mécaniquement un tissu pris entre les lames de coupe des ciseaux et d'appliquer un courant de cautérisation à une partie précise du tissu saisi, ce qui a pour effet de réduire au minimum le risque de brûler les tissus avoisinant. L'invention concerne en outre les configurations unipolaire et bipolaire de ces ciseaux chirurgicaux isolés.
PCT/US2003/014618 2003-05-12 2003-05-12 Ciseaux chirurgicaux isoles avec pointe de cauterisation Ceased WO2004105625A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/US2003/014618 WO2004105625A1 (fr) 2003-05-12 2003-05-12 Ciseaux chirurgicaux isoles avec pointe de cauterisation
AU2003235482A AU2003235482A1 (en) 2003-05-12 2003-05-12 Insulated surgical scissors including cauterizing tip

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US2003/014618 WO2004105625A1 (fr) 2003-05-12 2003-05-12 Ciseaux chirurgicaux isoles avec pointe de cauterisation

Publications (1)

Publication Number Publication Date
WO2004105625A1 true WO2004105625A1 (fr) 2004-12-09

Family

ID=33488743

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2003/014618 Ceased WO2004105625A1 (fr) 2003-05-12 2003-05-12 Ciseaux chirurgicaux isoles avec pointe de cauterisation

Country Status (2)

Country Link
AU (1) AU2003235482A1 (fr)
WO (1) WO2004105625A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2009095619A (ja) * 2007-10-12 2009-05-07 River Seiko:Kk 内視鏡用鋏型高周波処置具

Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1813902A (en) 1928-01-18 1931-07-14 Liebel Flarsheim Co Electrosurgical apparatus
US4128099A (en) 1976-09-22 1978-12-05 Richard Wolf Gmbh Single-pole coagulation forceps
US4375218A (en) 1981-05-26 1983-03-01 Digeronimo Ernest M Forceps, scalpel and blood coagulating surgical instrument
US4671274A (en) 1984-01-30 1987-06-09 Kharkovsky Nauchno-Issledovatelsky Institut Obschei I Bipolar electrosurgical instrument
US4890610A (en) 1988-05-15 1990-01-02 Kirwan Sr Lawrence T Bipolar forceps
US5026370A (en) 1981-03-11 1991-06-25 Lottick Edward A Electrocautery instrument
US5116332A (en) 1981-03-11 1992-05-26 Lottick Edward A Electrocautery hemostat
US5147357A (en) 1991-03-18 1992-09-15 Rose Anthony T Medical instrument
US5217460A (en) 1991-03-22 1993-06-08 Knoepfler Dennis J Multiple purpose forceps
US5373854A (en) 1993-07-15 1994-12-20 Kolozsi; William Z. Biopsy apparatus for use in endoscopy
US5776128A (en) * 1991-06-07 1998-07-07 Hemostatic Surgery Corporation Hemostatic bi-polar electrosurgical cutting apparatus
US5827281A (en) * 1996-01-05 1998-10-27 Levin; John M. Insulated surgical scissors
EP0927543A2 (fr) * 1997-10-08 1999-07-07 Ethicon, Inc. Ciseaux électrochirurgicaux bipolaires pour la dissection chirurgicale fine.

Patent Citations (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1813902A (en) 1928-01-18 1931-07-14 Liebel Flarsheim Co Electrosurgical apparatus
US4128099A (en) 1976-09-22 1978-12-05 Richard Wolf Gmbh Single-pole coagulation forceps
US5026370A (en) 1981-03-11 1991-06-25 Lottick Edward A Electrocautery instrument
US5116332A (en) 1981-03-11 1992-05-26 Lottick Edward A Electrocautery hemostat
US4375218A (en) 1981-05-26 1983-03-01 Digeronimo Ernest M Forceps, scalpel and blood coagulating surgical instrument
US4671274A (en) 1984-01-30 1987-06-09 Kharkovsky Nauchno-Issledovatelsky Institut Obschei I Bipolar electrosurgical instrument
US4890610A (en) 1988-05-15 1990-01-02 Kirwan Sr Lawrence T Bipolar forceps
US5147357A (en) 1991-03-18 1992-09-15 Rose Anthony T Medical instrument
US5217460A (en) 1991-03-22 1993-06-08 Knoepfler Dennis J Multiple purpose forceps
US5776128A (en) * 1991-06-07 1998-07-07 Hemostatic Surgery Corporation Hemostatic bi-polar electrosurgical cutting apparatus
US5373854A (en) 1993-07-15 1994-12-20 Kolozsi; William Z. Biopsy apparatus for use in endoscopy
US5827281A (en) * 1996-01-05 1998-10-27 Levin; John M. Insulated surgical scissors
EP0927543A2 (fr) * 1997-10-08 1999-07-07 Ethicon, Inc. Ciseaux électrochirurgicaux bipolaires pour la dissection chirurgicale fine.
US6283963B1 (en) * 1997-10-08 2001-09-04 Ethicon, Inc. Bipolar electrosurgical scissors for fine or delicate surgical dissection

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2009095619A (ja) * 2007-10-12 2009-05-07 River Seiko:Kk 内視鏡用鋏型高周波処置具

Also Published As

Publication number Publication date
AU2003235482A1 (en) 2005-01-21

Similar Documents

Publication Publication Date Title
US6562035B1 (en) Insulated surgical scissors including cauterizing tip
US5827281A (en) Insulated surgical scissors
US6174309B1 (en) Seal & cut electrosurgical instrument
US5599350A (en) Electrosurgical clamping device with coagulation feedback
US5755717A (en) Electrosurgical clamping device with improved coagulation feedback
US6620161B2 (en) Electrosurgical instrument with an operational sequencing element
US6371956B1 (en) Monopolar electrosurgical end effectors
US6554829B2 (en) Electrosurgical instrument with minimally invasive jaws
AU707821B2 (en) Bipolar cutting and coagulation device
US6652521B2 (en) Surgical instrument with a bi-directional cutting element
US6695840B2 (en) Electrosurgical instrument with a longitudinal element for conducting RF energy and moving a cutting element
US9579145B2 (en) Flexible endoscopic catheter with ligasure
US6790217B2 (en) Surgical instrument with a dissecting tip
EP1363547B1 (fr) Instrument electrochirurgical comportant un tuyau de fermeture pour conduire l'energie rf et des machoires mobiles
CA2110922C (fr) Instruments endoscopiques bipolaires pour electrochirurgie
US20100036370A1 (en) Electrosurgical instrument jaw structure with cutting tip
JPH08317934A (ja) 適応性電極を有する電気外科手術用止血装置
JP3610306B2 (ja) 高周波処置具
WO2004105625A1 (fr) Ciseaux chirurgicaux isoles avec pointe de cauterisation
JP7491738B2 (ja) 内視鏡用処置具

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MA MD MG MK MN MW MX MZ NI NO NZ OM PH PL PT RO RU SC SD SE SG SK SL TJ TM TN TR TT TZ UA UG US UZ VC VN YU ZA ZM ZW

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): GH GM KE LS MW MZ SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IT LU MC NL PT RO SE SI SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
122 Ep: pct application non-entry in european phase
NENP Non-entry into the national phase

Ref country code: JP