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WO2021116776A1 - Système ciseaux-aiguille pour hydrodissection intracavitaire et excision de tissus - Google Patents

Système ciseaux-aiguille pour hydrodissection intracavitaire et excision de tissus Download PDF

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Publication number
WO2021116776A1
WO2021116776A1 PCT/IB2020/050865 IB2020050865W WO2021116776A1 WO 2021116776 A1 WO2021116776 A1 WO 2021116776A1 IB 2020050865 W IB2020050865 W IB 2020050865W WO 2021116776 A1 WO2021116776 A1 WO 2021116776A1
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WO
WIPO (PCT)
Prior art keywords
blades
needle
surgical instrument
scissors
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/IB2020/050865
Other languages
English (en)
Inventor
Belthangady Monu Zeeshan HAMEED
Nithesh NAIK
Milap Shah
Shaweez FAIZI
Rahil Hussein BEARY
Rahul SHAGRITHAYA
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
Publication of WO2021116776A1 publication Critical patent/WO2021116776A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • A61B17/32—Surgical cutting instruments
    • A61B17/3203—Fluid jet cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—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
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
    • 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
    • A61B2018/00505—Urinary tract
    • A61B2018/00517—Urinary bladder or urethra
    • 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
    • A61B2018/00589—Coagulation
    • 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
    • A61B2018/00595—Cauterization
    • 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
    • A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
    • 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
    • A61B2018/146—Scissors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002—Irrigation

Definitions

  • the present disclosure relates to the technical field of surgical instruments.
  • the present disclosure relates to a surgical instrument for resection of bladder tumour.
  • BC Bladder cancer
  • CIS stage carcinoma in situ
  • Tl stage Ta or sub mucosa
  • Endoscopic surgery plays a dominant role in treatment of exophytic non-muscle- invasive tumours, i.e. stage Ta and Tl, which can theoretically be completely removed.
  • role of endoscopic surgery in flat lesions (CIS) is predominantly in diagnosis, as it is accepted that CIS cannot be completely resected.
  • First-line procedure for diagnosis, staging, and treatment of visible tumours is transurethral resection of bladder tumour (TURBT), which is used for primary resection of bladder tumour by piecemeal or en-bloc resection using electrocautery.
  • TURBT The goal of TURBT is to remove all visible lesions and provide viable tissues for accurate pathological diagnosis, which includes: establishing the histologic diagnosis of the bladder tumour; determining the tumour stage (the pathologist must be able to evaluate the depth of tumour invasion from the surgical specimen); and determining all clinically important prognostic factors, such as the grade, number, size, and configuration of the tumour as well as the presence of CIS.
  • TURBT remains the gold standard for the treatment of NMIBC, efficiency of the procedure is not optimal. In spite of mosturologists being familiar with TURBT procedure, it is not easy to perform and may not always achieve the desired goals. Moreover, its potential failures have negative impacts on patient outcomes.
  • the numerical parameters should be construed in light of the number of reported significant digits and by applying ordinary rounding techniques. Notwithstanding that the numerical ranges and parameters setting forth the broad scope of some embodiments of the invention are approximations, the numerical values set forth in the specific examples are reported as precisely as practicable. The numerical values presented in some embodiments of the invention may contain certain errors necessarily resulting from the standard deviation found in their respective testing measurements.
  • a general object of the present disclosure is to provide a simple and cost effective surgical instrument far resection of bladder tumour.
  • Another object of the present disclosure is to provide a surgical instrument for resection of bladder tumour that allows hydro dissection during excision of tissues within the bladder cavity, thereby facilitates en-bloc excision.
  • Another object of the present disclosure is to provide a surgical instrument for resection of bladder tumour that avoids perforation of the bladder.
  • Another object of the present disclosure is to provide a surgical instrument for resection of bladder tumour that avoids collateral damage to vital parts of the tissues.
  • Another object of the present disclosure is to provide a surgical instrument for resection of bladder tumour that allows measurement of objects or tissues, such as urinary bladder tumour.
  • Another object of the present disclosure is to provide a surgical instrument for resection of bladder tumour that overcomes inaccessibility to resect the tumour.
  • Yet another object of the present disclosure is to provide a surgical instrument for resection of bladder tumour that is adapted to the curvature of the interior of hollow cavity of the bladder.
  • Yet another object of the present disclosure is to provide a surgical instrument for resection of bladder tumour that obviates possibility of perforation due to obturator jerk.
  • Still another object of the present disclosure is to provide a surgical instrument for resection of bladder tumour obviates charring of the specimen leading to artefacts,
  • aspects of the present disclosure relate to a surgical instrument.
  • the aspects of the present disclosure pertain to a surgical instrument for resection of a tumour from internal cavity of a human organ, such as urinary bladder, that overcomes drawbacks of known techniques for the procedure.
  • the proposed instrument does not depend on electrocautery dissection, thereby preventing charring of the specimen leading to artefacts.
  • the disclosed surgical instrument incorporates a needle for injection of small amounts of fluid to cause vasoconstriction of the tumour vessels, thereby reducing the blood loss and improved vision during excision of the tumour.
  • the disclosed surgical instrument includes a pair of blades pivotally coupled to each other to form a scissors.
  • a portion of an inner edge of the blades, which is located at a distal end of the blades includes a sharp cutting edge made of a conducting material, and remaining of the inner edge of each of the blades is blunt.
  • the instrument further includes a needle configured for injecting a fluid, and is spaced away from the pair of blades configured.
  • the needle is configured for translator)' movement along an axis of the needle.
  • At least a portion of the blades towards the distal end of the instrument is curved, and the curvature of the pair of blades is such that distance between the axis of the needle and the blades increases towards the distal end of the instrument.
  • a near end of the pair of blades may be coupled to a distal end of a long shaft, and the needle may be located within the shaft for operation of the scissor-needle combination using a handle assembly provided at proximal end of the shaft.
  • the handle assembly may include means to actuate the scissors, and a lever mechanism to impart the translator ⁇ axial movement the needle, so as to retract the needle within the shaft or extend the needle out of the shaft.
  • the handle assembly may include means to couple the needle to a source of the fluid to be injected within tissues through the needle for hydro dissection during resection of tissues using the scissors.
  • the complete surface of the pair of blades, except the cutting edges, may be nonconducting.
  • the pair of blades, except the conducting cutting edges may be made of ceramic to avoid collateral damage to other vital parts of the tissue.
  • the pair of blades, except the conducting cutting edges may be coated with a non-conducting material.
  • the surgical instrument may be configured for being coupled to a source of high frequency electric current, wherein the high frequency electric current is configured to coagulate to control bleeding, and wherein the high frequency electric current is fed to the conducting cutting edges of the pair of blades.
  • the surgical instrument may be used for resecting a tumour of urinary bladder, and wherein the curvature of pair of blades may be adapted to internal walls of the bladder cavity.
  • Length of the cutting edges may be 4 mm being less than thickness of the wall of the bladder to avoid perforation of the bladder by the blades.
  • the handle assembly may incorporate means to rotate the shaft about a longitudinal axis of the shaft to enable orienting the scissors in a desired orientation.
  • the needle may have markings marked on outer surface at the distal end with a graduation of 0.5mm up to 10mm, said markings being meant to measure objects or tissues.
  • the distal end of the needle may be tapered to provide a pointed end, and wherein an eye of the tapered end faces towards the pair of blades.
  • FTGs. 1 A to 1C illustrate exemplary images showing a proximal perspective view, a distal perspective view and a top view respectively of the proposed scissors-needle combination, in accordance with embodiments of the present disclosure.
  • FIGs. 2A to 2D illustrate exemplary' perspective view, side, top view and end view respectively of a blade of the scissors of the disclosed scissors-needle combination, in accordance with embodiments of the present disclosure.
  • FIGs. 3A to 3C illustrate exemplary side view, top view and end view respectively of the proposed scissors-needle system with the proposed scissors-needle combination coupled to a distal end of a shaft having a handle assembly at its proximal end, in accordance with embodiments of the present disclosure.
  • FIGs. 4A to 4C illustrate exemplary perspective view, sectional perspective view and a top sectional view respectively of the handle assembly of the disclosed scissors-needle system, in accordance with embodiments of the present disclosure.
  • FIGs. 4D and 4E illustrate exemplary images showing a perspective view and internal details respectively of the handle assembly of the disclosed scissors-needle system, in accordance with embodiments of the present disclosure.
  • FIG. 5 illustrates exemplary views showing details of the knob of the disclosed scissors-needle system for rotating the scissors-needle combination, in accordance with embodiments of the present disclosure.
  • FIG. 6 illustrates an exemplary view showing use of the disclosed scissors-needle system for removal of a bladder tumour, in accordance with embodiments of the present disclosure.
  • the needle in the scissors-needle system is used for injection of small amounts of fluid to cause vasoconstriction of the tumour vessels, thereby reducing the blood loss and improved vision during excision of the tumour.
  • Blades of the scissors in the disclosed surgical instrument have sharp cutting edge only on a portion of an inner edge of the blades, which is located at a distal end of the blades, with remaining edge being blunt. Length of the cutting edge is configured to prevent accidental perforation. For example, length of the cutting edge is substantially less than thickness of wall of the urinary bladder.
  • the needle is configured for injecting fluid, and is spaced away from the pair of blades. It is further configured for translatory movement along an axis of the needle.
  • At least a portion of the blades towards the distal end of the instrument is curved, and the curvature of the pair of blades is such that distance between the axis of the needle and the blades increases towards the distal end of the instrument.
  • the curved blades help in adapting the scissors to the curvature of the interior surface of hollow cavity of the bladder, as well as helps in accidental perforation of wall of the bladder.
  • the conducting cutting edge of each of the blades can also transmit high frequency current to coagulate or to control bleeding in the cavity. Remaining portion of the blades is non-conducting to avoid collateral damage to other vital parts of the tissue by precise point coagulation. For example, dining the bladder tumour removal, if there is bleeding and the high frequency current is applied to control bleeding, there is no dissipation of current to the obturator nerves during coagulation.
  • the scissors-needle system further includes a shaft, and a handle assembly coupled to a proximal end of the shaft.
  • the scissors is coupled to the distal end of the shaft.
  • the handle assembly may include means to actuate the scissors, and a lever mechanism to impart the translatory axial movement the needle, so as to retract the needle within the shaft or extend the needle out of the shaft.
  • the handle assembly may include means to couple the needle to a source of the fluid to be injected within tissues through the needle for hydro dissection dining resection of tissues using the scissors.
  • the distal end of the needle may be tapered to provide a pointed end, and an eye of the tapered end may face towards the pair of blades.
  • the handle assembly may incorporate means to rotate the shaft about a longitudinal axis of the shaft to enable orienting the scissors in a desired orientation.
  • the needle may have markings marked on outer surface at the distal end with a graduation of 0.5mm up to 10mm, said markings being meant to measure objects or tissues.
  • the scissors-needle combination 100 at distal end 150 of the instrument includes a pair of blades, such as blades 102-1 and 102-2 (collectively referred to as blades 102)that are pivotally coupled to each other to form a scissors 104; and a needle 106.
  • the blades 102 are pivotally coupled to head 108 at a common fulcrum point (not shown here) in the head 108 such that they are pivotally coupled to each other as well as to the head 108.
  • the head 108 is located at a distal end of a shaft 110 such that the blades can be pivotally moved to actuate the scissors to cut tissues using sharp inner aspect/cutting edges of the blades 102 by operation of a scissors actuation mechanism (not shown here) located at a proximal end 152 of the instrument.
  • the needle 106 is spaced away from the pair of blades 102.
  • the needle 106 is configured for translatory movement, as shown by arrow 112, along a longitudinal axis of the needle 106 between a retracted position, in which the needle 106 is withdrawn within the head 108, and an extended position, as shown in FIGs. lA to 1C.
  • FIGs. 1A - 1C Also shown in FIGs. 1A - 1C is curved aspect of the blades 102.
  • Each of the blades 102 is curved in its plane, and direction of the curvature is such that the distance between the blades 102/scissors 104 and the needle 106 increases towards the distal end 150 of the instrument, as is evident from FIGs. 1A and IB.
  • FIGs. IB and lC show markings 114 marked on outer surface of the needle 106 at the distal end with a graduation of 0.5mm up to 10mm.
  • the markings can be useful in ascertaining depth to which the needle 106 has penetrated the tissues, such as by using axial movement 112 of the needle 106, thereby enabling measurement of objects or tissues.
  • the distal end of the needle 106 may be tapered, as shown in FIGs. 1A-1C, to provide a pointed end.
  • An eye 116 of the tapered end of the needle 106 may face towards the scissors 104 to facilitate insertion in tissues.
  • the configuration of the needle 106 is such that it can be used for hydro dissection to lift the tumour bed, and make excision using the scissors 104, simpler.
  • FIGs. 2A to 2D illustrate exemplary perspective view, side, top view and end view respectively of a blade 102 of the scissors 104 of the disclosed scissors-needle combination 100.
  • the blades 102 can have holes, such as holes 202 and 204 on the side towards the proximal end 152.
  • the hole 202 may be used to fix the blades 102 on a common fulcrum in thehead 108, and hole 204 may be used for coupling the blades 102 to the scissors actuation mechanism (not shown) located within the head 108.
  • the scissors actuation mechanism may intern be operatively coupled to a handle assembly (not shown here, refer to FIGs.
  • FIG. 2B shows curved aspect of the blades 102, wherein at least a portion of the plane of the blades 102, towards distal end 150, is curved with curvature R.
  • the curvature R may be selected such that the scissors 104 may adapt to internal walls of the bladder cavity.
  • at least a portion of an inner edge 206 of the blades 102, shown as L, towards distal end 150, is sharp to provide a cutting edge. Remaining portion of the inner edge 206 may be blunt.
  • each blade 102 can be about 7mm in length, with the distal half, for example, about 4 mm, having sharp cutting edge.
  • the cutting edge may be made of a conducting material, such as a metal, to conduct high frequency electric current, and the remaining portion of the blade 102 may be made of non-conducting material such as ceramic.
  • whole of the blade 102 may be made of a conducting material and its surface except the cutting edge may be coated with a non-conducting material.
  • FIGs. 3A to 3C illustrate exemplary side view, top view and end view respectively of the proposed scissors-needle system.
  • the scissors-needle combination 100 is coupled to a distal end 150 of a shaft 110 having a handle assembly 302 at its proximal end 152. Coupling of the proximal end of the shaft 110 to the handle assembly 302 is through a knob 304 that enables rotation of the shaft 110 relative to the handle assembly 302. The rotation of the shaft 110 using the knob 304 enables orienting the scissors-needle combination 100 relative to inner surface of the bladder cavity so that the needle 106 may be used for injecting fluid to the identified tissues, and/or the scissors 104 may be used for dissecting the identified tissues.
  • the shaft 110 may be approximately 400mm long and may have a diameter that allows it to easily pass through a working channel of a standard 20.8F Nephroscope. In a preferred embodiment, diameter of the shaft 110 is 3 -4mm. Internal diameter of the shaft 110 is enough to accommodate the needle 106 and allow its translatory motion.
  • the handle assembly 302 may include a lever 306 that is operatively coupled to the needle 106 for translatory movement of the needle as described earlier; a connector 308 for connecting to a source of high frequency electric current that is fed to the conducting cutting edges of the blades 102 to coagulate to control bleeding; and a fluid injector 310 that is fluidically coupled to the needle 106 for injecting a fluid, such as a saline, adrenaline, chemotherapeutic agents etc.
  • the connector 308 may be of the standard size and dimensions so that it can be connected to standard Monopolar/bipolar cautery cables.
  • FIGs. 4A and 4E illustrate further details of the handle assembly 302 of the disclosed scissors-needle system 300.
  • the handle assembly 302 may include a body having a fixed handle 402 and a movable handle 404 pivotally fixed to the body at a pivot point 406.
  • the movable handle 404 may be operatively coupled to the scissors actuation mechanism located within the head 108. Moving the movable handle 404 relative to the fixed handle 402, such as using a thumb and a finger, shall actuate the scissors 104 to cut tissues.
  • FIG. 5 shows details of the knob 304 configured to rotate the scissors-needle combination 100 relative to the handle assembly 302.
  • the knob 304 may include three gears, such as a first gear 502 configured around the shaft 110, a second gear 504 and an internal gear 506.
  • the internal gear 506 may be fixed to a rotatable outer casing 508 of the knob 304 such that rotation of outer casing 508 rotates the internal gear 506, and rotary motion of the internal gear 506 is transferred to the first gear 502 through the second gear 504.
  • Sizes of the gears 502, 504 and 506 may be selected so us to enable orienting the scissors-needle combination 100 with precision.
  • FIG. 6 illustrates an exemplary' view showing use of the proposed scissors-needle system 300 for removal of a bladder tumour.
  • visualization of bladder such as bladder602
  • the scissors-needle combination lOO may be inserted through the w'oridng channel of the nephroscope, The scissors may be connected to electrocautery using a high frequency energy cable coupled to the connector 308.
  • the bladder tumour is inspected.
  • saline or diluted Adrenaline can be injected to the base of the tumour, such as tumour 604, during hydro dissection.
  • the bleeders at the cut end of the base of the bladder is coagulated using the electrocautery, which may be conducted through the metallic aspect of the blades 102.
  • the scissors-needle combination lOO may be withdrawn from the working channel, and the tumour 604 retrieved from the bladder 602 using a grasper for histopathological examination.
  • the bladder catheter may be inserted.
  • Some of the other exemplary applications of the disclosed scissors-needle system can be, but not limited to: Ureterocele excision, Intravesical Botox injection for overactive bladder. Deflux injection for Vesicoureteric reflux, Foreign body excision inside the bladder, Incision for impacted vesico- ureteric junction stone, Uterine septal defects treatment, Uterine small fibroid excision.
  • the present disclosure provides a simple and cost effective surgical instruments for resection of bladder tumour.
  • the present disclosure provides a surgical instrument for resection of bladder tumour that overcomes drawbacks of known surgical instruments and techniques.
  • the present disclosure provides a surgical instrument for resection of bladder tumour that can be used through already available working elements.
  • the present disclosure provides a surgical instrument for resection of bladder tumour that allows en-bloc excision.
  • the present disclosure provides a surgical instrument for resection of bladder tumour that avoids perforation of the bladder.
  • the present disclosure provides a surgical instrument for resection of bladder tumour that allows hydro dissection during excision of tissues within the bladder cavity. [0085] Another object of the present disclosure is to provide a surgical instrument for resection of bladder tumour that avoids collateral damage to vital parts of the tissues. [0086] The present disclosure provides a surgical instrument for resection of bladder tumour that allows measurement of objects or tissues, such as urinary bladder tumour.
  • the present disclosure provides a surgical instrument for resection of bladder tumour that overcomes inaccessibility to resect the tumour.
  • the present disclosure provides a surgical instrument for resection of bladder tumour that is adapted to the curvature of the interior of hollow cavity of the bladder.
  • the present disclosure provides a surgical instrument for resection of bladder tumour that obviates possibility of perforation due to obturator jerk.
  • the present disclosure provides a surgical instrument for resection of bladder tumour obviates charring of the specimen leading to artefacts.

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  • 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)
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  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un instrument chirurgical comportant une combinaison ciseaux-aiguille 100, ayant une paire de lames 102 couplées de façon pivotante l'une à l'autre pour former des ciseaux 104, et une aiguille 106 espacée des ciseaux 104 et configurée pour injecter un fluide. Seule une partie d'un bord interne située à une extrémité distale 150 des lames 102 comporte un bord de coupe tranchant constitué d'un matériau conducteur, le reste du bord interne des lames étant émoussé et non conducteur. Au moins une partie des lames vers l'extrémité distale de l'instrument est incurvée pour adapter les ciseaux 104 à la paroi interne de la cavité d'un organe. L'aiguille 106 est configurée pour un mouvement de translation le long d'un axe longitudinal pour faciliter l'insertion dans des tissus pour une hydrodissection avant l'utilisation de ciseaux 104 pour l'excision de tissus. La longueur limitée du bord de coupe évite une perforation accidentelle de la vessie.
PCT/IB2020/050865 2019-12-12 2020-02-04 Système ciseaux-aiguille pour hydrodissection intracavitaire et excision de tissus Ceased WO2021116776A1 (fr)

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IN201941051409 2019-12-12
IN201941051409 2019-12-12

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR102764334B1 (ko) * 2023-09-13 2025-02-05 김충현 피부 양성 종양 수술에 사용되는 수력 분리 기능을 갖는 의료용 가위

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5797939A (en) * 1989-12-05 1998-08-25 Yoon; Inbae Endoscopic scissors with longitudinal operating channel
EP1237490B1 (fr) * 1999-09-08 2012-07-04 Joseph Grayzel Systeme d'entree percutanee

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5797939A (en) * 1989-12-05 1998-08-25 Yoon; Inbae Endoscopic scissors with longitudinal operating channel
EP1237490B1 (fr) * 1999-09-08 2012-07-04 Joseph Grayzel Systeme d'entree percutanee

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR102764334B1 (ko) * 2023-09-13 2025-02-05 김충현 피부 양성 종양 수술에 사용되는 수력 분리 기능을 갖는 의료용 가위

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