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WO2023039703A1 - Électrode monopolaire de type crochet en l - Google Patents

Électrode monopolaire de type crochet en l Download PDF

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Publication number
WO2023039703A1
WO2023039703A1 PCT/CN2021/118137 CN2021118137W WO2023039703A1 WO 2023039703 A1 WO2023039703 A1 WO 2023039703A1 CN 2021118137 W CN2021118137 W CN 2021118137W WO 2023039703 A1 WO2023039703 A1 WO 2023039703A1
Authority
WO
WIPO (PCT)
Prior art keywords
coating
electrode according
electrosurgical electrode
distal portion
ridges
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/CN2021/118137
Other languages
English (en)
Inventor
Yuan Kang
Xiaoxin Wang
Peng ZHA
Lijun Zhu
Yongming ZHAO
Tong SHEN
Xinmeng LIU
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.)
Covidien LP
Original Assignee
Covidien LP
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 Covidien LP filed Critical Covidien LP
Priority to PCT/CN2021/118137 priority Critical patent/WO2023039703A1/fr
Publication of WO2023039703A1 publication Critical patent/WO2023039703A1/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
    • 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
    • A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1402—Probes for open surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • 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
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • 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
    • A61B2018/0013—Coatings on the energy applicator non-sticking
    • 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
    • A61B2018/00136—Coatings on the energy applicator with polymer
    • 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
    • A61B2018/00148—Coatings on the energy applicator with metal
    • 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
    • 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
    • A61B18/1206—Generators therefor
    • A61B2018/1246—Generators therefor characterised by the output polarity
    • A61B2018/1253—Generators therefor characterised by the output polarity monopolar
    • 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
    • A61B2018/1422—Hook

Definitions

  • the present disclosure relates to an electrosurgical electrode and, more particularly, to a monopolar electrosurgical electrode having an L-hook shape.
  • Electrosurgery involves application of high radio frequency (RF) electrical current to a surgical site to cut, ablate, desiccate, or coagulate tissue.
  • RF radio frequency
  • a source or active electrode delivers radio frequency alternating current from the electrosurgical generator to the targeted tissue.
  • a patient return electrode is placed remotely from the active electrode to conduct the current back to the generator.
  • Electrosurgical devices are frequently used during surgical operations to help prevent blood loss.
  • One of the major benefits associated with electrosurgical devices is their ability to make precise cuts with limited blood loss.
  • electrosurgical devices generate thermal spread, potentially resulting in unwanted temperature increases to adjacent tissue and organs.
  • Traditional monopolar L-hook electrodes are used in laparoscopic surgeries, utilizes RF energy to heat the tissue to complete transection and hemostasis.
  • the inside of the electrode is used to hook the targeted tissue and is then pulled proximally to apply tension while applying RF energy to dissect tissue.
  • the ability to dissect tissue is related to the tension between the targeted tissue and the power setting.
  • higher power setting can lead to a better dissection performance.
  • higher power settings may also result in larger thermal spread.
  • An edge in the electrode can converge the current density, thereby increasing the cutting efficiency.
  • the desired transection can be achieved at a lower power setting, causing less thermal spread.
  • the edge is applied perpendicularly to the tissue.
  • surgeons need to apply the electrode at different angles based on procedural needs. Consequently, the electrode cannot always act perpendicularly on the tissue, affecting the cutting efficiency of the edge.
  • a monopolar L-hook electrode improves on traditional monopolar electrode designs by adding more ridges positioned at different angles to provide for better tissue contact.
  • the electrode includes an inner surface and an outer surface.
  • the inner surface includes a plurality of longitudinal ridges radiating at different angles allowing for better dissection performance with a lower power activation.
  • the inner surface of the L-hook electrode may be used for transection, while the outer surface may be used to conduct coagulation and/or dissection.
  • the electrode also includes a combination coating of conductive and insulative materials.
  • the inner surface of the L-hook electrode may be used for transection, while the outer surface may be used to conduct coagulation and/or dissection.
  • the electrode accommodates the user habits of traditional monopolar L-hook electrodes and extends the functions to enable precise operation with minimal thermal spread and lower RF energy passing through the patient.
  • the electrode includes coatings suitable for the different uses of each of the two sides.
  • the inside of the electrode includes an insulative, or electrically non-conductive, coating.
  • the outside of the electrode includes a conductive coating.
  • the insulative coating provides for a coating that may be non-stick, low friction, hydrophobic, thermally stabile, insulating, and/or chemically resistive. Therefore, applying the insulative coating on the inside of laparoscopic monopolar electrodes improves various properties of the electrode. Due to its dielectric properties, the insulative coating also prevents the spread of the current to the entire electrode thereby reducing the thermal spread. By centralizing the current to the ridges, the cutting efficiency is improved while the transecting force and thermal damage is reduced.
  • the conductive coating may be wear-resistant, inert, and conductive, which reduces galling between sliding components and helps retain sharp ridges.
  • the conductive coating also provides high adhesion ability, which increases the usability of the conductively coated electrode.
  • the conductive coating on the outer surface allows the electrode to cut and coagulate effectively by conducting current evenly, while also making the surface non-stick.
  • an electrosurgical electrode includes a working end having a proximal portion, a distal portion, a curved portion interconnecting the proximal portion and the distal portion.
  • Each of the proximal portion, the distal portion, and the curved portion includes an inner surface and an outer surface.
  • the electrode also includes a ridge formation disposed along at least a portion of the inner surface of the working end.
  • the electrosurgical electrode may also include a first coating disposed over the inner surfaces.
  • the first coating may be an insulative coating and may include a dielectric polymer which may be polytetrafluoroethylene and/or perfluoro alkoxy alkane polymer.
  • the electrosurgical electrode may further include a second coating that is different from the first coating.
  • the second coating may be disposed over the outer surfaces.
  • the second coating may be a conductive coating formed from a ceramic material, which may be titanium nitride, chromium nitride, and/or aluminum oxide.
  • the ridge formation may include a plurality of ridges, each of which is separated by a distance, which may be from about 0.2 mm to about 0.4 mm.
  • Each of the ridges may include a pair of sloping surfaces defining an angle from about 60 to about 120 degrees.
  • Each of the ridges may also include a curved peak having a radius from about 0.02 mm to about 0.05 mm.
  • the ridges are separated by a plurality of depressions, each of the depressions is located between adjacent ridges.
  • Each of the depressions may have an arcuate cross-sectional shape.
  • FIG. 1 is a perspective view of an electrosurgical system according to an embodiment of the present disclosure
  • FIG. 2 is a perspective view of an electrode according to an embodiment of the present disclosure
  • FIG. 3 is perspective view of a distal tip of the electrode of FIG. 1 according to an embodiment of the present disclosure
  • FIG. 4 is a side view of the electrode of FIG. 1 according to an embodiment of the present disclosure.
  • FIG. 5 is a cross-sectional view of the distal tip of the electrode of FIG. 1 taken along a cross-sectional line 5-5 according to an embodiment of the present disclosure.
  • distal refers to the portion of the surgical instrument coupled thereto that is closer to the patient, while the term “proximal” refers to the portion that is farther from the patient.
  • an electrosurgical system 10 for use with an electrosurgical instrument having an electrode according to the present disclosure, such as a monopolar electrosurgical instrument 20 is shown.
  • Monopolar electrosurgical instrument 20 includes an active electrode 30 (e.g., electrosurgical L-hook electrode, etc. ) for treating tissue of a patient.
  • the system 10 may include a plurality of return electrode pads 26 that, in use, are disposed on a patient to minimize the chances of tissue damage by maximizing the overall contact area with the patient.
  • Electrosurgical alternating RF current is supplied to the monopolar electrosurgical instrument 20 by a generator 100 via supply line 24. The alternating RF current is returned to the generator 100 through the return electrode pad 26 via a return line 28.
  • the electrode 30 is formed from a conductive material, such as, stainless steel.
  • the electrode 30 may be formed using any suitable metal forming technique such as a computer numeral control machining process or metal injection molding.
  • the electrode 30 includes a working end 31 having an L-hook shape with a proximal portion 32 and a distal portion 34 coupled to the proximal portion 32 at a curved portion 36.
  • the proximal portion 32 and the distal portion 34 may be disposed at any suitable angle relative to each other, the angle may be from about 45° to about 160°.
  • the proximal and distal portions 32 and 34 are substantially linear, e.g., rod-like, in shape.
  • Each of the portions 32, 34, 36 may have a substantially circular cross-section as shown in FIGS. 3 and 5. In embodiments, the portions 32, 34, 36 may have any other suitable cross-section, such as oval, polygonal, or combinations thereof.
  • each of the proximal portion 32 and the distal portion 34 defines a longitudinal axis, “y-y” and “x-x” , respectively, which intersect each other at the curved portion 36.
  • the proximal portion 32 includes an inner surface 33a and an outer surface 33b.
  • the distal portion 34 includes an inner surface 35a and 35b and the curved portion 36 includes an inner surface 37a and an outer surface 37b.
  • the electrode 30 includes a ridge formation 40 having a plurality (i.e., 2 to 6) of longitudinal ridges 42 extending along the inner surface 35a of distal portion 34.
  • the longitudinal ridges 42 may be parallel to the longitudinal axis of distal portion 34.
  • longitudinal ridges 42 extend along each of inner surfaces 33a, 35a, 37a of the proximal portion 32, the distal portion 34, and the curved portion 36, respectively, parallel to the corresponding longitudinal axes of the portions 32 and 34.
  • Each of the ridges 42 acts as a cutting edge, concentrating RF current.
  • the ridge formation 40 also includes a plurality of depressions 44 disposed (i.e., interspersed) between each pair of the ridges 42 (FIGS. 3 and 5) .
  • the ridge formation 40 may be integrally formed with the electrode 30 using any suitable metal-working technique.
  • the depressions 44 may have an arcuate cross-sectional shape as shown in FIGS. 3 and 5.
  • the ridges 42 are separated by a distance d, which may be uniform or may vary, and may be from about 0.2 mm to about 0.4 mm. The distance may be constant between any two ridges 42 or may narrow or widen to provide for non-parallel alignment. The distance d provides sufficient clearance between each of the ridges 42 to allow for current spread.
  • each of the ridges 42 includes a pair of sloping surfaces 43 defining an angle ⁇ , which may be from about 60° to about 120°. The angle ⁇ is designed to cause high current concentration when activated by RF energy.
  • Each of the ridges 42 also includes a peak 45.
  • the peaks 45 of the ridges 42 may have a curved surface having a radius r from about 0.02 mm to about 0.05 mm and act as the main emission area of RF energy.
  • the lower arcuate curvature of the depressions 44 is designed to be blunt enough to avoid causing physical damage and act as a balance to help angle ⁇ and the radius r of the peaks 45 to concentrate current.
  • Each of the peaks 45 may point in a different direction as defined by a radial line l drawn from a center of the electrode 30 to each of the peaks 45.
  • the working end 31 includes an insulative coating 50 disposed on the inner surface 35a of at least the distal portion 34.
  • conductive coating 52 is disposed over the inner surfaces 33a, 35a, 37a of the proximal portion 32, the distal portion 34, and the curved portion 36 thereby coating the ridge formation 40.
  • the coating 50 has a high impedance to RF energy and provides anti-stickiness performance at high temperature, e.g., about 300 °C.
  • Suitable polymers include polytetrafluoroethylene (PTFE) , perfluoro alkoxy alkane (PFA) polymers.
  • the working end 31 may operate based on conductor breakthrough on the longitudinal ridges 42 or through capacitive coupling across the longitudinal ridges 42 insulator. Desired operation may be tailored by adjusting dielectric properties of the coating 50, i.e., higher dielectric property to provide for capacitive coupling and lower to provide for conductor breakthrough.
  • the working end 31 also includes a conductive coating 52 disposed on the outer surface 35b of at least the distal portion 34.
  • conductive coating 52 is disposed over the outer surfaces 33b, 35b, 37b of the proximal portion 32, the distal portion 34, and the curved portion 36.
  • Suitable conductive coating materials include ceramics such as titanium nitride, chromium nitride, aluminum oxide, and the like.
  • the insulative coating 50 and the conductive coating 52 may be formed using any suitable coating technique such as spraying, dipping, chemical vapor deposition, and the like. The conductive coating 52 may be applied first and then masked, to allow for formation of the insulative coating 50.
  • the coating steps may be reversed, with the insulative coating 50 being applied first.
  • the conductive coating 52 may be applied to the entirety of the working end 31 and the insulative coating 50 may be applied only to the inner surfaces 33a, 35a, 37a of the proximal portion 32, the distal portion 34, and the curved portion 36 using masking to limit application.

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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

Une électrode électrochirurgicale de type crochet en L comprend une partie proximale, une partie distale, une partie incurvée interconnectant la partie proximale et la partie distale. Chacune de la partie proximale, de la partie distale et de la partie incurvée comprend une surface intérieure et une surface extérieure. L'électrode comprend également une formation de crête disposée le long de la surface interne d'au moins la partie distale.
PCT/CN2021/118137 2021-09-14 2021-09-14 Électrode monopolaire de type crochet en l Ceased WO2023039703A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/CN2021/118137 WO2023039703A1 (fr) 2021-09-14 2021-09-14 Électrode monopolaire de type crochet en l

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CN2021/118137 WO2023039703A1 (fr) 2021-09-14 2021-09-14 Électrode monopolaire de type crochet en l

Publications (1)

Publication Number Publication Date
WO2023039703A1 true WO2023039703A1 (fr) 2023-03-23

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Family Applications (1)

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PCT/CN2021/118137 Ceased WO2023039703A1 (fr) 2021-09-14 2021-09-14 Électrode monopolaire de type crochet en l

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WO (1) WO2023039703A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102939055A (zh) * 2010-01-22 2013-02-20 玛格戴恩医疗产品公司 具有电场集中飞边的电外科电极
US20160199119A1 (en) * 2015-01-13 2016-07-14 Megadyne Medical Products, Inc. Precision blade electrosurgical instrument
US20190159828A1 (en) * 2017-11-29 2019-05-30 Meshil A.M.O.H. Al-Jarba Active electrode assembly for an electrosurgical device
US20200060751A1 (en) * 2018-08-24 2020-02-27 Covidien Lp Cutting electrode enhancement for laparoscopic electrosurgical device
CN112512453A (zh) * 2018-08-03 2021-03-16 日本帕卡濑精株式会社 具有表面处理覆膜的外科用电极

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102939055A (zh) * 2010-01-22 2013-02-20 玛格戴恩医疗产品公司 具有电场集中飞边的电外科电极
US20160199119A1 (en) * 2015-01-13 2016-07-14 Megadyne Medical Products, Inc. Precision blade electrosurgical instrument
US20190159828A1 (en) * 2017-11-29 2019-05-30 Meshil A.M.O.H. Al-Jarba Active electrode assembly for an electrosurgical device
CN112512453A (zh) * 2018-08-03 2021-03-16 日本帕卡濑精株式会社 具有表面处理覆膜的外科用电极
US20200060751A1 (en) * 2018-08-24 2020-02-27 Covidien Lp Cutting electrode enhancement for laparoscopic electrosurgical device

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