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WO2025103898A1 - Instrument chirurgical à effecteur - Google Patents

Instrument chirurgical à effecteur Download PDF

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Publication number
WO2025103898A1
WO2025103898A1 PCT/EP2024/081673 EP2024081673W WO2025103898A1 WO 2025103898 A1 WO2025103898 A1 WO 2025103898A1 EP 2024081673 W EP2024081673 W EP 2024081673W WO 2025103898 A1 WO2025103898 A1 WO 2025103898A1
Authority
WO
WIPO (PCT)
Prior art keywords
electrode
surgical instrument
proximal
distal
jaw part
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.)
Pending
Application number
PCT/EP2024/081673
Other languages
German (de)
English (en)
Inventor
Justin Danny Cik
Nikolaus Hafner
Patrick HEIZMANN
Thomas MASER
Tom Schweitzer
Boris Teodorovic
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Aesculap AG
Original Assignee
Aesculap AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Aesculap AG filed Critical Aesculap AG
Publication of WO2025103898A1 publication Critical patent/WO2025103898A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

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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
    • A61B18/1442—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
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • 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
    • A61B2018/00065—Material properties porous
    • 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
    • A61B2018/00601—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
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B2018/146—Scissors

Definitions

  • the present disclosure relates to a surgical instrument, in particular a medical high-frequency surgical instrument (HF instrument), which is preferably designed in the form of a bipolar vessel sealing instrument, with an effector having two legs movable relative to one another.
  • HF instrument medical high-frequency surgical instrument
  • high-frequency surgery also known as HF surgery
  • a high-frequency alternating current is passed through the human body or a body part to specifically cauterize (coagulate) or cut (electrotomy) tissue through the resulting heat.
  • the damaged tissue is later reabsorbed by the surrounding healthy tissue.
  • a significant advantage over conventional cutting techniques using a scalpel is that bleeding can be stopped simultaneously with the incision by closing the affected vessels, a process known as coagulation.
  • One pole of the HF voltage source is connected to the patient via a counter electrode with the largest possible surface area, for example, through contacts on the operating table on which the patient lies, through contact armbands or contact foot bands, or through adhesive electrodes.
  • This counter electrode is often called the neutral electrode.
  • the other pole is connected to the surgical instrument, which forms the so-called active electrode.
  • the current flows along the path of least resistance from the Active electrode to neutral electrode.
  • the current density is highest in the immediate vicinity of the active electrode, where the thermal effect is most pronounced.
  • the current density decreases with the square of the distance.
  • the neutral electrode should have as large a surface area as possible and be well connected to the body so that the current density in the body is kept low and burns are avoided.
  • the skin at the neutral electrode is not noticeably heated due to its large surface area. Strict safety measures apply when applying the neutral electrode. To avoid burns, correct positioning and good contact of the neutral electrode (depending on the surgical area) are crucial.
  • the current flows through a small part of the body—the part where the surgical effect (incision or coagulation) is desired.
  • Two mutually insulated metal electrodes housed in the arms of the HF instrument's effector, with the HF voltage applied between them, are applied directly to the surgical site. The circuit is closed via the intervening tissue. The thermal effect occurs in the tissue between the metal electrodes.
  • the effectors are preferably manufactured/designed in a sandwich construction.
  • the effectors consist of or have a thin metal electrode, which acts as the contact surface to the tissue, a plastic spacer, which provides electrical and thermal insulation, and a carrier component, which is designed and configured to ensure force transmission and contains a closing mechanism.
  • the carrier component provides the effector with the necessary stability and rigidity.
  • such a solid metal electrode has a high thermal mass, which, especially with larger effectors, means that a large part of the energy supplied to the metal electrode by an RF generator does not flow into the tissue sealing but into the heating of the solid metal electrode.
  • the object of the present disclosure is to provide a surgical instrument in which temperature control and, in particular, the dynamics of a temperature change of the electrode(s) or the electrode carrier(s)/electrode sections of the effector are improved.
  • the object is achieved by the surgical instrument, in particular an HF instrument (high-frequency instrument) of the forceps or shaft type, with an effector or effector region which has two legs which are movable relative to one another, of which at least one leg is divided into a distal leg section intended for the application of at least one electrode (hereinafter referred to as electrode for the sake of simplicity) and an electrode-free or non-electrode-provided distal leg section.
  • HF instrument high-frequency instrument
  • the surgical instrument in particular an HF instrument (high-frequency instrument) of the forceps or shaft type, with an effector or effector region which has two legs which are movable relative to one another, of which at least one leg is divided into a distal leg section intended for the application of at least one electrode (hereinafter referred to as electrode for the sake of simplicity) and an electrode-free or non-electrode-provided distal leg section.
  • the proximal leg section (hereinafter referred to simply as the jaw part for the sake of simplicity) is divided into two sections, each of which is provided with a proximal leg portion (hereinafter referred to as the jaw part) intended for occupancy with at least one electrode, in the region of which the two legs have a coupling point at which they are coupled to one another in a relatively movable manner.
  • the proximal leg section, i.e. the jaw part, of at least one of the legs consists at least in part of a porous base material (microporous) and/or is formed or provided (at least) outside the coupling point with at least partially open cavities (macroporous).
  • microporous refers to cavities that are forming or have formed in the base material, such as those found in ceramic materials, sponges, foams, sintered materials and similar materials, or which represent a material property
  • macroporous refers to cavities that are introduced into the possibly already microporous base material in a quasi-constructive (design-based) manner, such as lattice-like structures using a rapid prototype process, perforation, drilling, etc. or any structures, such as churning, stirring, aeration, tempering, etc. It should be noted that microporous and macroporous cavities do not necessarily have to differ in their dimensions, although micropores are generally smaller and/or have a different shape than macropores.
  • the surgical instrument in particular an HF instrument (high-frequency instrument), having an effector or effector region with two legs that are (manually) movable relative to one another between an open state (release or receiving state) and a closed state (clamping or fixing or gripping state) of the surgical instrument, wherein at least one of the legs has the at least one electrode or the electrode section having a plurality of electrodes for contacting tissue and the jaw part or jaw part section arranged proximal to the at least one electrode or to the electrode section (which is not provided with an electrode or electrodes and is also not intended for contacting tissue).
  • HF instrument high-frequency instrument
  • This (electrodeless/electrode-free) jaw part of at least one of the legs has, is (or consists of) a porous structure.
  • the problem is solved by a surgical instrument of either the shaft design (in this case, the legs of the effector are arranged at the distal end section of an instrument shaft and coupled to a handle at the proximal end section of the shaft via an actuating cable within the shaft) or the scissors or forceps design (in this case, each leg of the effector is preferably integrally connected to a proximally adjoining branch, which in turn forms or has a handle), with a distal, jaw-like effector.
  • the effector has or consists of two legs which can be moved relative to one another via a coupling, for example a joint or a hinge, in a proximal leg section (proximal jaw part), preferably in a scissor-like manner, whereby this proximal leg section (proximal jaw part) of one leg forms a so-called end part.
  • end part is a type of (end) box which is a component of one leg and into which the possibly plate-shaped proximal leg section (proximal jaw part) of the other leg is inserted in a relatively movable, preferably relatively pivotable manner.
  • the surgical instrument can, for example, be a bipolar HF instrument in a scissors or forceps design or a laparoscopic design.
  • the surgical instrument includes at least one, preferably two contact electrodes, each of which is formed on one of the legs, in particular on the distal leg section, or can be coupled to one of the legs, in particular to one of the distal leg sections.
  • the contact electrodes are preferably at least partially made of metal or coated with metal. Embodiments with a plurality of contact electrodes are also conceivable, which are arranged distributed over the leg, in particular the distal leg section.
  • the contact electrode preferably includes at least one flat section, which is designed as a contact surface and faces an intermediate space/interior of the effector.
  • the contact surface of the contact electrode is made of metal or coated with metal.
  • the jaw part is formed, flanged, or connected to a proximal end portion of the electrode.
  • the jaw part can be coupled, or can be coupled, or connected, or formed with a (proximal) branch.
  • the jaw part has or consists of a porous base material and/or has a porous structure. This means that at least the aforementioned box-shaped, proximal leg portion is porous, at least in some regions.
  • Porosity is understood to mean that the jaw part has, at least in some regions, a hollow portion, optionally uniformly distributed over the volume or a volume section of the jaw part.
  • the jaw part can be configured with a plurality of three-dimensionally arranged cavities, which may be interconnected and/or partially open to the outside.
  • the three-dimensionally arranged cavities can, at least in some sections, preferably be arranged and/or formed in a regular manner.
  • the thermally relevant mass of the jaw part can be reduced (significantly), preferably without (or only slightly) compromising the stiffness or strength of the jaw part. Furthermore, a surface area of the jaw part can be (significantly) enlarged (particularly due to the open porosity), so that thermal energy from the jaw part or thermal energy introduced/introduced into the jaw part by the electrode can be dissipated/dissipated into a medium surrounding the jaw part (ambient air, patient fluid, etc.).
  • proximal leg section is porous or has porous regions (as defined above) which adjoins the electrode or the distal leg region equipped with electrodes, whereas all other regions, in particular the distal leg section (electrode) and more preferably the branch proximally adjoining the proximal leg section (jaw part), are not (or less) porous.
  • the electrode may have a substantially constant cross-sectional area in a first extension direction from distal to proximal.
  • the electrode can extend substantially in the first extension direction.
  • the first extension direction is a direction extending from a distal end of the jaw-like effector to a proximal end of the effector.
  • the cross-sectional area is an area that is oriented/spanned substantially normal to the extension direction of the electrode.
  • the cross-sectional area of the electrode can be substantially constant across the extension of the electrode in the first extension direction. In still other words, the cross-section can be uniform along the electrode, i.e., without large jumps.
  • the constant cross-sectional area of the electrode enables uniform heating of the electrode along its length. This can also have a positive effect on the sealing quality of the surgical instrument, thus generally enabling a more uniform and better seal.
  • the electrode may have at least one elongated hole extending in the first extension direction, wherein a width of the elongated hole changes over the extension of the elongated hole.
  • the electrode can have at least one elongated hole, preferably a plurality of elongated holes.
  • the at least one elongated hole can be formed in a support section facing away from the contact surface of the electrode.
  • the support section can essentially form a T-shape with the contact surface and stiffen the contact surface or the electrode.
  • the width of the elongated hole i.e., the dimension of the elongated hole in a direction normal to the contact surface, can vary from distal to proximal over the extension of the elongated hole along the longitudinal direction of the electrode.
  • the width of the elongated hole can increase from distal to proximal.
  • the width of each of the elongated holes may increase from distal to proximal across the electrode's length. In other words, the overall width of the elongated holes may increase from distal to proximal across the electrode's length.
  • the elongated holes allow for the electrode's contact surface to widen from distal to proximal. In other words, the elongated holes allow for a uniform/constant cross-section of the electrode to be achieved/ensured.
  • support struts can be formed in the at least one intermediate region.
  • support struts can be formed in the intermediate region between two elongated holes, connecting a rear side facing the support section of the electrode to the support section.
  • the support struts can be solid ribs, inclined columns, or other suitable geometries.
  • an insulating cap may be designed to surround the electrode, at least in sections, wherein the insulating cap may be designed with spacer elements in order to form or delimit at least one, preferably several, air chambers between the insulating cap and the electrode.
  • the insulating cap can be configured to enclose and insulate the electrode, and in particular the support portion of the electrode.
  • the insulating cap can include spacer elements that abut the electrode and position a body of the insulating cap at a distance from the electrode to form the air chamber or chambers between the insulating cap and the electrode.
  • Air is a good insulator, so the at least one air chamber formed between the insulating cap and the electrode allows the electrode to be well insulated from the environment surrounding the electrode or effector. This allows for rapid heating of the electrode or the electrode's contact surface and reduces energy loss during the heating process. Furthermore, the insulating cap can reduce the risk of burns for a user of the surgical instrument from the hot electrode.
  • At least one latching hook can be formed on a first, preferably distal, end portion of the insulating cap and a snap edge can be formed on a second, preferably proximal, end portion of the insulating cap in order to engage with the electrode and fix the insulating cap to the electrode.
  • the insulating cap can be designed with a locking and snap-in mechanism to fix the insulating cap to the electrode without the need for tools, preferably in a form-fitting manner.
  • the locking hook and/or the snap-in edge of the insulating cap can engage in one or more of the elongated holes in a form-fitting manner.
  • a hook can be formed at the tip, i.e. the distal end, of the electrode to receive the locking hook of the insulating cap.
  • the locking and snapping mechanism can permanently connect the insulating cap and the electrode.
  • the locking and snapping mechanism can be designed to form a detachable connection between the electrode and the insulating cap.
  • the porous base material may be or have a lattice structure.
  • the porous base material of the jaw part can be formed as a lattice structure or contain a lattice structure. Alternatively, it is also conceivable to form only sections of the jaw part from the lattice structure.
  • the porous base material can be constructed from three-dimensional, periodically arranged lattice and/or cell structures.
  • Common lattice cells are body-centered cubic cells, face-centered cubic cells, simple cubic cells, or space frameworks.
  • Other possible lattice types/lattice structures are the part graph lattice, the volume graph lattice, the 3D conformal structure lattice, the unit graph lattice, the quad graph lattice, or the ground graph lattice.
  • Such lattice structures can be produced using additive manufacturing processes in different porosities, i.e., with different distances between the individual lattice bars.
  • a lattice can absorb forces in different spatial directions and thus contribute to the stiffening of the jaw part or the leg without significantly increasing the mass.
  • the type of lattice can be adapted/selected. It is also conceivable to adapt the type and design of the lattice depending on the location on the Metal electrode or a load situation on the jaw part to adapt/select.
  • the grid structure also makes it easy to increase/enlarge the surface area for heat transfer from the jaw part to the environment without increasing the installation space required for the jaw part.
  • the lattice structure may be a three-dimensional crossing lattice structure.
  • the grid structure can be a three-dimensional grid structure.
  • the three-dimensional grid structure can also be an intersecting grid structure.
  • An intersecting grid structure is understood to mean a grid structure in which grid bars meet or intersect at a center point of a grid standard cell.
  • the grid standard cell can be designed in such a way that, starting from each corner of the grid standard cell, a grid bar runs towards the center of the grid standard cell and the grid bars cross and/or meet at/in the center of the grid standard cell.
  • the lattice structure By designing the lattice structure in this way, the surface area of the lattice structure can be further increased. In addition, the load-bearing capacity and torsional stiffness of the lattice structure can be maximized without significantly increasing the mass of the lattice structure.
  • the porous base material preferably the porosity or a mesh size or the grid width of the porous base material, can change over an extension of the jaw part, preferably in the first extension direction.
  • the porous base material can change in a property, in particular in a density of the porous base material or the mesh size or the grid width in an extension direction of the jaw part.
  • the porous base material itself can differ in its properties from different sections or positions of the jaw part.
  • This type of porous base material allows the jaw part to be designed for optimized load and thermal performance. In other words, this type of design allows for the forces acting on the jaw part to be taken into account while simultaneously reducing material and increasing surface area.
  • the porosity or mesh size of the porous base material may increase in a distal to proximal direction in a stepwise or linear or dynamic manner.
  • the porous base material can decrease in density from the electrode across the jaw.
  • the density decrease can occur in a stepwise or linear manner.
  • porous base material design enables effective heat dissipation from the electrode.
  • the coarser the porous base material can be designed to improve heat exchange with the environment.
  • the porosity or mesh size on a force flow path/load section/force conduction section of the jaw part may be reduced.
  • the density of the porous base material of the jaw part can be increased on the force flow path of the jaw part.
  • the load section of the jaw part connecting the electrode and the branch can be designed with increased density, i.e., a reduced mesh size or porosity.
  • Embodiments in which the load section is solid are also conceivable.
  • the jaw part can be further optimized in terms of load and thermal performance without significantly increasing the mass of the jaw part.
  • the porous base material can be designed as a sponge structure or a bionic structure.
  • a bionic structure is defined as a structure that is based on geometries found in nature or biology.
  • the porous base material can be formed, for example, as a honeycomb structure or as another load-oriented geometry known from nature.
  • the porosity of the porous structure can be designed differently/load-oriented at different locations on the jaw.
  • a load-adapted truss structure can be formed from the rod structures.
  • the electrode and the jaw part can be formed in a heat-conducting manner, preferably in one piece.
  • the electrode and the jaw part can be connected to each other in such a way that heat is dissipated/dissipated from the electrode into the jaw part.
  • the electrode and the jaw part can be formed as a single piece, in particular as a single piece of material.
  • the electrode and the jaw part can be monolithic. "Monolithic" means consisting of a single, inseparable unit.
  • the leg can be formed as a single piece.
  • at least the contact surface and the support section, as well as the jaw part can be formed as a monolithic/single piece with the porous base material.
  • the monolithic design allows for high component rigidity. Furthermore, the manufacturing of the leg, and especially the jaw part, is simplified, as a joining process between the individual assemblies and elements is eliminated. Furthermore, the reduction in the number of components prevents the accumulation of manufacturing tolerances, which increases manufacturing accuracy and thus the quality of the HF instrument's effector.
  • At least the electrode and the jaw part can be formed additively, preferably from metal.
  • At least the porous base material can be an additively manufactured structure.
  • Additive manufacturing involves manufacturing processes that are formed by material deposition, preferably in layered buildup processes, and thus differs from abrasive manufacturing processes in which material is removed.
  • the porous base material can be a 3D-printed structure, which can be formed, for example, by means of selective laser melting, selective electron beam melting, laser cladding, wire arc/plasma arc energy deposition or wire feed electron deposition.
  • the leg can be coated or overmolded with a coating, at least in sections.
  • the entire mouth can be coated with the exception of the branch or a branch connection or a branch coupling section and the electrode or the contact surface of the electrode.
  • the coating primarily serves as electrical insulation.
  • the coating also has a significant influence on thermal insulation.
  • the coating can be thermally and/or electrically insulating and made of a plastic, preferably polyetheretherketone, polyketone, Rilsan or the like.
  • the coating has good thermal insulating properties.
  • the heat transfer from the electrode to the insulating cap is minimized. Keeping the contact area between the electrode and the insulating cap as small as possible increases thermal resistance. This can be further enhanced by increasing the thickness of the insulating cap.
  • heat transfer from the insulation cap to the environment surrounding the electrode is as optimal as possible.
  • thermal resistance is reduced.
  • heat transfer from the electrode to the jaws is as good as possible.
  • the heat transfer from the jaw part to the jaw part coating/insulation is as good as possible. The heat temporarily stored in the jaw part should be directed into the jaw part insulation. The thermal resistance can be reduced by ensuring the largest possible contact area between the jaw part and the coating/insulation.
  • the thin insulation/coating on the jaw is designed to dissipate heat to the environment over the largest possible surface area.
  • Fig. 1 is a perspective view of a bipolar RF instrument according to the disclosure
  • Fig. 2 is an illustration of a leg of the RF instrument according to the disclosure
  • Fig. 3 is a perspective view of a leg electrode
  • Fig. 4 is an enlarged view of a jaw-like effector of the bipolar RF instrument without a coating
  • Fig. 5 is a schematic representation of a lattice structure of a porous structure of a jaw part of the effector
  • Fig. 6 is an illustration of the jaw part in a first embodiment
  • Fig. 7 is a representation of the leg with the jaw part in a second embodiment
  • Fig. 8 is an illustration of the jaw part in a third embodiment
  • Fig. 9 is a representation of the leg with the jaw part in a fourth embodiment
  • Fig. 10 is an illustration of the leg with the jaw part in a fifth embodiment
  • Fig. 11 is an illustration of an insulating cap in a first embodiment
  • Fig. 12 is a view of the insulating cap in the first embodiment mounted on the electrode
  • Fig. 13 is a view of the insulating cap in a second embodiment mounted on the electrode.
  • Fig. 14 is a schematic diagram of an assembly process of the insulating cap on the electrode.
  • Fig. 1 shows a bipolar HF instrument 1 according to the disclosure.
  • the HF instrument 1 is designed as a scissor-type instrument.
  • other designs such as a laparoscope-type instrument, are also possible.
  • the HF instrument 1 contains two scissor elements 3 which are movable relative to each other and which are movable in a hinge 5 or a final part are connected to one another.
  • a branch 7 extends proximally in/on each of the scissor elements 3.
  • a ring 9 is formed at a proximal end section of each of the branches 7. The two rings 9 of the two branches 7 can be grasped by a user of the HF instrument 1, and by actuating the rings 9, the scissor elements of the HF instrument 1 can be moved relative to one another.
  • Fig. 2 shows a leg 13 of the HF instrument 1.
  • An electrode 15 is formed at a distal end section of the leg 13.
  • the electrode 15 forms a fundamental functional component of the effector 11 of the HF instrument and will be explained in more detail later with reference to Fig. 3.
  • a jaw part 17 is integrally or monolithically connected.
  • the jaw part 17 has or consists of a porous base material 19.
  • a circular receptacle 21 is formed in the porous structure 19 to receive a bolt or a pin or a hinge element of the hinge 5.
  • the jaw part 17 will be explained in more detail later with reference to Figs. 4 to 10.
  • a branch receptacle 23 Proximally to the jaw part 17 is a branch receptacle 23.
  • the branch receptacle 23 is intended and designed to be fixed to the branch 7.
  • the branch receptacle 23 can be omitted, and the branch 7 can be connected directly to the jaw part 17.
  • the branch receptacle 23 is formed integrally with the electrode 15 and the jaw part 17.
  • the branch receptacle is detachably/reversibly connected to the jaw part 17.
  • Fig. 3 shows the electrode 15 in a perspective view.
  • the electrode 15 has a flat contact surface 25, which is intended and designed to contact and seal the tissue to be treated.
  • the contact surface 25 faces an interior of the effector 11 with a front side 27.
  • a support section 29 extends substantially normally from the contact surface 25.
  • the contact surface 25 and the support section 29 form a T-beam shape.
  • a cross-sectional area of the electrode 15 is substantially T-shaped, viewed in the longitudinal direction L of the electrode 15.
  • Elongated holes 31 are formed in the support section 29 along the longitudinal direction L of the electrode 15, i.e. in an extension from distal to proximal.
  • the elongated holes 31 have an extension in the longitudinal direction L and an extension in a width direction B.
  • the width direction is oriented normal to the contact surface 25 and normal to the longitudinal direction L.
  • the extension of the elongated holes 31 in the width direction i.e. the width of the elongated holes 31, increases continuously from distal to proximal.
  • an extension of the contact surface 25 in a depth direction T increases from distal to proximal.
  • the depth direction T is understood to be a direction oriented normal to the width direction B and normal to the longitudinal direction L.
  • the extent of the elongated holes 31 in the width direction B and the extent of the contact surface 25 in the depth direction are coordinated with one another such that the cross-sectional area of the electrode remains substantially constant in a plane spanned by the width direction B and the depth direction T along the longitudinal direction L of the electrode.
  • Embodiments are also conceivable in which the width of the elongated holes 31 changes gradually from distal to proximal, preferably increasing.
  • Support struts 33 are formed between the elongated holes 31 to connect the contact surface 25 and the support section 29.
  • the support struts 33 are oriented substantially at a 45° angle to the contact surface 25 and to the support section 29.
  • the support struts 33 are provided and designed to increase the rigidity and, in particular, the torsional rigidity of the electrode 15. Ribs or the like are conceivable as alternatives to the support struts 33.
  • a hook 35 is formed at a distal tip of the electrode 15, which will be described in more detail later with reference to Fig. 14.
  • Fig. 4 shows the leg 13 in a partially assembled state of the effector 11.
  • the jaw part 17 engages in a U-shaped manner around a counterpart 37, which belongs to the other scissor element 3.
  • the counterpart 37 contains a second electrode 39 and is connected to a second of the branches 7.
  • the jaw part 17 has two parallel jaw part walls 41 and a jaw part back 43 connecting the jaw part walls 41. Both the jaw part walls 41 and the jaw part back 43 are formed with the porous structure 19. In other words, the jaw part walls 41 and the jaw part back 43 are essentially formed from the porous structure 19.
  • the porous base material 19 forms a cooling structure of the jaw part 17 and thus a cooling structure of the effector 11.
  • lattice geometries/lattice structures are also possible, such as a cubic face-centered lattice structure in which the lattice bars 47 are arranged along edges of the lattice cell 45.
  • Fig. 6 shows the jaw part 17 in a first embodiment.
  • a grid cell size is a small grid cell size.
  • the grid structure is a dense/close-meshed grid structure.
  • the density of the jaw part 17 in the first embodiment is high and the porosity is low.
  • the grid cell size is substantially constant across the extent of the jaw part 17.
  • Fig. 7 shows the leg 13 with the jaw part 17 in a second embodiment.
  • the grid cell size is a medium grid cell size.
  • the grid structure in the second Embodiment a lattice structure of medium density.
  • the porosity of the jaw part 17 in the second embodiment is medium porosity.
  • the lattice cell size is essentially constant across the extent of the jaw part 17.
  • Fig. 8 shows the jaw part 17 in a third embodiment.
  • a grid cell size is a large grid cell size.
  • the grid structure in the third embodiment is a coarse/large-meshed grid structure.
  • the density of the jaw part 17 in the third embodiment is low and the porosity is high.
  • the grid cell size is substantially constant across the extent of the jaw part 17.
  • the grid cell size allows the thermal conduction properties and heat capacity and heat dissipation properties of the leg 13 to be adjusted.
  • Fig. 9 shows the leg 13 with the jaw part 17 in a fourth embodiment.
  • the lattice structure is a stepped lattice structure.
  • the lattice structure is denser at a distal end of the jaw part 17 than at a proximal end of the jaw part 17.
  • the density of the jaw part 17 changes in three stages. Embodiments are also conceivable in which the density of the jaw part 17 decreases linearly, i.e., dynamically, over the longitudinal extent in the longitudinal direction L of the jaw part 17 from distal to proximal.
  • a partial area of the jaw part walls 41 which connects an electrode connection 53 to the receptacle 21 and the branch receptacle 23, is formed with a grid structure with a higher density than a main part of the jaw part walls 41.
  • Fig. 11 shows an insulating cap 55.
  • the insulating cap is provided and designed to be fixed to the electrode 15.
  • Wall-shaped spacer elements 57 are formed on a section of the insulating cap 55 facing the electrode 15 in the assembled state.
  • the spacer elements 57 are provided and designed to form air chambers 59 between the insulating cap 55 and the electrode 15.
  • a latching hook 61 is formed on a distal end section of the insulating cap 55.
  • the latching hook 61 is provided and designed to positively engage the hook 35 of the electrode (see Fig. 14).
  • Snap edges 63 are formed on a proximal end section of the insulating cap 55 to engage the elongated holes 31.
  • Fig. 12 shows the insulating cap 55 from Fig. 11 in an assembled state.
  • An air gap 65 is formed between the insulating cap 55 and the electrode 15. In other words, the insulating cap 55 does not lie completely flush against the electrode 15 in the assembled state.
  • Fig. 13 shows an alternative embodiment of the insulating cap 55.
  • the insulating cap 55 lies flush against the electrode 15 in the assembled state.
  • no air gap is formed between the insulating cap 55 and the electrode 15.
  • the following describes an assembly process of the insulating cap 55 on the electrode 15 with reference to Fig. 14.
  • the insulating cap 55 is shown in a half-section for better illustration.
  • the locking hook 61 of the insulating cap 55 is hooked into the hook 35 of the electrode 15.
  • the insulating cap 55 is pushed onto the electrode 15 in the longitudinal direction L.
  • the snap edges 63 are brought into engagement with the elongated hole 31.
  • the insulating cap 55 is pushed onto the electrode 15 in the width direction B or in a negative width direction.
  • the snap connection thus formed can be released non-destructively in the reverse order of the steps.
  • the snap connection can also be designed as a non-detachable (not non-destructively removable) connection.
  • the electrode 15 and the jaw part 17 can be formed monolithically additively, i.e. the electrode 15 and the jaw part 17 and optionally the branch holder can be manufactured in one piece using a generative manufacturing process.

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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

La présente invention concerne un instrument chirurgical (1), en particulier un instrument HF conçu sous la forme de mâchoires ou d'un arbre, ayant un effecteur (11) ou une région effectrice qui a deux membres (13) qui peuvent être déplacés l'un par rapport à l'autre, dont au moins un membre est divisé en une partie de membre distale (15), destinée à être occupée par au moins une électrode, et en une partie de membre proximale (17), qui est exempte d'électrode et/ou non destinée à être occupée par au moins une électrode, dans la région de partie de membre au niveau de laquelle les deux membres (13) ont un point d'accouplement (5) auquel ils sont accouplés ensemble pour un mouvement relatif. La partie de membre proximale (17) est constituée au moins en partie d'un matériau de base (19) poreux, en particulier microporeux, et/ou est conçue de manière à avoir ou être pourvue de cavités au moins en partie ouvertes, de préférence macroporeuses, à l'exception du point d'accouplement (5).
PCT/EP2024/081673 2023-11-14 2024-11-08 Instrument chirurgical à effecteur Pending WO2025103898A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102023131675.3A DE102023131675A1 (de) 2023-11-14 2023-11-14 Chirurgisches Instrument mit einem Effektor
DE102023131675.3 2023-11-14

Publications (1)

Publication Number Publication Date
WO2025103898A1 true WO2025103898A1 (fr) 2025-05-22

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DE (1) DE102023131675A1 (fr)
WO (1) WO2025103898A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090125026A1 (en) * 2007-11-13 2009-05-14 Boston Scientific Scimed, Inc. Apparatus system and method for coagulating and cutting tissue
US20200100833A1 (en) * 2018-10-01 2020-04-02 Covidien Lp Electrosurgical instrument and passively cooled jaw members thereof
US20210369333A1 (en) * 2020-05-29 2021-12-02 Gyrus Acmi, Inc. D/B/A Olympus Surgical Technologies America Monolithic ceramic surgical device and method

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102005011869A1 (de) * 2004-03-22 2005-10-13 Erbe Elektromedizin Gmbh Bipolare Klemme

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090125026A1 (en) * 2007-11-13 2009-05-14 Boston Scientific Scimed, Inc. Apparatus system and method for coagulating and cutting tissue
US20200100833A1 (en) * 2018-10-01 2020-04-02 Covidien Lp Electrosurgical instrument and passively cooled jaw members thereof
US20210369333A1 (en) * 2020-05-29 2021-12-02 Gyrus Acmi, Inc. D/B/A Olympus Surgical Technologies America Monolithic ceramic surgical device and method

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Publication number Publication date
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