CA2130554C - Electrosurgical bipolar cutting handpiece - Google Patents
Electrosurgical bipolar cutting handpieceInfo
- Publication number
- CA2130554C CA2130554C CA002130554A CA2130554A CA2130554C CA 2130554 C CA2130554 C CA 2130554C CA 002130554 A CA002130554 A CA 002130554A CA 2130554 A CA2130554 A CA 2130554A CA 2130554 C CA2130554 C CA 2130554C
- Authority
- CA
- Canada
- Prior art keywords
- electrode
- distal end
- handpiece
- tissue
- exposed
- 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.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1402—Probes for open surgery
Abstract
An electrosurgical bipolar cutting apparatus comprising a handpiece (1) to which is connected a first active electrode and a second return electrode having exposed distal ends (6, 7) which define a tip for electrosurgically cutting tissue at an operational site on a patient, which tip is structured so that both distal ends simultaneously contact said tissue and wherein the active electrode has a higher tissue to electrode impedance than the return electrode.
Description
,._ ~130~
ELECTROSURGICAL BIPOLAR CUTTING HANDPIECE.
This invention relates to an el~ osurgical apparatus for cutting tissue and, more particularly, to an Ele 1,osurgical bipolar cutting apparatus.
The use of Flect,osurgery for cutting tissue is known in the art. A typical El~cbusurgical cutting apparal~s co"~priaes a handpiece having an active monopolar 10 electrode which conveys high frequency ele_t~ical energy from a generator to tissue at an operational site. The electric circuit is co",pleted through a retum electrode attached to the patient.
A monopolar elect,osurgical device gives s~tisfA~tory performance as long as the circuit is efficiently completed through the retum electrode. However, because of 15 possiLle dangers of ElE_tlical current flowing through the patient's body ~n undefined paths as it is conducted to the retum electrode, there has been a growing demand for a bipolar cutting device. A bipolar device is defined as a device which has two Elect,odes in close proximity to each other as well as to the surgical site and which does not require a patient retum elE ~lode for the pel lo""ance of save and efficacious 20 ele_tlosurgery.
In a bipolar device, one of the el~cbo~es is defined as the active electrode andthe other as the retum electrode. The active ~IE_t,ode must be carA~le of setting up a steam barrier with the tissue and be carA~le of performing the same operations of cut, blend and coag as a monopolar device.
The retum ele_tlode must be capa~'e of retuming the current delivered by the active electrode with minimal to no tissue desiccAl;on or destruction at its contact point with the patient's tissue.
Although bipolar instruments are known in the prior art, heretofore manufacturers have focused atler,lion on the generator output stage of units used with mono~,olar devices and a sAtisf~ctory and safe bipolar cutting device has not been produced.
It has now been found that a safe and efficacious bipolar cutting electrosurgical app~ alus is obtained by suitably controlling the configuration and characteristics of the bipolar ele_t,odes.
According to the presellt invention there is provided an ~IEct"~surgical bipolarcutting apparatus col~prisil.g a handpiece adapted to be connected to a generator which provides high frequency electrical energy for ~,e,lo""ing an electrosurgical operation, which handplece has mounted thereon a first actlve electrode havlng a proximal end and a dlstal end and a second return electrode havlng a proxlmal end and a dlstal end, the proxlmal end of each electrode belng connected to the handplece and the dlstal end of each electrode belng exposed and belng close to but spaced apart from the dlstal end of the other electrode, sald exposed dlstal ends deflnlng a blpolar tlp for electrosurglcally treatlng tlssue at an operatlonal slte on a patlent, whlch tlp ls structured so that both dlstal ends slmultaneously contact sald tlssue and whereln the exposed dlstal end of the actlve electrode ls substantlally the same slze as the exposed dlstal end of the return electrode and the exposed dlstal end of the actlve electrode ls coated wlth a hlgh lmpedance materlal so that the actlve electrode has a hlgher tlssue to electrode lmpedance than the return electrode.
As descrlbed above, to accomplish blpolar cuttlng one of the electrodes of the apparatus must have a substantlally larger tissue to electrode lmpedance than the other. As deflned hereln, the electrode havlng the hlgher tlssue contact lmpedance ls the actlve electrode and the electrode wlth low tlssue contact lmpedance ls the return electrode. Dlfferent technlques may be used to achleve the requlred dlfferentlatlon of tlssue contact lmpedance between the two electrodes, as descrlbed herelnafter.
Embodlments of the lnventlon may lnclude swltchlng means on the handpiece for actlvatlng the generator ln the -2a-cut, blend and coag modalltles. The cut and blend activatlon may be achleved by a single means of keylng where the modallty dellvered is defined by the generator conflguratlon.
The apparatus also may include capabillty for drlp lrrlgatlon, wlth posslble flow control, to keep the tlssue moist during surgery.
W O 93/19681 PC~r/US93/00018 3 ~ 13 0~ ~
Additionally, the apparatus may include suction means for aspiration of eschar and tissue debris.
Switching means for activation of the above car~h ';ties may be incorporated in the handpiece.
Plefer,ed embodiments of the invention are illustrated in the accompanying drawings, in which:
Fig. 1 is a sche"~alic side elevation of a standard electrosurgical pencil having a disposable bipolar electrode connected thereto;
Fig. 2 is an enlaryed side view, partly in section, of a bipolar elect, ode according to the invention;
Fig. 2A is an end view of the distal end of the bipolar electrode of Fig. 2;
Fig. 3 is a side view, partly in section, of another embodiment of a bipolar electrode accordi. ,g to the invention;
Fig. 3A is a view of the distal end of the electrode of Fig. 3; and Fig. 3B is a side view, partially cut-away, of another aspect of the embodiment of Fig. 3.
The appar~tus illustrated in Fig. 1 of the accG""~anying drawings includes a standard electrosurgical pencil cGIllprisi"9 a handpiece 1 adapted to be connected to an elect,usurgical generator through cables 2 and having a switch module 3 for activating the various modalities of the apparatus. The embodiment illu~ ted shows four switches, but the handpiece may contain any number of switches, depending upon the capabilities desired. For exar"r 'e, in addition to the cut car~ ty according to the invention, the appa~ ~lus may include the capabilities of coag, blend, aspi. tllion (suction) and/or irrigation. Circuitry for the selection and activation of these capabilities is known in the art and is not described in detail herein.
A disposable bipolar electroJe 4 is connected to the handpiece through a rele~c~ le cor,nector 5. The bipolar electrode comp,ises an active electrode with an ex~,osed distal end 6 and a retum ~lect,..de with an e~.osed distal end 7. The exposed distal ends 6, 7 define a tip for bipolar cutting, which tip is shown in more 30 detail in Fig. 2.
The bipolar elE_ttode 4 illustrated in detail in Fig. 2 comprises an active olect,ode with an Pxrosed distal end 6 and a retum electrode with an exposed distal end 7. The active electrode and retum electrode shown in the embodiment of Fig. 2 ~ ~3 o ~ PCl /US93/00018 are of the type known in the art as "needle~ electrodes and are made of an electrically conducting metal, for example, stainless steel. Typical needle electlodes have adiameter of about 0.5 mm. Apart from the exposed distal ends these needle electrodes are individually enveloped in a thin sleeve of electrically-insulating material 8, 9 such 5 as a polyalkylene or silicone rubber. The complete bipolar unit 4 is enveloped in a sleeve 10 of electrically-insulating material.
The active needle electrode and the return needle electrode are mounted in side-by-side relationship spaced apart by a high voltage r~sislarlt d El~ct~ic 11. The dielectlic material may be a plastic, such as polypropylene, or a ceramic.
The exposed distal end 6 of the active electrode is coated with a high i"~pedance material 12 such as a carboniferous ,naterial. The .li~erer,lial between the i",pedance of the active ~le~',ode and that of the retum is optimized to provide the desired cutting effect and pr~ferably it is at least two-fold.
The distal end of the active electrode and the distal end of the return electrode define a tip for bipolar elect,osurgical cutting and the Ji~ ce d between the distal ends is "~i~,i."i~ed so that open circuit voltage does not spark through the air gap between the electrodes. Using needle electrodes as desc,i6ed above, the distance d is of the order of 1 mm.
According to the invention, it is essential that the distal ends 6, 7 of the electrodes simultaneously contact tissue during operation of the apparatus.
Fig. 3 illustrates an alle" ,ati~/e embodiment of the invention wherein the exposed distal end 17 of the retum elect,ode is an annular ring spaced apart from the exposed distal end 16 of an axially ~isposed active ~le_tlode by a concer,l,ic ring 21 of high voltage resialarlt dielectric material.
Fig. 3A is an end view of this embodiment.
The retum electrode, apart from the ~'tl ~osed distal end, is individually insulated with a sleeve 19 of ele-t,i~ally-insulating material. The active electrode is similarly ins~ sted (not shown).
The complete bipolar ele_t~ode is ins~'sted with a sleeve 10 of insulating 30 ",alerial as shown in Fig. 3B.
To ensure simultaneous contact of both the active and retum electrodes with tissue during operation of the apparatus the distal end of the retum electrode is associated with spring means in the forrr~ of a colllplessiLle fluid 22 located in the WO 93/19681 PCr/US93/00018 ,~_ 2130~
annular ring. This com~.ressiL,le fluid maintains the annular distal end of the return elect,ode clear relative to the distal end of the active electlode when the apparatus is not in use but allows retraction of the distal end of the return electrode to provide an i"li",ate pressure contact with tissue when the a~,par~lus is used.
In this embodiment the distal end 16 of the active electrode may or may not be coated with a high impedance coating, depending upon achievement of the required;",peda~ce Ji~r~r~ntial for optimum pe"o"nance.
Providing the essential cha, act~ri~lics of impedance diiierenlial and simultaneous tissue contact are achieved, numerous variations in the specific 10 configuration of the bipolar electrode are possible within the scope of the invention.
By adhering to the stated characteristics, safe and ef~lcient bipolar electrosurgical cutting is achieved.
ELECTROSURGICAL BIPOLAR CUTTING HANDPIECE.
This invention relates to an el~ osurgical apparatus for cutting tissue and, more particularly, to an Ele 1,osurgical bipolar cutting apparatus.
The use of Flect,osurgery for cutting tissue is known in the art. A typical El~cbusurgical cutting apparal~s co"~priaes a handpiece having an active monopolar 10 electrode which conveys high frequency ele_t~ical energy from a generator to tissue at an operational site. The electric circuit is co",pleted through a retum electrode attached to the patient.
A monopolar elect,osurgical device gives s~tisfA~tory performance as long as the circuit is efficiently completed through the retum electrode. However, because of 15 possiLle dangers of ElE_tlical current flowing through the patient's body ~n undefined paths as it is conducted to the retum electrode, there has been a growing demand for a bipolar cutting device. A bipolar device is defined as a device which has two Elect,odes in close proximity to each other as well as to the surgical site and which does not require a patient retum elE ~lode for the pel lo""ance of save and efficacious 20 ele_tlosurgery.
In a bipolar device, one of the el~cbo~es is defined as the active electrode andthe other as the retum electrode. The active ~IE_t,ode must be carA~le of setting up a steam barrier with the tissue and be carA~le of performing the same operations of cut, blend and coag as a monopolar device.
The retum ele_tlode must be capa~'e of retuming the current delivered by the active electrode with minimal to no tissue desiccAl;on or destruction at its contact point with the patient's tissue.
Although bipolar instruments are known in the prior art, heretofore manufacturers have focused atler,lion on the generator output stage of units used with mono~,olar devices and a sAtisf~ctory and safe bipolar cutting device has not been produced.
It has now been found that a safe and efficacious bipolar cutting electrosurgical app~ alus is obtained by suitably controlling the configuration and characteristics of the bipolar ele_t,odes.
According to the presellt invention there is provided an ~IEct"~surgical bipolarcutting apparatus col~prisil.g a handpiece adapted to be connected to a generator which provides high frequency electrical energy for ~,e,lo""ing an electrosurgical operation, which handplece has mounted thereon a first actlve electrode havlng a proximal end and a dlstal end and a second return electrode havlng a proxlmal end and a dlstal end, the proxlmal end of each electrode belng connected to the handplece and the dlstal end of each electrode belng exposed and belng close to but spaced apart from the dlstal end of the other electrode, sald exposed dlstal ends deflnlng a blpolar tlp for electrosurglcally treatlng tlssue at an operatlonal slte on a patlent, whlch tlp ls structured so that both dlstal ends slmultaneously contact sald tlssue and whereln the exposed dlstal end of the actlve electrode ls substantlally the same slze as the exposed dlstal end of the return electrode and the exposed dlstal end of the actlve electrode ls coated wlth a hlgh lmpedance materlal so that the actlve electrode has a hlgher tlssue to electrode lmpedance than the return electrode.
As descrlbed above, to accomplish blpolar cuttlng one of the electrodes of the apparatus must have a substantlally larger tissue to electrode lmpedance than the other. As deflned hereln, the electrode havlng the hlgher tlssue contact lmpedance ls the actlve electrode and the electrode wlth low tlssue contact lmpedance ls the return electrode. Dlfferent technlques may be used to achleve the requlred dlfferentlatlon of tlssue contact lmpedance between the two electrodes, as descrlbed herelnafter.
Embodlments of the lnventlon may lnclude swltchlng means on the handpiece for actlvatlng the generator ln the -2a-cut, blend and coag modalltles. The cut and blend activatlon may be achleved by a single means of keylng where the modallty dellvered is defined by the generator conflguratlon.
The apparatus also may include capabillty for drlp lrrlgatlon, wlth posslble flow control, to keep the tlssue moist during surgery.
W O 93/19681 PC~r/US93/00018 3 ~ 13 0~ ~
Additionally, the apparatus may include suction means for aspiration of eschar and tissue debris.
Switching means for activation of the above car~h ';ties may be incorporated in the handpiece.
Plefer,ed embodiments of the invention are illustrated in the accompanying drawings, in which:
Fig. 1 is a sche"~alic side elevation of a standard electrosurgical pencil having a disposable bipolar electrode connected thereto;
Fig. 2 is an enlaryed side view, partly in section, of a bipolar elect, ode according to the invention;
Fig. 2A is an end view of the distal end of the bipolar electrode of Fig. 2;
Fig. 3 is a side view, partly in section, of another embodiment of a bipolar electrode accordi. ,g to the invention;
Fig. 3A is a view of the distal end of the electrode of Fig. 3; and Fig. 3B is a side view, partially cut-away, of another aspect of the embodiment of Fig. 3.
The appar~tus illustrated in Fig. 1 of the accG""~anying drawings includes a standard electrosurgical pencil cGIllprisi"9 a handpiece 1 adapted to be connected to an elect,usurgical generator through cables 2 and having a switch module 3 for activating the various modalities of the apparatus. The embodiment illu~ ted shows four switches, but the handpiece may contain any number of switches, depending upon the capabilities desired. For exar"r 'e, in addition to the cut car~ ty according to the invention, the appa~ ~lus may include the capabilities of coag, blend, aspi. tllion (suction) and/or irrigation. Circuitry for the selection and activation of these capabilities is known in the art and is not described in detail herein.
A disposable bipolar electroJe 4 is connected to the handpiece through a rele~c~ le cor,nector 5. The bipolar electrode comp,ises an active electrode with an ex~,osed distal end 6 and a retum ~lect,..de with an e~.osed distal end 7. The exposed distal ends 6, 7 define a tip for bipolar cutting, which tip is shown in more 30 detail in Fig. 2.
The bipolar elE_ttode 4 illustrated in detail in Fig. 2 comprises an active olect,ode with an Pxrosed distal end 6 and a retum electrode with an exposed distal end 7. The active electrode and retum electrode shown in the embodiment of Fig. 2 ~ ~3 o ~ PCl /US93/00018 are of the type known in the art as "needle~ electrodes and are made of an electrically conducting metal, for example, stainless steel. Typical needle electlodes have adiameter of about 0.5 mm. Apart from the exposed distal ends these needle electrodes are individually enveloped in a thin sleeve of electrically-insulating material 8, 9 such 5 as a polyalkylene or silicone rubber. The complete bipolar unit 4 is enveloped in a sleeve 10 of electrically-insulating material.
The active needle electrode and the return needle electrode are mounted in side-by-side relationship spaced apart by a high voltage r~sislarlt d El~ct~ic 11. The dielectlic material may be a plastic, such as polypropylene, or a ceramic.
The exposed distal end 6 of the active electrode is coated with a high i"~pedance material 12 such as a carboniferous ,naterial. The .li~erer,lial between the i",pedance of the active ~le~',ode and that of the retum is optimized to provide the desired cutting effect and pr~ferably it is at least two-fold.
The distal end of the active electrode and the distal end of the return electrode define a tip for bipolar elect,osurgical cutting and the Ji~ ce d between the distal ends is "~i~,i."i~ed so that open circuit voltage does not spark through the air gap between the electrodes. Using needle electrodes as desc,i6ed above, the distance d is of the order of 1 mm.
According to the invention, it is essential that the distal ends 6, 7 of the electrodes simultaneously contact tissue during operation of the apparatus.
Fig. 3 illustrates an alle" ,ati~/e embodiment of the invention wherein the exposed distal end 17 of the retum elect,ode is an annular ring spaced apart from the exposed distal end 16 of an axially ~isposed active ~le_tlode by a concer,l,ic ring 21 of high voltage resialarlt dielectric material.
Fig. 3A is an end view of this embodiment.
The retum electrode, apart from the ~'tl ~osed distal end, is individually insulated with a sleeve 19 of ele-t,i~ally-insulating material. The active electrode is similarly ins~ sted (not shown).
The complete bipolar ele_t~ode is ins~'sted with a sleeve 10 of insulating 30 ",alerial as shown in Fig. 3B.
To ensure simultaneous contact of both the active and retum electrodes with tissue during operation of the apparatus the distal end of the retum electrode is associated with spring means in the forrr~ of a colllplessiLle fluid 22 located in the WO 93/19681 PCr/US93/00018 ,~_ 2130~
annular ring. This com~.ressiL,le fluid maintains the annular distal end of the return elect,ode clear relative to the distal end of the active electlode when the apparatus is not in use but allows retraction of the distal end of the return electrode to provide an i"li",ate pressure contact with tissue when the a~,par~lus is used.
In this embodiment the distal end 16 of the active electrode may or may not be coated with a high impedance coating, depending upon achievement of the required;",peda~ce Ji~r~r~ntial for optimum pe"o"nance.
Providing the essential cha, act~ri~lics of impedance diiierenlial and simultaneous tissue contact are achieved, numerous variations in the specific 10 configuration of the bipolar electrode are possible within the scope of the invention.
By adhering to the stated characteristics, safe and ef~lcient bipolar electrosurgical cutting is achieved.
Claims (3)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:
1. An electrosurgical bipolar treating apparatus comprising a handpiece adapted to be connected to a generator which provides high frequency electrical energy for performing an electrosurgical operation, which handpiece has mounted thereon a first active electrode having a proximal end and a distal end and a second return electrode having a proximal end and a distal end, the proximal end of each electrode being connected to the handpiece and the distal end of each electrode being exposed and being close to but spaced apart from the distal end of the other electrode, said exposed distal ends defining a bipolar tip for electrosurgically treating tissue at an operational site on a patient, which tip is structured so that both distal ends simultaneously contact said tissue and wherein the exposed distal end of the active electrode is substantially the same size as the exposed distal end of the return electrode and the exposed distal end of the active electrode is coated with a high impedance material so that the active electrode has a higher tissue to electrode impedance than the return electrode.
2. An apparatus according to claim 1 which includes hand-operated switching means mounted on the handpiece for activating said electrodes.
3. An apparatus according to claim 2, in which the electrosurgical operation includes blend and coag and said switching means also includes switches for activating the generator in the blend and coag modalities.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US860,816 | 1992-03-31 | ||
US07/860,816 US5281216A (en) | 1992-03-31 | 1992-03-31 | Electrosurgical bipolar treating apparatus |
Publications (2)
Publication Number | Publication Date |
---|---|
CA2130554A1 CA2130554A1 (en) | 1993-10-14 |
CA2130554C true CA2130554C (en) | 1999-03-02 |
Family
ID=25334091
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002130554A Expired - Lifetime CA2130554C (en) | 1992-03-31 | 1993-01-11 | Electrosurgical bipolar cutting handpiece |
Country Status (10)
Country | Link |
---|---|
US (1) | US5281216A (en) |
EP (1) | EP0633749B1 (en) |
JP (1) | JP2648239B2 (en) |
AT (1) | ATE156987T1 (en) |
AU (1) | AU670258B2 (en) |
CA (1) | CA2130554C (en) |
DE (2) | DE69313269T2 (en) |
FI (1) | FI944522A (en) |
NO (1) | NO943627L (en) |
WO (1) | WO1993019681A1 (en) |
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JPS62211060A (en) * | 1986-03-12 | 1987-09-17 | オリンパス光学工業株式会社 | High frequency treatment tool |
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DE9104876U1 (en) | 1991-04-22 | 1991-08-14 | Select Medizin-Technik Hermann Sutter Gmbh, 7800 Freiburg, De |
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1992
- 1992-03-31 US US07/860,816 patent/US5281216A/en not_active Expired - Lifetime
-
1993
- 1993-01-11 AT AT93902903T patent/ATE156987T1/en not_active IP Right Cessation
- 1993-01-11 CA CA002130554A patent/CA2130554C/en not_active Expired - Lifetime
- 1993-01-11 JP JP5517414A patent/JP2648239B2/en not_active Expired - Lifetime
- 1993-01-11 AU AU34306/93A patent/AU670258B2/en not_active Expired
- 1993-01-11 WO PCT/US1993/000018 patent/WO1993019681A1/en active IP Right Grant
- 1993-01-11 DE DE69313269T patent/DE69313269T2/en not_active Expired - Lifetime
- 1993-01-11 EP EP93902903A patent/EP0633749B1/en not_active Expired - Lifetime
- 1993-01-11 DE DE9390075U patent/DE9390075U1/en not_active Expired - Lifetime
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1994
- 1994-09-29 NO NO943627A patent/NO943627L/en unknown
- 1994-09-29 FI FI944522A patent/FI944522A/en unknown
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AU3430693A (en) | 1993-11-08 |
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EP0633749A1 (en) | 1995-01-18 |
AU670258B2 (en) | 1996-07-11 |
US5281216A (en) | 1994-01-25 |
ATE156987T1 (en) | 1997-09-15 |
CA2130554A1 (en) | 1993-10-14 |
FI944522A (en) | 1994-09-29 |
WO1993019681A1 (en) | 1993-10-14 |
DE69313269T2 (en) | 1997-12-18 |
EP0633749B1 (en) | 1997-08-20 |
DE69313269D1 (en) | 1997-09-25 |
DE9390075U1 (en) | 1994-11-03 |
NO943627L (en) | 1994-09-29 |
JP2648239B2 (en) | 1997-08-27 |
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