CN102860866A - Device for fusing and cutting blood vessels - Google Patents
Device for fusing and cutting blood vessels Download PDFInfo
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- CN102860866A CN102860866A CN2012103832710A CN201210383271A CN102860866A CN 102860866 A CN102860866 A CN 102860866A CN 2012103832710 A CN2012103832710 A CN 2012103832710A CN 201210383271 A CN201210383271 A CN 201210383271A CN 102860866 A CN102860866 A CN 102860866A
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- arm
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- pocket knife
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Abstract
A device (10) for fusing and cutting blood vessels comprises a first arm (19), a second arm (20) and a knife (21), wherein the first arm (19) is provided with an electric insulating substrate (23); the electric insulating substrate (23) is provided with a groove-shaped slot (32) and a guiding narrow groove (25); retaining components (37, 38 and 39) are arranged on the substrate (23) and are used for mounting an electrode (33) with a bent side at a fixed position; the second arm (20) is movably mounted on the substrate (23), accordingly can move towards the electrode (33) or towards a direction far away from the electrode (33), and is provided with a longitudinal narrow groove (31); and the knife (21) is arranged in the guiding narrow groove (25) of the substrate (23), accordingly can longitudinally move and can be inserted in the longitudinal narrow groove (31) or move to the longitudinal narrow groove (31).
Description
Technical field
The present invention relates to a kind ofly suffer from the particularly device of blood vessel of the soft tissue of the human body of disease or animal body or vascular for clamping and cutting.
Background technology
Atherosclerosis is a kind of progressive lysis, and wherein the blood flow in the lumen of artery is restricted because of the obstruction that is commonly called atheromatous plaque.In heart, and at its periphery, the obstruction of tremulous pulse can cause pain, afunction and even dead.Once used for many years a large amount of methods in the tissue of the downstream of obstruction of artery, to carry out reconstructing blood vessel.These ways comprise uses the device of fusion, cutting blood vessel that blood vessel is rebuild.
This device generally includes slender axles, is provided with two arms for the clamping blood vessel at the slender axles far-end.In addition, at the slender axles far-end vertical adjustable pocket knife can also be set, thereby can cut off clamping and vascular that condense.Have the handle of driver part in the near-end setting of slender axles, by using this handle with driver part, can closed two arms and can drive pocket knife.Two arms are designed to two electrodes, and it can heat the blood vessel that is clamped between them and can the coagulate blood vessels wall and then blood vessel wall fused together.
When the cutting blood vessel, guarantee the end tight seal of the blood vessel that cuts off.Also should satisfy other conditions, for example, should avoid as much as possible the damage to surrounding tissue, and the thickness of the size of the sealing of blood vessel and blood vessel and blood vessel wall have no relations substantially.In addition, this device also will be considered the available confined space especially when being used for endoscope or peritoneoscope.
Summary of the invention
Based on top reason, purpose of the present invention just provides a kind of device for fusion and cutting blood vessel, and by this device, blood vessel can be able to high-level fusion and cutting.
According to one embodiment of the present invention, a kind of device for fusion and cutting blood vessel is disclosed, it comprises that far-end is provided with the slender axles of two arms, and wherein at least one arm is mounted to so that its relatively another motion, preferably can pivoting action.Two arms are mounted to them and can move with respect to the slender axles of device.And arm can be rigidly connected to slender axles and another arm movably is installed on it.
The first arm has the electric insulation matrix, and for example pottery or suitable plastics, this insulating body have for the recess of the groove shape of electrode and are used for the guide slit of pocket knife.The shape of ditch shape groove and electrode is complementary.Electrode has recessed recess.This electrode for example is designed to cylindrical shell, but it can also be designed to have the U-shaped cross section of the straight wing.In other alternative examples, it can be flat electrode.Preferably it is formed by the thin-walled flat part, and this flat part has necessary mechanical stability by being supported in the matrix.
This electrode is connected to the circuit that extends through axle by electric connecting part.This connecting device is preferably the electric conductor of isolation.It extends through passage suitable in the matrix or path, and the second arm movably is installed near the joint of the first arm therein, extends along the outside of matrix.Matrix is provided with the recess of the longitudinal extension that satisfies this requirement, and its disposed inboard has circuit.This guarantees that the head of device can not exceed maximum outer cross section, and this device, for example for laparoscopically, can be promoted by the trocar.
The physiology compatible material, such as silver, titanium etc. is preferably used as electric conductor.This electric conductor is designed to filled circles line, tubular wire, flat wire or fabric, band etc.
Pocket knife is able to accurate guiding at least in the guide slit of matrix.The pocket knife here preferably guides to electrode centers, and guides to the second arm center, enters vertical slit that it can move.When promoting forward, at least part of can the guiding by vertical slit of the second arm of pocket knife led.
When the accurate guiding of pocket knife can be guaranteed to cut off blood vessel, this cut-out occurred in the center of the previous fusion area of blood vessel.Therefore the fusion section of the two ends of the blood vessel that cuts off with equal length.Minimized the danger of bleeding owing to not accurately do not cut the non-control that causes at the center.
Pocket knife preferably has pilot tape and blade, and they firmly connect each other.Pilot tape is preferably the elongated member that extends along the direction of motion of pocket knife, for example is the form of plastic guide rail.It can be connected on the blade of metal.Yet blade can also be pottery, diamond, plastics or other materials.Pilot tape can also be metal.Pilot tape can also be formed by the reinforcement of blade, and pilot tape and blade form the seamless unit of single-piece like this.Yet two modular constructions are preferred.
Pocket knife in guide slit or the horizontal operating distance in vertical slit preferably less than five times of blade thickness.The horizontal operating distance of pocket knife preferably approximates the maximum ga(u)ge of blade.This so that pocket knife be able to accurately in the middle of guiding, and come therefrom in the middle of the fusion tissue regions guiding to cut.The transverse guidance of pocket knife can provide by guide slit.Alternately, the transverse guidance of pocket knife is provided by vertical slit.Transverse guidance preferably guides by guide slit and vertical these two of slits.
The horizontal operating distance of the pocket knife here is interpreted as when pocket knife mediates that the flank of pilot tape is apart from the distance of guide slit or vertical slit flank.Like this, the operating distance of the corresponding twice of the transverse movement of pocket knife.
Pocket knife preferably have towards and the sliding edge of the straight and longitudinal extension of adjacent electrode.It is relatively short and preferably directly in abutting connection with the cutting edge of pocket knife that sliding edge can design.Thus, guarantee that the blood vessel of clamping between the arm is cut off at its whole cross section, and the remnant tissue that not can't cut.
The cutting edge preferred arrangements is in the front side of pocket knife.It is preferably angled with the direction of motion of pocket knife.This angle can be acute angle.Cutting edge is preferably designed for straight and extends along the direction of pilot tape.Pilot tape preferably projection surpasses cutting edge, thereby stops the part of blood vessel to be cut off to be exerted pressure and resultant the cutting unsuccessfully at pocket knife.
The second arm has conductive surface in its side towards electrode at least.If the second arm is nonmetallic materials, this surface can be formed by the thin electrodes plate afterwards.Yet the second arm is preferably solid metal.Mutually independently, the second arm has the shape of following electrode shape in its side towards electrode therewith.In other words, clearance distance substantially constant or reduce towards the centre forms between electrode and the second arm apart from the gap.Mutually independently, the surface of the second arm can be shaped as for example ribbed, villous or other shape therewith.Electrode can also be provided with surperficial die mould.Even the die mould of the die mould of electrode and the second arm is different, they preferably have the basic configuration that matches each other and follow each other, in order to restriction have gap width apart from the gap, this gap width preferably reduces towards the centre.
Be preferably formed in the top edge of the recess relative with another for the holding member that electrode is fixed to the first arm.These holding members are preferably formed by the electric insulation projection, and it has for example identical with matrix material material.They preferably extend also the thus top edge of coated electrode along the direction of the second arm.When device was closed, this projection preferably limited the gap with the second arm, and this gap has apart from B, this apart from B when it is maximum with identical in abutting connection with the width A at holding member place apart from the gap.
Because the electrical insulating property of projection, vascular tissue can be clamped between the second arm and this projection can not condense.If arm is not strict symmetrical because of tissue characteristics, can guarantee that also tissue is held.If for example the blood vessel of clamping has the cross section with its length variations, this can cause lateral separation B to have different values, does not namely have identical size.Yet blood vessel still is held securely.Even be clamped in the tissue in the middle of arm and the electrode, owing to reducing at that point, heat effect and coagulation and clamping effect shrink, also can eliminate reliably the slip of blood vessel.In the subsequently start-up course of pocket knife, the horizontal slip of blood vessel and cut off blood vessel at improper point afterwards and can both eliminate by this mode.
The holding member that is for example formed by projection has dual-use function: the clamping that keeps electrode and improve blood vessel.
Distance member preferably is set between the first and second arms.The short circuit that this distance member stops the second arm contact electrode and occurs thus.In addition, this distance member stops at blood vessel and is not intended to apply and the excess pressure of the blood vessel of can crushing thus.This distance member is preferably formed by metal protuberance, is furnished with nonmetal retainer at its offside.Metal protuberance preferably is connected to power supply, namely is connected to electrode or is connected to the second arm.If organize between the contact surface that is in projection and arranges the fault that then can stop generation not expected.If this projection arrangement near anti-phase electrode, especially is connected to power supply, then can cause certain electric current to flow into the biological tissue of clamping, will shrink thus and no longer hinder the minimum expectation distance is set between the second arm and electrode.By alternative design example, distance member can be formed by non-conducting material.The danger of short circuit between the arm can be reduced like this, and coagulation region can also be expanded.
Description of drawings
From the following describes, other details of the present invention may be better understood dependent claims or the accompanying drawing favourable embodiment:
Fig. 1: according to schematically illustrating of device of the present invention.
Fig. 2: the arm of this device and the diagrammatic side view of pocket knife.
Fig. 3: according to the arm of Fig. 2 and the fragmentary cross-sectional view of pocket knife.
Fig. 4: simplify during the tool closes of observing from y direction and the arm that schematically illustrates and the vertical section of pocket knife represent.
Fig. 5: according to the perspective view of device head of the present invention, and
Fig. 6: represent from the simplification of y direction observation and the vertical section of the matrix that schematically illustrates and pocket knife.
The specific embodiment
Fig. 1 shows the device 10 that can for example be used for clamping, fusion or cut off blood vessel when operating in human body or animal body.Device 10 is used in particular for endoscopic surgery.It comprises slender axles 11, and these slender axles 11 near-ends remain on the shell 12.Shell 12 has control member, for example handle 13 and driving element 14.But these comprise for example pivoting handle section 15 and/or activation button or bar 16, and other elements, for example in case of necessity electric switch.Driving element 14 is connected to the application section 18 that is arranged on axle 11 far-ends via the power transmission component 17 that only schematically shows by chain-dotted line among Fig. 1.Application section or the head 18 of this surgical device comprise the element shown in Fig. 2 and 3 at least, i.e. the first arm 19, the second arm 20 and pocket knife 21. Arm 19,20 is used for the clamping blood vessel, and wherein they can move towards each other and clamp securely the blood vessel between them.Pocket knife 21 is used for cutting off blood vessel.
In current example, arm 19 is rigidly connected to axle 11, and arm 20 can be by driving handle section 15 towards arm 19 or away from arm 19 rotations.On the contrary, under the driving of activation button 16, along the longitudinal direction propelling pocket knife 21 of axle 11, shown in the arrow 22 of Fig. 2.
As shown in Figure 2, pocket knife 21 preferably has the sliding edge that is arranged in such as on the blade 28, and it can slide and vertical guide pocket knife 21 along the matrix of arm 19.The result is shown in Figure 4 and 5, and pocket knife 28 can move ahead or the distance very short apart from electrode 33 along electrode 33 in abutting connection with the most advanced and sophisticated 28b of cutting edge 28c below, and can not wear and tear.
In abutting connection with guide slit 25, the second arm is installed on the matrix 23 pivotally in this district in straight extension for bearing district or hinged region 30.Arm 20 is connected among power transmission component 17(Fig. 5 and is not shown specifically), thus can be around the axle rotation of lateral arrangement on matrix 23.
Below arm 20, matrix 23 has groove shape or through state recess 32, wherein is furnished with electrode 33.In this design example, form electrode 33 by thin cylinder dish plate.This electrode 33 has crooked in the side towards arm 19, be preferably recessedly, is preferably closed smooth surface.Here electrode 33 extends along the whole length direction of recess 32 substantially, and stays free zone 34 at the front end of matrix 23.The holding member 37 that is used for electrode 33 is arranged in the top edge 35,36 of matrix 23.As shown in Figure 4, these parts form by fastening projection 38,39, and described projection comprises that electrically insulating material and preferred and matrix 23 are integrated assembly. Fasten projection 38,39 and form the retainer lug that clamps electrode 33 top edges.Their length preferably is slightly larger than the thickness of electrode 33, thus their outstanding a little electrode surfaces that exposes that surpasses.
Extend to the nose shape prominence 41 of matrix 23 in the far-end setting of the second arm 20, and when this device is closed, be supported in the end region 34 of matrix 23.Under this situation, limit width between the inboard of electrode surface 40 and electrode 33 and be A apart from the gap.This width A preferably be slightly larger than at least projection 38/39 and electrode surface 40 or arm 20 in abutting connection with between the wing 42,43 apart from B.
Can find out that from Figure 4 and 5 electrode 33 is connected to power supply by electric conductor 44.Conductor 44 at first extends through axle 11 at this and enters shell 12 and be connected to the switch (not shown in detail), and is connected to supply unit by supply lines 45.
Similarly, the conductor (not shown in detail) extends to device from arm 20.Conductor 44 is such as having the round line that is provided with insulant 46 grades.Be connected to electrode 33 its some place approximate center between electrode 33 and matrix 23.Particularly in hinged region 30, conductor 44 passes transverse opening 47 in matrix 23 outsides, and extends in vertical recess 49 and reach shoulder 24.Enter axle 11 at this some place conductor 44.Conductor 44 is the silver-colored line of insulation especially.
Described device is pressed following operation:
Be sealing and cut-out blood vessel, vascular clamp is held between the arm 19,20.The driving of handle portion 15 impels arm 19,20 to move towards each other in order to clamp blood vessel and blood vessel wall is pressed against each other.Here blood vessel wall presses together, and particularly is squeezed between electrode surface 40 and the electrode 33.In addition they be clamped in projection 38,39 and electrode surface 40 or the wing 42,43 between.Ideally, projection 41 is positioned in the district 34 of matrix 23, also stops thus blood vessel distortion as thrust bearing.
Between arm 20 and electrode 33, apply curtage, be preferably HF voltage, begin coagulation treatmently, open and protein release and degeneration at the cell of this processing medium vessels wall.The blood vessel wall that is clamped between arm 20 and the electrode 33 and presses each other combines.They can reduce volume in this processing.Be independent of the contraction of blood vessel wall volume, projection 38,39 and arm 20 between the vasculature part of clamping at least fully keep naturalness, almost do not stand thus any contraction.They are clamped reliably, have therefore stoped the horizontal slip of blood vessel, and this sealing to the less blood vessel is particular importance.
If as thrust bearing, clearance distance A was just less times greater than actual desired like this between residue tissue entered nose 41 and distinguishes 34, then close clearance B is as the protecting component that resists the horizontal slip of blood vessel.And, the distance between the front end 48 of nose 41 and electrode 33 little to so that any tissue that the there exists can condense and shrink thus.This is a significant benefit to and clamps reliably tissue between arm 19,20.
In case coagulation treatment sufficiently leading, the doctor for example can drive pocket knife by start button 16.Now by guide slit 25 with vertically slit 31 advances at the center, the guiding pocket knife is to arm 19,20 free end.Here pocket knife 21 is roughly accurately pressed the dotted line extension in the median plane M of Fig. 4 indicating, to guarantee that the seal blood vessels end edge region is in the both sides of pocket knife 21 equal in length.Thereby minimized the danger of off-center cutting, and then minimized uncontrolled danger of bleeding.
The device 10(that invades operation preferably suitable for minimum for example can introduce in the body by the trocar) have two arms 19,20 and the center guiding pocket knife 21 that is used for clamping blood vessel.The center guiding of pocket knife at least one arm 19,20 avoided off-center to cut off the drawback of coagulating tissue.And the accurate center guiding of pocket knife 21 produces less wearing and tearing thereon.Therefore the present invention guarantees pocket knife 21 better cutting qualities and long life more.
An arm preferably has ceramic matrix 23, and the edge arranges the inwardly outstanding projection with undercutting form 38,39 thereon.These electric insulation projections are extended and two improvement are provided along the direction of median plane M: on the one hand, be convenient to assemble electrode 33.On the other hand, produce two and organize bite.Distance A preferably reduces to guide slit 31 gradually from projection 38,39.By this device, the width that condenses is determined by insulation projection 38,39, and thus reliably regeneration, and this has greatly improved the quality of condensing.
List of reference signs
10 devices
11 axles
12 shells
13 handles
14 driving elements
15 handle components
16 activation button or bar
17 power transmission components
18 application components, head
19 first arms
20 second arms
21 pocket knives
22 arrows
23 matrixes
24 shoulders
25 guide slit
26, the 27 groove wings
Gap between the S 25 and 21
The thickness of D cutter 21
The thickness of DK blade 28
28 blades
The 28a sliding edge
28b is most advanced and sophisticated
The 28c blade
29 pilot tapes
30 hinged region
31 vertical slits
Gap between the S1 31 and 21
32 recesses
33 electrodes
The end region of 34 matrixes 23
35,36 top edges
37 holding devices
38,39 fasten projection
40 electrode surfaces
41 projections
Between the A 33 and 40 apart from width
Distance between the B 38,39 and 40
The wing of 42,43 arms 20
44 conductors
45 supply lines
46 insulants
The lateral openings of 47 matrixes 23
48 33 front end
The M median plane
49 longitudinal flutings
52,53 31 the slit wing.
Claims (12)
1. device (10) that is used for fusion and cutting blood vessel, it comprises:
The first arm (19), it has electric insulation matrix (23), this electric insulation matrix (23) has groove shape recess (32) and guide slit (25), wherein be provided with holding member (37,38,39) on the matrix (23), be used for the electrode (33) of curving is installed in the fixed position;
The second arm (20), it movably is installed on the matrix (23), thereby it can towards with away from electrode (33) motion, wherein the second arm (20) has vertical slit (31); And
Pocket knife (21), it is arranged in the guide slit (25) of matrix (23), thereby it can lengthwise movement and is arranged to protrude into vertical slit (31) or moves in vertical slit (31), described pocket knife (21) comprises pilot tape (29) and the blade (28) that firmly connects each other, it is characterized in that the horizontal operating distance (S) of described pocket knife (21) in guide slit (25) is less than five times of blade (28) thickness (D), and described pocket knife (28) has the sliding edge (28a) of straight and longitudinal extension, this sliding edge towards and contact electrode (33).
2. device according to claim 1 is characterized in that described pocket knife (21) has cutting edge (28c) in the front side, and the direction of motion of itself and pocket knife (21) is angled.
3. device according to claim 1, it is characterized in that described pocket knife (21) has pilot tape (29) in the side back to electrode (33), its be arranged in the guide slit of matrix (23) (25) but in lengthwise movement and protrude into vertical slit (31) of the second arm (20) or be arranged to be manoeuvred into vertical slit (31), and this has determined the horizontal operating distance (S) of pocket knife (21) in matrix (23) and the second arm (20).
4. device according to claim 1 is characterized in that described the second arm (20) is formed by solid metal.
5. device according to claim 1 is characterized in that described the second arm (20) has the shape of following electrode (33) shape in the side towards the electrode (33) of the first arm (19).
6. device according to claim 1, when it is characterized in that the arm (19) of described device (10) and (20) are closed, between electrode (33) and the second nose (20) restriction have width (A) apart from the gap.
7. device according to claim 1 is characterized in that described holding member (37) is formed on two edges (35,36) that face with each other of recess (32).
8. according to claim 6 or 7 described devices, it is characterized in that described holding member (37) is formed by electric insulation projection (38,39), described projection (38,39) is outstanding along the direction of the second arm (20), and when the arm 19 that installs (10) and 20 closure, described projection (38,39) limits distance (B) with the second arm (20), and this distance (B) is equal to or less than the width (A) apart from the gap.
9. device according to claim 1 is characterized in that described electrode (33) is connected to power supply by electric conductor (44), and described electric conductor (44) is arranged on the outside of matrix (23) at least in part.
10. device according to claim 1, it is characterized in that described matrix (23) is connected to slender axles (11), described axle (11) extends from shell (12), and its axis (11) has the selectivity motion that power transmission component (17) is used for the second arm (20) and/or pocket knife (21).
11. device according to claim 1 is characterized in that at the first and/or second arm (19,20) distance member being set.
12. device according to claim 11 is characterized in that described distance member is metallic conduction or electric insulation projection (41).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2012103832710A CN102860866A (en) | 2012-10-10 | 2012-10-10 | Device for fusing and cutting blood vessels |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2012103832710A CN102860866A (en) | 2012-10-10 | 2012-10-10 | Device for fusing and cutting blood vessels |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN102860866A true CN102860866A (en) | 2013-01-09 |
Family
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2012103832710A Pending CN102860866A (en) | 2012-10-10 | 2012-10-10 | Device for fusing and cutting blood vessels |
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| Country | Link |
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| CN (1) | CN102860866A (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104840247A (en) * | 2014-02-12 | 2015-08-19 | 爱尔博电子医疗仪器股份有限公司 | Surgical instrument comprising electrode support |
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|---|---|---|---|---|
| WO1999040861A1 (en) * | 1998-02-17 | 1999-08-19 | Baker James A | Radiofrequency medical instrument for vessel welding |
| US6656177B2 (en) * | 2000-10-23 | 2003-12-02 | Csaba Truckai | Electrosurgical systems and techniques for sealing tissue |
| US7789878B2 (en) * | 2005-09-30 | 2010-09-07 | Covidien Ag | In-line vessel sealer and divider |
| US20110082494A1 (en) * | 2009-10-06 | 2011-04-07 | Tyco Healthcare Group Lp | Jaw, Blade and Gap Manufacturing for Surgical Instruments With Small Jaws |
| CN102949236A (en) * | 2011-08-02 | 2013-03-06 | 厄比电子医学有限责任公司 | Instrument for vessel fusion and separation with two arms and with a curved electrode |
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2012
- 2012-10-10 CN CN2012103832710A patent/CN102860866A/en active Pending
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1999040861A1 (en) * | 1998-02-17 | 1999-08-19 | Baker James A | Radiofrequency medical instrument for vessel welding |
| US6656177B2 (en) * | 2000-10-23 | 2003-12-02 | Csaba Truckai | Electrosurgical systems and techniques for sealing tissue |
| US7789878B2 (en) * | 2005-09-30 | 2010-09-07 | Covidien Ag | In-line vessel sealer and divider |
| US20110082494A1 (en) * | 2009-10-06 | 2011-04-07 | Tyco Healthcare Group Lp | Jaw, Blade and Gap Manufacturing for Surgical Instruments With Small Jaws |
| CN102949236A (en) * | 2011-08-02 | 2013-03-06 | 厄比电子医学有限责任公司 | Instrument for vessel fusion and separation with two arms and with a curved electrode |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104840247A (en) * | 2014-02-12 | 2015-08-19 | 爱尔博电子医疗仪器股份有限公司 | Surgical instrument comprising electrode support |
| CN104840247B (en) * | 2014-02-12 | 2017-07-07 | 爱尔博电子医疗仪器股份有限公司 | Surgical instruments including electrode support |
| US9848939B2 (en) | 2014-02-12 | 2017-12-26 | Erbe Elektromedizin Gmbh | Surgical instrument comprising electrode support |
| US11723715B2 (en) | 2014-02-12 | 2023-08-15 | Erbe Elektromedizin Gmbh | Surgical instrument comprising electrode support |
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Application publication date: 20130109 |