WO2013010602A1

WO2013010602A1 - Bipolar resectoscope and carriage and cable therefor

Info

Publication number: WO2013010602A1
Application number: PCT/EP2012/001988
Authority: WO
Inventors: Pieter Brommersma; Andreas Pohlmann; Angela Ehlers; Harald Hanke
Original assignee: Olympus Winter & Ibe Gmbh
Priority date: 2011-07-15
Filing date: 2012-05-09
Publication date: 2013-01-24
Also published as: DE102011107783B4; DE102011107783A1

Abstract

The invention relates to a bipolar resectoscope (100), comprising an electrode arrangement (5) having two contact surfaces (6, 7) in a proximal end region, a cable (12, 13) that can be connected to a high frequency generator (115) and has two plug contacts (14, 23), and a carriage (2) that is mounted such as to be longitudinally movable on the resectoscope (100) and receives in a receptacle (4) the end region of the electrode arrangement (5) that can be fastened to the carriage (2), characterised in that the carriage (2) has an intermediate contact element (30), wherein the first contact surface (6) is electrically contacted with the first plug contact (14) indirectly via the intermediate contact element (30) and the second contact surface (7) is electrically contacted directly with the second plug contact (23) in the position of the electrode arrangement (5) fastened to the carriage (2).

Description

Bipolar resectoscope

as well as carriages and cables for it

The invention relates to a bipolar resectoscope referred to in the preamble of claim 1 and a carriage and a cable for it.

Bipolar resectoscopes are used for surgical work, especially in urology, but e.g. also used in gynecology. They have an electrode arrangement which carries in the distal end area for tissue processing serving exposed electrodes, which are connected to a high-frequency generator in order to apply the electrodes required for working high-frequency voltage. The resectoscope has a longitudinally displaceably mounted carriage, on which the electrode arrangement is fastened with a proximal end region. By moving the carriage in the longitudinal direction can thus be generated when working with the electrode assembly required longitudinal movement. On the carriage, the electrical contact between the conductors of the electrode assembly and the cable leading to the high frequency generator is made.

CONFIRMATION COPY Monopolar resectoscopes have only one conductor and have an active cutting or coagulating free electrode. The conductor is connected to one pole of the high-frequency generator. The second pole of the high-frequency generator is contacted over a large area with the patient's body at a great distance from the operating area via a return electrode. This operation involves disadvantages, mainly due to the current flowing uncontrolled between the electrodes for a long time through the body.

Bipolar resectoscopes have two conductors and two electrodes, with the electrodes connected to the two conductors connected to the two poles of the high frequency generator and located adjacent to the distal end of the resectoscope. The current flows on a short path between the electrodes. This is done in a highly conductive liquid.

Reprocessing and use causes problems with the contacts of the carriage, e.g. by oxidation. When exposed to high frequency current, it may then lead to an adverse increase in resistance. The contact with the contact surfaces and the plug contacts therefore regularly brings great problems. The prior art shows a number of different approaches to solving these problems.

US 6,974,458 B2 shows a generic construction in which a two-wire cable has both plug contacts in a plug which is inserted with a bore in the longitudinal direction of the end portion of the electrode assembly. This is an extremely simple construction that also has seals for the contacting areas to keep out moisture. Of great advantage in this direct contacting is also the direct contact between the plug connector arranged on the cable connector and the contact surfaces on the electrode assembly. Is there in the contact area disorders, z. B. by scorching, so the electrode assembly is replaced since, which is the case anyway after every operation, and the cable is replaced with the plug, which does not cause any major costs. All faults can be eliminated completely.

However, this known construction has the disadvantage that the plug must be plugged in the longitudinal direction. However, it is more common and useful for the surgeon to plug the cable connector transversely to the longitudinal direction, ie transversely to the extension of the electrode assembly and in particular with hanging cable, which is not possible with the known construction. Another disadvantage is the cramped spatial conditions on the plug. Because of the cramped spatial conditions, the plug can not be provided with an ergonomic large handle. The assembly is therefore complicated and the closely adjacent arrangement of conductors and contacts, which are located at different poles of the high-frequency voltage, leads to further problems.

From further, non-generic state of the art, DE 10042097 C1 is known, which, in the case of a monopolar resectoscope with a cable plug, makes contact with the contact surface of the electrode arrangement by lateral engagement in the slide. This very open construction does not allow sealing of the contacts. It may therefore come in the humid environment during the operation to flash over to other metallic parts. Similar constructions of urological resectoscopes with monopolar electrode arrangement, which is contacted directly from the cable connector, further show the US 4,917,621 A and US 4,919, 131 A.

DE 202005013853 U1 likewise shows a monopolar resectoscope in which the cable connector makes contact with an intermediate contact element on the carriage, which in turn contacts the contact surface of the electrode arrangement. This indirect type of contacting has fundamental advantages in terms of seal and encapsulation of the contact points and the further advantage that the plugging sequence is arbitrary. It can therefore be inserted first the electrode assembly and then the cable connector, or vice versa, which is not possible in the direct contacts described above.

The object of the present invention is to reduce the contact problems in the generic bipolar urological resectoscope.

This object is achieved with the features of the characterizing part of claim 1 and claims 7 and 8.

According to the invention, the first contact surface is connected to an intermediate contact element, which in turn is first contacted by the plug contact. So here is an indirect contact. The second plug contact, however, contacted the second contact surface directly. So here is a direct contact. There are thus used for the two plug contacts two different types of contacting, resulting in a number of advantages. In the first plug contact the advantages of indirect contacting can be used, so the solid, especially reusable construction that allows good fluid seal and insulation. The second plug contact, which is arranged on the second plug of the cable, can be kept very simple and contact the electrode arrangement without special sealing measures. It has been shown that sealing and insulation is not so much required by the plug contacts to the outside, but in particular between the plug contacts, which lie on different polarity. It is therefore sufficient according to the invention a particularly good seal and isolation of only one of the plug contacts. Another advantage of the invention is that the plug-in sequence, ie the order in which the electrode arrangement and the respective plug-in contact are inserted, is arbitrary, which greatly simplifies handling. The respective contact points and contact surface existing contact points need not necessarily be sealed in all application traps against liquid, for example when working in a guaranteed dry environment. Advantageously, however, according to claim 2, at least one of the contact points encapsulated and sealed against liquid, which is particularly advantageous in urological operations in which fluid exposures occur frequently. In this case, the sealing of one of the contact points is already sufficient, in particular to avoid an electrically conductive liquid film between the two contact points.

It is advantageous according to claim 3, the first plug contact having contact pad sealed, so the contact point with indirect contacting. It can be the design principles of DE 202005013853 Ul apply.

The two connectors of the cable can be moved independently of each other, and then leave z. B. constructions in which one plug is inserted laterally and the other plug in the longitudinal direction. Even with such constructions, the two connectors can be connected to form a structural unit, for example with an elastically bendable connection.

Advantageously, however, the features of claim 5 are provided. The two connectors are formed with a parallel plug-in direction. This significantly facilitates the operation and also the construction. The plug can hereby be rigidly connected.

Advantageously, the features of claim 6 are provided. Such a distally open bore in the carriage allows easy insertion of the longitudinally extending proximal end portion of the electrode assembly. The claims 7 and 8 relate to a carriage according to the invention, or an inventive cable with plug.

In the drawings, the invention is shown for example and schematically. Show it:

Fig. 1 is a side view of a novel resectoscope with

Sled and two plugs,

2 shows a longitudinal section through the carriage,

Fig. 3 is a view of one of the plug in the longitudinal direction and

Fig. 4 is a representation corresponding to FIG. 2 in a second embodiment.

Fig. 1 shows in a highly schematic representation a e.g. for urological purposes exemplary embodiment of a resectoscope 100 according to the invention with a shaft tube 101, which is fastened with its proximal end to a main body 102. The shaft tube 101 and the main body 102 are traversed by an optic 103 having at its distal end a lens and at its proximal end an eyepiece 104, which is held on a guide plate 105.

The main body 102 and the guide plate 105 are connected by a guide tube 1 guidingly receiving the optics 103, on which a carriage 2 shown in section in FIG. 2 is guided with a guide bore 3. The carriage 2 is mounted longitudinally displaceable in this manner on the guide tube 1. On the carriage 2, a distal lever 106 is mounted with a joint 107, which is connected at a middle joint 108 with a proximal lever 109. The proximal lever 109 is mounted with a hinge 1 10 on the guide plate 105. A finger grip 1 1 1 is attached to the carriage 2 and a finger grip 1 12 on the proximal lever 109. By operating the finger grip pieces 1 1 1 and 1 12 with the fingers of one hand, the surgeon can control the sliding movement of the carriage 2 on the guide tube 1.

For details of the resectoscope and the arrangement of the carriage, and its function in a resectoscope is made to DE 10 2004 045 337 AI and DE 20 2005 013 853 Ul referenced.

As FIG. 2 shows, a receptacle in the form of a distally open bore 4 is provided in the slide 2 made of insulating plastic, which is formed parallel to the guide tube 1, ie in the longitudinal direction, and into which the proximal end region of an electrode arrangement 5 extends in the longitudinal direction , as shown in Fig. 1 and 2, can be inserted. As shown in FIG. 2, two contact surfaces are formed on the end region of the electrode arrangement 5, wherein a first proximal contact surface 6 forms the proximal end of the electrode arrangement 5. Spaced apart in the longitudinal direction, a second contact surface 7 is arranged. The remaining outer surfaces of the electrode assembly 5 are formed insulating. The contact surfaces 6 and 7 are connected to conductors 8 and 9 extending in the interior of the electrode arrangement 5, which extend to electrodes 1 13 and 1 14 exposed to the outside, as shown in FIG. 1, in order to supply them. In particular, as shown in FIG. 1, it can be a bipolar electrode arrangement with a cutting loop 1 13 as a first electrode and a return electrode 1 14 as a second electrode, which is embodied here as an example as part of the otherwise insulating sheathing of the electrode arrangement 5. The conductors 8, 9 must be connected via the contact surfaces 6 and 7 to a remote high-frequency generator 1 15. For this purpose, provided with a first connector 10 and a second connector 1 1 provided cables 12 and 13. The contact surfaces 6 and 7 can be contacted by the plugs 10 and 11 in the position of the electrode arrangement 5 shown in FIG. 2, in which the latter is fastened to the carriage 2.

The first plug 10 can be plugged with a first plug contact 14 into a socket 15, which is electrically connected by an intermediate contact element 30 with a socket 16, which, as shown in FIG. 2, the terminal end portion of the electrode assembly 5 slightly clamped, and thus giving electrical contact, picks up. The intermediate contact element 30, which causes an indirect contact between the first contact surface 6 and the first plug contact 14, is integrally formed in the embodiment with the socket 15 and the socket 16 and is encapsulated in an insulating body 17, as shown in FIG , Is arranged removably in an insertion opening in the carriage 2. For the details of this construction, reference is made to FIG. 2 of DE 202005013853 Ul.

As stated therein, the pad containing the first contact pad 6 and the intermediate contact member 30 is outwardly encapsulated and liquid-isolated. 1, an O-ring 18 surrounding the bore 4 in the insulating body 17 is sufficient. Furthermore, the plug 10 is provided with an O-ring 19, which seals the plug on the outside of the bushing 15. Also to the details of this construction, reference is made to FIG. 2 of the mentioned DE 202005013853 Ul. As well as there is sealed in the present case, the insulating body 17 against the body of the carriage 2 with an O-ring 20, which is not necessarily in the present case for sealing is required, but z. B. can be used to ensure the tight fit of the insulating body 17 in the carriage 2.

The second plug 1 1 can be inserted with a guide member 21 in a side, in the embodiment downwardly open slot 22 of the carriage 2 until a formed on the plug 1 1 second plug contact 23, the second contact surface 7 contacted. The second plug contact 23 may, as shown in Fig. 3, pincer-like or fork-shaped consisting of two gripper arms 24 and 25, which detect in this exemplary embodiment in cross-section round electrode assembly 5 in the region of the second contact surface 7 from both sides with slight clamping, so , as shown schematically in Figures 2 and 3.

The plug 10 and 1 1, as well as the cables 12 and 13 may be formed separately from each other. However, they can also be integrated with a connector 26 shown in dashed lines between the plugs 10 and 1 1 and with connecting straps 27 between the cables 12 and 13. In another embodiment, the plug 10, 1 1 may be formed completely integrated and the cables 12 and 13th be connected to a two-wire cable.

The plug 10 and 1 1 are, as shown in FIGS. 1 and 2, formed with the same direction of insertion, so can both be stuck from below into the carriage 2. This corresponds to the preferred hanging outgoing direction of the cables 12 and 13 from the carriage 2. However, the construction can also be chosen such that e.g. Both plugs are inserted laterally, ie in the direction perpendicular to the plane of the drawing of Fig. 2. Then the plug 1 1 receiving slot 22 and the insulating piece 17 receiving shaft to be rotated by 90 ° to order.

If the plug 10 and 1 1 are formed separately, can also form a plug from below and the other plug laterally einsteckend example. FIG. 2 of DE 202005013853 U1 shows a locking pin which, acting on the electrode arrangement, fastens it to the carriage. Also in the present design additional locking measures for secure attachment of the electrode assembly 5 on the carriage 2 can be made. By way of illustration, FIGS. 1 and 2 show a shaft 28 which extends in a direction perpendicular to the plane of the drawing and through which a clamping pin, a clamping screw or the like can be brought into clamping engagement with the electrode arrangement 5.

In the embodiment of FIGS. 1-3, the indirectly contacting plug 10, in which the intermediate contact element 30 conveys the contact between the contact surface 6 and the plug contact 14, lies proximally. The directly contacting plug 1 1 is distal. This arrangement can also be reversed, as shown in FIG. 4. Here, as far as possible, the same construction elements and the same reference numerals are used as in FIGS. 1 to 3.

The first plug 10, which serves for indirect contacting, is arranged distally in the case of the construction of FIG. 4. The insulating body 17 with the bushing 15 in the intermediate contact element 30 is displaced in the distal direction with respect to the construction of FIG. The electrode assembly 5 passes completely through the insulating body 17. Therefore, in addition to the O-ring 18, a further O-ring 29 is still provided at the proximal end of the insulating body 17. The second plug 1 1 is formed on the second plug contact 23 as well as shown in FIG. 1 to 3. It clamps with the second plug contact 23 freely suspended on the second contact surface 7 and sits in an open also in the proximal direction of the shaft 22, in which he can hang freely swinging.

The free design of the shaft 22 in the construction of FIG. 2 in the proximal direction also permits other plug-in directions for the plug 1 1, which can also be plugged in the longitudinal direction, ie in the extension direction of the guide tube 1. The plug 1 1 can be additionally optimized for plugging in the longitudinal direction.

If the plug 1 1, as well as in Fig. 1, inserted from the bottom, then the shaft 22 may be formed as shown in FIG. 1 with good guidance on the plug 1 1.

The illustrated in the embodiment of Figure 2 direct contact between the second plug contact 23 and the second contact surface 7 allows both of the possible plug-in sequences. It can therefore first the electrode assembly 5 inserted into the bore 4 of the carriage 2 and then the second plug 1 1 are inserted, or conversely, first the second plug 1 1 and then the electrode assembly 5 are inserted.

This is achieved in the embodiment of Figure 2 by the shown accurately positioned positioning of the plug 1 1 with its guide member 21 in the slot 22 of the carriage 2 and above all by the clean definition of an end stop for the insertion movement through the illustrated paragraph at the end of the guide member 21st ,

In the embodiment of Figure 4, the plug 1 1 no strict leadership in the slot 22 and can therefore only be plugged onto the previously inserted electrode assembly 5. A version with precise guidance, which then also allows both Steckreihenfolgen, but is also possible here.

The indirect contacting between the first plug contact 14 and the first contact surface 7, on the other hand, permits both plug sequences to be carried out in accordance with both FIG. 2 and FIG. 4. Thus, it is optional to first insert the plug 10 or the electrode assembly 5. So far, an electrode arrangement has been described in which the two electrodes 13 and 14 are contacted via the two contact surfaces 6 and 7. If required, however, even more contact surfaces can be provided in order, for example, to contact further electrodes and sensors, such as temperature sensors. Thus, for example, devices for identifying the correct electrode arrangement can be realized.

Claims

1. Bipolar resectoscope (100) with a proximal end region of two contact surfaces (6, 7) having electrode assembly (5) with a high-frequency generator (1 15) connectable cable (12, 13), the two plug contacts (14, 23 ), and with a longitudinally displaceable on the resectoscope (100) mounted carriage (2) in a receptacle (4) the end portion of the carriage (2) attachable electrode assembly (5) receives, characterized in that the carriage (2) a Intermediate contact element (30), wherein in the mounted on the carriage (2) position of the electrode assembly (5) the first contact surface (6) with the first plug contact (14) indirectly via the intermediate contact element (30) and the second contact surface (7) with the second plug contact (23) are contacted directly electrically.

2. Bipolar resectoscope according to claim 1, characterized in that at least one of the contact surfaces (6, 7) is encapsulated and sealed against liquid.

3. Bipolar resectoscope according to claim 2, characterized in that the first contact surface (6) is sealed.

4. Bipolar resectoscope according to one of the preceding claims, characterized in that the two connectors (10, 11) are connected to form a structural unit.

Bipolar resectoscope according to claim 4, characterized in that the two connectors (10, 1 1) are formed with a parallel plug-in direction.

Bipolar resectoscope according to one of the preceding claims, characterized in that the receptacle is designed as a distally open bore (4).

A carriage (2) for use in a bipolar resectoscope according to any one of claims 1 to 6.

8. cable (12, 13) with plug (10, 1 1) for use in a bipolar resectoscope according to one of claims 1 to 6.