CA1126119A - Device for treating living tissue - Google Patents

Abstract

ABSTRACT OF THE DISCLOSURE

A device is disclosed for use in a laparoscopic tubal cauterization for blocking the fallopian tubes of a patient and comprises a substantially tubular body member having a piston slidably mounted therein; a spring urges the piston to a first position relative to the body member; a button extends from one end of the body member for moving the piston to a second position against the urging of the spring; first and second electrodes are incorporated for either monopolar or bipolar treatment of the living tissue; the first and second electrodes are disposed to grasp the living tissue when the piston is in the first position and to release the living tissue when the piston is in the second position; the invention includes a circuit breaker for terminating continuity when the piston is disposed in the second position and means for disabling an activating switch when the piston is in the second position.

Description

BACKGROUND OF THE INVENTION
Field of the Invention This invention relates to medical instruments and, more particularly, to a device for treating living tissue with an electric current suitable for use in laparoscopic tubal cauterization.
Background of the Invention The procedure of female sterili~ation by laparoscopic~
tubular cauterization has provided the most efficient and least painful method of sterilization of women. Under this procedure, the fallopian tubes are cauterized with an electri-cal current from an electrical power source. Both monopolar and bipolar treatment have been used in the cauterization of fallopian tubes.
In the monopolar cauterization, the patient is physically placed upon a metallic base plate connected to one side of the electrical power source. An electrode which is connected to the other side of the power source is inserted into the abdomen of the patient through the use of a trochar or the like. Accordingly, the electric current passes between the inserted electrode and the metallic base plate through ~he living tissue. The monopolar device had the distinct dis-advantage of controlling the flow of current between the inserted electrode and the base plate. In addition, the surgeon is required t,o take great care to insure that the device is not activated prior to proper positionin~ within the abdomen of the patient. Otherwise, the electrical current from the device will flow in an undesirable direction thereby damaging adjacent tissue.
This disadvantage of the monopolar device was overcome with the introduction of a bipolar device comprising ~ , ~
. . . . -a first and a second electrode insertable into the abdomen of the patient. An example of a bipolar device may be found described in applicant's U.S. patent No. 4,016,881 issued April 12, 1977. In such bipolar device, the living tissue is :~
grasped between the first and second electrode thereby controlling the electrical current through the living tissue between the first and second electrodes.
It has been found that certain bipolar devices of the prior art are difficult to control by the surgeon and require the surgeon to physically grasp the living tissue by the use of a trigger, lever or the like against the urging of a spring. Simultaneously therewith, a switch must be depressed to pass electrical current between the first and second electrodes. These two movements make the prior art devices awkward to use by a surgeon. Also, the prior art bipolar devices do not provide for a safety interlock to prevent the accidental activation of the device prior to proper positioning within the abdomen of the patient.
Therefore, it is an object of th;s invention to provide an apparatus which overcomes the aforementioned inadequacies of the prior art devices and provides an im-provement which is a signif;cant contr;but;on to the advancement of the sterilization art.
Another object of this invention is to provide a devlce for treating living tissue w;th an electr;cal current from an electr;cal power source wherein the dev;ce may be used either as a bipolar or a monopolar device and capable of e;ther cauterizing or severing liv;ng t;ssue.
Another object of this invention is to provide a device for treating living tissue with an electrical current from an electrical power source comprising a pis~on slidably ` ~
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mounted in a body with urging means urging the piston to a first position with a first and a second electrode disposed to grasp the living tissue when the piston is urged to the first position. The urging means of the device will con-tinually grasp the living tissue disposed between the firstand the second electrode elements in the first position.
Another obiect of this invention is to provide a device for treating living tissue with an electrical current from an electrical power source comprising circuit breaker means for terminatiny continuity to the electrodes when the piston is in the second position thereby making the device incapable of operation until the electrodes are grasping the tissue.
Another object of this invention is to provide a device for treating living tissue with an electrical current from an electrical power source including a switch for activating electrical power to the electrodes with means for disabling the switch when the piston is in the second position.
Another object of this invention is to provide a device for treating living tissue with an electrical current from an electrical power source wherein the device may be easily manufactured as a disposable single use item.
The foregoing has outlined some of the more pertinent objects of the invention. These objects should be construed to be merely illustrative of some of the more promlnent features and applications of the intended invention. Many other beneficial results can be attained by applying the disclosed invention in a different manner or modifying the invention within the scope of the disclosure. ~ccordingly, other objects and a fuller understanding of the invention may be had by referring to the summary of the invention and the detailed description describing the preferred embodiment, in addition to the scope of the invention defined by the claims taken in conjunction with the accompanying drawings.
SUMMARY OF THE INVENTION
The invention is defined by the appended claims to cover the disclosed embodiments shown in the attached drawings and the equ;valent thereof as set forth in the detailed dis-cussion. For the purpose of summarizing the invention, the invention may be incorporated into a device for treating living tissue with an electric current from an electrical power source. The device comprises a body member and a piston slidably mounted relative to the body member. Urging means, such as a spring, urges the piston to a first position relative to the body member. Means are provided for moving the piston to a second position relative to the body member against the urging means. A first and a second electrode element is mounted with the first electrode element moving in accordance with the movement of the piston. The first and second ; electrode elements are disposed to grasp the living tissue when the piston is in the first position whereas the electrodes release the living tissue when the piston is in the second position. The-first and-second electrodes are-connected to the electrical power source to provide an clectrical current P10w relative to the living tissue.
In a more specif-ic example of the invention, a circuit breaker is included for terminating continuity to the electrocie elements when the piston is in the second position.
This eliminates the possibility of accidental triggering of the device. The first and second electrodes may be moved into the open position by a button extending from a first end of the body member for moving the piston to the second position.

In this embodiment, the first and the second electrodes extend from the second end of the body member such that the piston slidably extends along the axis of a substantially cylindrical body member. A switch is disposed on one surface of the body member for connecting the electrical power source to the electrode elements. Means such as a projection on the piston is provided for disabling the switch when the piston is in the second position. This configuration provides a second safety interlock for preventing accidental electrification of the electrodes when the first and second electrode elements are in the open position. In one embodiment, the switch means is connected in electrical series with the circuit breaker thereby providing a series switch interconnection system. In another embodiment, the switch means is connected in electrical series directly with the electrodes.
The foregoing has outlined rather broadly the more pertinent and important features of the present in~ention in order that the detailed description of the invention that follows may be better understood so that the present contri-bution to the art can be more fully appreciated. Additionalfeatures of the invention will be described hereinafter which form the subject of-the claims of the invention. It should be appreciated by those skilled in the art that the conception and the specific embodiment disclosed may be readily utilized as a basis for modifyiny or des;gn;ng other structures for carry;ng out the same purposes of the present invent;on. It should also be real;zed by those sk111ed in the art that such equivalent constructions do not depart from the $pirit and scope of the inYention as set forth in the appended cla;ms.
BRIEF DESCRIPTION OF THE DRAWINGS
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For a fuller understanding of the nature and objects

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of the inventi~n, reference should be had to the following detailed description taken in connection wi~h the accompanying drawings in which:
Figure l is an elevational view o~ a surgeon utilizing S the new improved device in a laparoscopic cauterization process;
Figure 2 is a magnifie~ elevational view of the device shown in Fig. l;
Figure 3 is a sectional view o~ the device shown in Fig. 2 illustrating the piston in a second position;
Figure 4 is a sectional view of the device shown in F;g. 2 ;llustrating the pistnn in a first position;
Figure 5 is a sectional view showing another embodi-ment of the device made in accordance with the presen~
invention, illustrating the piston in the second position;
Figure 6 is an enlarged view of the piston shown in the devices in Figs. 1-5; and ~
Figure 7 is a view along line 7-7 in Fig. 6. ; --DETAILED DESCRIPTION
Figs. 1-7 illustrate a device 10 for treating living tissue 12, such as the blocking of a fallopian tube 12 of a patient 14 by laparoscopic tubal cauterization. The device 10 is specifically designed to enable a physician 16 to conveniently hold the device lO and grasp the tissue 12 by the manlpulation of a button 18 conveniently located at a termlnal end of the device 10. The specific position of the button 18 and an ac~ivation switch 20 permits the physician 16 to easily manipulate the device 10 while viewin~ the fallopian tube 12 through an abdominal optical device 22.
The device lO is primarily designed to be a disposable device which is convenient to operate and inexpensive to manufacture.
Although the device lO is disclosed with reference to the laparoscopic tubal cauterization for blocking fallopian tubes of a patient, it should be understood that the principles of the inYention set forth herein are applicable to other electrical surgical treatments and the application disclosed herein should not be construed as a limitation on the claimed subject matter.
Fig. 2 illustrates an enlarged view of the device 10 with Figs. 3 and 4 being sectional views of the device of Fig. 2. Fig. 3 illustrates the electrode elements of the ~; 10 device 10 in an open position whereas Fig. 4 illustrates the electrode elements in a closed position and grasping the fallopian tube 12. The device 10 comprises a substantially cylindrical body member 24 with the button 18 extending from a first end 24A of the body member 24 and with the electrodes 26 extending from a second end 24B of the body member 24. A
piston 28 shown enlarged in Fig. 6 is slidably received within the body member 24 by guides 30, 32 and 34. An urging means biases the piston 28 into a first position shown in Fig. 4. The urging means includes a spring 36 coacting between guide 32 and a flange 38 extending from piston 28 to urge the p;ston 28 into the first position shown in Fig. 4.
Depressing button 18 causes the piston 28 to move into a second position, shown in Fig. 3, against the urging of spring 36. The piston 28 may be integrally molded to contain the ' 25 electrode means 26. In this example, a first and a second ' electrode'41 and 42 extends along an internal reg;on of piston ; 28 and terminate as contact arms 44 and 46 extending perpendi-cularly to the axis of piston 28~ Each of the el,ectrodes 41 and 42 has an inwardly projecting tab 48 and 50 for grasping the fallopian tube 12. Fig. 7 is an elevational view along line 7-7 showing in greater detail the specific configuration :
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of the electrodes 41 and 42.
Piston 28 also comprises an elevated region 52 having a tapered ramp 54 interconnectin~ the elevated region 52 with the surface o~ the piston 28. The function of the elevated region 52 w;ll be explained hereinafter. The piston 28 and the electrodes 41 and 42 may be united in a single injection molding process. The formed electrodes 41 and 42 may be positioned within a mold cavity prior to introduction of a plastic material into the mold cavity. ~
A sleeve 56 has an outwardly projecting annular ~.
flange 58 which abuts guide 30 as the sleeve 56 extends through an aperture 60 in the second end 24B of the body member 24. -The piston 2~ is slidably received within the sleeYe ~6 such that terminal end 62 of sleeve 56 controls the biased divergence of the ~irst and second electrodes 41 and 42. A
first and a second contact pad 64 and 66 are secured to guide 32 and connected to wires 68 and 70-which extend through power cable 72 to an electrical power source (not shown~. It will be evident to the person skilled in the art that the wires of cable 72 can be arranged to have the device of the present invention adapted for either monopolar or bipolar treatment of the livi-ng tissue. Wire 70 extends directly into cable 72 whereas wire 68, which is preferably connected to the ungrounded terminal of the electr~cal power source, extends through the swltch 20. In the embodiment illustrated in Fig. 5, the device is structurally and operatively identical to the device shown in Fig. 3 except that wires 68 and 70 are connected directly to the arms 44 and 46, respectively. H.ence, the contact pads 64 and 66 are eliminated in this embodiment.
Switch 20 comprises a switch activator 76 shown as a b~tton having a stem 78 which extends through an aperture in the body member 24. A suitable resilient material 84 biases the activator 76 into the outward position. The switch 20 com~rises a first and a second contact element 86 and 88 separated by an electrical insulator 90. The first and second contact elements 86 and 88 are interposed in wire 68 shown in Figs. 3 and 4 to enable electrical continuity only upon physical contact of the first and second contact elements 86 and 88. The second contact element 88 ;s biased toward a position shown in Fig. 3 whereas depression of activator 76 will not cause physical contact between the first and second contact elements 86 and 88. When piston 28 is in the first position the elevated region 52 moves the second contact element 88 into the position shown in Fig. 4. Accordingly, depression of activator 76 will cause physical contact between first and second contact elements 86 and ~.
The operation of the device 10 may be explained with reference to Figs. 1-4. The first and second electrodes 41 and 42 and sleeve 56 are inserted înto the abdomen of the patient 14 through the use of a trochar or similar device. The physician l~ depresses button 18 into the second position shown in Fig. 3 while invest;gating the abdominal cavity.
When piston 28 is in the second position, the contact arms 44 and 46 are displaced from contact pads 64 and 66. This circuit breaker reduces the possibility of accidental activation of the device lO. Elevated region 52 -is also moved ;nto the position to disable switch 20. The comb;nation of a circuit breaker 1n series with a disabled switch reduces the possibility of accidental discharge of the device 10 during the preliminary steps of identifying the proper tissue by the physician. The problem of accidental activation in the prior art has been a substantial area of concern for the treating physic;an.

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Inadvertent activation of the device 10 can cause severe damage to adjacent tissue which can result in substantial liability '~
for the treating physician. The use of plural switching '' elements in e'lectrical series substantially reduces this ' -5 hazard. ', -The first and second electrodes 41 and 42 diverge upon a longitudinal movement of piston 2B to the second position in Fig. 3 to enable the fallopian tube 12 to be grasped by the ,~
physician 16. Upon identifying the fallopian tube 12; the physician releases button 18 enabling spring 36 to return piston 28 to the first position shown in Fig. 4. The first and second electrodes 41 and 42 and the inwardly projecting - tabs 48 and 50'withdraw and grasp the fallopian tube 12. ~,~
Contact arms 44 and 46 engage the contact pads 64 and 66 while 15~ the ~levated region 52 moves the second contact element 88 nto the position shown in Fig. 4. The treating physician merel~y depresses activator 76 to produce electrical current flow between the first and se'cond electrodes 41 and 42 to seal the fallopian tubes 12.
It should be appreciated that the device 10 maintains the grasp on the tissue during the electrical current flow process. The prior art devices required the treating physician to actively maintain tension to hold the fallopian tubes while activating the device. The combination of these two hand movements made the prior art devices difficult to operate.
The present invention ellminates the need of compound Function by the treating physician. During the grasping process, only button 18 is manipulated by the physician. After grasplng the tissue, only activator 76 is manipulated by the physician.
After treatment of the fallopian tube 12, button 18 is depressed to release the treated tissue from the electrodes . .

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41 and 42. The device 10 may then be withdrawn from the abdomen of the patient 14. Depression of button 18 opens the electrical circuit at contact arms 4~ and 46 and disables switch 20.
It should be appreciated that the device 10 shown in Figs. 1-7 is constructed of only a few relatively simple components. The molded plastic piston 28 and electrodes 41 and 42 are slidably received in plastic body member 2~. The sleeve 56 ;s held into position by flange 58 and aperture 60.
The contact pads 64 and 66 are pressed into slots ~not shown) in guide 32 with the switch 20 being preassembled for quick installation into the body member 24. The configuration set forth in Figs. 1-7 provides a simple, reliable, safe and inexpensive disposable unit for the electr;cal treatment of living tissue.
; The embodiment shown in Figs. 1-7 illustrate various unique features of the invention. It should be understood that various aspects of each of the specific embodiments may be utilized and interchanged with other embodiments to obtain additional advantages and benefits which are within the ordinary scope of those skilled in the art. Further, various types of physical arrangements of parts and component structures may be modified and utilized For adapting the device for other applications and uses. These modifications are also considered to be within the scope of the invent~on and the appended cla~ms. For example, the f;rst electrode element may move relative to the second electrode element upon movement of the piston. The movement of the first and second electrodes may be in a diverse direction upon longitudinal movement of the piston. The first and second electrode elements may both be mounted on the piston. In another form, only the first ... . ;, , . ~

electrode element may be mounted to the piston and the second electrode e1ement is secured to the body member. The piston rnay be integrally molded to contain a first electrode element with the piston slidably received in a sleeve extending from the second end of the body. The first element may be biased to diverge relative to the second electrode element upon a longitudinal movement of the piston toward the second position.
Each of the first and second electrodes may be secured to the piston with an inwardly projecting tab extending from~the terminal end thereof. The electrodes open upon movement o~
the piston to the second position and grasp the living tissue by releasing of the button. Furthermore, the second electrode may be secured to the body member in fixed spatial relation-~ ship, the first electrode element diverging relative to the ;~ 15 second electrode element upon 10ngitudinal movement of the piston relative to the body member. Still, the first electrode element may terminate in a hook whereas the second electrode element terminates in a pro~ection, the hook having a greater electrode area than the projection for cutting tissue between j 20 the first and second electrode elements.
The present disclosure includes that contained in theappended claims, as-wel-l--as -that of the foregoing descript10n.
Although this invention has been described in its preferred form with a certain degree of particularity, it is understood that the present disclosure of ~he preferred form has been made only by way of example and that numerous changes in the details of the circuit and the combination and arrangement of c~rcuit elements may be resorted to without depart~ng from the spirit and scope of the invention.

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Claims (11)

The embodiments of the invention in which an exclu-sive property or privilege is claimed are defined as follows:

1. A device for treating living tissue with an electric current from an electrical power source, comprising in combination:
a body member;
a piston slidably mounted relative to said body member;
urging means for urging said piston to a first position relative to said body member;
means for moving said piston to a second position relative to said body member against said urging means;
a first and a second electrode element;
means for mounting said electrode elements for movement in accordance with the movement of said piston;
said first and second electrode elements disposed to grasp the living tissue when said piston is in said first position and disposed to release the living tissue when the piston is in said second position; and means for connecting said first and second electrode elements to the electrical power source to provide an electrical current flow relative to the living tissue; said connecting means including switch means mounted on said body member and means mounted on said piston cooperating with said switch means to allow said electrical current to flow only when said piston is in said first position.

2. A device as set forth in Claim 1, wherein said means for moving said piston includes a button extending from a first end of said body member.

3. A device as set forth in Claim 2, wherein said first and second electrode elements extend from a second end of said body member.

4. A device as set forth in Claim 3, wherein said body member is substantially cylindrical.

5. A device as set forth in Claim 1, wherein said piston is integrally molded to contain said electrode elements.

6. A device as set forth in Claim 5, wherein said piston is slidably received in a sleeve extending from an end of said body.

7. A device as set forth in Claim 5, wherein each of said first and second electrode elements includes an in-wardly projecting tab.

8. A device as defined in Claim 1, including means for connecting said electrode elements to a same polarity of said electrical power source to provide monopolar treatment of said living tissue.

9. A device as defined in Claim 1, including means for connecting said electrode elements to different polarities of saicl electrical power source to provide bipolar treatment of said living tissue.

10. A device as in Claim 1, wherein said switch means is manually operable for completing, when operated, a circuit between said power source and said elements so that current flows only when said piston is in said first position and said switch means is operated.

11. A device as in Claim 14, wherein said switch means includes first and second contact members biased apart, an activator mounted in said body member positioned for engaging one of said contact members to move that member toward the other contact member and wherein said cooperating means includes an elevated region on said piston positioned for engaging said other contact member when said piston is in said first position to move said other contact member toward said one member so that when said region engages said other contact member and said activator engages said one contact member said contact members are in electrical connection.