CN1929794A - 多功能的可伸缩单极/双极外科手术设备及其方法 - Google Patents

多功能的可伸缩单极/双极外科手术设备及其方法 Download PDF

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CN1929794A
CN1929794A CNA2005800069858A CN200580006985A CN1929794A CN 1929794 A CN1929794 A CN 1929794A CN A2005800069858 A CNA2005800069858 A CN A2005800069858A CN 200580006985 A CN200580006985 A CN 200580006985A CN 1929794 A CN1929794 A CN 1929794A
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伊恩·考斯麦斯库
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1402Probes for open surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/042Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating using additional gas becoming plasma
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/1253Generators therefor characterised by the output polarity monopolar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/126Generators therefor characterised by the output polarity bipolar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1475Electrodes retractable in or deployable from a housing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/007Aspiration
    • A61B2218/008Aspiration for smoke evacuation

Abstract

公开了一种与电外科单元(ESU)一起使用的多功能可伸缩单极/双极电外科手术电刀笔。该单极/双极电外科手术电刀笔包括具有夹在激活单极和返回单极之间的绝缘体的双极电极,其中该双极电极与能交替地用双极电极实现切割和凝固的手柄相连。单极/双极电外科手术电刀笔能用作单极和双极设备,并可用于开放性手术和封闭式的腹腔镜和内窥镜手术。用于调节双极单极的长度的可伸缩装置也被设置为用于排烟和吸引/灌洗的装置。该多功能可伸缩单极/双极设备也可适于配合ESU氩束凝固器使用。

Description

多功能的可伸缩单极/双极外科手术设备及其方法
技术领域
本发明一般涉及电外科单元(ESU)笔,尤其涉及具有双极电极的ESU电刀笔,其中激活和返回电极包含在ESU电刀笔的同一端内,并由耐高温无线射频(RF)电介质分隔开。具有双极电极的ESU电刀笔被设计成用于配合单极ESU设备在医疗操作中用作切割和凝固双极功能。当配合单极ESU设备使用时,具有双极电极的ESU电刀笔也可用于单极应用,其中独立的电极被施加于患者身体的一部分,通常是患者的腿部以用作返回电极。该单极功能在现有技术中是普遍的。
本发明还涉及可伸缩的腹腔镜用单极/双极ESU电刀笔,它具有能适应不同深度和/或不同大小的成人和儿童的可调长度电极。可伸缩的腹腔镜用单极/双极ESU电刀笔也可与在诸如美国专利5,199,944中描述的集成式排烟器系统一起使用。此外,本发明的具有双极电极的ESU电刀笔可与在本人的题为“AutomaticSuction/irrigation Apparatus for Use in Laparoscopic Surgery and Electrosurgery andMethod therefor”(用于腹腔镜手术和电外科手术的自动吸引/灌洗装置及其方法)的共同待批专利申请中所述的自动吸引/灌洗设备和装置组合,该申请与本申请同时提交并且通过引用结合于此。最后,本发明的具有双极电极的ESU电刀笔可与附件组合,从而可用于氩束凝固。
背景技术
在过去,电外科设备具有用于执行切割和凝固的激活电极,以及通常包括接触患者皮肤的粘结剂的返回电极。当激活电外科单元手术电刀笔时,RF能量从激活电极到返回电极通过患者的身体循环,其中激活和返回电极之间的距离相当大。
这种现有技术系统呈现了若干缺点,并产生了众多危及患者的问题。第一,因为激活和返回电极之间的较大距离,高频的高电压横穿身体,以闭合激活和返回电极之间的电路。这些高电压和高频对患者是非常危险的。第二,由于身体具有电阻的事实,随着激活和返回电极之间的距离变大,切割和凝固作用会显著减小。因此,为了获得有效的切割和凝固性能,需要来自ESU的高能量。所需的来自ESU的高能量对患者也是危险的。
第三,在许多情形中,由于返回电极与患者皮肤的较差接触,患者会遭受严重的灼伤。最后,危险的电容性耦合会在腹腔镜手术中发生,导致对患者危险的的灼伤。因为这些灼伤在腹腔镜的视野之外,所以并不能被检测到,从而危及患者的生命。
用于开放性手术和腹腔镜手术的双极功能目前与ESU的双极吸引器一起使用。然而,本系统和相关仪器仅用于患者体内的止血,而不能进行切割操作。
如前在“相关申请”一节中所述,本发明相关于本发明人的题为“TelescopicSurgical Device and Method Therefor”(可伸缩外科设备及其方法)的待批专利申请。待批申请中所述的可伸缩电刀笔和本申请中本发明之间的相似性是两个发明都涉及具有多功能应用的可伸缩电刀笔。它们之间的主要差异在于:待批可伸缩电刀笔专利申请仅涉及仅具有一个触点作为电极的单极电刀笔,而本申请中所述的本发明的ESU电刀笔可用作单极仪器、单极/双极仪器、或双极仪器。本发明的ESU电刀笔具有一个包括两个触点的电极,当该仪器用于单极/双极作用仪器的双极作用仪器时,其中一个触点用作激活电极,而另一个用作返回电极。或者,当仪器仅用作单极作用仪器时,独立的电极被施加于或者身体的不同部位,通常在患者的腿部。该独立电极用作返回电极。
发明内容
本发明的一个主要目的是提供一种电外科电极,用于对开放性手术与封闭式的内窥镜和腹腔镜手术执行切割和凝固,其中电外科电极在同一端上包含激活电极和返回电极。
本发明的另一个目的是提供一种单极/双极电极,它可用于电外科单元的单极区段上执行单极功能,从而消除对单独的返回电极的需要。
本发明的又一个目的是提供一种具有排烟装置的可伸缩的单极和单极/双极电极与电刀笔,其中电极的操作端与手柄之间的距离可调,以适应关联于不同身材患者的所需长度。
本发明的再一个目的是提供一种可伸缩的单极和单极/双极内窥镜与腹腔镜电极,带有或不带排烟装置,其中腹腔镜电极的长度可调。
本发明的另一个目的是提供一种具有吸引/灌洗装置的可伸缩的单极和单极/双极ESU电刀笔,其中双极电极在激活吸引装置之后可自动收回。
本发明的又一个目的是提供一种具有吸引/灌洗装置的可伸缩的单极和单极/双极电极和电刀笔,用于开放性手术与封闭式的内窥镜和腹腔镜手术,其中电极在激活吸引装置之后可自动收回。
本发明的再一个目的是提供一种多功能的可伸缩ESU电刀笔,当配合如前参照题为“Telescopic Surgical Device and Method Therefor(可伸缩外科设备及其方法)”的本人待批美国专利申请所述的相应附件使用时,可用于开放性和腹腔镜电外科手术、还能进行吸引和灌洗、并且可用于氩束凝固。
因此,本发明的多功能可伸缩单极/双极外科设备包括双极单极和具有电触点的手柄,其中双极电极与手柄的电触点相连,并且手柄的电触点与用于激活该设备的能量源相连。电外科单元可被用作能量源。双极电极包括激活电极、返回电极、和夹在激活电极和返回电极之间的绝缘体。该多功能可伸缩单极/双极外科手术设备还可包括与双极电极和手柄耦合的可伸缩元件,用于调节双极电极的长度。此外,该多功能可伸缩单极/双极外科手术设备可包括与双极电极耦合的排烟装置,用于去除在电外科手术期间产生的烟和其它碎屑。
本发明还涉及一种用于开放性手术和内窥镜腹腔镜手术的可伸缩吸引/灌洗装置,它包括:一中空手柄元件,其具有开口远端和开口近端、以及用于将手柄连接到用于激活吸引和灌洗的能量源的连接装置;一细长中空管状元件,其具有远端开口端和近端开口端,其中该远端开口端插入手柄的开口近端使细长中空管状元件共中心地包含在手柄的腔内;以及一锁定装置,用于将细长中空元件锁定于手柄内。可伸缩吸引/灌洗装置的另一实施方式包括:一手柄元件,其具有与能量源的连接装置、以及用于实现吸引和灌洗功能的装置;一具有内腔和外腔的双腔可伸缩吸引/灌洗管,其中双腔可伸缩吸引/灌洗管被插入手柄元件使双腔可伸缩吸引/灌洗管的一部分共中心地夹持在手柄内;一连接装置,用于连接所述双腔可伸缩吸引/灌洗管的内腔与灌洗端口、并连接所述双腔可伸缩吸引/灌洗管的外腔与吸引端口;以及一锁定装置,用于将双腔可伸缩吸引/灌洗管锁定于手柄元件内。
本发明还涉及一种用于对患者执行电外科手术的方法,包括以下步骤:将具有激活电极和返回电极的双极电极连接到手柄,该手柄具有用双极电极交替地实现切割和凝固的装置;将激活和返回电极连接到能量源;并使用双极电极激活切割或凝固功能。
从结合附图的以下描述中,将可以更全面地理解本发明的前述和其它目的、特征和优点,及其较佳实施例。
附图说明
图1a是使用具有需要独立回路电极的单极电极的现有技术ESU电刀笔对患者执行的电外科手术的图解视图。
图1b是使用本发明的用于电外科手术的可伸缩单极/双极外科手术设备对患者执行电外科手术的图解视图。
图2a是在本发明的用于电外科手术的可伸缩单极/双极外科手术设备内使用的双极电极的第一实施例的立体图,该双极电极也可用作单极电极。
图2b是在本发明的用于电外科手术的可伸缩单极/双极外科手术设备内使用的双极电极的第二实施例的立体图,该双极电极也可用作单极电极。
图2c是在本发明的用于电外科手术的可伸缩单极/双极外科手术设备内使用的双极电极的第三实施例的立体图,该双极电极也可用作单极电极。
图2d是在本发明的用于内窥镜和/或腹腔镜手术的多功能可伸缩单极/双极外科手术设备内使用的双极电极的第一实施例的立体图,其中该双极电极有单极功能。
图2e是在本发明的用于内窥镜和/或腹腔镜手术的多功能可伸缩单极/双极外科手术设备内使用的双极电极的第二实施例的立体图,其中该双极电极有单极功能。
图2f是在本发明的用于内窥镜和/或腹腔镜手术的多功能可伸缩单极/双极外科手术设备内使用的双极电极的第三实施例的立体图,其中该双极电极有单极功能。
图3a是本发明的多功能单极/双极可伸缩电外科设备的立体图;
图3b是图1所示设备在无电线情况下的立体分解图;
图3c是图3a所示设备在无电线情况下的横截面视图;
图3d是内窥镜和/或腹腔镜可伸缩元件的立体图,它可替换图3c所示的多功能单极/双极可伸缩电外科设备的可伸缩元件,以创建用于内窥镜和/或腹腔镜手术的多功能单极/双极可伸缩电外科设备。
图4a是吸引/灌洗窥镜的立体图,它可替换图3c中的电外科窥镜或图3d中的腹腔镜窥镜以提供具有能执行吸引或灌洗的吸引/灌洗装置的可伸缩外科手术设备。
图4b是吸引/灌洗窥镜的第二实施例的立体分解图和部分横截面视图,它可替换图3c中的电外科窥镜或图3d中的腹腔镜窥镜以提供具有能同时执行吸引和灌洗的吸引/灌洗装置的可伸缩设备。
图4c是水力切割喷嘴的部分横截面视图,其中喷嘴的内管被示为收回。
图4d是图4c所示的水力切割喷嘴的部分横截面视图,其中所示内管被示为伸出。
图5是本发明的可伸缩吸引/灌洗装置的一个实施例的立体分解图。
具体实施方式
配备具有单极电极的ESU电刀笔的用于执行电外科的现有系统如图1a所示。电外科电刀笔10包括对患者14执行切割或凝固的激活电极12。包括激活电极12的ESU电刀笔10与电外科单元16相连,该电外科单元16提供能量源以激活ESU电刀笔10。返回电极18包括胶布20,它距离激活电极12以相当距离22定位并贴附到患者身上。返回电极18也与电外科单元16相连,从而建立一闭合电路,其中从激活电极12发出的电压和频率通过患者14的身体传送并通过返回电极20接收。图1a示出目前如何进行单电极电外科手术。
使用本发明的多功能可伸缩单极/双极外科手术设备对患者执行的电外科手术如图1b所示。使用本发明,电外科电刀笔10包括双极电极11,它包括激活电极12和返回电极18,其间由用作绝缘体的材料电介质13分隔。激活电极12和返回电极18都与电外科单元16相连,从而形成完整的电路。当电外科单元16被激活且双极电极11接触患者14的组织时,电路通过激活电极12和返回电极18之间患者组织的极小部分闭合。激活电极12和返回电极18之间的缩短距离导致先前关联于现有技术的单极电极为实现切割和凝固所需的功率要求降低。两个电极12、18之间的缩小距离还导致与高频的高电压穿过患者身体的大部分相关联的危险降低,这些危险之一是患者灼伤可能性的上升。
图2a-c示出双极电极的不同实施例的立体图,该双极电极构成用于开放性电外科手术的本发明的多功能可伸缩单极/双极手术设备的一部分。这些电极能结合电外科单元展现双极和单极功能。
图2a示出双极片状电极的立体图。绝缘体26夹在激活电极28与返回电极30之间。激活电极28还包括激活叉尖32,它被设计成与包含在以下参照图3b和3c示出并描述的本发明设备的可伸缩元件内的激活导体相接触。此外,返回电极30包括返回叉尖34,它被设计成与包含在以下参照图3b-3c示出并描述的本发明设备的可伸缩元件内的返回导体相接触。
图2b示出双极针状电极的立体图。绝缘体26还是夹在激活电极28与返回电极30之间,其中激活电极28和返回电极30还包括激活叉尖32和返回叉尖34,分别与包含在如图3b-3c所示的本发明设备的可伸缩元件内的导体元件相连。
图2c示出可用于切割和/或凝固、并用于体表凝固或切除的特定弯角双极电极的立体图。绝缘体26夹在激活和返回电极之间,其中激活电极28和返回电极30之一置于绝缘体26的对面。更具体地,在绝缘体26的第一侧(未示出)有顶部激活电极28A和底部返回电极30B,而在绝缘体26的第二侧有顶部返回电极30A和底部激活电极28B。激活叉尖32将顶部激活电极28A连接到底部激活电极28B,而返回叉尖34用于将顶部返回电极30A连接到底部返回电极30B,从而在将激活和返回电极28、30连接到包含在以下参照图3b-3c说明的本发明设备的可伸缩元件内的导体时分别形成激活电极28和返回电极30的连接装置。前述电极还可通过包括不同形状的变体变化,而不背离本发明的目的。
图2d-2f示出双极电极的立体图,它构成用于执行内窥镜和/或腹腔镜手术的本发明的多功能可伸缩单极/双极外科手术设备的一部分,其中该单极还具有单独的单极功能。图2d和2e示出用于内窥镜和/或腹腔镜手术的钩状双极电极,其中双极电极也能用作单极电极。图2f示出用于内窥镜和/或腹腔镜手术的桨状双极电极,它也可用作单极电极。图2d-2f所示的所有双极电极都包括夹在激活电极28和返回电极30之间的绝缘体26。此外,激活电极28包括激活叉尖32,而返回电极30包括返回叉尖34,其中激活叉尖32和返回叉尖34均用作连接装置,用于将激活电极28和返回电极30连接到包含在以下参照图3d详细说明的本发明设备的腹腔镜/内窥镜可伸缩元件内的导体。
其它电极形状和形式可相对于内窥镜和/或腹腔镜手术的双极电极使用,而不背离本发明的目的。此外,前面参照图2a-2f所述的全部双极电极上的激活电极28和返回电极30可翻转,使激活电极28和返回电极30在绝缘体26的与图示相对的一侧上。
激活电极28最好由不锈钢或其它适当的导体制成,而返回电极30最好由陶瓷或其它可用作绝缘体的适当材料制成。绝缘体26最好由适合用作射频应用和极高温度电介质的电介质材料(诸如某些类型的陶瓷)制成。然而,可使用任何适合极高温RF应用的条件的电介质材料。
如前参照图1b所述,在ESU被激活且电极接触患者的组织时,由激活电极28和返回电极30建成的电路是闭合的。该患者组织的极小部分闭合了激活电极28和返回电极30之间的间隙。结果,为闭合电路并实现切割和凝固操作仅需要少得多的功率横穿患者的组织。负载电阻器可串联安装以避免两个电极之间的意外短路。
现在参看图3a,示出了本发明的多功能可伸缩单极/双极电外科设备的立体图。简言之,本发明的多功能可伸缩单极/双极电外科设备40包括:主体42;可伸缩体44,它沿圆周地包含在主体42内以使其可从主体42中向外伸出并向内收缩;锁定元件46,将预定伸出长度的可收缩体44锁定在主体42上;双极电极48,它包含在可收缩体和主体内从而可与电外科单元电接触;以及连接器元件50,用于将设备40的主体42连接到排烟管(未示出)。设备40的主体42还包括一系列选择按钮,一个用于切割(CUT)的选择按钮52、一个用于凝固(COAG)的选择按钮54、以及一个用于氩束凝固(ABC)的选择按钮56。用于氩束凝固的选择按钮56是任选的。主体可仅设置切割和凝固选择按钮52、54。
本发明的多功能可伸缩单极/双极电外科设备40的分解图如图3b所示。设备40的主体42包括由腔62相连的远端螺纹58和近端螺纹60。主体42还包括激活触点64和返回触点66,它们彼此平行地位于腔62的内表面上,其间具有类似细长槽68的一间隙。可收缩体44包括远端70和近端72,由直径比主体42内所包含的腔62小的第二腔74分隔。可伸缩体44还包括位于可伸缩体44的第二腔74内的一对细长导体76、78。各细长导体76、78分别在触头80、82终止,从而触头80、82位于可伸缩体44接近其近端72的外部表面上。中空喷嘴84可与可伸缩体44的远端70相连。
双极电极48与可伸缩体44相连,从而激活电极86和返回电极88分别与细长导体接触。最后,锁定元件46内部中空具有远端90和近端92。锁定元件46还包括包含在其内孔内的凸纹94,以及位于凸纹94上的“O”形环96。结果,锁定元件46可在可伸缩体44上滑动并与主体42的远端螺纹58相连,以使可伸缩体44被锁定在主体42内的位置中。
图3c示出图3a所示的多功能可伸缩单极/双极电外科单元电刀笔的横截面视图。如前所述,主体42包括激活触点64和患者返回触点66,它们彼此平行从而在整个长度上分开相同距离。可伸缩体44外表面上所包含的触头80、82微微啮合并安置在细长槽68内,该细长槽68将激活触点64与患者返回触点66分开。双极电极48经由细长导体76、78与触头80、82相连。可伸缩体44在主体42内伸出或收回,以调节双极电极48的期望长度。
氩束凝固附件(未示出)用特定窥镜替换上述可收缩体44,且类似于题为“Telescopic Surgical Device and Method Therefor”的本人先前美国专利申请所述的端部附件可被附加于设备40的主体42的近端螺纹60上。诸如以下如图4a-4b描述和示出的吸引/灌洗附件、以及排烟管的连接器(未示出)也可与设备40的主体42的近端螺纹60相连。锁定元件46可拧到设备40的主体42的远端螺纹58上,以便于将可伸缩体44锁定到位。可伸缩体44通过将锁定元件46紧固在主体42的远端螺纹58上来锁定到位。结果,将包含在锁定元件46内的凸纹94向前推到压在“O”形环96上,而“O”形环96又压在可伸缩体44上,从而将其锁定到位。
在使用过程中,当压下切割按钮52或凝固按钮54时,激活触点64通电,且返回触点66动作以将电流从患者处返回到电外科单元。触头80、82用来使射频能量穿过细长导体76到达双极电极48,然后将RF能量通过细长导体78返回到触头82。如果本发明的多功能可伸缩单极/双极外科电刀笔设备仅作单极使用,则激活触点64和返回触点66都将传导激活能量,且单独的返回单极将如图1a所示地设置和使用。能量通过电线49(参见图3a)导入本发明的多功能可伸缩单极/双极外科电刀笔设备,该导线49与电外科单元(未示出)相连。
现在参看图3d,示出内窥镜/腹腔镜可伸缩体98,它替换图3b-3c所示的可伸缩体44以便于执行内窥镜和/或腹腔镜手术。第二锁定元件100与参照图3b-3c所述的锁定元件46相似地工作。当压下切割按钮52时激活切割手术,而当压下凝固按钮54时激活凝固。氩束激活按钮56是可选的,并且如果使用,可用在诸如题为“Telescopic Surgical Device and Method Therefor”的本人待批专利申请中所述的不同伸缩体来替换内窥镜/腹腔镜可伸缩体98,并且适配器在设备40的主体42的近端螺纹60上装于设备40的端部。该适配器与以下参照图4示出并描述的用于吸引/灌洗的适配器极为相似。
图4a-4c示出本发明的电外科电刀笔的另一个实施例,它涉及用于电外科手术的可伸缩吸引/灌洗电刀笔。如图3a-3d所示的可伸缩单极/双极外科电刀笔通过用图4a-4b中示出的附件替换图3b-3c中的可伸缩体44和图3d中的内窥镜/腹腔镜可伸缩体98,将变成可伸缩吸引/灌洗电刀笔。由此得到的可伸缩吸引/灌洗电刀笔是有利的,因为它允许外科医生调节吸引/灌洗头的长度而无需去除和添加不同长度的头。
图4a示出吸引/灌洗附件102的第一实施例的立体图,它包括具有远端106和近端108的单腔中空管104。吸引/灌洗附件102还包括导轨110,它在圆周上适配于单腔中空管104的近端108上,从而使吸引/灌洗附件102能在图3b所示的可伸缩单极/双极电外科设备40的主体42内滑动啮合。如图3b所示的锁定元件46还结合如图4a所示的吸引/灌洗附件102使用,以便将吸引/灌洗附件102锁定在距离图3b所示主体42预定伸出长度的位置上。由此得到的设备是用于电外科手术、以及腹腔镜和内窥镜手术的可伸缩吸引/灌洗电刀笔。
吸引和灌洗通过将如图3a所示的切割按钮52用于灌洗并将如图3a所示的凝固按钮54用于吸引来激活。在灌洗期间,灌洗液体通过连接器元件50进入可伸缩吸引/灌洗电刀笔,然后通过如图4a所示的单腔中空管104的近端108,并通过如图4a所示的单腔中空管104的远端106流出可伸缩吸引/灌洗电刀笔。相反,当激活吸引时,液体从患者体内抽出,并在单腔中空管104的远端106进入可伸缩吸引/灌洗电刀笔,然后抽入单腔中空管104的近端108,最后通过如图3b所示的连接器元件50流出可伸缩吸引/灌洗电刀笔。
吸引/灌洗附件102的远端106可变窄以形成诸如图4a所示的喷嘴112。远端106的喷嘴112配置便于通过使灌洗液体能以高压和高速流出吸引/灌洗附件102的远端106,来将可伸缩吸引/灌洗电刀笔用于水力切割。
图4b示出能同时进行吸引和灌洗的吸引/灌洗附件114的第二实施例的分解立体图。可伸缩吸引和灌洗管的长度也是可调节的。吸引/灌洗附件114的第二实施例包括双腔管116和单连接管118。双腔管116包括沿圆周包含在第二中空管122内的第一中空管120,其中第一和第二中空管120、122的长度基本相同。双腔管116还包括远端124、近端126、位于双腔管116的近端126上的分隔元件128、以及作用与参照图3b示出和描述的锁定元件46相似的锁定元件46。
双腔管116包含由第一中空管120的中空内部区域限定的中央内腔130,以及由第二中空管122的内径和内部中空管120的外径之间的差所产生的开口限定的外部环状腔132。灌洗通过中央内腔130进行,而吸引通过外部环状腔132进行。
第二中空管122在双腔管116的远端124上的第一中空管120附近闭合,但多个孔134包含在第二中空管122靠近远端124的圆周周围,从而形成一开口,通过它液体可流过外部环形腔132。分隔元件128包括具有近端开口端的缩短中空圆柱体,以及位于其对面开口端内的多个翼片136。多个翼片136置于外部环形腔132内,该外部环形腔132位于第一中空管120和第二中空管122之间以保持管120、122之间的距离并支承外部环形腔132,同时还允许灌洗液体最小阻力地流过外部环形腔132。
单独连接管118包括具有开口远端140和开口近端143的管138,其中开口近端142位于复式连接件144内。该复式连接件144包括具有带有容纳螺纹的凹槽148的大开口远端146的中空件,以及位于其近端156分别具有螺纹154的两个较小腔150、152。螺纹腔150被设计成与灌洗装置相连,而螺纹腔152被设计成与吸引装置相连。
在使用过程中,复式连接件144的大开口远端146上的凹槽148与图3b所示的设备40的主体42的近端螺纹60相连,而管138通过主体43的腔62插入,从而当分隔元件128滑入图3b所示的设备40的主体42内时管138将退出腔62并进入双腔管116的第一中空管120的中央内腔130。管138具有比第一中空管120的内径略小的外径,从而中空管120和管138在共中心接合时形成伸缩体。
当激活灌洗时,灌洗液体将在压力下通过管138的开口近端142引入,并将穿过因将管138接合于第一中空管120内产生的可伸缩配置,然后通过第一中空管120在双腔管116的远端124流出。当激活吸引时,吸引装置施加在吸引腔152上,且液体通过第二中空管122内所包含的多个孔从患者体内抽出。液体通过环状外腔132抽出,然后在吸引腔152排出。分隔元件128在图3b所示的设备40的主体42内滑动,且第二中空管122通过将锁定元件46连接到设备40的主体42的远端螺纹58来锁定到位。
如图4b所示的吸引/灌洗附件的双腔管116的远端124可包括如图4c-4d所示的另一配置。图4c-4d示出一喷嘴配置,其中第一中空管120的远端开口端158形成针状头部160,它能在第二中空管122内伸缩,从而使操作人员或外科医生能调节灌洗装置的长度,使它能伸到吸引装置长度外的应用之处。
尽管本发明已经参照其较佳实施例进行了特别的示出和说明,但本领域技术人员可以理解,可进行前述形式和细节中的变化而不背离本发明的精神和范围。例如,如果将不同形状或形式给予单极/双极电极但它们仍然能用于单极ESU吸引以提供双极功能,则确信该新配置包括在本发明的范围内。此外,用于将可伸缩作用元件锁定到位的不同锁定装置、以及用于在设备的可伸缩体和主体内提供电接触手段的不同配置也确信被包括在本发明的精神和范围内。

Claims (10)

1.一种与能量源一起使用的多功能电外科电刀笔,包括:
双极电极;
手柄,具有用于将所述双极电极连接到所述能量源的装置;
可伸缩元件装置,与所述双极电极和所述手柄耦合,用于调节所述双极电极的长度;以及
排烟装置,与所述双极电极耦合,用于去除在使用所述电外科电刀笔和能量源的医疗过程中产生的烟和碎屑。
2.如权利要求1所述的多功能电外科电刀笔,其特征在于,所述能量源是电外科单元。
3.如权利要求1所述的多功能电外科电刀笔,其特征在于,还包括用于实现交替和同步吸引与灌洗功能的至少之一的装置。
4.如权利要求3所述的多功能电外科电刀笔,其特征在于,所述能量源是电外科单元。
5.一种与电外科单元一起使用的多功能电外科电刀笔装置,包括:
单极切割和凝固装置,在医疗过程中用于切割和凝固;
双极切割和凝固装置,在所述医疗过程中用于双极切割和凝固以及单极/双极切割和凝固;
排烟装置,与所述单极和双极切割和凝固装置耦合,用于去除在所述医疗过程中产生的烟、液体和碎屑;以及
可伸缩元件装置,与所述单极和双极切割和凝固装置、以及所述排烟装置和吸引/灌洗装置的至少之一耦合,从而使所述单极和双极切割和凝固装置的位置能沿着所述多功能电外科电刀笔装置的长度进行调节。
6.如权利要求5所述的多功能电外科电刀笔装置,其特征在于,所述电刀笔装置用于开放性手术与闭合式腹腔镜和内窥镜手术。
7.一种与能量源一起使用的可伸缩吸引/灌洗装置,包括:
手柄元件,具有通过腔相连的开口远端和开口近端、位于所述手柄元件的内部长度上的至少一个电触点、以及用于将所述手柄元件连接到用于交替地激活吸引和灌洗功能的能量源的连接装置;
具有远端和近端开口端的细长中空管状元件,其中所述细长中空管状元件的远端开口端插入所述手柄的开口近端,使所述细长中空管状元件共中心地夹持在手柄的腔内;以及
锁定装置,用于将所述细长中空管以预定长度锁入所述手柄元件。
8.如权利要求7所述的与能量源一起使用的可伸缩吸引/灌洗装置,其特征在于,还包括用于执行切割、凝固和氩束凝固的至少之一的装置。
9.一种与能量源一起使用的可伸缩吸引/灌洗装置,包括:
手柄元件,具有通过腔相连的开口远端和开口近端、位于所述手柄元件的内部长度上的至少一个电触点、以及连接装置,用于将所述手柄元件连接到所述能量源以实现吸引和灌洗的交替和同步激活的至少之一;
具有由内腔和外腔接合的远端和近端的双腔可伸缩管,其中所述双腔管的所述远端开口端被插入所述手柄元件的开口近端,使双腔可伸缩管共中心地夹持在所述手柄的腔内;
连接装置,包括具有开口远端和开口近端的单独细长管、以及复式连接件,其中所述单独细长管的开口近端装于所述复式连接件内,且所述单独细长管的开口远端插入所述双腔可伸缩管内腔的近端开口端,使所述单独细长管共中心地夹持在双腔可伸缩管的内腔内,并且其中所述手柄元件的开口近端与所述复式连接件相连,所述复式连接件有一独立入口用于灌洗且有一独立出口用于吸引;以及
锁定装置,用于将所述双腔可伸缩管以预定长度锁入所述手柄元件内。
10.如权利要求9所述的可伸缩吸引/灌洗装置,其特征在于,还包括用于执行切割、凝固和氩束凝固的至少之一的装置。
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