WO2001000098A1

WO2001000098A1 - A bipolar electro-coagulator for surgical use

Info

Publication number: WO2001000098A1
Application number: PCT/EP2000/005725
Authority: WO
Inventors: Francesco Pianetti
Original assignee: Francesco Pianetti
Priority date: 1999-06-28
Filing date: 2000-06-21
Publication date: 2001-01-04
Also published as: ITMI990424V0; ITMI990424U1; AU5817200A; IT246825Y1

Abstract

A bipolar electro-coagulator for surgical use is described in which the internal face of at least one of the jaws of the forceps belonging to the bipolar electro-coagulator has at least one protrusion directed towards the other jaw of the forceps. This protrusion may consist of a blade element or of at least a line of pointed protrusions which are preferably, but not necessarily, cone or cylindrically shaped. If the bipolar electro-coagulator is incorporated into scissors for surgical use, one of the scissor blades has a line of pointed protrusions. This arrangement enhances the coagulation properties of the forceps.

Description

A BIPOLAR ELECTRO-COAGULATOR FOR SURGICAL USE

Field of the invention.

The invention consists of a bipolar electro-coagulator for surgical use in which the internal face of at least one of the jaws of the forceps belonging to the bipolar electro-coagulator has at least one protrusion directed towards the other jaw of the forceps.

This protrusion may consist of a blade element or of at least a line of pointed protrusions which are preferably, but not necessarily, cone or cylindrically shaped. If the bipolar electro-coagulator is incorporated into scissors for surgical use, one of the scissor blades has a line of pointed protrusions. Prior Art

Electro-coagulation is a well known technique and is widely used in many sectors of medicine (surgery, cosmetic surgery, dermatology, etc.) and of cosmetology to occlude a vessel that supplies (at least partially) the tissue to be sectioned and/or ablated before sectioning the same vessel and sectioning and/or removing the aforesaid tissue.

Electro-coagulation has gradually assumed ever increasing importance with the assertion of surgical techniques also geared towards "important" operations (e.g. a hysterectomy) gaining access to organs, situated inside the abdominal and/or thoracic cavity, through relatively small openings made in the skin and muscular fasciae of the patient.

Such surgical techniques (reducing skin lesions to a minimum and, especially, lesions to subcutaneous muscular fasciae) allow the reduction of haemorrhaging, the length of convalescence and possible consequences often permanent and, in any event, annoying which result from such lesions.

The (relatively) reduced dimensions of the openings made to gain access to the internal organs make practically impossible a manual access to vessels to be occluded (e.g. by ligature) and sectioned: hence surgical apparatuses have been designed in which the "active" elements (forceps, scissors, etc.) are mounted onto the end of a probe and operated (in a manner known in itself) by means placed inside the probe, possibly with the use of viewing aids (e.g. optic fibres), preferably, but not necessarily, housed in the probe itself. The bipolar electro-coagulators for surgical use currently in use (and the relative power supply and control apparatuses) will not be described in detail presently, since they are known in themselves and, in any case, are unrelated to the present invention: it should just be remembered that their "active" element is normally shaped like forceps and is made up of two electrodes which are placed against the side of the vessel to be occluded before applying a potential difference that causes (or should cause) occlusion of the vessel by coagulating the blood present in the same vessel at the point where the electro-coagulator is applied and fusing together the vessel walls. It has been discovered in current practice that a known type bipolar electro- coagulator is not always reliable, since it does not always totally occlude the vessel which, when sectioned, may lead to a certain amount of bleeding and annoying, in any case: to stop the bleeding, it is necessary to trace the vessel (that has retracted) and recoagulate it, also more than once before commencing with the operation.

Such a drawback is more frequent and/or probable when the vessel to be "treated" has a (relatively) significant diameter and/or is difficult to reach, e.g. when it is enveloped by "adhesions", surrounded by connective tissue and/or situated alongside another vessel of identical diameter. As a mere example, the uterine artery is a vessel, the bleeding of which is not infrequent, that is situated alongside the uterine vein and which is difficult to "treat" using a traditional electro-coagulator.

In addition, the so-called "monopolar coagulant scissors" are both known and available for surgical use, i.e. scissors of the type normally used to section a vessel, the blades of which make up one of the electrodes of an electro- coagulator, whose second electrode consists of a plate positioned under the patient.

The "monopolar coagulant scissors" present the risk of causing lesions to the patient since, if the plate does not adhere perfectly to the patient then arcs are triggered (or could be triggered), at the moment of electrocoagulation between the plate and the patient, which damage (or may damage) the patient's skin. The bipolar electro-coagulator for surgical use, subject of the present invention eliminates the aforesaid drawbacks caused by known type bipolar electro- coagulators.

Summary of the invention

A bipolar electro-coagulator for surgical use is the subject of the present invention, including a pair of electrodes, preferably facing each other: on the internal face of at least one of the electrodes there is at least one protrusion directed towards the other electrode of the bipolar electro-coagulator.

Preferably, but not necessarily, the electrodes are made up of the jaws of a forceps and at least one protrusion consists of at least a line of pointed protrusions, which are cone or cylindrically shaped, directed towards the other electrode of the bipolar electro-coagulator.

Alternatively, at least one protrusion consists of a blade element directed towards the other electrode of the bipolar electro-coagulator.

If the bipolar electro-coagulator is incorporated into scissors for surgical use, one of the scissor blades has a line of pointed protrusions.

Brief description of the drawings

The invention will now be better described with reference to unrestricted embodiment examples illustrated in the figures enclosed, in which:

- figure 1 outlines a side view of a forceps embodiment, in its rest position, of a bipolar electro-coagulator modified according to the invention;

- figure 2 outlines a side view of the forceps in figure 1 , open;

- figure 3 outlines a view from below of the forceps in figure 1 ;

- figure 4 outlines a side view of monopolar coagulant scissors, in rest position, modified according to the invention; - figure 5 outlines a side view of the scissors in figure 4;

- figure 6 outlines an aerial view of the scissors in figure 4;

- figure 7 outlines a perspective view of an additional forceps embodiment of a bipolar electro-coagulator modified according to the invention;

- figure 8 outlines two side views, a view from below and a section according to the A-A plane of an additional forceps embodiment of a bipolar electro-coagulator modified according to the invention, in which one of the electrodes carries a blade element directed towards the other electrode of the bipolar electro-coagulator; - figures 9 and 10 outline two side views, a view from below and a section according to the A-A plane of additional forceps embodiments of a bipolar electro- coagulator modified according to the invention, in which both electrodes carry a blade element directed towards the other electrode of the bipolar electro- coagulator.

In the figures enclosed, the corresponding elements will be identified by the same reference numbers.

Detailed description of the Invention

Figure 1 outlines a side view of the forceps, in rest position, of a bipolar electro- coagulator, modified according to the invention, carried by probe 5.

As may be seen from figures 1 and 2, the forceps include a pair of jaws (or electrodes) facing each other: on the internal face of one of the jaws (jaw 2, in figure 1 ) there is at least one protrusion that (in the embodiment example described in figures 1 to 3) consists of a line of pointed protrusions 3, directed towards the other jaw 1 of the forceps of the bipolar electro-coagulator, with a length of between 2 to 5 mm (preferably 2-2.5 mm).

In the embodiment example illustrated in figures 1-3, the jaw 2 carries a line of three cone-shaped pointed protrusions 3 but, without leading away from the scope of the invention, at least one line of pointed protrusions 3 present on the internal face of one of the jaws (jaw 2 in figures 1-3) may include between two and five (preferably two or three) pointed protrusions 3, which may be shaped differently from the cone-shaped one, e.g. cylindrical (preferably, but not necessarily, with an approx. diameter of 1 mm) or, alternatively pyramidal. The jaws (1 , 2) of the forceps illustrated as an unrestricted example in figures 1-3 have a "zig-zag" contour and the pointed protrusions 3 are of differing lengths but, without leading away from the scope of the invention, pointed projection 3 could be of similar length and/or be applied to a jaw of the forceps of any known type bipolar electro-coagulator, of any shape, size and contour of the same jaw. In particular, if the jaws (1 , 2) of the forceps are flat, the pointed protrusions 3 have the advantage of being of the same length.

If the electro-coagulator at least includes a line of at least three pointed protrusions 3, at least one pointed projection 3 at the centre can be longer than the side ones. Experiments have shown that the addition of the pointed protrusions 3 increases the efficiency of the electro-coagulator, making it able to coagulate the blood also in the central zone of the vessel, occluding it completely and eliminating bleeding.

Such an advantageous result derives from the fact that the potential difference applied between the jaws (or electrodes) of the electro-coagulator forceps is

"concentrated" at the pointed protrusions 3: therefore a stronger current passes through the vessel placed between the two jaws, which increases the locally generated heat and, consequently, the coagulant effect.

Moreover, the presence of the pointed protrusions 3 helps the formation of an electric "arc" between the jaws of the electrocoagulator, permitting the attainment of the coagulant effect even if the pointed protrusions 3 do not come into contact with the other jaw.

Figure 2 outlines a side view of the forceps open in figure 1 ; the cone-shaped pointed protrusions 3 are better seen in figure 2. Figure 3 outlines a view from below the forceps in figure 1 , where the seats 4 are visible, made in jaw 2, in which the pointed protrusions 3 are inserted and welded, belonging to the line of pointed protrusions 3 on jaw 2.

Figure 4 outlines a side view of monopolar coagulant scissors F in rest position, modified according to the invention, which differ from the forceps illustrated in figures 1-3, basically due to the fact that the line of pointed protrusions 3 is carried by one of the scissor blades and, in particular, by blade 7, not visible in figure 4 since it is covered by blade 6; in figure 4 the ends of the pointed protrusions 3 protrude from blade 6.

The plate P that makes up the second electrode of the bipolar electrocoagulator has been omitted to simplify the drawings.

The characteristics of the pointed protrusions 3 carried by blade 7 have been described previously with reference to those applied to a jaw of the forceps of an electro-coagulator (figures 1-3).

Figure 5 outlines a side view of the scissors in figure 4 open; in figure 5 the blade 6 and blade 7 which carry the line of pointed protrusions 3 are more clearly visible.

Figure 6 outlines an aerial view of the scissors in figure 4, where the line of pointed protrusions 3 carried by blade 7 is visible. Without leading away from the scope of the invention, it is possible to make "bipolar" coagulant scissors, electrically isolating the blades (6, 7) from each other in a manner known in itself: in these "bipolar" scissors, blade 6 constitutes the second electrode of the bipolar electrocoagulator, replacing plate P which is therefore omitted.

Such "bipolar" coagulant scissors eliminate the risk of causing skin lesions in patients.

Figure 7 outlines a perspective view of an additional forceps embodiment of a bipolar electro-coagulator modified according to the invention, which differs from the forceps illustrated in figures 1-3 basically due to the fact that on the internal face of one (denoted by 8 in figure 7) of its jaws (8, 9) there are two lines of pointed protrusions 3 directed towards the other jaw (denoted by 9 in figure 7) of the bipolar electro-coagulator and due to the fact that jaw 8 carrying the two lines of pointed protrusions 3 has a central hole 10 (preferably but not necessarily) elliptically shaped, whereas the other jaw 9 is flat.

The characteristics of the pointed protrusions 3 belonging to the two lines of pointed protrusions carried by jaw 8 have been described previously with reference to figures 1 to 3. Figures 8 to 10 outline additional forceps embodiments of a bipolar electro- coagulator modified according to the invention, in which at least one of the electrodes (11 , 12) carries a protruding casing consisting of a blade element (13, 14, 15) directed towards the other electrode of the bipolar electro-coagulator. At least one blade element (13, 14, 15) permits the "clamping" of the vessel to be treated, before subjecting it to the coagulant effect of the potential difference applied between the electrodes, thus improving the efficiency of the bipolar electro-coagulator.

Figure 8 outlines the forceps of a bipolar electro-coagulator altered according to the invention, in which an electrode (12) carries the blade element 13 (of a basically pentagonal section; figure 8d) directed towards the other electrode 11 of the bipolar electro-coagulator, of a basically rectangular section.

In figure 8 the side views of the closed forceps (figure 8a) and open (figure 8b) are visible, a view from below the forceps (figure 8c) and a section according to the A- A plane (figure 8d) of the open forceps.

Figures 9 and 10 outline two additional forceps that differ from those shown in figure 8 basically due to the fact that both electrodes (11 , 12) carry a blade element (14, 15 respectively). The blade elements carried by the electrodes (11 , 12) are same and may have a basically triangular section (element 14, figure 9d) or basically pentagonal, identical to that of element 13 in figure 8 (element 15; figure 10d). Still without leading away from the scope of the invention, it is possible for a technician to make all the changes and improvements suggested by normal experience and natural evolution of the technique to the bipolar electro-coagulator for surgical use, subject of the present description.

Claims

1. A bipolar electro-coagulator for surgical use including a pair of electrodes (1 , 2; 6, 7; 8, 9; 11 , 12; P, F), characterised in that on the internal face of at least one (2, 7, 8, 12, F) of the electrodes (1 , 2; 6, 7; 8, 9; 11 , 12; P, F) there is at least one protrusion (3, 13, 14, 15) directed towards the other electrode (1 , 6, 9, 11 ,

P) of the bipolar electro-coagulator.

2. An electro-coagulator according to claim 1 , characterised in that at least one protrusion is made up of at least one line of pointed protrusions (3) directed towards the other electrode (1 , 6, 9, P) of the bipolar electro-coagulator.

3. An electro-coagulator according to claim 2, characterised in that the pointed protrusions (3) belonging to at least one line are cone-shaped.

4. An electro-coagulator according to claim 2, characterised in that the pointed protrusions (3) belonging to at least one line are cylindrically shaped.

5. An electro-coagulator according to claim 4, characterised in that the cylindrically shaped pointed protrusions (3) belonging to at least one line has a diameter of approx. 1 mm.

6. An electro-coagulator according to claim 2, characterised in that at least one line includes between two and five pointed protrusions (3).

7. An electro-coagulator according to claim 6, characterised in that at least one line includes two or three pointed protrusions (3).

8. An electro-coagulator according to claim 2, characterised in that the pointed protrusions (3) belonging to at least one line are 2 to 5 mm in length.

9. An electro-coagulator according to claim 8, characterised in that the pointed protrusions (3) belonging to at least one line are 2 to 2.5 mm in length.

10. An electro-coagulator according to claim 2, characterised in that the pointed protrusions (3) belonging to at least one line are of the same length.

11. An electro-coagulator according to claim 2, characterised in that the pointed protrusions (3) belonging to at least one line are of different lengths.

12. An electro-coagulator according to claim 1 1 in which at least one line includes three pointed protrusions (3) at least, characterised in that at least one pointed projection (3) located in the centre is longer than the side ones.

13. An electro-coagulator according to claim 2, characterised in that on the internal face of one (8) of the electrodes (8, 9) there are two lines of pointed protrusions (3) directed towards the other electrode (9) of the bipolar electro-coagulator.

14. An electro-coagulator according to claim 13, characterised in that the electrode (8) carrying the two lines of pointed protrusions (3) has a central hole (10) and in that the other electrode (9) of the bipolar electro-coagulator is flat.

15. An electro-coagulator according to claim 14, characterised in that the hole (10) in the centre of the electrode (8) carrying the two lines of pointed protrusions (3) is elliptically shaped.

16. An electro-coagulator according to claim 2, characterised in that the electrodes consist of jaws (1 , 2; 8, 9) of forceps of a bipolar electro-coagulator for surgical use.

17. An electro-coagulator according to claim 2, characterised in that one of the electrodes consists of the blades (6, 7) of scissors for surgical use and in that the second electrode consists of a plate (P) placed under the patient; further characterised in that on the internal face of one (7) of the blades (6, 7) there is a line of pointed protrusions (3).

18. An electro-coagulator according to claim 2, characterised in that the electrodes consist of scissor blades (6, 7), electrically isolated from each other, for surgical use and in that on the internal face of one (7) of the blades (6, 7) there is a line of pointed protrusions (3) directed towards the other blade (6).

19. An electro-coagulator according to claim 1 , characterised in that at least one protruding casing consists of a blade element (13, 14, 15) directed towards the other electrode (1 1 ) of the bipolar electro-coagulator.

20. An electro-coagulator according to claim 19, characterised in that one (12) of its electrodes (1 1 , 12) carries a blade element (13) while the other electrode

(1 1 ) is of a basically rectangular section.

21 . An electro-coagulator according to claim 20, characterised in that the blade element (13) is of a basically pentagonal section.

22. An electro-coagulator according to claim 19, characterised in that both its electrodes (1 1 , 12) carry a blade element (14, 15).

23. An electro-coagulator according to claim 22, characterised in that the blade elements (14) are identical and of a basically triangular section.

24. An electro-coagulator according to claim 22, characterised in that the blade elements (15) are identical and of a basically pentagonal section.