WO2010130419A1

WO2010130419A1 - Application electrode with a coagulating section and a cutting section for use in an electrosurgical appliance

Info

Publication number: WO2010130419A1
Application number: PCT/EP2010/002901
Authority: WO
Inventors: Michael Reick; Uwe Schnitzler; Jürgen BELLER
Original assignee: Erbe Elektromedizin Gmbh
Priority date: 2009-05-12
Filing date: 2010-05-11
Publication date: 2010-11-18
Also published as: DE102009020930A1; DE102009020930B4

Abstract

The present invention describes an application electrode for coagulating and cutting bipolar tissue, said application electrode comprising: at least one coagulating electrode section; at least one cutting electrode section, wherein the coagulating electrode section and the cutting electrode section are arranged electrically insulated from each other and each have at least one contact face for contact with the tissue, wherein the contact face of the cutting electrode section is substantially smaller than the contact face of the coagulating electrode section. An important concept of the present invention therefore lies in providing the application electrode with a plurality of voltage-carrying sections which, depending on the use, can be supplied with an HF voltage. In this way, the geometry can be adjusted as a function of the chosen operating mode.

Description

M / ERB-365-PC BO / JW / eh

APPLICATION ELECTRODE WITH A COAGULATION SECTION AND A CUTTING SECTION FOR USE IN AN ELECTRO-SURGICAL APPARATUS

description

The invention relates to an application electrode according to claim 1, an electrosurgical instrument according to claim 7 and an electrosurgical apparatus according to claims 11 and 15.

In high-frequency surgery (HF surgery), high-frequency alternating current is passed through the human body to selectively damage or cut or coagulate tissue. Here, a distinction is generally made between a monopolar and a bipolar application of the treatment stream.

In a monopolar application usually only one application electrode is provided, to which a high-frequency AC voltage is applied. The application electrode is located, for example, on an electrosurgical instrument for cutting and / or coagulating tissue. Furthermore, a large-area neutral electrode is attached to the body of the patient. During the application of the HF current, an RF voltage is applied to the application electrode and the neutral electrode, the circuit being closed via the tissue lying between them. The shape of the application electrode depends on the respective field of application. The surface or contact surface of the application electrode, through which the alternating current is conducted into the tissue, is relatively small, so that in the immediate vicinity of the application electrode, a high current density and consequently also a high heat development occur.

The current density decreases sharply with increasing distance to the application electrode, unless high current densities occur at other parts of the body due to considerable differences in the tissue conductivity.

In bipolar application, the RF voltage is applied to two application electrodes located close to each other, eg on a bipolar coagulation forceps. That is, the current flows mainly through between the application electrodes located tissue. Preferably, the application electrodes are arranged on an instrument. In many cases, poorly accessible tissue sites can only be accessed and treated poorly or not at all with such instruments.

It is known to provide bipolar as well as monopolar instruments with different RF voltages to support different modes of operation. Thus, alternately a suitable tension for coagulation of tissue and another suitable tension for cutting the tissue can be provided on the same instrument. Furthermore, the connected RF generator can be designed such that further operating modes, e.g. for different tissue types. Instruments that allow for alternate cutting and coagulation are particularly popular with surgeons, as it is not possible to change the instrument during surgery. Replacement of the instrument used is not only problematic in terms of sterilization, but also costs time that may be significant to the patient.

Since the application electrode of corresponding instruments for coagulation must be relatively large, it is problematic to generate a sufficiently high voltage in order to achieve satisfactory results in the section of tissue with a corresponding electrode.

Based on this prior art, it is an object of the present invention to provide a suitable application electrode for coagulating and cutting tissue. Furthermore, a suitable instrument and electrosurgical device should be provided.

This object is achieved by the application electrode according to claim 1.

In particular, the object is achieved by an application electrode for coagulating and cutting biological tissue, wherein the application electrode comprises:

at least one coagulation electrode section; at least one cutting electrode section, wherein the coagulation electrode section and the cutting electrode section are arranged so as to be electrically insulated from one another and each have at least one contact surface for contacting the fabric, wherein the contact area of the cutting electrode portion is substantially smaller than the contact area of the coagulation electrode portion.

An essential idea of the present invention is therefore to design the application electrode of a monopolar instrument or the application electrodes of a bipolar instrument such that they each consist of at least two electrically isolated sections, preferably the coagulation electrode section and the cutting electrode section. These sections can be used to vary the geometry of the current-carrying section or sections, in particular the contact surface with the tissue to be treated. Thus, depending on the operating mode, another electrode section of the application electrode or a selection of the electrode sections can be supplied with a corresponding HF voltage. For example, the contact surface of the cutting electrode section can be made substantially smaller than the contact surface of the coagulation electrode section. Thus, depending on the operating mode, optimal application of the HF current can be ensured. This is particularly advantageous since large-area electrodes and small-area electrodes are required for the coagulation.

In one exemplary embodiment, the contact area of the cutting electrode section may be less than one third, in particular less than one quarter, in particular less than one sixth, in particular less than one eighth, in particular less than one tenth, in particular less than one twentieth, of the contact surface of the coagulation electrode section.

In a further exemplary embodiment, a further electrode section can be provided, for example, for dissecting on the application electrode in order to support a further operating mode. This further electrode section is also electrically insulated from the cutting electrode section and the coagulation electrode section. Theoretically, it is conceivable to provide a multiplicity of electrode sections and, depending on the selected operating mode, to apply an HF voltage to these electrode sections.

The application electrode may have an elongated shape, wherein at least one elongated contact surface of the cutting electrode section is formed substantially along the longitudinal axis of the application electrode. Preferably, therefore, the length the contact surface of the cutting electrode along the longitudinal axis significantly longer than the width of this contact surface. Thus, over a large area of the application electrode can be cut while a suitably high current density is achieved in the immediate vicinity of the contact surface of the cutting electrode portion.

The contact surfaces of the cutting electrode section and / or the coagulation electrode section may, in particular in pairs, be mutually arranged on the application electrode. Preferably, the contact surfaces of the cutting electrode portion and / or the coagulation electrode portion are arranged substantially axially symmetrical to the longitudinal axis of the application electrode, which is preferably cylindrical. The application electrode is substantially symmetrical and can be used for cutting in different directions. The intervening surfaces may be large areas formed as contact surfaces of the coagulation electrode portion.

The cutting electrode section and / or the coagulation electrode section may be formed at least partially from a tungsten and / or stainless steel alloy and / or a conductive ceramic.

The object mentioned at the outset is furthermore achieved by an electrosurgical instrument which comprises:

an application electrode, in particular as described above;

- A connecting device having at least a first contact element and at least one second contact element for producing a connection or plug connection to a supply device, lines for connecting the at least one Koagulationselektrodenabschnitts with the first contact element and the cutting electrode portion with the second contact element.

The electrosurgical instrument thus preferably has a connecting device, for example a plug, which has a plurality of contact elements in order to supply the individual electrode sections, in particular the coagulation electrode section and the cutting electrode section, separately with a suitable HF voltage. Thus, the geometry of the current-carrying sections of the instrument can be selectively changed. The electrosurgical instrument may comprise a switching device having at least two functional positions, which in a first functional position for applying an RF voltage provided via the first contact element to the coagulation electrode section and in a second functional position for applying an RF voltage provided via the second contact element to the cutting electrode section is trained. It is thus possible to apply differing RF voltages to an electrosurgical instrument to assist in different modes of operation. Depending on the functional position of the switching device, the RF voltage is switched through to the associated electrode section.

The switching device can be designed such that in a certain operating mode only one particular electrode section is supplied with an RF voltage. Alternatively, different electrode sections may be cumulatively interconnected for particular modes of operation to form a suitable electrode section for a particular mode of operation. For example, the switching device may be such that in the second operating position, an RF voltage is applied to the coagulation and cutting electrode section.

The above object is further achieved by an electrosurgical device comprising:

an RF generator for providing an RF voltage; an electrosurgical instrument having at least a first electrode section and at least one second electrode section,

a further electrode section, in particular a neutral electrode section,

a control unit which controls an HF generator such that in a first operating mode an RF voltage is applied between the first electrode section and the further electrode section and in a second operating mode an RF voltage is applied between the second electrode section and the further electrode section.

Also in the electrosurgical device according to the invention, an essential idea of the present invention is the geometry of the current-carrying To make portions of the application electrode adjustable by providing a plurality of electrode sections. That is, depending on the operating mode set, one or more electrode sections may be used to apply a suitable RF voltage. Thus, a first RF voltage can be applied by means of a first electrode section and a second RF voltage by means of a second electrode section.

In one embodiment, in the second mode of operation, multiple electrode sections of the electrosurgical instrument are used to apply a suitable RF voltage.

Preferably, the electrosurgical instrument comprises a plurality of electrode sections and the control unit is designed such that it selects a set of electrode sections for applying an HF voltage depending on the set operating mode. The greater the number of electrically isolated electrode sections provided, the more numerous the configuration possibilities. This means that the contact areas used to apply the HF current can be individually addressed depending on the operating mode set. Very narrow contact surfaces for operation in a cutting mode and very large contact surfaces for operation in a coagulation mode are conceivable.

The object mentioned at the outset is furthermore achieved by an electrosurgical device which comprises:

- At least one RF generator for simultaneously providing at least a first and at least a second RF voltage;

an electrosurgical instrument having at least one application electrode as described above, wherein the electrosurgical device, in particular the RF generator, is adapted to simultaneously apply the first RF voltage to the coagulation electrode portion and the second RF voltage to the cutting electrode portion.

Preferably, the first and second voltages differ in a particular property. So the first tension can be especially suitable for one To perform coagulation. The second RF voltage can be selected so that it can be advantageously implemented by means of a cutting process. The said property may be a frequency used, a maximum voltage, an intermittent application time, etc.

Said electrosurgical device has the advantage that two different voltages can be applied simultaneously via a connected electrosurgical instrument so that several operations are carried out simultaneously. For example, it is conceivable to make a very targeted cut and at the same time to soil the edge areas over a large area.

Further advantageous embodiments will be apparent from the dependent claims.

The invention will be described with reference to some embodiments, which are explained in more detail by means of illustrations. Hereby show:

FIG. 1 shows a supply unit to which a monopolar instrument is connected; FIG.

FIG. 2 shows a first monopolar instrument for cutting and coagulating tissue; FIG.

FIG. 3 shows a cross section through the instrument of FIG. 2; FIG.

FIG. 4 shows a second monopolar instrument for cutting and coagulating tissue; FIG.

FIG. 5 shows a cross section through the instrument of FIG. 4; FIG.

FIG. 6 is a detailed view of the instrument of FIG. 5; FIG.

FIG. 7 is a plan view of the monopolar instrument of FIG. 2; FIG. and

- Fig. 8 subcomponents of the supply unit of FIG. 1.

In the following description, the same reference numerals are used for the same and like parts. 1 shows an electrosurgical device comprising a supply unit 60, a monopolar electrosurgical instrument 10 and a neutral electrode 70. The electrosurgical instrument 10 is designed for the monopolar application of an HF voltage. The supply unit comprises, as shown in FIG. 8, an HF generator 61, a control unit 62 and a switching unit 63. The HF generator 61 and the switching unit 63 are in communicative connection with the control unit 62. The supply unit 60 can comprise control elements, which allow the setting of a specific operating mode. The control unit 62 controls the HF generator 61 depending on the set operating mode such that a suitable RF voltage between the electrosurgical instrument 10 and the neutral electrode 70 is applied. The electrosurgical instrument 10 has an instrument head 20 having a plurality of electrode sections. As shown in FIGS. 2 to 7, these are preferably at least one coagulation electrode section 21 and at least one cutting electrode section 22.

Upon activation of the electrosurgical instrument 10, for example by means of an actuating button, an HF current flows through the tissue of a torso 3, on which the neutral electrode 70 is located.

While the current density in the immediate vicinity of the electrosurgical instrument 10 is relatively high, it decreases with increasing distance. Thus, 10 can be coagulated and cut by means of the electrosurgical instrument targeted.

According to the invention, the switching unit 63 is to be controlled by the control unit 62 such that a preset selection of electrode sections is selected for a specific operating mode, which are supplied with a corresponding HF voltage. Thus, depending on the operating mode set, the current-carrying contact surfaces of the electrosurgical instrument 10 can be configured. The shape and area of the sections used to apply the RF current may vary.

2 and 3 show a first embodiment of an electrosurgical instrument 10 according to the invention. This can be roughly divided into the distal instrument head 20, a handle 12 and an instrument connector 40, the instrument connector 40 the proximal end of the Instrument 10 forms. The instrument head 20 is elongated and has a substantially elliptical cross-section. He has two plane

Koagulationselektrodenabschnitte 21, which are mutually arranged on the instrument head 20. Between the coagulation electrode sections 21 is the cutting electrode section 22, which extends in a band shape along the upper edge and the lower edge of the elongated instrument head 20.

FIG. 7 shows a plan view of the electrosurgical instrument from FIGS. 2 and 3, wherein the band-shaped configuration of the cutting electrode section 22 can be recognized particularly well. The coagulation electrode sections 21 and the cutting electrode section 22 are electrically insulated from each other by an insulating layer 46. The instrument connector 40 at the distal end of the instrument 10 has a coagulation port 41 and a cutting port 42 connected to the coagulation electrode portions 21 and the cutting electrode portion 22 via the leads 45, 45 ', respectively. The first line 45 thus connects the coagulation electrode sections 21 with the coagulation connection 41 and the second line 45 'connects the band-shaped cutting electrode section 22 to the cutting connection 42. The lines 45, 45' are likewise insulated from one another by the insulation layer 46. The instrument connector 40 can be connected to the supply unit 60, so that via the switching unit 43, the coagulation electrode sections 21 and the cutting electrode section 22 can be supplied separately from each other with a suitable RF voltage.

The embodiment of the electrosurgical instrument 10 shown in FIGS. 2 and 3 is distinguished by the fact that the instrument plug connection 40 has electrically separate contact surfaces, which in the end form a two-pole jack plug. In contrast, the electrosurgical instrument 10 of FIGS. 4 and 5 has only a single-pole jack plug as an instrument connector 40, wherein a stop between the instrument connector 40 and the handle 12 forms the second pole.

Also, the electrosurgical instrument 10 of FIGS. 4 and 5 has two mutually-disposed coagulation electrode portions 21 and a band-shaped cutting electrode portion 22 extending along the side surfaces of the instrument head 20. As shown in FIG. 5, there is also an electrical connection between the coagulation port 41 and the Koagulationselektrodenabschnitten 21 and between the cutting port 42 (stop) and the cutting electrode section 22nd

FIG. 6 shows a detailed view of the cross section from FIG. 5 along the longitudinal axis of the electrosurgical instrument 10. It can be clearly seen that the lines 45 together with the coagulation electrode sections 21 form the core of the instrument head 20, which extends essentially rectangularly along the Longitudinal axis of the instrument 10 extends. This core is partially encased by the insulating layer 46 on which the cutting electrode portion 22 is disposed.

It is conceivable to arrange a switching device on the handle 12 in order to supply either the coagulation electrode sections 21 or the cutting electrode section 22 with an HF voltage. Alternatively, as described above, the switching unit 63 may be used to connect the power supply accordingly.

In the embodiments described above, the electrosurgical instrument 10 comprises the coagulation electrode sections 21, which are supplied with an RF voltage in a coagulation process, and the cutting electrode section 22, which is supplied with a corresponding RF voltage during a cutting process. According to the invention, it is also conceivable to simultaneously use the coagulation electrode sections 21 and the cutting electrode section 22 in order to apply an HF voltage for coagulation. Thus, a large-scale coagulation of tissue is ensured.

In a further embodiment, a plurality of electrode sections may be provided, which are each supplied separately with a corresponding RF voltage. Thus, it is possible to address by means of the control unit 62 or a correspondingly formed switching device, the individual electrode sections separated from each other and depending on the set operating mode to apply an RF voltage. Even with such an embodiment, it is conceivable to supply a plurality of electrode sections simultaneously with an RF voltage. Again, the voltage-carrying geometry of the application electrode changes depending on the activated mode (eg coagulation mode or cutting mode). It is also conceivable to provide a different voltage-carrying geometry within an operating mode. Thus, it makes sense to use only the cutting electrode section 22 during a gating phase and then to switch on the coagulation electrode sections 21.

In advance, monopolar instruments 10 have been described, each having a plurality of electrode sections to apply an RF current. It is possible to equip bipolar instruments according to the invention, so that the individual application electrodes or poles are more divided and can be supplied separately with different HF currents.

It is particularly advantageous if the geometry of the instrument head 20 corresponds to the arrangement of the electrode sections. For example, an instrument head 20 may be formed similarly to a knife blade with the cutting electrode portions 22 extending along the cutting edge while the coagulating electrode portions are disposed on the side surfaces of the blade. In advance, instruments 10 having a mutual arrangement of coagulation electrode portions 21 have been described. It is possible to provide only one coagulation electrode section 21.

In the foregoing, numerous embodiments have been described in which the RF voltage has been applied to either the cutting electrode portion 22 or the coagulation electrode portion 21. Theoretically, it is also conceivable to apply a differing HF voltage at the same time to the two electrode sections 21, 22. For example, the applied RF voltages may be applied between the coagulation electrode portion 21 and the neutral electrode 70 and between the cutting electrode portion 22 and the neutral electrode 70. It is also conceivable to provide a plurality of cutting electrode sections 22 on the electrosurgical instrument 10 and to apply a suitable HF voltage to these multiple cutting electrode sections 22, while a second RF voltage is applied to the coagulation electrode section 21 and the neutral electrode 70. Numerous alternative embodiments which fall within the scope of the present application should be conceivable for the person skilled in the art.

LIST OF REFERENCES 3 torso

10 electrosurgical instrument

12 handle

20 instrument head

21 coagulation electrode section

22 cutting electrode section

40 instrument plug connection

41 coagulation connection

42 cutting connection

45, 45 'pipe

46 insulation layer

60 supply unit

61 HF generator

62 control unit

63 switching unit

70 neutral electrode

Claims

claims

An application electrode for coagulating and cutting biological tissue comprising:

- At least one coagulation electrode section (21);

at least one cutting electrode section (22), wherein the coagulation electrode section (21) and the cutting electrode section (22) are electrically isolated from each other and each have at least one contact surface for contacting the fabric, wherein the contact surface of the cutting electrode section (22) is substantially smaller than that Contact surface of the coagulation electrode section (21).

2. The application electrode according to claim 1, characterized in that the contact area of the cutting electrode section (22) is less than 1/3, in particular less than ¹ A, in particular less than 1/6, in particular less than 1/8 , in particular less than 1/10, in particular less than 1/20 of the contact surface of the coagulation electrode section (22).

The application electrode according to claim 1, wherein the application electrode has an elongated shape, wherein at least one elongated contact surface of the cutting electrode section is formed substantially along the longitudinal axis of the application electrode.

4. The application electrode according to claim 1, wherein the application electrode has a substantially cylindrical shape, wherein the at least one coagulation electrode section and / or the at least one cutting electrode section are arranged at least in sections on the lateral surface is.

5. Application electrode according to one of the preceding claims, since you think back ze ze et that the contact surfaces of the cutting electrode portion (22) and / or the Koagulationselektrodenabschnitts (21) are mutually arranged on the application electrode.

6. Application electrode according to one of the preceding claims, characterized in that the cutting electrode section (22) and / or the

Koagulationselektrodenabschnitt (21) are at least partially formed of a tungsten and / or stainless steel alloy and / or a conductive ceramic.

7. Electrosurgical instrument comprising:

- At least one application electrode, in particular according to one of the preceding claims;

a connection device (40) having at least one first contact element (41) and at least one second contact element (42) for establishing a connection to a supply device,

- Leads (45, 45 ') for connecting the at least one Koagulationselektrodenabschnitts (21) with the first contact element (41) and the cutting electrode portion (22) with the second contact element (42).

8. The electrosurgical instrument according to claim 7, characterized in that the application electrode comprises a plurality of electrode sections which are arranged and connected to contact elements (41, 42) such that a selection of the electrode sections provides a predetermined electrode geometry an HF voltage can be supplied.

9. Electrosurgical instrument according to claim 7 or 8, geken nzei ch n et du rch a switching device with at least two functional positions, in a first functional position for applying a via the first contact element (41) provided RF voltage to the coagulation electrode section (21) and in a second functional position for applying an RF voltage provided via the second contact element (42) to the cutting electrode section (22). The electrosurgical instrument according to one of claims 7 to 9, characterized in that the switching device is designed such that in the second functional position an HF voltage is applied to the coagulation and cutting electrode section (21, 22) ,

ll.Electro-surgical device, comprising:

- An RF generator (61) for providing an RF voltage; an electrosurgical instrument having at least a first electrode portion and at least a second electrode portion, in particular an electrosurgical instrument according to one of claims 7 to 10, a further electrode portion, in particular a neutral electrode portion, a control unit (62) which controls an RF generator (61) in that, in a first operating mode, an HF voltage is applied between the first electrode section and the further electrode section and, in a second operating mode, an HF voltage is applied at least between the second electrode section and the further electrode section.

12. An electrosurgical device according to claim 11, since you ge ken nzeich net that in the second operating mode, the control unit controls the RF generator such that an RF voltage between the first electrode portion and the further electrode portion and between the second electrode portion is applied ,

13. The electrosurgical apparatus according to claim 11 or 12, characterized in that the first operating mode is a cutting mode and the second operating mode is a coagulation mode.

14. The electrosurgical apparatus of claim 11, wherein the electrosurgical instrument comprises a plurality of electrode sections, and the control unit is configured to respond as appropriate set operating mode selects a set of electrode sections for applying an RF voltage.

15. An electrosurgical device comprising:

- At least one RF generator (61) for simultaneously providing at least a first and at least a second RF voltage;

- An electrosurgical instrument having at least one application electrode according to any one of claims 1-6, wherein the electrosurgical device, in particular the RF generator, is adapted to simultaneously the first RF voltage to the coagulation electrode portion (21) and the second RF voltage to apply the cutting electrode section (22).