WO2013068583A1

WO2013068583A1 - Electrosurgical gripping instrument

Info

Publication number: WO2013068583A1
Application number: PCT/EP2012/072376
Authority: WO
Inventors: Michael Krogmann; Hannes Miersch
Original assignee: Olympus Winter & Ibe Gmbh
Priority date: 2011-11-10
Filing date: 2012-11-12
Publication date: 2013-05-16

Abstract

The invention relates to an electrosurgical gripping instrument in which, of an electrode and an abutment, at least one is designed to be movable, while the other is either also movable or immovable.

Description

Electrosurgical gripping instrument

The invention relates to an electrosurgical gripping instrument for connection to a radio frequency (RF) generator. The electrosurgical gripping instrument has a first jaw part and a second jaw part, which can perform a pincer-like gripping movement relative to one another. Furthermore, it has a cutting electrode facing the second jaw part on the first jaw part and an abutment facing the cutting jaw and on the second jaw part. In addition, it has a switch, by means of which a generator can be activated, which generates a cutting current which can be introduced into the cutting electrode.

Electrosurgical gripping instruments of the type mentioned are used to sever human or animal tissue. For example, a blood-carrying vein can be severed with such an electrosurgical gripping instrument. Typically, for this purpose, an RF voltage is applied to the cutting electrode by means of a high-frequency (HF) generator, which leads to a current and thus to an arc through the tissue to be cut. The associated heating of the tissue leads to the bursting of cell walls and thus to the severing of the tissue.

An exemplary electrosurgical gripping instrument is shown in document DE 10 2007 053 359 C3. It has a clamping device with which a to cutting tissue can be held, and it further comprises a separator, with which the tissue held by the clamping device can be severed. A modification of this instrument is shown in the document DE 20 201 1 000 800 U1, wherein by using flexible materials, a cutting operation can be performed while bending components of the electrosurgical gripping instrument.

It is desirable to provide an alternative, for example, easier to handle, electrosurgical gripping instrument.

This is inventively achieved by an electrosurgical gripping instrument according to claim 1. Advantageous embodiments can be taken, for example, the dependent claims.

An inventive electrosurgical gripping instrument has a first jaw part and a second jaw part, which can perform a pincer-like gripping movement relative to one another. In addition, it has a cutting jaw facing the second jaw part on the first jaw part and can have an abutment facing the cutting jaw and lying opposite to the second jaw part. The electro-surgical gripping instrument further has a switch by means of which a cutting current can be introduced into the cutting electrode.

The electrosurgical gripping instrument according to the invention is designed either so that the cutting electrode is movable relative to the first jaw part and in the direction of the second jaw part, or that the anvil is movable relative to the second jaw part and in the direction of the first jaw part, or that both the cutting electrode and the Counter bearing are movable relative to the respective jaw part. In this sense, either the cutting electrode, or the abutment or both form a relative to the respective jaw member movable element which is mechanically connected to an actuatable activation device. The actuatable activation device has a trigger and is connected to the cutting electrode and / or the anvil. It is designed such that an actuation of the trigger causes a force acting in the direction of the counter bearing force on the cutting electrode or a force acting in the direction of the cutting electrode force causes the counter-bearing, so that the cutting electrode and the anvil can approach each other, without the jaws move relative to each other. The trigger is coupled to the switch so that when the trigger is operated, an RF current flows into the cutting electrode during operation. The trigger thus causes both a mechanical activation and an electrical activation of the cutting electrode. The electrosurgical gripping instrument according to the invention enables a particularly simple handling and a reliable severing of tissue by establishing a contact between the cutting electrode and the tissue. This is achieved on the one hand by the fact that the cutting electrode directly faces an abutment on which a tissue to be cut can be pressed. The area in which the tissue to be cut can be pressed by the cutting electrode is thereby limited. This reduces the tensile load on the sites where the tissue is pinched. On the other hand, it is achieved by the switch coupled to the trigger that the HF voltage is activated immediately upon extension of the respective movable element. This saves an additional working step of the user, namely the separate switching on of the HF generator, and prevents possible problems due to too early or too late switching on.

The first jaw part and the second jaw part are typically connected to one another by means of a joint, for example a rotary joint. Both the first jaw part and the second jaw part can each be embodied as part of an industry, with a respective industry also having a respective grip part in addition to the respective jaw part. The gripping member serves to hold the electrosurgical gripping instrument in the hand, and it may also be used to move the two jaw members relative to each other. If both the first jaw part and the second jaw part are designed as part of a respective branch with respective handle part, the electrosurgical gripping instrument may have the known form of a grasping forceps. By compressing the two handle parts can then be achieved a pincer-like gripping movement of the two components relative to each other. This allows a particularly easy handling. Alternatively, however, only one of the two jaws can be designed as part of an industry with a handle, the other jaw in this case in a different way, for example by means of a slider or a gun trigger, relative to the jaw part, which with the handle part Industry forms, is movable.

The cutting electrode is formed on the first jaw part. For example, it may be designed such that it consists of a surface of the second jaw part facing the first jaw part is extendable. In this case, it preferably has a retracted position in which it does not at least partially project beyond the surface of the first jaw part.

In the case of the cutting electrode, only such an area is preferably conductive (cutting surface), which is directed towards the counterbearing. The transverse side surfaces of the cutting electrode are preferably insulated. Thus, the formation of an arc on the sides of the cutting electrode can be prevented. In other words, in this way the electrical cutting action is concentrated on the top of the cutting electrode. Alternatively, however, the side surfaces may be partially isolated and partially conductive.

In particular, it has been shown that the speed and reliability of a cutting process can be increased by largely avoiding line contact between the cutting surface of the cutting electrode and the tissue to be cut during cutting. Rather, a reduction of the contact area, for. B. by one or more point contacts, advantage. In order to avoid line contact, various configurations of the cutting electrode or their cutting surface that are comparatively simple and therefore advantageous to implement are conceivable.

In a preferred embodiment, a cutting surface of the cutting electrode is convex or concave in the direction of the second jaw part. A cutting electrode can only have exactly one convex or concave section. The cutting surface of the cutting electrode may also, starting from the forceps joint in the direction of the tissue to be gripped, be formed inclined and / or sloping obliquely in the direction of the second jaw part. A cutting electrode can only have exactly one obliquely rising and / or exactly one sloping section. The abutment may be formed in each case complementary to the cutting surface of the cutting electrode.

A line contact between the cutting surface of the cutting electrode and the tissue to be cut can be effected both by the just described configurations of the cutting surface and by a suitable guiding of a (possibly also straight and / or flat) cutting surface of a cutting electrode with respect to the tissue. In a preferred embodiment of the gripping instrument, the cutting electrode and tissue gripped between the first and second jaw parts can be guided towards one another in such a way that line contact is achieved between a cutting surface of the cutting electrode. de and the tissue is substantially avoided. In this way, a cutting current density can advantageously be maximized.

The counter-bearing of the second jaw part facing the cutting electrode and lying opposite this serves as a support for the tissue to be cut. According to a preferred embodiment, the electrosurgical gripping instrument is designed so that the cutting electrode reaches in its maximum actuated position to the anvil.

Through the counter bearing, the cutting electrode contacts the tissue with a defined contact surface. The anvil represents a defined counterpart, against which the cutting electrode presses the tissue. This ensures permanent contact between the tissue and the cutting electrode during the entire cutting process. This also a potential tensile load on laterally located parts of the tissue can be reduced.

The electrical connection serves to be able to apply a voltage to the cutting electrode by means of the electrical line, which is typically a high-frequency voltage supplied by an HF generator. If a corresponding counterelectrode is present, which can be arranged, for example, in the first or second jaw part or in the abutment or else externally to the electrosurgical gripping instrument, a current flows through the electrical line when the voltage is applied, which current is emitted by the cutting electrode to the tissue , This typically creates an arc that can cut through the tissue.

By means of the switch, the electrical connection between the RF generator and the cutting electrode is controllable, ie normally the electrical supply can be switched on or off by means of the switch. By means of the switch, for example a manual switch, the output connected to the cutting electrode can be activated or deactivated, whereby a cutting current generated by the generator is conducted into the cutting electrode. This makes it possible to determine only by means of the switch located in the electrosurgical gripping instrument, the periods in which the RF voltage is to be applied. The coupling of the trigger with the switch ensures that the cutting electrode is subjected to the electrical current during operation of the trigger. The trigger is normally operated when the cutting operation is to begin. Forming the electrosurgical gripping instrument may provide for the RF voltage to be applied to the cutting electrode at the exact moment when contact with the tissue is made.

In order to favor the formation of an arc, for example for cutting tissue rich in fat, it has proven to be advantageous to apply a cutting current to the cutting electrode even before contact with the tissue or before movement in the direction of the tissue. Accordingly, the activation device can be formed or the trigger can be coupled to the switch in such a way that contact of the cutting electrode with tissue or rather the approximation / movement to the tissue, in particular between the first and second jaw part gripped or tissue to be gripped, is only effected After the cutting electrode is subjected to cutting current, ie after the switch is actuated.

The electrosurgical cutting is often effected without contact by means of an arc which burns between the cutting electrode and the tissue. A "time offset" between seeing contact of the cutting electrode with the tissue and the application of the cutting electrode with cutting current can be ensured by a corresponding mechanical coupling of trigger with the switch by the fastening paths and / or spring forces are dimensioned so that First, the circuit is closed to the cutting electrode, for example by means of the switch and only a course of the further actuation path of the trigger of the cutting electrode is moved to a position in which it can have tissue contact. The coupling between the trigger and switch can be configured so variable Thus, the electrosurgical gripping instrument can optimally be optimally adapted to different tissue conditions, According to a preferred embodiment, the switch or a spring element contained in the switch, which counteracts the operation of the switch , be serially coupled to the trigger and / or one of the gripping instrument encompassed spring element, in particular a return spring and / or compensating spring, coupled. The spring element contained in the switch may be weaker than the included spring element. There are three possibilities for the design of the movable element. On the one hand, the cutting electrode can be movable relative to the first jaw part and in the direction of the second jaw part. On the other hand, the anvil can be movable relative to the second jaw part and in the direction of the first jaw part. Besides, it is also possible that both the cutting electrode and the anvil are movable relative to the respective jaw part. In the first two cases, the movable element is formed only by either the cutting electrode or the anvil. In the latter case, the movable element is formed by both the cutting electrode and the counter-bearing.

If the cutting electrode is designed to be movable, this means that the cutting electrode is actively pressed against the tissue. If further electrodes are present on the first jaw part, for example coagulation electrodes as described below, a sufficient isolation distance is preferably provided between the cutting electrode and the further electrodes in order to prevent a flashover between the electrodes. Relative to the expansion of the first jaw part, the cutting electrode is therefore typically made narrow. In addition, the narrow design ensures a high current density that is important for arc generation.

If the anvil is designed to be movable relative to the second jaw part, the cutting principle is reversed. In this case, the anvil is moved towards the cutting electrode to control the tissue in a controlled manner against the cutting electrode and guide the arc. This embodiment has the advantage that in the second jaw part, ie in the jaw part with the counter bearing, often more space for a power transmission is available. In addition, the requirements for insulation distances at the counter bearing are lower. This allows a simpler design of the instrument can be achieved.

It should be noted that the embodiment with the movable abutment can further have the advantage that in the event that the trigger is to be attached to an industry for ergonomic reasons, which contains the second jaw part, a complicated transmission of the movement of the trigger on the first jaw part is no longer necessary.

The activation device serves to trigger or move the movable element. This means in practice that the distance between the cutting electrode and the anvil is reduced. Actuation of the trigger typically occurs by a user exerting a force on the trigger. The trigger may be, for example, an operating handle for such operation by a user. This can be designed, for example, as a lever, as an actuating slide or as a trigger. According to one embodiment, a mechanical connection between the trigger and the movable element can take place in that the activation device has a force transmission device which transmits the actuating grip to the cutting electrode and / or the abutment for transmitting a hand force exerted on the actuating grip to the cutting electrode or to the cutting element Anvil connects. Such a power transmission device can be designed, for example, in the form of a Bowden cable, a cable pull, a push rod, a system of rods with joints and / or deflection rollers, by means of a hydraulic or pneumatic device or the like. Alternatively, an electromotive or magnetic actuation is possible.

According to a preferred embodiment, the transmission device has a force limiting element which limits the maximum transmitted force. With the help of such a force limiting element, the transmission of excessive force to the tissue can be prevented. This in turn can prevent the tissue from being cut mechanically, i. H. It is ensured by the force limiting element that the cut is actually due to a trained arc and not due to mechanical cutting action of the cutting electrode. Thus, for example, damage to the tissue can be prevented. The transmitted force can thereby be kept below a tissue separation force. In order to be able to work in a particularly gentle manner, the maximum transmitted force can be limited to the amount of force which is just required to bring about an approach of the cutting electrode and tissue up to a common contact.

The force limiting element is according to a preferred embodiment, a tension or compression spring. Whether a tension spring or a compression spring is used is largely determined by the specific design of the power transmission device. When the force transmission device transmits a pressure force for triggering the movable element, a pressure spring is preferably used as the force limiting element. Likewise, if the power transmission device transmits a tensile force for triggering on the movable element, preferably a tension spring is provided as a force limiting element. However, embodiments are also conceivable in which the respective other type of spring can be used as a force limiting element.

It may be desirable in an individual case, the force required for an approach of cutting electrode and tissue to a common contact, or for example Also to be able to selectively exceed a defined by the force limiting element maximum force threshold. This, for example, to advantageously overcome slight tissue adhesions, which may possibly occur after several cutting cycles. For this purpose, the activation device may be designed to limit and / or cushion a hand force applied via the trigger on a first actuation path of the trigger. The activation device can likewise be designed to forward or transmit a hand force applied via the trigger on a second actuation path of the trigger in a substantially limitless and / or unsprung manner. In order to allow a particularly simple operation, the first actuation path can start from a rest position of the trigger, the second actuation path can follow the first actuation path in the same actuation direction. In order in turn to increase operating safety, the first and / or the second actuating travel can also start from a rest position of the trigger in different directions of actuation.

When using a compression spring, which can serve as described as a force limiting element, a first actuating travel can be defined by the free spring travel of the compression spring. A force applied to the trigger hand force is accordingly cushioned on the first actuation path. A second actuation path can be realized, for example, in that the compression spring in the activation device can go to block. If the compression spring is on block, it can not store any further spring energy as of this spring state, so that an additional hand force, which is additionally applied to the trigger, is now transmitted to the cutting mechanism indefinitely or unsprung via the power transmission device. As an alternative to a spring going to block, a mechanical stop can also be provided in each case, which provides the cutting electrode at a certain actuation travel for a direct force transmission from the trigger. Such a stop can also be realized in conjunction with a tension spring as a force limiting element. According to a preferred embodiment, the actuating handle is connected to a return element, which resets the operating handle and / or the movable element in a rest position. Such a return element may for example be a suitably mounted spring. This ensures that the operating handle returns to its rest position when it is released by the user. This usually also ensures that the movable element returns to a rest position. In the case of a movable cutting electrode, this may mean, for example, that the cutting electrode retracts again below the surface of the first jaw part. In the case of a movable counter bearing, this can mean, for example, that the counter bearing moves away from the cutting electrode again and occupies its greatest possible distance from the cutting electrode.

Alternatively, it is also possible that the return element is not connected to the actuating handle, but is connected directly to the movable element or with another location of the activation device. If, for example, the restoring element is directly connected to a movable cutting electrode and returns it to its rest position, then, as a rule, due to a connection acting on both sides of the activating device, the actuating grip will also return to its rest position.

According to an alternative embodiment for execution with an actuating handle, the trigger has a force storage element that is biased in its rest state. The energy storage element is connected to the cutting electrode and / or the anvil in such a way that the energy storage element causes the force acting in the direction of the abutment or the cutting electrode force on the cutting electrode or the abutment after its release. Such an embodiment may be performed for example by means of a spring as a force storage element, wherein the spring is stretched at rest and is held by a lock to be solved, for example a hook. Upon actuation of the trigger, the lock is released, so that the spring can relax. The corresponding force is exerted on the movable element. Such an embodiment has the advantage, for example, that the user no longer has to apply the force necessary for cutting himself, but only has to release the brake. Thus, the effort expended by the user can be reduced. In addition, with such an embodiment, a defined contact pressure of the cutting electrode or the abutment can be adjusted to the tissue by, for example, a suitably strong spring is provided as a force storage element. The electrosurgical gripping instrument can thus be used identically by users with different force in the fingers or automatically triggered, for example by the RF generator. The term "force which acts on the cutting electrode in the direction of the abutment or on the abutment in the direction of the cutting electrode" is not to be understood as meaning that the force in the sense of a vector must necessarily be assigned to the other of the two elements Under this name to understand any force that causes the respective element, ie the cutting electrode or the anvil, moves toward the other element.

The force can, for example, act on the respective element in such a way that it points vectorially to the other element. This occurs, for example, when the respective element is mounted in a guide on both sides and can move linearly to the respective other element.

According to an alternative embodiment, the cutting electrode and / or the abutment is fixed by means of a joint on the respective jaw part that it / it moves towards the abutment or the cutting electrode upon the action of the force acting in the direction of the abutment or the cutting electrode. In such an embodiment, the respective element does not move linearly, but partially rotates about the joint and the force causes a corresponding torque.

In a preferred embodiment, in the electrosurgical gripping instrument, the first jaw part has a first coagulation section facing the second jaw part and a further first coagulation section facing the second jaw part, the cutting electrode being arranged between the first coagulation section and the further first coagulation section. The first coagulation section and the further first coagulation section are preferably legs of a U-shaped first coagulation electrode. Alternatively, however, the first coagulation section and the further first coagulation section can each also be separate electrodes.

The first coagulation section and the further first coagulation section or the first coagulation electrode are preferably electrically conductively connected to an electrical coagulation electrode connection. Such may be part of a multi-function socket having a plurality of pins, eg for bipolar coagulation, bipolar cutting, input line for manual switch or instrument recognition. By means of the electrical coagulation electrode connection, the first coagulation section and the further coagulation section or the coagulation electrode can be connected to an HF generator or to another or the same, for example multi-electrode. functional bipolar output of the RF generator already used for cutting are connected, the output provides a high-frequency voltage.

As with the first jaw part, it is also preferable for the second jaw part if it has a second coagulation section facing the first jaw part and a further second coagulation section facing the first jaw part, wherein the anvil is arranged between the second coagulation section and the further second coagulation section. Here too, it is preferred if the second coagulation section and the further second coagulation section are limbs of a U-shaped second coagulation electrode. In addition, it is also preferable here if the second coagulation section and the further second coagulation section or the second coagulation electrode are connected by means of a further electrical coagulation connection to a further HF generator, to another output of the HF generator already used for cutting or preferably to the same output are binding bar. As mentioned, the coagulation sections are preferably arranged such that they laterally surround the cutting electrode or the counterbearing. This makes it possible to coagulate a tissue to be cut adjacent to the interface. For this purpose, a high-frequency voltage is preferably applied, for example, between the first coagulation electrode on the one hand and the second coagulation electrode on the other hand. For example, if the tissue to be treated is a blood-bearing vein, it may be closed by coagulation, thereby preventing blood from escaping from the vein after subsequent tissue cutting. Further, one or both coagulation electrode (s) is preferably used as a return electrode in bipolar cutting. Other features and advantages of the invention will become apparent to those skilled in the art upon consideration of the embodiments described below with reference to the accompanying drawings. Features of various embodiments may be combined as desired.

Fig. 1 shows an embodiment of an electrosurgical gripping instrument according to the invention.

FIG. 2 shows a transparent side view of a jaw part of the electrosurgical gripping instrument of FIG. 1. FIG. FIG. 3 shows a perspective view of a jaw part of the electrosurgical grasping instrument of FIG. 1 with the cutting electrode retracted. FIG.

4 shows the jaw part of FIG. 3 with the cutting electrode extended.

5 shows a sectional view of part of the activation device of the electrourgical gripping instrument of FIG. 1.

Fig. 6 shows the activation device of Fig. 5 in an actuated state.

Fig. 7 shows a schematic view of an embodiment of an activation device.

Fig. 8 shows a schematic view of another embodiment of a

Activation device.

9 shows a schematic view of yet a further embodiment of an activation device.

Fig. 10 shows a schematic view of an embodiment of an activation device, which has a force storage element. Fig. 1 1 shows a schematic view of an embodiment of jaws of an electrosurgical gripping instrument with movable abutment.

Fig. 12 shows a modification of the embodiment of Fig. 1 1.

Fig. 13 shows schematically possible embodiments of the anvil.

14 shows a second embodiment of a jaw part with a cutting electrode.

Fig. 15 shows the embodiment of Fig. 14 in a sectional view.

Fig. 16 shows a third embodiment of a jaw member with a cutting electrode. Fig. 17 shows the embodiment of Fig. 16 in a sectional view.

Fig. 18 shows a schematic view of another embodiment of a

Activation device.

Fig. 19 shows a schematic view of another embodiment of a

Activation device.

Fig. 20 shows a schematic view of another embodiment of a

Activation device.

Fig. 21 shows schematic views of various embodiments of a

Cutting electrode of an electrosurgical gripping instrument.

Fig. 1 shows an electrosurgical gripping instrument 10 according to the invention. The electrosurgical gripping instrument 10 has a first branch 100 and a second branch 200, which are connected to one another in a rotatable manner by means of a forceps joint 20. The first sector 100 has a first grip part 110 and a second jaw part 120. The second branch 200 has a second grip part 210 and a second jaw part 220.

On the first jaw part 120, a cutting electrode is mounted, which is not visible in the illustration in Fig. 1, since the two jaw parts 120, 220 are closed relative to each other. Likewise, an abutment is arranged in the second jaw part 220, which is also not visible in the illustration of FIG. 1.

The cutting electrode can be actuated by means of an activation device 300. The activation device 300 in turn is actuated by means of a trigger 310, which in the present case is similar to a gun trigger. The operation of the activation device 300 and the trigger 310 will be described with reference to the following figures.

Furthermore, the electrosurgical gripping instrument 10 has an electrical connection 400 and an activation connection 405. The electrical connection 400 allows the cutting electrode to be connected to an HF generator. By means of the activation terminal 405, the HF generator can be activated. FIG. 2 shows a sectional view of the first jaw part 120 of the electrosurgical grasping instrument 10 of FIG. 1. The illustration of FIG. 2 shows a cutting electrode 500, which in the present case is elongate. The cutting electrode 500 is rotatable about a joint 510 offset from the forceps joint 20 and connected to a power transmission device 320 of the activation device 300 at an attachment point 520. Due to the offset arrangement of the forceps joint 20 relative to the hinge 510, the cutting electrode 500 has a different pivot point than the two jaw members 120, 220. In an alternative embodiment, not shown, however, the hinge 510 and the forceps joint 20 could be superimposed, ie, the same pivot point exhibit. When the power transmission device 320, which is embodied here in the form of a Bowden cable, is pushed toward the cutting electrode 500, the part of the cutting electrode 500 shown in FIG. 2 on the left side of the joint 510 is pressed downwards.

FIG. 3 shows the first jaw part 120 of the electrosurgical gripping instrument 10 of FIG. 1 in a perspective view. In this case, also the cutting electrode 500 can be seen, which is in the representation of FIG. 3 in a retracted state. In other words, the cutting electrode 500 does not protrude beyond an outer contour of the first jaw part 120 in the retracted state. So she can not cut through tissue yet. As can also be seen in FIG. 3, the first jaw part 120 has a first coagulation electrode 600, which in the present case is U-shaped. A first coagulation section 610 and a further first coagulation section 620 are formed by legs of the U-shaped coagulation electrode 600. The first coagulation electrode 600 has an electrically conductive surface, with which a coagulation onsstrom can be applied to a tissue to be treated.

As shown, the cutting electrode 500 is disposed between the first coagulation section 610 and the further first coagulation section 620. In this way, a tissue to be severed can be coagulated laterally to the region to be cut, in order subsequently to be severed by the cutting electrode 500. If, for example, the tissue to be cut is a blood-carrying vein, it is possible in this way to prevent blood from escaping after the vein has been cut through. FIG. 4 shows the first jaw part 120 of the electrosurgical grasping instrument 10 in the same illustration as in FIG. 3. In contrast to the representation of FIG. 3, however, in the illustration of FIG. 4 the cutting electrode 500 is extended. Thus, the cutting electrode can transmit current to a tissue adjacent to the first jaw part 120 and thereby cut it through.

For cutting, a high-frequency voltage is usually applied to the cutting electrode 500. However, this also requires a counterelectrode, which may be formed, for example, in the anvil. Alternatively and preferably, however, a coagulation electrode, for example a coagulation electrode, may also be attached to the second jaw part 220. Furthermore, an external to the electrosurgical gripping instrument 10 attached to the patient electrode can be used.

In the case of the cutting electrode 500, in the present case only the part pointing directly to the second jaw part 220 is conductive. The side surfaces which are transverse to this, on the other hand, are designed to be electrically insulating. This prevents a flashover, for example in the form of an arc, to the first coagulation electrode 600. An insulation distance 550 to be maintained between the cutting electrode 500 and the first coagulation electrode 600 can thus be reduced.

At the conductive part of the cutting electrode 500 is formed during operation, d. H. with extended cutting electrode 500 and when applying a high-frequency voltage, an arc out. This leads in the adjacent tissue to a local heating and thus to the evaporation of cell water. Thus, the tissue can be cut by bursting the cell walls.

5 shows a sectional view of a portion of the activator 300 of the electrosurgical grasper 10 in a resting position. When the activation device is in this rest position, typically also a connected cutting electrode is in a rest position.

The activation device 300 has the already mentioned trigger 310, which is in the illustration of FIG. 5 in its rest position. This stands out on the first handle part 1 10 and can thus be used and operated by a user. The trigger 310 is rotatable about a hinge 330. The part projecting beyond the first grip part 110 can thus be pulled away from the user in the direction of the first jaw part 120. The trigger 310 further has a semicircular part 340, which serves to receive a round end part 350 of the power transmission device 320, which, as already mentioned, is designed here as a Bowden cable. The end portion 350 is thereby held by the semi-circular portion 340 of the trigger 310 so that it can not be further than the semi-circular portion 340 allowed to move to the first jaw portion 120.

Between the semicircular part 340 of the trigger 310 and the power transmission device 320 is also a connection by a compression spring 360, which abuts on the one hand to the semicircular part 340 of the trigger 310 and on the other hand to a abutting element 365 of the power transmission device 320. By the compression spring 360, a force directed to the left in the illustration of FIG. 5, which is exerted by the semicircular part 340 upon actuation of the trigger 310 of the compression spring 360, is transmitted in the same direction to the power transmission device 320. Thus, the power transmission device 320 is pushed toward the first jaw part 120, which, as explained with reference to FIG. 2, leads to the fact that the cutting electrode 500 is deflected.

The spring 360 limits the maximum transmitted to the power transmission device 320 force. For example, if the cutting electrode 500 encounters a resistance during deflection, the spring 360 will compress from a predetermined force, which, despite a further deflection of the trigger 310, does not lead to a further movement of the power transmission device 320. By this spring 360 thus the electrosurgical gripping instrument 10 and also a tissue to be treated are protected from mechanical damage. Furthermore, due to the limitation of the maximum transmitted force, it can be prevented by the spring 360 that the tissue is undesirably mechanically cut. Rather, this ensures that the tissue is cut through the electrical and not a mechanical cutting action.

Due to the free spring travel of the spring 360, a first actuation path is defined at the same time. A force applied to the trigger 310 hand force is accordingly cushioned on this first actuation path. The spring 360 can also be provided in the activation device 300 such that the spring 360 can go to block (this is not the case in the present embodiment). If the spring 360 to block, it can save from this spring state no further spring energy, so that in addition to the trigger 310 applied hand force now unlimited or unsprung over the power transmission device 320 is transmitted to the cutting mechanism (not shown).

As can further be seen in FIG. 5, the electrosurgical gripping instrument has a switch 420, which is connected to the activation connection 405 by means of an activation line 430. Thus, the switch 420 may provide an enable signal to an RF generator coupled to the enable port 405 to apply the RF voltage at the exact moment the switch 420 is touched by the trigger 310. A touch by the trigger 310 is equivalent to having the user operate the electrosurgical cutting electrode and begin the cutting process. This ensures that the cutting electrode 500 is supplied with an electrical voltage at just the right time.

In addition, Fig. 5 shows a return spring 380, which is designed in the present case in the form of a leaf spring. The return spring 380 pushes the trigger 310 in the direction of its rest position. FIG. 6 shows the activation device 300 of FIG. 5 in an indented state. It is shown that the trigger 310 has been pressed. He touches the switch 420, whereby this can activate as described an external RF generator.

Furthermore, the semicircular part 340 of the trigger 310 has been moved towards the first jaw part 120, so that the end part 350 of the power transmission device 320 is now no longer in contact with the semicircular part 340 of the trigger 310. The spring 360 is thus pressed and is under increased tension. It will therefore exert a force on the power transmission device 320 starting from the state shown in FIG. 6, which, in the absence of counterpressure from the cutting electrode 500, will cause the end 350 of the power transmission device 320 to return to the semicircular part 340 of the trigger 310 will approach. At the same time, the cutting electrode is then also extended, as already described with reference to FIG. 2. When tissue is gripped, the cutting electrode pushes against the tissue with the force of the spring 360. However, other embodiments without the spring 360 are also possible, with the trigger 310 being directly connected to the power transmission device. The return spring 380 is deflected in the state of Fig. 6 so that it pushes the trigger 310 back to its rest position as soon as the trigger is released by the user.

FIG. 7 shows a schematic representation of an exemplary embodiment of an activation device 300 a, as it can be used in an electrosurgical gripping instrument according to the invention and is in an idle state.

Activation device 300a has a trigger 310a which is rotatable about a hinge 330a. The trigger 310a is coupled to a switch 420a, which may activate an external RF generator as previously described. A power transmission device 320a is presently rod-shaped. The power transmission device 320a is connected to the trigger 310a by means of a force-limiting spring 362a. The force limiting spring 362a limits the maximum force transmitted to the power transmission device 320a. Thus, as already described with reference to FIG. 6, the advantages mentioned there are achieved. The force-limiting spring 362a may be provided to realize a second actuation path so that it can go to block. The power transmission device 320a is connected to the cutting electrode 500a at an attachment point 520a of a cutting electrode 500a. The cutting electrode 500a is in the view of FIG. 7 in its rest state and adjoins a stop 570 at. The cutting electrode, when it is to be deflected, can rotate about a hinge 510a. When the power transmission device 320a is pulled away from the cutting electrode 500a by operation of the trigger 310a by means of the force limiting spring 362a, the cutting electrode 500a moves around the hinge 510a. Similar to what has already been described with reference to FIG. 2, the cutting electrode 500a is deflected therewith. The activation device 300a further comprises a restoring spring 364a, which restores the power transmission device 320a, and thus via the force limiting spring 362a, also the trigger 310a, to a rest position when the user releases the trigger 310a. Thus, the cutting electrode 500a is pushed back into its rest position. In the present case, the restoring spring 364a is made weaker than the force-limiting spring 362a. This ensures that the force limiting spring 362a can transmit a greater tensile force to the power transmission device 320a than the reset spring. which exerts 364a in the opposite direction. Thus, the power transmission device 320a is allowed to move so as to deflect the cutting electrode 500a.

Generally speaking, it is fundamentally advantageous if a restoring force acting on the force transmission device 320a is smaller than the maximum force that can be transmitted by the trigger 310a to the power transmission device 320a. Otherwise, it could happen that the user actuates the trigger 310a, but the cutting electrode 500a itself is not deflected in the absence of external counterforce.

Fig. 8 shows a modification of the activating device shown in Fig. 7, wherein like-acting parts are denoted by the index "b" instead of the index "a". In the following, only the differences between the embodiments of FIGS. 7 and 8 will be discussed. Equivalent parts are therefore no longer mentioned.

In contrast to the cutting electrode 500a of FIG. 7, a cutting electrode 500b of FIG. 8 is formed so as to be deflected from its rest position when a power transmission device 320b applies a pressing force thereto. For this purpose, the cutting electrode 500b is rotatable about a hinge 510b. The power transmission device 320b is attached to a trigger 310b by means of a force limiting spring 362b, which can be actuated by a user. When the user operates the trigger 310b as indicated by the arrow shown in FIG. 8, the force limiting spring 362b pushes the power transmission device 320b toward the cutting electrode 500b. Thus, a pressing force is exerted on the cutting electrode 500b, whereby it is deflected. The pressure force is limited by the force limiting spring 362b, which leads to the advantages already described. Further, a return spring 364b is attached to the trigger 310b, which returns the trigger 310b and thereby the cutting electrode 500b to its rest position when released by the user. In other words, upon actuation of the trigger 310b, the user presses against the force exerted by the return spring 364b. In the case of the embodiment of FIG. 8, it is not mandatory that the return spring 364b is made weaker than the force-limiting spring 362b. Rather, by means of the return spring 364b regardless of the maximum on the Cutting electrode 500b to be transmitted force to be set that force which the user must overcome to actuate the trigger 310b. This can prevent unintentional triggering, for example.

Fig. 9 shows a further modification of the activation device, wherein also similar acting components as in those of Fig. 7 and 8 are now shown with the index "c" and the same numbering, and wherein will not be discussed again on identically acting components.

As in the embodiment of FIG. 7, in the embodiment of FIG. 9, a cutting electrode 500c is deflected by exerting a tensile force on an attachment point 520c. A trigger 310c may be actuated by a user as indicated by the arrow shown in FIG. In this case, the user, as already explained in connection with Fig. 8, exerts a force against a restoring force, which is exerted by a return spring 364c. After the end of the operation, the trigger 310c and the cutting electrode 500c are returned to its rest position by the return spring 364c.

A force transmitted by the user to the trigger 310c is transmitted by means of a force limiting spring 362c to a power transmission device 320c, which in the present case is designed as a rod. By the interposition of the force limiting spring 362c, the advantages already mentioned are achieved. Also in the case of the embodiment of Fig. 9, the strengths of the force limiting spring 320c and the return spring 364c can be independently selected.

FIG. 10 shows an embodiment of an activation device modified in comparison to FIG. 9 in that, in the embodiment of FIG. 10, an actuation of a trigger 31 Od is not effected directly by an applied force. Rather, the embodiment of FIG. 10 includes an energy storage spring 366d which is biased in a rest position such that upon relaxation, it exerts a force similar to that which a user would exercise in the embodiment of FIG. 9 on the trigger 31Od can. The rest position is held by a lock 370d, which prevents relaxation of the energy storage spring 366d in the rest position. The lock 370d is provided with a recess 372d, which can be pulled by the user in a direction indicated by the arrow shown in Fig. 10 direction. Thus, the trigger 31 Od is released, whereby the power storage spring 366 d can relax under movement of the trigger 31 Od. In this case, as already described, the force is transmitted by means of a force-limiting spring 362d to a power transmission device 320d, whereby a cutting electrode 500d is deflected. After performing the cutting operation, the trigger 31 Od can be returned to its rest position, which can be done manually. Subsequently, the latch 370d can be returned to its original position, thereby holding the trigger 31Od in its rest position again. This makes the device ready for a new assignment.

It should be noted at this point that the force limiting springs 362b, 362c and 362d described with reference to FIGS. 8 to 10 may also be provided for realizing a second actuation path such that they can go to block.

Fig. 1 1 shows schematically a possible embodiment of an electrosurgical gripping instrument with an adjustable abutment. Only a schematic sectional view through a first jaw part 120e and a second jaw part 220e is shown.

An abutment 700e is disposed opposite a cutting electrode 500e. The cutting electrode is located between a first coagulation section 61 Oe and a further first coagulation section 620e, which are formed as part of a first coagulation electrode 600e. The anvil is located between a further coagulation section 630e and a further second coagulation section 640e, which are formed as constituents of a second coagulation electrode 625e.

The cutting electrode 500e is fixedly or movably attached to the jaw part 120e. The anvil is as shown by the double arrow shown in Fig. 1 1 movable. The actuation can take place via an activation device, as has already been described with reference to the previous figures. As with the cutting electrode all possible designs are applicable for the operation of an abutment.

As shown in FIG. 1 1, the cutting electrode 500e reaches into a recess of the second jaw part 220e with the jaw parts 120e, 220e almost closed. By moving the anvil 700e towards the immovable cutting electrode 500e to, a clamped between the two jaws 120e, 220e tissue is pressed onto the cutting electrode 500e. When subjected to a high-frequency voltage and as described above, a suitable counter-electrode is present, the electrical current flowing between the cutting electrode 500e and the tissue can cut through the tissue.

FIG. 12 shows a modification of the embodiment of FIG. 11 in that even when the jaws 120f, 220f are completely closed, a cutting electrode 500f does not extend into a recess of the second jaw part 220f, but is retracted in the first jaw part 120f. An abutment 700f must therefore continue to be moved toward the first jaw part 120f. The cutting process thus takes place in a recess of the first jaw part 120f. Otherwise, the embodiments of Fig. 1 1 and 12 are identical.

Fig. 13 shows possible embodiments of the anvil with respect to that surface which is adjacent to the cutting electrode. Fig. 13a shows a case in which an abutment 700g has a tip with which it abuts a cutting electrode 500g.

In the embodiment of FIG. 13b, an abutment 700h has an area toward a cutting electrode 500h which is exactly as wide as the cutting electrode 500h. In addition to the abutting area to the cutting electrode 500h, the abutment 700h is chamfered. Fig. 13c shows a case in which an abutment 700i has a flat surface on the entire side facing e in the direction of a cutting electrode 500i. This also corresponds to the case shown in FIGS. 11 and 12.

Which type of counter bearing is used depends in particular on the tissue to be treated. FIG. 14 shows a second embodiment of a first jaw part 120j. The first jaw part 120j has a cutting electrode 500j which, in a modification to the embodiments shown in FIGS. 3 and 4, is located in an elongated recess 505j which leaves a clearly visible air gap between the cutting electrode 500j and the surrounding material of the first jaw part 120j. This serves for the isolation and the mobility of the cutting electrode 500j. The cutting electrode 500j is rotatable about a hinge 51 Oj and deflectable by means of an actuator mounted on an attachment point 520j. Thus, the cutting electrode 500j can be operated as well as the already described embodiments. The cutting electrode 500j has a widened region 530j, at which the cutting electrode 500j laterally adjoins very closely to the surrounding region of the first jaw part 120j. Thus, the cutting electrode 500j is stabilized laterally, which ensures a straight guidance of the cutting electrode 500j at a deflection out of the depression 505j. The first jaw part 120j furthermore has a first coagulation electrode 600j, which is embodied in a U-shaped manner. Here, the first coagulation electrode 600j encloses the cutting electrode 500j and the depression 505j such that a first leg 61 Oj of the coagulation electrode 600j is located along a longitudinal side of the cutting electrode 500j, and another first coagulation section 620j coagulation electrode 600j is formed along an opposite longitudinal side of the cutting electrode 500j is located. Both between the first coagulation portion 61 Oj and the recess 505j, as well as between the other first coagulation portion 620j and the recess 505j, an isolation distance 550j is formed respectively. This largely suppresses an electric current flow between the cutting electrode 500j and the first coagulation section 61 Oj or the further first coagulation section 620j.

A bent part associated with the first coagulation electrode 600j, which connects the first coagulation section 61oj and the second coagulation section 620j, is located at a distal end of the first jaw part 120j.

FIG. 15 shows the embodiment of a first jaw part 120j of FIG. 14 in a sectional view. Furthermore, FIG. 15 also shows a second jaw part 220j opposite the first jaw part 120j, in which an abutment 700j opposite the cutting electrode 500j is formed.

The abutment 700j is formed in a groove into which the cutting electrode 500j enters upon tripping. A tissue, not shown in FIG. 15, which is typically located between the first jaw part 120j and the second jaw part 220j at the time of cutting, is cut between the cutting electrode 500j and the abutment 700j. The fabric can be up to the abutment 700j of the cutting electrode 500j, which reduces the tensile stress on surrounding tissue and ensures good contact between the tissue and the cutting electrode 500j.

15 clearly shows the arrangement of the first coagulation electrode 600j with its first coagulation section 61 Oj and its further first coagulation section 620j, which is arranged opposite to a second coagulation electrode 625j formed in the second jaw part 220j, the second coagulation electrode 625j having a first coagulation section 620j the second coagulation section 630j opposite the first coagulation section 61 Oj and also having a further second coagulation section 640j opposite the further first coagulation section 620j. Respective areas of the coagulation sections 61 Oj, 620j, 630j, 640j facing the respective other jaw part directly face the respective opposing coagulation section, so that a current can close on a short path between respective opposing coagulation sections 61 Oj, 620j, 630j, 640j. As already described, tissue can be severed laterally to the point to be cut with this current.

FIG. 16 shows a third exemplary embodiment of a first jaw part 120k. The first jaw part 120k of FIG. 16 is largely identical to the first jaw part 120j shown in FIG. On the same parts with the same function is therefore not discussed again. This applies in particular to a first coagulation electrode 600k with its first coagulation section 610k and its further first coagulation section 620k, for a hinge 510k and for an attachment point 520k.

In contrast to the cutting electrode 500j of FIG. 14, a cutting electrode 500k of the first jaw part 120k of FIG. 16 has a surrounding insulation 540k. The insulation 540k ensures that the cutting electrode 500k, together with the surrounding insulation 540k, occupies a considerably larger part of the cross section of an elongated recess 505k, which, like the recess 505j of FIG. 14, is formed in the first jaw part 120k. Thus, the insulation 540k also ensures that the cutting electrode 500k is stabilized during an operation in which the cutting electrode 500k is deflected out of the first jaw part 120k. A widened region, as shown in FIG. 14, can therefore be dispensed with in this exemplary embodiment. Furthermore, the insulation 540k also ensures that current flow on the side surfaces of the cutting electrode 500k is effectively prevented. This not only ensures that any potential flow of current to the first coagulation electrode 600k is further suppressed, but also that current flow through the tissue concentrates on top of the cutting electrode, further improving the cutting action. For example, this can facilitate the formation of an arc.

FIG. 17 shows a cross section through the first jaw part 120k of FIG. 16. Furthermore, FIG. 17 also shows an opposite jaw part 220k. The representation of FIG. 17 is largely identical to that of FIG. 15. Therefore, identical and identically acting parts will not be discussed below. This applies in particular to the coagulation electrode 600k with its first coagulation section 610k and its further coagulation section 620k, for an abutment 700k, for a second coagulation electrode 625k with a second coagulation section 630k and a further second coagulation section 640k, and for the arrangement and effect of the coagulation electrodes 600k, 625k.

FIG. 17 shows a cross section of the insulator 540k. It is shown how the insulator 540k is formed so wide to respective side surfaces of the recess 505k that it has only a slightly smaller width than the recess 505k. As already described, the cutting electrode 500k is thus stabilized when deflected out of the recess 505k. A cutting action of the cutting electrode 500k is also as described with reference to FIG. 15, and as a modification to this in the embodiment of FIG. 17, the cutting action is concentrated even closer to an upper side of the cutting electrode 500k. As already described, this is because respective side surfaces of the cutting electrode 500k are insulated by the insulator 500k. The following is described with reference to FIGS. 18 to 20, as can be achieved by suitable exemplary embodiment of an activation device, that a contact of the cutting electrode with tissue or a movement in the direction of tissue is only effected after the cutting electrode is subjected to cutting current. The activation devices 300I, 300M, 300N shown here are modifications of the activation devices already described in detail above with reference to FIGS. 7 to 9. Similar parts are, following the previous numbering, denoted by the indices "I", "m" and "n". The activation device 3001, 300m, 300n of FIGS. 18 to 20, which are shown in an idle state, have a trigger 3101, 310m or 31 On, which is rotatable about a joint 330I, 330M and 330N. The trigger 3101, 310m or 31 On is coupled to a presently rod-shaped power transmission device 320 I, 320 M or 320 N, which in turn is coupled to an attachment point of a cutting electrode (not shown). The deflection of the cutting electrode then takes place, for example, as described with reference to FIGS. 7 to 9.

The activation device 300I, 300M or 300N of FIGS. 18 to 20 furthermore has a switch 420I, 420M or 420N which, as already described, can activate an external HF generator.

The switch 420I of the activation device 300I of FIG. 18 is rigidly coupled to the trigger 3101. The activation device 3001 further has a restoring force FR effecting return spring 3641, which is coupled to the trigger 3101. A user actuation of the cutting mechanism, indicated by the manual force FH in the direction of arrow takes place in the present example not directly on the trigger 3101, but indirectly via the switch 4201. A temporally downstream of the cutting electrode with cutting current movement of the cutting electrode in the direction of tissue is characterized achieved that a spring element contained in the switch 4201, which counteracts the electrical operation of the switch 4201, is formed weaker than the return spring 3641. A force applied to the switch 4201 manual force FH leads accordingly first to an electrical actuation of the switch 4201 and thus to admission the cutting electrode with cutting current. At this moment, the cutting mechanism is not or only slightly deflected. Continued operation of the switch 4201 results in compression of the return spring 3641 and deflection of the trigger 3101, causing deflection of the cutting mechanism toward the tissue. The spring element contained in the switch 4201, the return spring 3641 and the trigger 3101 are serially coupled with each other.

In the case of the activation device 300m in FIG. 19, in contrast to the previous exemplary embodiment, the switch 420m is fixed to the frame and is coupled to the trigger 310m via a compensating spring 363m designed as a compression spring. A spring element contained in the switch 420m, the trigger 310m and the balancing spring 363m are also serially coupled with each other. A user actuation of the cutting mechanism, indicated by the manual force FH in the arrow direction, via the trigger 310m directly. A movement downstream of the cutting electrode with cutting current tion of the cutting electrode in the direction of tissue is achieved in that the spring element contained in the switch 420m is formed weaker than the compensating spring 363m. Accordingly, a hand force FH applied to the trigger 310m initially leads to no compression of the compensating spring 363m but to an electrical actuation of the switch 420m. A compression of the balancing spring 363m is effected only by a further operation of the trigger 310m, which in turn causes a deflection of the cutting mechanism towards the tissue. The compensating spring 363m may optionally be dimensioned simultaneously as a return spring 363m. In the case of the activation device 300n in FIG. 20, the switch 420n is coupled, on the one hand, to the balance spring 363n which is fixed to the frame, and on the other hand via a pressure piece 321n to the force transmission device 320n which is in the form of a bar. The trigger 310n is in turn coupled to the return spring 364n effecting a return force FR. The return spring 364n is connected via the trigger 31 On in parallel with the compensating spring 363n. A spring element contained in the switch 420n is made weaker than the balancing spring 363n. If now a user actuation in the form of a manual force FH in the direction of the arrow, via the trigger 31 On, the force transmission device 320n and the pressure piece 321 n are equally deflected along the path s. As a result of the fact that the switch 420n is pressed against the pressure piece 321n by the compensating spring 363n, an electrical actuation of the switch 420n takes place already at an early stage of the deflection, namely when the cutting electrode still has no tissue contact.

Various embodiments of a cutting surface 500 'of a cutting electrode 500 for cutting a fabric 1 while avoiding line contact will now be described with reference to FIG. In each of the subfigures a) to e), the position of a second jaw part 220 and a forceps joint 20 is indicated.

A cutting surface 500 'in FIG. 21 a) is formed convexly in the direction of the second jaw part 220. The cutting electrode 500 has exactly one convex portion in the form of the cutting surface 500 '. A cutting surface 500 'in FIG. 21 b) is concave in the direction of the second jaw part 220. The cutting electrode 500 has exactly one concave portion in the form of the cutting surface 500 '. A cutting surface 500 'in FIG. 21 c) is formed inclined in an inclined manner with respect to the second jaw part 220 in a direction pointing away from the forceps joint 20 in the direction of the tissue 1. The cutting electrode 500 has exactly an obliquely rising portion in the form of the cutting surface 500 '. A cutting surface 500 'in FIG. 21 d) is formed sloping obliquely with respect to the second jaw part 220 in the direction pointing towards the tissue 1 by the forceps joint 20. The cutting electrode 500 has exactly a sloping portion in the form of the cutting surface 500 '.

A cutting surface 500 'in FIG. 21 e) is initially rising obliquely in the direction pointing towards the fabric 1 from the forceps joint 20 and subsequently sloping with respect to the second jaw part 220. The cutting electrode 500 has exactly an obliquely rising and exactly a sloping portion in the form of the cutting surface 500 'on.

Claims

claims

1. An electrosurgical gripping instrument for connection to an RF generator with a first jaw part and a second jaw part, which can perform a pincer-like gripping movement with one another, the second jaw facing cutting electrode on the first jaw part, and with a switch, by means of which a cutting current in the Cutting electrode is introduced, characterized in that the cutting electrode is movable relative to the first jaw part and in the direction of the second jaw part and in this sense forms a movable element, which is operatively connected to an actuatable activation device having a trigger and which connected to the cutting electrode and is formed so that an actuation of the trigger causes a force acting in the direction of the second jaw part force on the cutting electrode, and in that the trigger is coupled to the switch, so that upon actuation of the trigger, the cutting electrode in operation with Cutting current is applied.

2. Electrosurgical gripping instrument for connection to an HF generator with a first jaw part and a second jaw part, which can perform a pincer-like gripping movement with a second jaw facing cutting electrode on the first jaw part, one of the cutting electrode facing and this opposite abutment on the second jaw part, and with a switch by means of which a cutting current can be introduced into the cutting electrode, characterized in that either the cutting electrode is movable relative to the first jaw member and towards the second jaw member or the anvil is movable relative to the second jaw member and toward the first jaw member or both the cutting electrode and the anvil are movable relative to the respective jaw part and in this sense form a movable element, which is operatively connected to an actuatable activation device, which has a trigger and which is connected to the cutting electrode and / or the anvil and designed so that an actuation of the trigger causes a force acting in the direction of the thrust bearing force on the cutting electrode and / or causes a force acting in the direction of the cutting electrode force on the anvil, so that the cutting electrode and the anvil can approach each other without the jaw parts relative to each other, and in that the trigger is coupled to the switch, so that upon actuation of the trigger, the cutting electrode is acted upon in operation with cutting current.

Electrosurgical gripping instrument according to claim 1 or 2, wherein the activation means is designed such that a movement of the cutting electrode in the direction of a gripped between the first and second jaw tissue is only effected after the cutting electrode is subjected to cutting current.

An electrosurgical grasper instrument according to any one of claims 1 to 3, wherein the trigger is an actuation lever or an actuation slider.

Electrosurgical gripping instrument according to claim 4, wherein the activating means comprises a power transmission device connecting the actuating lever or actuating slide with the cutting electrode and / or the abutment for transmitting a force exerted on the operating lever or actuating slide hand force on the cutting electrode and the counter-bearing and a force-limiting element which limits the maximum transmitted force.

Electrosurgical gripping instrument according to claim 5, wherein the activating means is adapted to limit and / or cushion a hand force applied via the trigger on a first actuation path of the trigger and a hand force applied via the trigger on a second actuation path of the trigger substantially without limitation and / or unsprung to transfer.

Electrosurgical gripping instrument according to claim 5 or 6, wherein the force limiting element is a tension or compression spring.

An electrosurgical grasper instrument according to any one of claims 4 to 7, wherein the actuation handle is connected to a return member which returns the actuation lever or actuation slider to a rest position.

Electrosurgical gripping instrument according to claim 1 or 2, wherein the trigger comprises a force storage element which is biased in its rest state and wherein the force storage element is connected to the cutting electrode or the abutment such that the force-storing element after its release in the direction of the abutment or the cutting electrode acting force on the cutting electrode or the counter bearing causes.

Electrosurgical gripping instrument according to one of claims 1 to 9, wherein the cutting electrode and / or the abutment is fixed by means of a joint to the respective jaw part, that it acts on the counter-bearing when the force acting in the direction of the abutment or of the cutting electrode or the cutting electrode moves to.

Electrosurgical gripping instrument according to one of claims 1 to 10, wherein the first jaw part has a first coagulation section facing the second jaw part and a further first coagulation section facing the second jaw part, wherein the cutting electrode is arranged between the first coagulation section and the further first coagulation section.

The electrosurgical gripping instrument of claim 1 1, wherein the first coagulation portion and the further first coagulation portion are legs of a U-shaped first coagulation electrode.

13. The electrosurgical gripping instrument according to claim 1, wherein the second jaw part has a second coagulation section facing the first jaw part and a further second coagulation section facing the first jaw part, wherein the anvil is arranged between the second coagulation section and the further second coagulation section.

14. The electrosurgical gripping instrument according to claim 13, wherein the second coagulation section and the further second coagulation section are legs of a U-shaped second coagulation electrode.

15. The electrosurgical gripping instrument according to claim 1, wherein the cutting electrode and tissue gripped between the first and second jaw parts can be guided against one another such that, during cutting, line contact between a cutting surface of the cutting electrode and the tissue is substantially avoided.

16. The electrosurgical gripping instrument according to claim 1, wherein a cutting surface of the cutting electrode is profiled in the direction of the second jaw part such that line contact between the cutting surface and tissue gripped between the first and second jaw part is substantially avoided during cutting.