JPS61501068A - 二極性電気外科用器械 - Google Patents
二極性電気外科用器械Info
- Publication number
- JPS61501068A JPS61501068A JP59502857A JP50285784A JPS61501068A JP S61501068 A JPS61501068 A JP S61501068A JP 59502857 A JP59502857 A JP 59502857A JP 50285784 A JP50285784 A JP 50285784A JP S61501068 A JPS61501068 A JP S61501068A
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- electrosurgical instrument
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1402—Probes for open surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2945—Curved jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1425—Needle
- A61B2018/1432—Needle curved
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- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Medical Informatics (AREA)
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- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Ophthalmology & Optometry (AREA)
- Physics & Mathematics (AREA)
- Plasma & Fusion (AREA)
- Otolaryngology (AREA)
- Surgical Instruments (AREA)
- Nitrogen And Oxygen Or Sulfur-Condensed Heterocyclic Ring Systems (AREA)
Abstract
(57)【要約】本公報は電子出願前の出願データであるため要約のデータは記録されません。
Description
【発明の詳細な説明】
二匣性電気外科用器械
技術分野
本発明は、一般的には医学シて関し、特tZC外科に関しており、4体的には二
甑性這気外科用器賊に関している。
本発明は、広い周波数範囲における生体組織の電気切開及び電気凝固のための高
周波電気外科を含む、人体の峡も多種類の解剖学領域においての手術に広い利用
を見い出すことができる。本発明の二匣性電気外科用器城だよると、矢のような
外科処1ヒまく行うことができる。すなわち、電気切開技術による組織の切断な
いし切除、胃、腸、膀胱等の厚壁器官の切開、いろいろな太さの血管の切断及び
凝固、等。
本発明の二区性電気外科用器械は、肝臓、膵臓、腎臓等の実質器官の無血外科処
置、及び、最も多種類の太さの血管の処置に用いる時に、最大の有用性を見い出
すことができる。
背景技術
高周波電気外科は、一般外科、腫瘍外科、神経外科、胃腸病学、泌尿器科学、眼
科外科、及びその池多くの臨床医学の分野において、最も多種類の手術処置を行
うのに今日欠くことのできない技術に属する。
高周波電気外科は、患者の身体の組織を切開ないし凝固する目的で、この組織に
形成された高周波電流による外科効果の方法全意味すると理解されている。この
方法は、身体組織の中で進行する物理的、化学的プロセスに基づいておp、かつ
、主としてシアチルミーを流効果によって引き起こ高周波電気外科は2つの蟹、
すなわち、15E性と二千性に分かれる。
暎甑性電気外科の場合には、一方の1陽が能動的であって、これに最大電流密圀
が生じ、この電玉が作用用具であり、池の(補助)1啄は受動的である。
二玉性電気外科の場合には、両方の電子が能動的であり、そのため、作用用具と
して用いられる。
今日までの外科における最も緊急な問題の1つは、組織、特に肝臓、腎臓、膵臓
等のような実質組織の外傷の確実で、急速な、かつ高品質のと血、及び、事前に
計画を立てた外科処置の間の主血管のと血である。
今日の公知技術は、多くの種類の二匝性電気外科用器械、すなわち、鉗子、特に
血管凝固用鉗子である(例えば、広告パンフレット「電気医学器械の外科医術付
属品ERBEJ参照)。
このような器1?!!各々は、王として相互に絶縁された2本のアームからなり
、各アームは血管をとらえる導電性作用ジョー上端えており、両方のアームに高
量e電流が供給される。しかしながら、このような器械は、実質組織の萎縮全切
開してこの組織牛深くに立置している血管全確実にとらえてつかむことができず
、血管?とらえようとそれ以上試みると、周囲のより広い領域の組織に物理的損
傷を加えることになる。
さらて、上記し念器械は、手術した血管をと夛まく組織に大きな凝固作用を受け
た領域を形成し、かつ、器械の作用面にくっついている凝固され之組織ないし血
橙は、凝固の後に器械を取り除く時に、引きさかれる恐れがある。
その上、上記した器械は、実質基管のかたまりの中に深く位1する非切断血管全
同時に無血で露出させかつこれ全機械的に確実につかむことかで発明の開示
本発明の主要で本質的な目的は、実質組織及び太さの異なる血管をすばやくかつ
高品質に手術することができる二駆性電気外科用器械を提供することである。
この目的は、相互に電気的に絶縁されていて導電性作用ジョーtWえたアームか
らなる二鷺性電気外科用器賊において、本発明により、作用ジ1−は同じ方向に
曲がっている尖端の形状に形成され、ま几、1つのアームの作用ジ1−はフォー
ク形状に形成されているものによって8 bMされる。
この器械のこのような構漬的配置により、実質組織のすばやくかつ高品質の外科
処置が可能になる。
器械のアームは相互に予行に配置し、また、作用ジ運−は相互に軸方向へ移動す
るように構成すると実際的である。
この特徴により、どのよりな事前セットの長さでどのような太さの非切断血管で
もその内腔を融合することが可能となる。
一方のアームの曲がった尖端は能力のアームの7オーク尖端より長いと良い〇
これによって、実質′ul織深部の血管を確実(つかんでこれを移動することが
できる。
−一尖端の表面面積はフォーク尖端の全表面面積と等しいと良い。
これによって、つかんだ生体m織の高品質な凝固ができる。
嘆−尖端の表面面積はフォーク尖端の全表面積より小さくて良い。
これによって、つかんだ組織を切開することができる。
発明を実施するための最適実施例
本発明の二啄性電気外科用器械は、電気的に絶縁され之導電性アーム1 (第1
図、第2図)を備えており、このアーム1はピン2によシミ気的に絶縁され之池
の導電性アーム3に結合している。
アーム3には制限器4が設けられていて、この器械の開き角を制限するよプにな
っている。各アーム1.3は、高周波電流供給用のリード綴5全備えており、ま
友、図示のケースの場合、それぞれ尖端6.7の形状に形成さi之作用ジq−を
存している。アーム1は池のアーム3の尖端7と接触する位置において電気的に
絶縁されている尖7sA6(嘉3図)で終端している。アーム3の尖端7は二叉
ないし〉本の尖端フォーク(第4図)を構成している。アーム1と3を相互に近
接させると(軍5図)、尖端6は尖端7の間にかみ合う。尖端6と7は同じ方向
だ曲がっている。
アーム1の曲がった尖端6は池のアーム3のフォーク尖端7より長いのが都合が
良く、一方、尖端60表面面yt(第6図)はフォーク尖端7の全体の表面面積
と等しくて良い。知られているように、血管8と生体組織の確実な凝固は、二甑
性電気外科用器械の能動電量(すなわち、この特別な場合には、尖端6と7)の
面積が等しい場合だけである。
しかしながら、尖端6の表面面積はフォーク尖端7の全体の表面面積より小さく
ても良い(第7図)。
1甑の導電性作用ジ1−をこのような構造的配置(することにより、つかまえた
組織を介して切開することが5T能になる。なぜなら、作用ジョーに展開するエ
ネルギーはその表面面積の逆数に比例するからである。その上、導電性シアー全
このように構成することにより、例えば胃壁、膀胱壁等の中空器官組織を切開す
ることが可能になる。
絶縁され念アーム1及び3は相互にモ行に配置されても良い(第8図)。このよ
うな場合、尖端6.7として形成され之これらのアームの作用ジョーは、相互に
軸方向へ移動することができる(第9図)。
本発明の電気外科用器械の機能全簡略に理解する九めに、手術全党けた傷の割れ
目の中にある非切断面マに適用する電気凝固を参照にして説明する(第10図、
第11図)。処置は次のように行うロ
アーム1の尖端6を、手術された傷の中の無傷の(非切断)血管8の機械的遊離
のための案内部材をして用いる。無傷血管8が遊離すると、尖端6をその位置に
置く。
アーム1と3t−相互に近接させて、遊離された血管8金尖端6と7オーク7に
よってつかみ、そして高周波電流を電流リード線5に与える。手術が終わると、
まずアーム1と3とを制限器4の位置まで離なし、そして手術した傷からこの器
械を外す口
上記した二匣性電気外科用器械は、10分の2〜3ミリメータから約3ミリメー
タの太さのi傷の血管の凝固に鏝も有効に利用できる。この器械は対象の血管の
まわりの生体組織に機械的かつ電気凝固損傷を負わせるがそれは小さい領域であ
る。
さて、実質組織深部にある切断された血管の血管内−外凝固の典型的な処置を考
える(第12図)7処置は次のように行う。
手術の前にこの器械のアームlと3を制限器4の位置まで離なす。尖端6全中間
太さの血管の内腔の中に差し込む。アーム3の二叉になった尖端7を手術する血
管の上の肝臓実質組織の中に導入する。アーム1と3を相互に近接させ、尖端7
を尖端6に対してしつかり加圧することにより、管壁を機械的に変形させて、電
流リード縁5に沿って高周波電流を供給する。血管の凝固の後にアーム1と3を
制限器4の位置まで離なし、処置し念傷からこの器械を引きぬいて元の状態にも
どす口尖端6と7は近接させた時一定の角変金なししかも積f的に交差するので
、この二甑性電気外科用器械は10分の2〜3ミリメータから約8ミリメータの
太さの血管80断端?確実につかむことができるが、主として肝臓、膵臓、腎臓
等の生体組aK外傷全加える:
さらに、実質組織深部に立置する切断され定血管に血管外−外電気凝固処置を残
す場合を参照にして、本電気外科用器械の操作を説明する(第13離なす。次に
、尖端6を実質組織の千の出血している大きな内径の血管8の壁の近くに導入し
、そしてアーム3の二叉の尖端7を血管8の上の肝臓実質組織の中ば導入する。
次に、アーム1と3を相互番て近接させ、血管8のつかんだ襞を相互に接触させ
、器械の尖端6.7に対してしっかりと押しつける。こうして、電流リード巌5
に沿って高周波電流を供給する。電気凝固処置が終わると高周波電流を切って、
アーム1と3を制限器4の位責まで離なし、器械亡兄の位置へ引きぬく。
アーム1と3が刊行に配置されていることを特徴とする本発明の電気外科用器械
(嘉819%第9図)を用いて電気凝固?行う場合、(尖端6と7として形成さ
れている)作用ジョー?相互に引き寄せると、尖端7は血管8に機械的圧力を加
えることになる。次に、尖端7は、尖端6の両@?スライドする間に、行おうと
している血管融合位置の血管8内部から血液を移動させる。この例の場合、アー
ム1と3の作用ジ1−はアーム自身に子行な軸方向へ移動する。
融合する血管8の部分の必要な長さに応じて(これが長ければ長いほど血管8自
身の太さは大きくなる)、中央尖端6はフォーク尖端70間を通りすぎ、血管8
と共に短かい距離ないし長い距離だけ引っばられる。上記したように、融合する
血管の太さが大きければ大きいほど、融合に必要な血管の無血部分はより長り、
シたがって、尖端6及びこれによってつかまれる血管8はより長く伸ばされなけ
ればならない。上記し几全てのステップは、子行に配置されたアーム1と3が与
えられる時、この電気外科用器械によって簡鵬かつ容易に行うことができる。第
14図から明らかなように、融合する血管部分の長さけ、畦−尖端6によって2
本の池の尖端7形状のフォークの中に引き込まれる無血の血管部分に依存する。
上記した長さは、中央尖端6からフォーク尖端7の一方への距離の2暗に相当す
る。
すでに上記し念ように、高周波tR,によって対向する血管壁同士ヲ躍実に融合
できるのは、融合する血管部分の内腔が無血のときのみである。したがって、約
4ミリメータの太さの血管を彊実に融合する次めには、無血部分の長さは6ミリ
メータでなければならず、血管の太さが8ミリメータであるとき、無血部分の長
さはほぼ10から12ミリメータの範囲になければならない、等である。
融合する血管部分の長さは、適宜に広い範囲内で、術者の一方の手によって何ら
池の補助器具ないし器械に之よることなく、容易にかつ薄笑に調節することがで
きる。
中央尖端6がフォーク尖端7より長いと都合が良い。こうすると、本発明の電気
外科用器械は手術するのにより便利で信頼がおける。その理由は、必要な組織や
露出した血管8を容易につかむことができるからである。
@東上の利用可能
したがって、同じ方向に曲がっている尖端の形状のこの器械の作用ジ1−を設け
ることてよって、実質組E&深部にあるいかなる太さの血管でも確実につかむこ
とができ、融合しようとする位置の露出血管内部から血液を有効に移動させるこ
とができる。また、太さの大きい0血管を含むいがなる太さの非切断血管の内腔
全確実に融合することができる。この場合、いわゆる「ハサミ効果」がない之め
、血管は機械的に損giJを受けないでいる。
その上、非切断血管の内腔は、どのような事前設定の長さでも、電気凝固え死に
よって影響される領域を最少にし、がっ、血管を取りかこむ組織に対する機械的
損s?最少にして、融合することができる。
図面の簡単な説明
以下に、本発明の!気外科用器賊を、実例としてあげたいくつかの特定の説明用
の実施例の詳細な説明を添付の図面を参考にしながら行うことにより、開示する
。
第1図は本発明の二甑性電気外科用器械の全体の概略図;
第2図は第1図の二啄性電気外科用器誠の子面図;
茗3図は本発明の二匣性電気外科用器械の自力のアームの導電性作用ジブ−であ
って琳−の尖端として形成され念ものの説明図;
嘉4図は本発明の二翫性電気外科用器械の一方のアームの導電性作用ジブ−であ
ってその尖端が7オーク全形戊しているものの説明図;第5図は本発明の電気外
科用器械のアームを相互に近接させた時の導電性作用ジ1−の位置を示す説明図
;
第6図は本発明の器械の1実施例において導電性ジ1−を尖端形状に形成したも
のの子面図であって、啄−尖端の表置面積がフォークの両方の尖端の表面面積と
等しいものの図面;
第7図は本発明の器械の1実施例において導電性ジ]−を尖端形状に形成したも
ののモ面図であって、琳−尖端の表面面積がフォークの両方の尖端の表面面積よ
り小さいものの図面;
第8図は本発明の子桁配置のアーム全特徴とする二田性電気外科用器城の1実施
例の概略図:第9図は本発明の嘉8図に示した予行配置のアーム?有する二玉性
電気外科用器賊の実施例の(尖端側からの)側面図;
第10図は生体組織深部の傷の割れ目にある切断されていない血管(本発明によ
り1用する電気凝固処置の操作ステップを概略的に示す図面;第11図は移動さ
せられ之切断されていない血管に本発明により適用する心気装置処置の操作ステ
ップ全7a略的に示す図面:
箒12図は冥X岨織深部にある切断され之血管に本発明により (血管同一外に
)通用する電気凝固処置の操作ステップ全概略的に示す図面:第13図は実質祖
wc深部にある切断された血管に本発明により (血管外−外だ)適用する電気
凝固処置の操作ステップを概略的に示す図面;第14図は本発明のアームが相互
に予行に配電されている電気外科用器械の実施例において器械の尖端と手術する
血管の相互配置の概略図;国際調量報告
Claims (1)
- 【特許請求の範囲】 1)相互に電気的に絶縁されていて導電性作用ジョーを備えたアームからなる二 極性電気外科用器械において、作用ジョーは同じ方向に曲がつている尖端(6及 び7)の形状に形成され、また、アーム(3)の作用ジョーはフォーク形状に形 成されていることを特徴とする二極性電気外科用器械。 2)アーム(1及び3)は相互に平行に配置され、また、これらの作用ジョーは 相互に軸方向へ移動するように構成されていることを特徴とする特許請求の範囲 第1項の二極性電気外科用器械。 3)一方のアームの曲がつた尖端は他方のアーム(3)のフオーク形状のジョー よりも長いことを特徴とする特許請求の範囲第1項の二極性電気外科用器械。 4)単一尖端(6)の表面面積がフオーク尖端(7)の全表面面積に等しいこと を特徴とする特許請求の範囲第1項の二極性電気外科用器械。 5)単一尖端(6)の表面面積がフオーク尖端(7)の全表面面積より小さいこ とを特徴とする特許請求の範囲第1項の二極性電気外科用器械。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/SU1984/000004 WO1985003214A1 (en) | 1984-01-30 | 1984-01-30 | Bipolar electric surgical instrument |
Publications (1)
Publication Number | Publication Date |
---|---|
JPS61501068A true JPS61501068A (ja) | 1986-05-29 |
Family
ID=21616834
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP59502857A Pending JPS61501068A (ja) | 1984-01-30 | 1984-01-30 | 二極性電気外科用器械 |
Country Status (6)
Country | Link |
---|---|
US (1) | US4671274A (ja) |
JP (1) | JPS61501068A (ja) |
DE (2) | DE3490633C2 (ja) |
GB (1) | GB2161082B (ja) |
SE (1) | SE8504485L (ja) |
WO (1) | WO1985003214A1 (ja) |
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- 1984-01-30 WO PCT/SU1984/000004 patent/WO1985003214A1/ru active Application Filing
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US11607267B2 (en) | 2019-06-10 | 2023-03-21 | Covidien Lp | Electrosurgical forceps |
US11376030B2 (en) | 2020-02-10 | 2022-07-05 | Covidien Lp | Devices and methods facilitating the manufacture of surgical instruments |
US11944369B2 (en) | 2020-03-16 | 2024-04-02 | Covidien Lp | Forceps with linear trigger kickout mechanism |
US11628008B2 (en) | 2020-03-16 | 2023-04-18 | Covidien Lp | Forceps with linear trigger kickout mechanism |
US11617612B2 (en) | 2020-03-16 | 2023-04-04 | Covidien Lp | Forceps with linear trigger mechanism |
US11844562B2 (en) | 2020-03-23 | 2023-12-19 | Covidien Lp | Electrosurgical forceps for grasping, treating, and/or dividing tissue |
Also Published As
Publication number | Publication date |
---|---|
GB2161082A (en) | 1986-01-08 |
WO1985003214A1 (en) | 1985-08-01 |
SE8504485D0 (sv) | 1985-09-27 |
GB2161082B (en) | 1986-12-03 |
DE3490633T (de) | 1985-12-12 |
DE3490633C2 (de) | 1988-06-23 |
SE8504485L (sv) | 1985-09-27 |
US4671274A (en) | 1987-06-09 |
GB8520820D0 (en) | 1985-09-25 |
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