US20220061908A1 - Electrosurgical device - Google Patents
Electrosurgical device Download PDFInfo
- Publication number
- US20220061908A1 US20220061908A1 US17/408,560 US202117408560A US2022061908A1 US 20220061908 A1 US20220061908 A1 US 20220061908A1 US 202117408560 A US202117408560 A US 202117408560A US 2022061908 A1 US2022061908 A1 US 2022061908A1
- Authority
- US
- United States
- Prior art keywords
- tubular element
- electrosurgical
- end effector
- rotatable
- cutting
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
- 239000012636 effector Substances 0.000 claims description 37
- 238000002679 ablation Methods 0.000 claims description 20
- 238000005345 coagulation Methods 0.000 claims description 20
- 230000015271 coagulation Effects 0.000 claims description 20
- 239000000463 material Substances 0.000 claims description 15
- 239000000919 ceramic Substances 0.000 claims description 6
- 239000012811 non-conductive material Substances 0.000 claims description 6
- 229920000642 polymer Polymers 0.000 claims description 6
- OKTJSMMVPCPJKN-UHFFFAOYSA-N Carbon Chemical compound [C] OKTJSMMVPCPJKN-UHFFFAOYSA-N 0.000 claims description 3
- 229910052799 carbon Inorganic materials 0.000 claims description 3
- 229910003460 diamond Inorganic materials 0.000 claims description 3
- 239000010432 diamond Substances 0.000 claims description 3
- 238000004381 surface treatment Methods 0.000 claims description 2
- 239000011810 insulating material Substances 0.000 abstract description 7
- 230000009471 action Effects 0.000 description 10
- 239000012634 fragment Substances 0.000 description 3
- 238000000926 separation method Methods 0.000 description 3
- 230000004913 activation Effects 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000009413 insulation Methods 0.000 description 2
- 229910052751 metal Inorganic materials 0.000 description 2
- 239000002184 metal Substances 0.000 description 2
- 238000000034 method Methods 0.000 description 2
- 230000037361 pathway Effects 0.000 description 2
- 230000036316 preload Effects 0.000 description 2
- -1 DLC Substances 0.000 description 1
- 238000007792 addition Methods 0.000 description 1
- 230000002411 adverse Effects 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 239000011248 coating agent Substances 0.000 description 1
- 238000000576 coating method Methods 0.000 description 1
- 238000012217 deletion Methods 0.000 description 1
- 230000037430 deletion Effects 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 238000002955 isolation Methods 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 150000002739 metals Chemical class 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 229910052755 nonmetal Inorganic materials 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000036346 tooth eruption Effects 0.000 description 1
- 238000009834 vaporization Methods 0.000 description 1
Images
Classifications
-
- 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
- A61B18/1206—Generators therefor
-
- 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
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1659—Surgical rasps, files, planes, or scrapers
-
- 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
-
- 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
- A61B18/148—Probes or electrodes therefor having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
-
- 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
- A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
-
- 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
- A61B18/149—Probes or electrodes therefor bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00071—Electrical conductivity
- A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00107—Coatings on the energy applicator
- A61B2018/00136—Coatings on the energy applicator with polymer
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00107—Coatings on the energy applicator
- A61B2018/00142—Coatings on the energy applicator lubricating
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00172—Connectors and adapters therefor
- A61B2018/00178—Electrical connectors
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00184—Moving parts
- A61B2018/00202—Moving parts rotating
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00184—Moving parts
- A61B2018/00202—Moving parts rotating
- A61B2018/00208—Moving parts rotating actively driven, e.g. by a motor
-
- 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
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
-
- 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
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00589—Coagulation
-
- 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
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00601—Cutting
-
- 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
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00607—Coagulation and cutting with the same instrument
-
- 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
- A61B2018/0091—Handpieces of the surgical instrument or device
-
- 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
- A61B2018/0091—Handpieces of the surgical instrument or device
- A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
-
- 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
- A61B18/1206—Generators therefor
- A61B2018/1246—Generators therefor characterised by the output polarity
- A61B2018/126—Generators therefor characterised by the output polarity bipolar
-
- 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
- A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
-
- 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
- A61B2018/1497—Electrodes covering only part of the probe circumference
-
- 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
- A61B18/16—Indifferent or passive electrodes for grounding
- A61B2018/167—Passive electrodes capacitively coupled to the skin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/007—Aspiration
Definitions
- Embodiments of the present invention described herein relate to an electrosurgical device, and in particular to an electrosurgical device wherein a means of reducing conductivity is provided between a first cutting portion and a pair of electrodes so as to improve the performance of the device.
- U.S. Pat. No. 7,150,747 B1 describes a surgical device with a blade used to cut tissue mechanically and to coagulate cut tissue.
- the blade is electrically conductive and serves as an active electrode in a bipolar arrangement with a return electrode. Electrical energy is transferred to the blade through an electrical connection between the distal region of the blade and a second member which has a lumen for receiving the first member.
- Embodiments of the present invention provide an improved electrosurgical instrument configured to improve the RF field consistency of RF electrodes which in turn improves the performance of RF coagulation and ablation.
- the end effector has a complex layout which can cause current to follow unintended paths from the electrodes to other sections of the end effector, such as a rotating cutting edge. It is important to reduce the conductivity of the current path to rotating elements, as this will improve the consistency of the RF field generated.
- Conductivity may be reduced by providing an insulating or isolating portion between the electrodes and the inner cutting member.
- This may take the form of an insulating layer, or an insulating, projecting portion that not only provides insulation itself but ensures separation between the return electrode and the inner cutting member.
- the insulating portion can substantially reduce shedding, where the inner and outer blade contact and microscopic blade fragments can be created. This minimises the generation of unwanted particulates within the surgical site, which could adversely affect surgeon visibility and patient anatomy.
- an electrosurgical end effector comprising: a rotary shaver arrangement, having a rotatable tubular element with a cutting portion having a cutting blade formed therein that when in use is able to cut tissue located in an operative cutting direction; an active electrode; a second tubular element concentrically arranged around the rotatable tubular element, the second tubular element having a cutting window formed in a wall thereof such that the cutting blade of the rotatable tubular element is located within the window, wherein the outside surface of the second tubular element is a return electrode; and an insulating portion projecting distally from the distal end of the rotatable tubular element, arranged so as to reduce electrical conductivity between the second tubular element and the first cutting portion.
- Such an arrangement improves upon the known RF shaver arrangements of the prior art by ensuring that the majority of the RF current follows the intended path from the active electrode to the return electrode. Leakage to the rotatable tubular element is reduced through reduced conductivity, improving the RF efficiency and RF performance of the device during ablation and coagulation.
- the inner cutting member may be “parked” during which it is stationary (no cutting action being performed). The RF field generated is more consistent over a wider range of inner blade ‘parking angles’ as the variable position of the insulated rotatable inner cutting element does not significantly affect the useful RF field generated at the active electrode.
- the insulating portion is in contact with the inner distal end of the second tubular element, acting as the bearing surface between the rotatable tubular element and the second tubular element.
- the insulating portion reduces the area of contact between the rotatable tubular element and the second tubular element. This reduces conductivity, as the only contact between the rotatable tubular element and the second tubular element is through an insulating material. Further, the insulating portion ensures separation between the remaining surfaces of the rotatable tubular element and the second tubular element, acting to provide an insulating gap. In a standard RF shaver there may be shedding, where small pieces of the cutting blade break off due to friction between the blades. By reducing the contact area between the rotatable tubular element and the second tubular element to just the insulating portion, shedding is reduced. This increases the working life of the electrosurgical instrument and reduces the incidence of fragments being left within a patient during surgery.
- the insulating portion is one of: a ceramic or a polymer. Providing a non-metal insulating portion results in there being no metal-on-metal contact during cutting over the distal hemisphere portion of the inner blade, reducing shedding.
- the insulating portion is overmoulded or deposited on the distal end of the first cutting portion.
- the insulating portion is a push-fit insert that is inserted into a suitable receiving geometry, wherein the suitable receiving geometry is located on one of: the distal end of the first cutting portion or the inner distal hemisphere of the second tubular element.
- a push-fit (or snap-fit) insert allows the insulating portion to be easily attached.
- Geometries may be chosen to allow different benefits, for example the geometry may comprise a hole, a groove or a slot.
- the material of the insulating portion is lubricous.
- a lubricous material reduces the friction between the insulating portion and the second tubular element. This can lead to a more consistent cutting action by preventing snags and allowing the rotatable tubular element to rotate consistently, which may further increase the efficiency of the electrosurgical end effector by reducing energy lost to heat.
- the lubricous material can also substantially reduce shedding. Further, this allows closer interaction between the cutting blade and the cutting window of the second tubular element, as less distance is required to prevent the sections catching or snagging. This allows a closer, more accurate tissue cutting action.
- an electrosurgical instrument comprising: a hand-piece; one or more user operable buttons on the handpiece that control the instrument; and an operative shaft, having RF electrical connections, and drive componentry for an end effector, the electrosurgical instrument further comprising an electrosurgical end effector according to any of the above, the rotary shaver arrangement being operably connected to the drive componentry to drive the rotary shaver to operate in use, and the active electrode being connected to the RF electrical connections.
- an electrosurgical system comprising: an RF electrosurgical generator; a suction source; and an electrosurgical instrument according to the above, the arrangement being such that in use the RF electrosurgical generator supplies an RF coagulation or ablation signal via the RF electrical connections to the active electrode, to permit tissue coagulation or ablation.
- an electrosurgical end effector comprising: a rotary shaver arrangement, having a rotatable tubular element with a cutting portion having a cutting blade formed therein that when in use is able to cut tissue located in an operative cutting direction; an active electrode; a second tubular element concentrically arranged around the rotatable tubular element, the second tubular element having a cutting window formed in a wall thereof such that the cutting blade of the rotatable tubular element is located within the window, wherein the outside surface of the second tubular element is a return electrode; and an insulating layer arranged so as to reduce the conductivity between the second tubular element and the first cutting portion.
- An axial pre-load force from a hand-piece may be applied to the rotatable tubular element, which forces the cutting portion of the rotatable tubular element into intimate mechanical and electrical contact with the second tubular element.
- the radius of the rotatable tubular element may be separated by a gap from the radius of the second tubular element. Therefore, the insulating layer between the first cutting portion and the electrodes has the greatest impact on reducing conductivity.
- the insulating layer is one of: a surface treatment, such as an anodized layer; a polymer layer; or a diamond like carbon, DLC, layer.
- Another embodiment describes the material of the insulating layer as being lubricous.
- a lubricous material reduces the friction between the insulating layer and the inner distal end of the second tubular element, which can lead to a more consistent cutting action by preventing snags and allowing the rotatable tubular element to rotate consistently.
- the lubricous material also prevents or reduces shedding. As there is a lower chance of shedding, the rotatable tubular element and the second tubular element can be located closer together, which provides a more accurate cutting action.
- a further example describes how the insulating layer is a layer covering one or more of: the rotatable tubular element; the distal end of the rotatable tubular element; the internal radius of the second tubular element; and/or the external radius of the second tubular element.
- Providing an insulating layer on the surface of the rotatable tubular element reduces conductivity.
- the distal end of the rotatable tubular element is in closest proximity to the second tubular element therefore providing an insulating layer on the distal end can reduce the amount of insulating layer or coating material required, whilst still reducing conductivity.
- a combination of insulating layers on the rotatable tubular element and second tubular element can reduce conductivity further.
- the rotatable tubular element is constructed of a non-conductive material, such as ceramic, wherein the surface of the non-conductive material acts as the insulating layer. Constructing the inner blade of a non-conductive material isolates the blade from the active electrodes. Beneficially, a separate insulating layer is not required, reducing manufacturing steps.
- FIG. 1 is a schematic diagram of an electrosurgical system including an electrosurgical instrument according to an embodiment of the present invention.
- FIG. 2 is a side view of an electrosurgical instrument according to an embodiment of the present invention.
- FIG. 3 is view of the tip of FIG. 2 , showing the electrosurgical end effector, wherein the RF function is facing upwards.
- FIG. 4 is cross-sectional view of the distal end of the electrosurgical end effector.
- FIGS. 5 a and 5 b are plan views showing the hollow conductive tube and the rotatable shaver element.
- FIG. 6 is a view of the distal end of the rotating shaver blade, with an insulating portion.
- FIG. 7 is a view of the distal end of the rotating shaver blade, with a push-fit or snap-fit insulating portion.
- FIG. 8 is a side view of the rotating shaver blade, with an insulating layer.
- FIG. 9 is a side view of the rotating shaver blade, with an insulating layer on the distal end of the rotating shaver blade.
- FIG. 1 shows electrosurgical apparatus including an electrosurgical generator 1 having an output socket 2 providing a radio frequency (RF) output, via a connection cord 4 , for an electrosurgical instrument 12 .
- the instrument 12 has a suction tube 14 which is connected to a suction source 10 .
- Activation of the generator 1 may be performed from the instrument 12 via a handswitch (not shown) on the instrument 12 , or by means of a footswitch unit 5 connected separately to the rear of the generator 1 by a footswitch connection cord 6 .
- the footswitch unit 5 has two footswitches 5 a and 5 b for selecting a coagulation mode or a cutting or vaporisation (ablation) mode of the generator 1 respectively, although in some embodiments of the electrosurgical instrument 12 described herein it is envisaged that only one or other of the coagulation or ablation modes would be used, with cutting being provided mechanically by way of a rotating tube having a sharpened cut-out portion, described further below.
- the generator front panel has push buttons 7 a and 7 b for respectively setting ablation (cutting) or coagulation power levels, which are indicated in a display 8 .
- Push buttons 9 are provided as an alternative means for selection between the ablation (cutting) and coagulation modes.
- FIG. 2 shows the electrosurgical instrument 12 forming the basis of an embodiment of the present invention.
- the instrument 12 includes a proximal handle portion 22 , a hollow shaft 24 extending in a distal direction away from the proximal handle portion, and an end effector assembly 26 at the distal end of the outer shaft.
- a power connection cord 4 connects the instrument to the RF generator 1
- tube 14 connect the instrument to the suction source 10 .
- the instrument may further be provided with activation buttons (not shown), to allow the surgeon operator to activate either the mechanical cutting function of the end effector, or the electrosurgical functions of the end effector, which in this embodiment typically comprise coagulation or ablation.
- FIG. 3 shows an example of the RF side of the electrosurgical end effector 26 .
- the instrument comprises an active electrode 32 , the opening to the primary suction channel 42 and the outer insulating sheath 34 .
- FIG. 4 shows the end effector assembly 26 in more detail, comprising an opposite sided shaver arrangement.
- the end effector comprises a series of concentrically arranged tubes, with outer insulating sheath 34 containing a hollow conductive tube 36 , having at is distal end an opening cut out of one side thereof to act as a cutting window 66 .
- the edges of the cutting window 66 may be sharpened to provide scissor action in use against a cutting edge 38 of a cylindrical rotatable shaver element 40 .
- the hollow, conductive tube 36 acts as a return electrode and concentrically surrounds a rotatable cylindrical shaver element 40 .
- ‘concentrically surrounds’ we mean that the shaver element 40 is inside and coaxial with the tube 36 .
- the proximal part of the tube 36 is covered with the insulating sheath 34 .
- the distal part of the tube 36 has the opening which acts as the cutting window 66 .
- the shaver blade itself is a hollow cylinder of C-shape cross-section at the distal end, meaning a hollow cylinder which has a segment cut out for a portion of the distal end. The cut out portion is sharpened and serrated, to form the cutting edge 38 .
- the shaver blade 40 has a sharp cutting edge 38 , which may be serrated or shaped into points to provide cutting teeth.
- the hollow shaver blade 40 in use defines an internal suction lumen 62 , which extends along the shaft 24 and ultimately connects to the suction source 10 . That is, as explained further below, the shaver blade 40 is operative when in use to cut tissue that it is presented against and which is located in a direction to the side of the shaft of the instrument i.e. in a direction orthogonal to the long axis of the instrument.
- the active electrode 32 operatively faces in the opposite direction to the operative direction of the shaver blade 40 , so that in use the user may turn the electrosurgical instrument 180 degrees to coagulate or ablate tissue that was cut using the shaver element.
- the user manipulates the instrument 12 such that the active electrode 32 is adjacent to the tissue to be treated, and activates the generator 1 to supply RF power to the active electrode 32 , via the connection cord 4 .
- the RF signal supplied is dependent on whether the active electrode is to simply coagulate (dessicate) tissue, or to ablate the tissue, wherein a higher power RF signal is used for tissue ablation than tissue coagulation.
- the active electrode 32 and the return electrode 36 act in a bipolar electrode arrangement.
- the suction lumen 62 is connected to the suction source 10 such that fluid, tissue fragments, bubbles or other debris in the vicinity of the electrode 32 can be aspirated from the surgical site.
- the line bb indicates the shorter preferential RF tracking path between the active electrode 32 and the return electrode 36 .
- the line cc 1 indicates the longer, unintended tracking path through the primary suction channel 42 to the inner blade edge.
- the line cc 2 indicates the longer, unintended tracking path through the primary suction channel 42 to the outer blade—whilst still flowing between the electrodes, this reduces current density at the point of electrosurgical application. So as to improve the efficiency and consistency of the generated RF field, it is preferable to reduce current conducted to the rotatable shaver element (path cc 1 ) or along the longer path to the return electrode (path cc 2 ).
- the distal ends of the rotatable shaver element 40 , the hollow conductive tube 36 and the active RF electrode 32 are in close proximity. This provides a path for a portion of the RF current to pass from the active tip 32 , through the primary suction channel 42 , to the rotatable shaver element 40 .
- the electrosurgical instrument 12 it is desirable to increase the efficiency and consistency of the RF field. This may be achieved by reducing electrical conductivity between the electrodes 32 , 36 , and the rotatable shaver element 40 , reducing the current conducted by the rotatable shaver element 40 . In some instances, this may include providing electrical isolation between the electrodes 32 , 36 , and the rotatable shaver element 40 to prevent or reduce the RF current flowing to the rotatable shaver element 40 . This results in an increased proportion of the RF current following the desired path (bb) from the active electrode 32 to the return electrode 36 .
- FIG. 5 a shows a simplified plan view of the end effector assembly 26 including only the hollow conductive tube 36 and the rotatable shaver element 40 .
- Other parts of the end effector have not been included here so as to simplify understanding of the concept.
- the distal end of the rotatable shaver element 36 may be in contact with or close proximity to the hollow conductive tube 36 at point 402 .
- FIG. 5 b includes an insulating portion 400 .
- This insulating portion 400 is made of an insulating material, such as a polymer or ceramic. As shown in FIG.
- the insulating portion 400 is attached to and projects distally from the distal end of the rotatable shaver element 40 .
- the insulating portion 400 may be attached to the concave hemispherical surface of the hollow conductive tube 36 and project towards the convex hemispherical distal end of the rotatable shaver element.
- the insulating portion 400 may be over-moulded or deposited on the surface of the rotatable shaver element 40 . The insulating portion prevents contact between the distal end of the rotatable shaver element 40 and the concave hemispherical distal end of the hollow conductive tube 36 .
- the bearing surface between the rotatable shaver element 40 and the hollow conductive tube 36 is the insulating portion 400 . This reduces conductivity, by ensuring that any contact area between the rotatable shaver element 40 and the hollow conductive tube 36 is an insulating material.
- the rotatable shaver element 40 and the hollow conductive tube 36 are in closest proximity at the distal tip of the electrosurgical instrument 12 , so that they may act to provide a scissor action. Therefore, reducing conductivity at the distal tip will have the most profound effect on overall conductivity between the electrodes and the rotatable shaver element.
- the insulating portion 400 provides a physical insulating separation at the distal end, as well as resulting in a gap 404 between the remaining surfaces of the rotatable shaver element 40 and the hollow conductive tube 36 . This gap provides a further insulating mechanism.
- FIG. 7 shows a push-fit (or snap-fit) insert 500 that is attached to a hole 502 (or any suitable receiving geometry such as a groove or slot) in the distal end of the rotatable shaver element 40 .
- This enables easy positioning of the push-fit insert 500 on the distal end of the rotatable shaver element 40 .
- This brings the same advantages as the insulating portion 400 described above.
- FIG. 8 shows the rotatable shaver element 40 with an insulating layer 600 provided over its surface. This is an alternative technique to the use of a distally projecting insulating portion 400 , and reduces the conductivity between the RF electrodes and the rotatable shaver element.
- FIG. 9 shows the rotatable shaver element 40 with an insulating layer 700 provided on only the distal tip.
- an insulating layer 700 provided on only the distal tip.
- the insulating layer may instead be placed on the hollow conductive tube 36 .
- the layer may be applied to only the internal surface of the hollow conductive tube 36 , as this is the closest section of the hollow conductive tube 36 to the rotatable shaver element 40 which it surrounds and allows the external surface of the hollow conductive tube to act as the return electrode. This reduces the amount of insulating material needed.
- the insulating layer may be provided over the entire hollow conductive tube 36 .
- the insulating layer 600 , 700 may be a diamond like carbon (DLC) or polymer layer applied to the surface of rotatable shaver element. Alternatively, the insulating layer 600 may be provided by an anodized surface.
- DLC diamond like carbon
- the insulating layer 600 may be provided by an anodized surface.
- the layer of insulating material 600 , 700 provided over the rotatable shaver element 40 , the insulating layer provided over the hollow conductive tube 36 , or the insulating portion 400 , 500 at the distal end of rotatable shaver element 40 may be a lubricous material.
- a lubricous material reduces the coefficient of friction, reducing frictional forces with any material in contact with the lubricous material.
- the shaver may experience shedding. Shedding is the generation of particulates due to contact, and thus friction, between the rotatable shaver element and the hollow conductive tube.
- the rotatable shaver element 40 may be constructed from a non-conductive material, such as ceramic. This would prevent the RF current flowing from the active electrode to the rotatable shaver element 40 .
- the inventors envisage a situation where the above described examples relating to insulating layers on multiple parts of the electrosurgical instrument and the insulating portion 400 may be combined. This would further reduce conductivity between the electrodes and the rotatable shaver element. Further, whilst the means of reducing conduction to the rotatable tubular element have been described with respect to an opposite sided shaver, the inventors believe that the methods relating to insulating layers can be applied to a same-sided electrosurgical end effector. In a same-sided end effector, the RF function is located on the same side of the end effector as the cutting window, allowing ablation/coagulation to be used at the same time as the cutting action or at the same location without needing to move the electrosurgical instrument.
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Otolaryngology (AREA)
- Plasma & Fusion (AREA)
- Physics & Mathematics (AREA)
- Neurology (AREA)
- Neurosurgery (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgical Instruments (AREA)
Abstract
A surgical instrument is configured to reduce conductivity between an RF electrosurgical portion and a cutting portion. This reduces improves the efficiency and consistency of the generated RF field, with higher current densities nearest the target tissue, improving the performance of the RF electrosurgical instrument. The conductivity may be reduced using a layer of insulating material, a projecting insulating portion or a cutting portion constructed from an insulating material. Further, by providing a lubricous insulating layer shedding may be reduced, increasing the usable life of the cutting portion.
Description
- Embodiments of the present invention described herein relate to an electrosurgical device, and in particular to an electrosurgical device wherein a means of reducing conductivity is provided between a first cutting portion and a pair of electrodes so as to improve the performance of the device.
- Background to the Invention and Prior Art A prior art arrangement, U.S. Pat. No. 7,150,747 B1, describes a surgical device with a blade used to cut tissue mechanically and to coagulate cut tissue. The blade is electrically conductive and serves as an active electrode in a bipolar arrangement with a return electrode. Electrical energy is transferred to the blade through an electrical connection between the distal region of the blade and a second member which has a lumen for receiving the first member.
- Embodiments of the present invention provide an improved electrosurgical instrument configured to improve the RF field consistency of RF electrodes which in turn improves the performance of RF coagulation and ablation. In a system that provides both bipolar RF functions and a cutting action, the end effector has a complex layout which can cause current to follow unintended paths from the electrodes to other sections of the end effector, such as a rotating cutting edge. It is important to reduce the conductivity of the current path to rotating elements, as this will improve the consistency of the RF field generated.
- Conductivity may be reduced by providing an insulating or isolating portion between the electrodes and the inner cutting member. This may take the form of an insulating layer, or an insulating, projecting portion that not only provides insulation itself but ensures separation between the return electrode and the inner cutting member. Beneficially, the insulating portion can substantially reduce shedding, where the inner and outer blade contact and microscopic blade fragments can be created. This minimises the generation of unwanted particulates within the surgical site, which could adversely affect surgeon visibility and patient anatomy.
- In view of the above, from one aspect the present invention provides an electrosurgical end effector, comprising: a rotary shaver arrangement, having a rotatable tubular element with a cutting portion having a cutting blade formed therein that when in use is able to cut tissue located in an operative cutting direction; an active electrode; a second tubular element concentrically arranged around the rotatable tubular element, the second tubular element having a cutting window formed in a wall thereof such that the cutting blade of the rotatable tubular element is located within the window, wherein the outside surface of the second tubular element is a return electrode; and an insulating portion projecting distally from the distal end of the rotatable tubular element, arranged so as to reduce electrical conductivity between the second tubular element and the first cutting portion.
- Such an arrangement improves upon the known RF shaver arrangements of the prior art by ensuring that the majority of the RF current follows the intended path from the active electrode to the return electrode. Leakage to the rotatable tubular element is reduced through reduced conductivity, improving the RF efficiency and RF performance of the device during ablation and coagulation. When using the coagulation or ablation function of the electrosurgical instrument, the inner cutting member may be “parked” during which it is stationary (no cutting action being performed). The RF field generated is more consistent over a wider range of inner blade ‘parking angles’ as the variable position of the insulated rotatable inner cutting element does not significantly affect the useful RF field generated at the active electrode. By reducing conductivity to the rotatable tubular element that is in close proximity to the plasma generating electrodes, electrical losses are reduced. An axial pre-load force from a hand-piece may be applied to the rotatable tubular element, which forces the cutting portion of the rotatable tubular element into intimate mechanical and electrical contact with the second tubular element. In contrast, the radius of the rotatable tubular element may be separated by a gap from the radius of the second tubular element. Therefore, placing the insulating portion on the distal end of the rotatable tubular element has the greatest impact on reducing conductivity.
- In one embodiment, the insulating portion is in contact with the inner distal end of the second tubular element, acting as the bearing surface between the rotatable tubular element and the second tubular element. In acting as the bearing surface, the insulating portion reduces the area of contact between the rotatable tubular element and the second tubular element. This reduces conductivity, as the only contact between the rotatable tubular element and the second tubular element is through an insulating material. Further, the insulating portion ensures separation between the remaining surfaces of the rotatable tubular element and the second tubular element, acting to provide an insulating gap. In a standard RF shaver there may be shedding, where small pieces of the cutting blade break off due to friction between the blades. By reducing the contact area between the rotatable tubular element and the second tubular element to just the insulating portion, shedding is reduced. This increases the working life of the electrosurgical instrument and reduces the incidence of fragments being left within a patient during surgery.
- In an embodiment, the insulating portion is one of: a ceramic or a polymer. Providing a non-metal insulating portion results in there being no metal-on-metal contact during cutting over the distal hemisphere portion of the inner blade, reducing shedding.
- Moreover, in a further example the insulating portion is overmoulded or deposited on the distal end of the first cutting portion.
- In one embodiment, the insulating portion is a push-fit insert that is inserted into a suitable receiving geometry, wherein the suitable receiving geometry is located on one of: the distal end of the first cutting portion or the inner distal hemisphere of the second tubular element. A push-fit (or snap-fit) insert allows the insulating portion to be easily attached. Geometries may be chosen to allow different benefits, for example the geometry may comprise a hole, a groove or a slot.
- In a further embodiment, the material of the insulating portion is lubricous. A lubricous material reduces the friction between the insulating portion and the second tubular element. This can lead to a more consistent cutting action by preventing snags and allowing the rotatable tubular element to rotate consistently, which may further increase the efficiency of the electrosurgical end effector by reducing energy lost to heat. The lubricous material can also substantially reduce shedding. Further, this allows closer interaction between the cutting blade and the cutting window of the second tubular element, as less distance is required to prevent the sections catching or snagging. This allows a closer, more accurate tissue cutting action.
- Another example describes an electrosurgical instrument, comprising: a hand-piece; one or more user operable buttons on the handpiece that control the instrument; and an operative shaft, having RF electrical connections, and drive componentry for an end effector, the electrosurgical instrument further comprising an electrosurgical end effector according to any of the above, the rotary shaver arrangement being operably connected to the drive componentry to drive the rotary shaver to operate in use, and the active electrode being connected to the RF electrical connections.
- A further embodiment discloses, an electrosurgical system, comprising: an RF electrosurgical generator; a suction source; and an electrosurgical instrument according to the above, the arrangement being such that in use the RF electrosurgical generator supplies an RF coagulation or ablation signal via the RF electrical connections to the active electrode, to permit tissue coagulation or ablation.
- Another aspect of the present invention provides, an electrosurgical end effector, comprising: a rotary shaver arrangement, having a rotatable tubular element with a cutting portion having a cutting blade formed therein that when in use is able to cut tissue located in an operative cutting direction; an active electrode; a second tubular element concentrically arranged around the rotatable tubular element, the second tubular element having a cutting window formed in a wall thereof such that the cutting blade of the rotatable tubular element is located within the window, wherein the outside surface of the second tubular element is a return electrode; and an insulating layer arranged so as to reduce the conductivity between the second tubular element and the first cutting portion.
- This improves upon the known RF shaver arrangements of the prior art by ensuring that the majority of the RF current follows the intended path from the active electrode to the return electrode. Leakage to the rotatable tubular element is reduced through reduced conductivity improving the RF efficiency and RF performance of the device during ablation and coagulation. When using the coagulation or ablation function of the electrosurgical instrument, the inner cutting member may be “parked”. The RF field generated is more consistent over a wider range of inner blade ‘parking angles’ as the variable position of the insulated rotatable inner cutting element does not significantly affect the useful RF field generated at the active electrode. By reducing conductivity to the rotatable tubular element that is in close proximity to the plasma generating electrodes, electrical losses are reduced. An axial pre-load force from a hand-piece may be applied to the rotatable tubular element, which forces the cutting portion of the rotatable tubular element into intimate mechanical and electrical contact with the second tubular element. In contrast, the radius of the rotatable tubular element may be separated by a gap from the radius of the second tubular element. Therefore, the insulating layer between the first cutting portion and the electrodes has the greatest impact on reducing conductivity.
- An example describes how the insulating layer is one of: a surface treatment, such as an anodized layer; a polymer layer; or a diamond like carbon, DLC, layer.
- Another embodiment describes the material of the insulating layer as being lubricous. A lubricous material reduces the friction between the insulating layer and the inner distal end of the second tubular element, which can lead to a more consistent cutting action by preventing snags and allowing the rotatable tubular element to rotate consistently. The lubricous material also prevents or reduces shedding. As there is a lower chance of shedding, the rotatable tubular element and the second tubular element can be located closer together, which provides a more accurate cutting action.
- A further example describes how the insulating layer is a layer covering one or more of: the rotatable tubular element; the distal end of the rotatable tubular element; the internal radius of the second tubular element; and/or the external radius of the second tubular element. Providing an insulating layer on the surface of the rotatable tubular element reduces conductivity. The distal end of the rotatable tubular element is in closest proximity to the second tubular element therefore providing an insulating layer on the distal end can reduce the amount of insulating layer or coating material required, whilst still reducing conductivity. A combination of insulating layers on the rotatable tubular element and second tubular element can reduce conductivity further.
- Another example describes how the rotatable tubular element is constructed of a non-conductive material, such as ceramic, wherein the surface of the non-conductive material acts as the insulating layer. Constructing the inner blade of a non-conductive material isolates the blade from the active electrodes. Beneficially, a separate insulating layer is not required, reducing manufacturing steps.
- Further features and examples will be apparent from the appended claims.
- Embodiments of the invention will now be further described by way of example only and with reference to the accompanying drawings, wherein like reference numerals refer to like parts, and wherein:
-
FIG. 1 is a schematic diagram of an electrosurgical system including an electrosurgical instrument according to an embodiment of the present invention. -
FIG. 2 is a side view of an electrosurgical instrument according to an embodiment of the present invention. -
FIG. 3 is view of the tip ofFIG. 2 , showing the electrosurgical end effector, wherein the RF function is facing upwards. -
FIG. 4 is cross-sectional view of the distal end of the electrosurgical end effector. -
FIGS. 5a and 5b are plan views showing the hollow conductive tube and the rotatable shaver element. -
FIG. 6 is a view of the distal end of the rotating shaver blade, with an insulating portion. -
FIG. 7 is a view of the distal end of the rotating shaver blade, with a push-fit or snap-fit insulating portion. -
FIG. 8 is a side view of the rotating shaver blade, with an insulating layer. -
FIG. 9 is a side view of the rotating shaver blade, with an insulating layer on the distal end of the rotating shaver blade. - Referring to the drawings,
FIG. 1 shows electrosurgical apparatus including an electrosurgical generator 1 having anoutput socket 2 providing a radio frequency (RF) output, via a connection cord 4, for anelectrosurgical instrument 12. Theinstrument 12 has asuction tube 14 which is connected to asuction source 10. Activation of the generator 1 may be performed from theinstrument 12 via a handswitch (not shown) on theinstrument 12, or by means of a footswitch unit 5 connected separately to the rear of the generator 1 by afootswitch connection cord 6. In the illustrated embodiment, the footswitch unit 5 has twofootswitches electrosurgical instrument 12 described herein it is envisaged that only one or other of the coagulation or ablation modes would be used, with cutting being provided mechanically by way of a rotating tube having a sharpened cut-out portion, described further below. The generator front panel haspush buttons Push buttons 9 are provided as an alternative means for selection between the ablation (cutting) and coagulation modes. -
FIG. 2 shows theelectrosurgical instrument 12 forming the basis of an embodiment of the present invention. Theinstrument 12 includes aproximal handle portion 22, ahollow shaft 24 extending in a distal direction away from the proximal handle portion, and anend effector assembly 26 at the distal end of the outer shaft. A power connection cord 4 connects the instrument to the RF generator 1, whereastube 14 connect the instrument to thesuction source 10. The instrument may further be provided with activation buttons (not shown), to allow the surgeon operator to activate either the mechanical cutting function of the end effector, or the electrosurgical functions of the end effector, which in this embodiment typically comprise coagulation or ablation. -
FIG. 3 shows an example of the RF side of theelectrosurgical end effector 26. The instrument comprises anactive electrode 32, the opening to theprimary suction channel 42 and the outer insulatingsheath 34. -
FIG. 4 shows theend effector assembly 26 in more detail, comprising an opposite sided shaver arrangement. The end effector comprises a series of concentrically arranged tubes, with outer insulatingsheath 34 containing a hollowconductive tube 36, having at is distal end an opening cut out of one side thereof to act as a cuttingwindow 66. The edges of the cuttingwindow 66 may be sharpened to provide scissor action in use against acutting edge 38 of a cylindricalrotatable shaver element 40. The hollow,conductive tube 36 acts as a return electrode and concentrically surrounds a rotatablecylindrical shaver element 40. By ‘concentrically surrounds’ we mean that theshaver element 40 is inside and coaxial with thetube 36. The proximal part of thetube 36 is covered with the insulatingsheath 34. The distal part of thetube 36 has the opening which acts as the cuttingwindow 66. The shaver blade itself is a hollow cylinder of C-shape cross-section at the distal end, meaning a hollow cylinder which has a segment cut out for a portion of the distal end. The cut out portion is sharpened and serrated, to form thecutting edge 38. - As just noted, at the distal end of the end effector, the
shaver blade 40 has asharp cutting edge 38, which may be serrated or shaped into points to provide cutting teeth. Thehollow shaver blade 40 in use defines aninternal suction lumen 62, which extends along theshaft 24 and ultimately connects to thesuction source 10. That is, as explained further below, theshaver blade 40 is operative when in use to cut tissue that it is presented against and which is located in a direction to the side of the shaft of the instrument i.e. in a direction orthogonal to the long axis of the instrument. Theactive electrode 32, operatively faces in the opposite direction to the operative direction of theshaver blade 40, so that in use the user may turn the electrosurgical instrument 180 degrees to coagulate or ablate tissue that was cut using the shaver element. - In more detail, to electrosurgically coagulate or ablate tissue, the user manipulates the
instrument 12 such that theactive electrode 32 is adjacent to the tissue to be treated, and activates the generator 1 to supply RF power to theactive electrode 32, via the connection cord 4. The RF signal supplied is dependent on whether the active electrode is to simply coagulate (dessicate) tissue, or to ablate the tissue, wherein a higher power RF signal is used for tissue ablation than tissue coagulation. Theactive electrode 32 and thereturn electrode 36 act in a bipolar electrode arrangement. Thesuction lumen 62 is connected to thesuction source 10 such that fluid, tissue fragments, bubbles or other debris in the vicinity of theelectrode 32 can be aspirated from the surgical site. During operation, rather than entire RF current flowing along the preferred pathway from theactive tip 32 to the hollowconductive tube 36 which acts as a return electrode, there may be a current that does not follow the preferred pathway and reduces system performance. This problem is exacerbated by the positioning of thesuction lumen 62 and theprimary suction channel 42, which, as described above, acts to remove debris from the vicinity of both the electrode and the cutting window. - The line bb indicates the shorter preferential RF tracking path between the
active electrode 32 and thereturn electrode 36. The line cc1 indicates the longer, unintended tracking path through theprimary suction channel 42 to the inner blade edge. The line cc2 indicates the longer, unintended tracking path through theprimary suction channel 42 to the outer blade—whilst still flowing between the electrodes, this reduces current density at the point of electrosurgical application. So as to improve the efficiency and consistency of the generated RF field, it is preferable to reduce current conducted to the rotatable shaver element (path cc1) or along the longer path to the return electrode (path cc2). Due to the nature of the scissor action and positioning of the active electrode, the distal ends of therotatable shaver element 40, the hollowconductive tube 36 and theactive RF electrode 32 are in close proximity. This provides a path for a portion of the RF current to pass from theactive tip 32, through theprimary suction channel 42, to therotatable shaver element 40. - So as to improve the performance of the RF function of the
electrosurgical instrument 12, it is desirable to increase the efficiency and consistency of the RF field. This may be achieved by reducing electrical conductivity between theelectrodes rotatable shaver element 40, reducing the current conducted by therotatable shaver element 40. In some instances, this may include providing electrical isolation between theelectrodes rotatable shaver element 40 to prevent or reduce the RF current flowing to therotatable shaver element 40. This results in an increased proportion of the RF current following the desired path (bb) from theactive electrode 32 to thereturn electrode 36. -
FIG. 5a shows a simplified plan view of theend effector assembly 26 including only the hollowconductive tube 36 and therotatable shaver element 40. Other parts of the end effector have not been included here so as to simplify understanding of the concept. As can be seen, the distal end of therotatable shaver element 36 may be in contact with or close proximity to the hollowconductive tube 36 atpoint 402. So as to prevent a current flowing from the hollowconductive tube 36 to therotatable shaver element 40,FIG. 5b includes an insulatingportion 400. This insulatingportion 400 is made of an insulating material, such as a polymer or ceramic. As shown inFIG. 6 , the insulatingportion 400 is attached to and projects distally from the distal end of therotatable shaver element 40. Alternatively, the insulatingportion 400 may be attached to the concave hemispherical surface of the hollowconductive tube 36 and project towards the convex hemispherical distal end of the rotatable shaver element. The insulatingportion 400 may be over-moulded or deposited on the surface of therotatable shaver element 40. The insulating portion prevents contact between the distal end of therotatable shaver element 40 and the concave hemispherical distal end of the hollowconductive tube 36. Instead, the bearing surface between therotatable shaver element 40 and the hollowconductive tube 36 is the insulatingportion 400. This reduces conductivity, by ensuring that any contact area between therotatable shaver element 40 and the hollowconductive tube 36 is an insulating material. - As described earlier, the
rotatable shaver element 40 and the hollowconductive tube 36 are in closest proximity at the distal tip of theelectrosurgical instrument 12, so that they may act to provide a scissor action. Therefore, reducing conductivity at the distal tip will have the most profound effect on overall conductivity between the electrodes and the rotatable shaver element. In the embodiment ofFIG. 5b , the insulatingportion 400 provides a physical insulating separation at the distal end, as well as resulting in agap 404 between the remaining surfaces of therotatable shaver element 40 and the hollowconductive tube 36. This gap provides a further insulating mechanism.FIG. 7 shows a push-fit (or snap-fit) insert 500 that is attached to a hole 502 (or any suitable receiving geometry such as a groove or slot) in the distal end of therotatable shaver element 40. This enables easy positioning of the push-fit insert 500 on the distal end of therotatable shaver element 40. This brings the same advantages as the insulatingportion 400 described above. -
FIG. 8 shows therotatable shaver element 40 with an insulatinglayer 600 provided over its surface. This is an alternative technique to the use of a distally projecting insulatingportion 400, and reduces the conductivity between the RF electrodes and the rotatable shaver element. -
FIG. 9 shows therotatable shaver element 40 with an insulatinglayer 700 provided on only the distal tip. As described above, due to proximity to the electrodes, providing insulation at the distal end of therotatable shaver element 40 has the greatest effect on reducing conductivity. Beneficially, this requires a smaller portion of therotatable shaver element 40 being covered with an insulating layer, which may reduce the amount of material required, or decrease the time required to apply the insulating layer. - Rather than placing the insulating layer on the
rotatable shaver element 40, it may instead be placed on the hollowconductive tube 36. The layer may be applied to only the internal surface of the hollowconductive tube 36, as this is the closest section of the hollowconductive tube 36 to therotatable shaver element 40 which it surrounds and allows the external surface of the hollow conductive tube to act as the return electrode. This reduces the amount of insulating material needed. Alternatively, the insulating layer may be provided over the entire hollowconductive tube 36. - The insulating
layer layer 600 may be provided by an anodized surface. - The layer of insulating
material rotatable shaver element 40, the insulating layer provided over the hollowconductive tube 36, or the insulatingportion rotatable shaver element 40 may be a lubricous material. A lubricous material reduces the coefficient of friction, reducing frictional forces with any material in contact with the lubricous material. In normal operation, especially where therotatable shaver element 40 and the hollowconductive tube 36 are metals, the shaver may experience shedding. Shedding is the generation of particulates due to contact, and thus friction, between the rotatable shaver element and the hollow conductive tube. This can damage thecutting edge 38 of therotatable shaver element 40, reducing its ability to cut tissue. It may also or alternatively damage the cuttingwindow 36 of the hollow conductive tube. Providing a more effective bearing surface between therotatable shaver element 40 and the hollowconductive tube 36 by using a lubricous material reduces shedding and thus increases the usable life of the electrosurgical instrument. - In an alternative example, the
rotatable shaver element 40 may be constructed from a non-conductive material, such as ceramic. This would prevent the RF current flowing from the active electrode to therotatable shaver element 40. - The inventors envisage a situation where the above described examples relating to insulating layers on multiple parts of the electrosurgical instrument and the insulating
portion 400 may be combined. This would further reduce conductivity between the electrodes and the rotatable shaver element. Further, whilst the means of reducing conduction to the rotatable tubular element have been described with respect to an opposite sided shaver, the inventors believe that the methods relating to insulating layers can be applied to a same-sided electrosurgical end effector. In a same-sided end effector, the RF function is located on the same side of the end effector as the cutting window, allowing ablation/coagulation to be used at the same time as the cutting action or at the same location without needing to move the electrosurgical instrument. - Various modifications whether by way of addition, deletion, or substitution of features may be made to above described embodiment to provide further embodiments, any and all of which are intended to be encompassed by the appended claims.
Claims (16)
1. An electrosurgical end effector, comprising:
a rotary shaver arrangement, having a rotatable tubular element with a cutting portion having a cutting blade formed therein that when in use is able to cut tissue located in an operative cutting direction;
an active electrode;
a second tubular element concentrically arranged around the rotatable tubular element, the second tubular element having a cutting window formed in a wall thereof such that the cutting blade of the rotatable tubular element is located within the window, wherein the outside surface of the second tubular element is a return electrode; and
an insulating portion projecting distally from the distal end of the rotatable tubular element, arranged so as to reduce conductivity between the second tubular element and the first cutting portion.
2. The electrosurgical end effector according to claim 1 , wherein the insulating portion is in contact with the inner distal end of the second tubular element, acting as the bearing surface between the rotatable tubular element and the second tubular element.
3. The electrosurgical end effector according to claim 1 , wherein the insulating portion is one of:
a ceramic; or
a polymer.
4. The electrosurgical end effector according to claim 1 , wherein the insulating portion is overmoulded or deposited on the distal end of the first cutting portion.
5. The electrosurgical end effector according to claim 1 , wherein the insulating portion comprises a push-fit insert that is inserted into a suitable receiving geometry, wherein the suitable receiving geometry is located on one of:
the distal end of the first cutting portion; or
the inner distal hemisphere of the second tubular element.
6. The electrosurgical end effector according to claim 1 , wherein the material of the insulating portion is lubricous.
7. An electrosurgical instrument comprising an electrosurgical end effector according to claim 1 , the electrosurgical instrument comprising:
a hand-piece;
one or more user operable buttons on the handpiece that control the instrument; and
an operative shaft, having RF electrical connections, and drive componentry for the end effector, the rotary shaver arrangement being operably connected to the drive componentry to drive the rotary shaver to operate in use, and the active electrode being connected to the RF electrical connections.
8. An electrosurgical system comprising an electrosurgical instrument according to claim 7 , and further comprising:
an RF electrosurgical generator; and
a suction source;
the arrangement being such that in use the RF electrosurgical generator supplies an RF coagulation or ablation signal via the RF electrical connections to the active electrode, to permit tissue coagulation or ablation.
9. An electrosurgical end effector, comprising:
a rotary shaver arrangement, having a rotatable tubular element with a cutting portion having a cutting blade formed therein that when in use is able to cut tissue located in an operative cutting direction;
an active electrode;
a second tubular element concentrically arranged around the rotatable tubular element, the second tubular element having a cutting window formed in a wall thereof such that the cutting blade of the rotatable tubular element is located within the window, wherein the outside surface of the second tubular element is a return electrode; and
an insulating layer arranged so as to reduce the conductivity between the second tubular element and the first cutting portion.
10. The electrosurgical end effector according to claim 9 , wherein the insulating layer is one of:
a surface treatment, such as an anodized layer;
a polymer layer; or
a diamond like carbon, DLC, layer.
11. The electrosurgical end effector according to claim 9 , wherein the material of the insulating layer is lubricous.
12. The electrosurgical end effector according to claim 9 , wherein the insulating layer is a layer covering one or more of:
the rotatable tubular element;
the distal end of the rotatable tubular element;
the internal radius of the second tubular element; and/or
the external radius of the second tubular element.
13. The electrosurgical end effector according to claim 9 wherein the rotatable tubular element is constructed of a non-conductive material, such as ceramic, wherein the surface of the non-conductive material acts as the insulating layer.
14. An electrosurgical instrument comprising an electrosurgical end effector according to claim 9 , and further comprising:
a hand-piece;
one or more user operable buttons on the handpiece that control the instrument; and
an operative shaft, having RF electrical connections, and drive componentry for an end effector, the rotary shaver arrangement being operably connected to the drive componentry to drive the rotary shaver to operate in use, and the active electrode being connected to the RF electrical connections.
15. An electrosurgical system comprising an electrosurgical end effector according to claim 9 , and further comprising:
an RF electrosurgical generator; and
a suction source;
the arrangement being such that in use the RF electrosurgical generator supplies an RF coagulation or ablation signal via the RF electrical connections to the active electrode, to permit tissue coagulation or ablation.
16. An electrosurgical system comprising an electrosurgical instrument according to claim 14 , and further comprising:
an RF electrosurgical generator; and
a suction source;
the arrangement being such that in use the RF electrosurgical generator supplies an RF coagulation or ablation signal via the RF electrical connections to the active electrode, to permit tissue coagulation or ablation.
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB2013367.4A GB2598332A (en) | 2020-08-26 | 2020-08-26 | Electrosurgical instrument |
GB2013367.4 | 2020-08-26 | ||
GB2014541.3A GB2598404A (en) | 2020-08-26 | 2020-09-15 | Electrosurgical device |
GB2014541.3 | 2020-09-15 |
Publications (1)
Publication Number | Publication Date |
---|---|
US20220061908A1 true US20220061908A1 (en) | 2022-03-03 |
Family
ID=72660866
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US17/391,133 Pending US20220061910A1 (en) | 2020-08-26 | 2021-08-02 | Electrosurgical instrument |
US17/408,560 Abandoned US20220061908A1 (en) | 2020-08-26 | 2021-08-23 | Electrosurgical device |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US17/391,133 Pending US20220061910A1 (en) | 2020-08-26 | 2021-08-02 | Electrosurgical instrument |
Country Status (4)
Country | Link |
---|---|
US (2) | US20220061910A1 (en) |
JP (2) | JP7335926B2 (en) |
DE (2) | DE102021121408A1 (en) |
GB (2) | GB2598332A (en) |
Families Citing this family (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB2612370B (en) * | 2021-11-01 | 2023-10-25 | Gyrus Medical Ltd | Electrosurgical instrument |
GB2621153A (en) | 2022-08-02 | 2024-02-07 | Gyrus Medical Ltd | Erosion fuse to reduce risk of RF tip detachment |
GB2622265A (en) * | 2022-09-08 | 2024-03-13 | Gyrus Medical Ltd | Rotary shaver arrangement for a surgical instrument |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20140276704A1 (en) * | 2013-03-15 | 2014-09-18 | Warsaw Orthopedic, Inc. | Nerve and soft tissue ablation device |
US20140316401A1 (en) * | 2013-03-14 | 2014-10-23 | Intuitive Surgical Operations, Inc. | Sheath assemblies for electrosurgical instruments |
US20190059983A1 (en) * | 2017-08-28 | 2019-02-28 | RELIGN Corporation | Arthroscopic devices and methods |
US20190380774A1 (en) * | 2018-06-18 | 2019-12-19 | Stryker Corporation | Radiofrequency Probe and Methods of Use and Manufacture of Same |
US20220015822A1 (en) * | 2020-07-17 | 2022-01-20 | Olympus Winter & Ibe Gmbh | Surgical handheld device, insulation insert for a surgical handheld device, and method for manipulating a surgical handheld device |
Family Cites Families (24)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6610059B1 (en) * | 2002-02-25 | 2003-08-26 | Hs West Investments Llc | Endoscopic instruments and methods for improved bubble aspiration at a surgical site |
US7150747B1 (en) | 2003-01-22 | 2006-12-19 | Smith & Nephew, Inc. | Electrosurgical cutter |
US7674263B2 (en) | 2005-03-04 | 2010-03-09 | Gyrus Ent, L.L.C. | Surgical instrument and method |
GB2451623A (en) | 2007-08-03 | 2009-02-11 | Gyrus Medical Ltd | Electrosurgical Instrument for underwater surgery with aspiration aperture in electrode |
US8454599B2 (en) | 2008-08-13 | 2013-06-04 | Olympus Medical Systems Corp. | Treatment apparatus and electro-surgical device |
US8372068B2 (en) | 2008-10-21 | 2013-02-12 | Hermes Innovations, LLC | Tissue ablation systems |
GB2477354B (en) * | 2010-02-01 | 2016-02-24 | Gyrus Medical Ltd | Electrosurgical instrument |
DE102012005536A1 (en) * | 2012-03-21 | 2013-09-26 | Olympus Winter & Ibe Gmbh | Surgical milling instrument |
US9078664B2 (en) * | 2012-06-20 | 2015-07-14 | Gyrus Acmi, Inc. | Bipolar surgical instrument with two half tube electrodes |
US9693818B2 (en) * | 2013-03-07 | 2017-07-04 | Arthrocare Corporation | Methods and systems related to electrosurgical wands |
US20150173825A1 (en) | 2013-12-20 | 2015-06-25 | Medtronic Xomed, Inc. | Debridement device having a split shaft with biopolar electrodes |
US10813686B2 (en) * | 2014-02-26 | 2020-10-27 | Medtronic Advanced Energy Llc | Electrosurgical cutting instrument |
US10039915B2 (en) | 2015-04-03 | 2018-08-07 | Medtronic Xomed, Inc. | System and method for omni-directional bipolar stimulation of nerve tissue of a patient via a surgical tool |
WO2017034863A1 (en) * | 2015-08-24 | 2017-03-02 | Smith & Nephew, Inc. | Electrosurgical wand with a spacer and with an active electrode, an associated system and an ablation method including generating a plasma |
US10022140B2 (en) * | 2016-02-04 | 2018-07-17 | RELIGN Corporation | Arthroscopic devices and methods |
WO2017180423A1 (en) * | 2016-04-14 | 2017-10-19 | Smith & Nephew, Inc | Cutting tool with bearing |
GB2552682B (en) * | 2016-08-03 | 2019-02-27 | Gyrus Medical Ltd | Surgical instrument |
US20190008538A1 (en) * | 2017-05-09 | 2019-01-10 | RELIGN Corporation | Arthroscopic devices and methods |
WO2018213465A1 (en) * | 2017-05-16 | 2018-11-22 | Smith & Nephew, Inc. | Electrosurgical systems and methods |
US11883053B2 (en) | 2018-04-23 | 2024-01-30 | RELIGN Corporation | Arthroscopic devices and methods |
US11617596B2 (en) * | 2018-04-30 | 2023-04-04 | RELIGN Corporation | Arthroscopic devices and methods |
US11712290B2 (en) * | 2018-06-08 | 2023-08-01 | RELIGN Corporation | Arthroscopic devices and methods |
US11246650B2 (en) | 2019-01-10 | 2022-02-15 | RELIGN Corporation | Arthroscopic devices and methods |
CN113329709A (en) * | 2019-02-22 | 2021-08-31 | 史密夫和内修有限公司 | Combined electrosurgical and mechanical resection device |
-
2020
- 2020-08-26 GB GB2013367.4A patent/GB2598332A/en active Pending
- 2020-09-15 GB GB2014541.3A patent/GB2598404A/en active Pending
-
2021
- 2021-08-02 JP JP2021126495A patent/JP7335926B2/en active Active
- 2021-08-02 US US17/391,133 patent/US20220061910A1/en active Pending
- 2021-08-18 DE DE102021121408.4A patent/DE102021121408A1/en active Pending
- 2021-08-23 US US17/408,560 patent/US20220061908A1/en not_active Abandoned
- 2021-08-25 JP JP2021137135A patent/JP7339985B2/en active Active
- 2021-08-26 DE DE102021122097.1A patent/DE102021122097A1/en active Pending
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20140316401A1 (en) * | 2013-03-14 | 2014-10-23 | Intuitive Surgical Operations, Inc. | Sheath assemblies for electrosurgical instruments |
US20140276704A1 (en) * | 2013-03-15 | 2014-09-18 | Warsaw Orthopedic, Inc. | Nerve and soft tissue ablation device |
US20190059983A1 (en) * | 2017-08-28 | 2019-02-28 | RELIGN Corporation | Arthroscopic devices and methods |
US20190380774A1 (en) * | 2018-06-18 | 2019-12-19 | Stryker Corporation | Radiofrequency Probe and Methods of Use and Manufacture of Same |
US20220015822A1 (en) * | 2020-07-17 | 2022-01-20 | Olympus Winter & Ibe Gmbh | Surgical handheld device, insulation insert for a surgical handheld device, and method for manipulating a surgical handheld device |
Also Published As
Publication number | Publication date |
---|---|
GB202014541D0 (en) | 2020-10-28 |
GB2598332A (en) | 2022-03-02 |
DE102021121408A1 (en) | 2022-03-03 |
JP7335926B2 (en) | 2023-08-30 |
DE102021122097A1 (en) | 2022-03-03 |
JP2022040065A (en) | 2022-03-10 |
JP7339985B2 (en) | 2023-09-06 |
GB2598404A (en) | 2022-03-02 |
US20220061910A1 (en) | 2022-03-03 |
GB202013367D0 (en) | 2020-10-07 |
JP2022039992A (en) | 2022-03-10 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20220061908A1 (en) | Electrosurgical device | |
EP1853187B1 (en) | Surgical blade assembly | |
JP5981646B2 (en) | Bipolar surgical instrument with two half tube electrodes | |
EP1427340B1 (en) | Surgical system for cutting and coagulation | |
US7699846B2 (en) | Surgical instrument and method | |
JP4785332B2 (en) | Surgical microablation instrument with electrocautery function | |
US10314647B2 (en) | Electrosurgical cutting instrument | |
US8992520B2 (en) | Dual-mode electrosurgical devices and electrosurgical methods using same | |
EP1164961A1 (en) | Device for converting a mechanical cutting device to an electrosurgical cutting device | |
GB2582318A (en) | Electrosurgical device | |
US20090076412A1 (en) | Apparatus and Methods for Obtaining a Sample of Tissue | |
US9730751B2 (en) | Dual-mode electrosurgical devices and electrosurgical methods using same | |
US20230024565A1 (en) | Electrosurgical instrument | |
US20240081895A1 (en) | Rotary shaver arrangement for a surgical instrument | |
US20230132995A1 (en) | Electrosurgical instrument | |
GB2594973A (en) | An operative shaft for an electrosurgical device | |
GB2406057A (en) | Surgical instrument and method |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: GYRUS MEDICAL LIMITED, UNITED KINGDOM Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:MCALEER, LIAM JOHN;LLOYD, THOMAS;DICKSON, JAMES ALAN;SIGNING DATES FROM 20210825 TO 20210907;REEL/FRAME:057783/0702 |
|
STPP | Information on status: patent application and granting procedure in general |
Free format text: DOCKETED NEW CASE - READY FOR EXAMINATION |
|
STPP | Information on status: patent application and granting procedure in general |
Free format text: NON FINAL ACTION MAILED |