Electrosurgical instrument, electrosurgical device and method for operating an electrosurgical device

Abstract

The invention relates to an electrosurgical instrument which can be connected to a supply device for operation. The electrosurgical instrument has an end opening at the distal end and supports at least one electrode in the region of the end opening to which an alternating voltage potential can be applied. Directly adjacent to the end opening, a lining of the electrosurgical instrument delimits a flow chamber within the lining. With the distance to the end opening, an irrigation channel leads to the flow chamber via an outlet opening and a suction channel leads to the flow chamber via an inlet opening. Irrigation fluid can be introduced into the flow chamber via the irrigation channel and can be extracted by suction via the suction channel. The main part of the irrigation fluid flowing into the flow chamber is discharged from the flow chamber via the suction channel and therefore cannot leave the flow chamber via the end opening (30). In this way, a light inlet surface of a light-conducting device arranged inside the lining can be effectively protected from contamination.

Description

Technical Field

[0001] The invention relates to an electrosurgical instrument which can be supplied with, in particular, electrical energy and an irrigation fluid by means of a supply device. In addition, the supply device can comprise further devices or units which can be electrically and / or fluidically and / or optically connected to the instrument. The invention also relates to an electrosurgical device comprising an electrosurgical instrument connected to the supply device, and a method for operating such an electrosurgical device. Background Art

[0002] EP 2 815 713 A1 describes an electrosurgical instrument comprising a light-conducting device and at least one electrode. Biological tissue can be treated with the aid of the electrode, for example for cutting or coagulating tissue. Light generated due to spark formation between the electrode and the tissue can be captured with the aid of a light inlet window and can be transmitted to a light analysis unit via the light-conducting device. Based on the light analysis, the type of tissue treated with the aid of the at least one electrode can be determined. In order to capture the light, a fluid body is formed on the instrument. During operation of the instrument, the fluid body can be renewed with the aid of a fluid channel and a fluid outlet opening at the distal end.

[0003] A similar electrosurgical instrument is described in EP 3 517 028 A1. Summary of the invention

[0004] It may be seen as an object of the present invention to provide an electrosurgical instrument comprising improved protection against contamination of the light inlet surface of the light conducting means.

[0005] This object is achieved by an electrosurgical instrument having the features of claim 1 , an electrosurgical device having the features of claim 10 , and a method having the features of claim 14 .

[0006] The electrosurgical instrument according to the invention can be configured for open surgery or laparoscopic applications. The electrosurgical instrument has a connection device for connecting to a supply device. By means of the connection device, electrical, optical and fluid connections can be established between the electrosurgical instrument and the supply device. For example, the connection device can include one or more plugs or other suitable connecting elements, by means of which a particularly releasable connection can be established between the supply device and the electrosurgical instrument. The electrical connection, the optical connection and the fluid connection can thus be established by means of one or more common or separate plugs or other suitable connecting elements.

[0007] The electrosurgical instrument further comprises a liner having an end opening at the distal end of the liner. In one embodiment, the liner can be formed by the housing or a portion of the housing, for example in a configuration for open surgery. A portion of the housing can be used as a handle or can include a handle. In addition, one or more operating elements for manual actuation can be provided on the housing.

[0008] The lining can also be formed by a flexible hose, a rigid tube or a combination of flexible hose and rigid tube sections, for example in electrosurgical instruments used in conjunction with an endoscope for laparoscopy or with a flexible endoscope. Depending on the configuration, the lining can therefore be rigid or flexible, at least in sections. For example, the lining can consist of plastic and / or a metal alloy.

[0009] The connection means may be arranged at the proximal end of the liner. The connection means may comprise one or more lines and / or one or more plugs or similar connection elements.

[0010] The instrument has at least one electrode at its distal end. The at least one electrode is electrically connected to the connection means and can thus be connected to a supply device via the connection means. Depending on the embodiment, the at least one electrode is arranged adjacent to the end opening of the liner or extends beyond the end opening in the longitudinal direction, wherein the at least one electrode can extend through the end opening. The longitudinal direction is the direction in which the instrument extends at least adjacent to the end opening of the liner and / or the direction in which the at least one electrode extends adjacent to its distal end. In one embodiment, the plane in which the end opening extends can be oriented orthogonal to the longitudinal direction.

[0011] Electrosurgical instruments can be designed as monopolar or bipolar or multipolar instruments. In the case of monopolar instruments, a single electrode on the instrument is sufficient. An additional electrode, which can be designated as a counter-electrode, can be designed separately from the electrosurgical instrument and can be connected to a supply device. If the electrosurgical instrument is designed as a bipolar instrument, there are at least two electrodes between which a voltage can be applied during operation.

[0012] The electrosurgical instrument also has a light-conducting device optically connected to the connecting device. At its distal end, the light-conducting device includes a light entrance surface, which is arranged inside the lining and is oriented substantially toward the end opening and / or toward the at least one electrode. The light entrance surface is arranged and oriented so that light generated during spark formation at the at least one electrode can be incident through the light entrance surface and can be further optically transmitted via the light-conducting device toward the connecting device. The captured light can be further transmitted to the supply device via the connecting device and can be analyzed there, for example in a light analysis unit. In one embodiment, if the light analysis unit is part of the electrosurgical instrument, the light-conducting device is directly connected to the light analysis unit and the optical connection to the connecting device can be omitted.

[0013] The electrosurgical instrument also includes a flushing channel, which is fluidically connected to the connecting device and preferably extends within the sleeve. The flushing channel has an outlet opening at its distal end, which leads to a flow chamber defined by the liner. The outlet opening is arranged at a distance from the end opening in the longitudinal direction. In the opposite longitudinal direction, the end opening of the liner leads to the flow chamber. From the longitudinal direction, the flow chamber is therefore arranged between the outlet opening and the end opening. The flushing fluid flowing out of the outlet opening forms a flushing fluid flow in the flow chamber. Preferably, the flushing fluid flow is at least substantially directed away from the outlet opening towards the end opening. By means of the flushing fluid flow in the flow chamber, the entry of contaminants that may contaminate the light inlet surface is avoided or at least reduced.

[0014] The electrosurgical instrument further comprises a suction channel which is fluidically connected to the connection device and is preferably arranged inside the sleeve. The suction channel has an inlet opening leading to the flow chamber. Via the inlet opening and the suction channel, at least a portion of the irrigation fluid can be discharged from the flow chamber. Preferably, the suction channel is dimensioned so that substantially all of the irrigation fluid can be discharged from the flow chamber before the irrigation fluid flows out of the flow chamber via the end opening.

[0015] Thus, for example, the amount of rinsing fluid that exits from the end opening and impinges on the biological tissue to be treated can be adjusted. A major part of the rinsing fluid that enters the flow chamber or all of the rinsing fluid that enters the flow chamber can be discharged via the suction channel before the rinsing fluid exits from the end opening. It has been shown that contamination of the optics and in particular of the light inlet opening of the light-conducting device can thereby be significantly reduced, which leads to an improved analysis of the biological tissue actually treated. The volume flow rate of the rinsing fluid can be significantly increased compared to previous instruments and is preferably greater than 1 l / min and can have an amount of, for example, up to 8 l / min.

[0016] In each case, a plurality of suction channels with an inlet opening can be provided. In addition or as an alternative, a plurality of flushing channels can also be provided, which have an outlet opening in each case.

[0017] In one embodiment, the outlet opening of the flushing channel or a section of the flushing channel adjacent to the outlet opening is oriented such that the main flow direction enters the flow chamber parallel to the longitudinal direction or is inclined at an acute angle relative to the longitudinal direction. The main flow direction may be determined by a central axis oriented orthogonal to the plane of the outlet opening.

[0018] The inlet opening of the suction channel is preferably arranged at a distance from the end opening in the longitudinal direction. Advantageously, the inlet opening of the suction channel is arranged closer to the end opening in the longitudinal direction than the outlet opening of the flushing channel. Alternatively, the inlet opening and the outlet opening have an equal distance from the end opening in the longitudinal direction. In this configuration, it is possible that the inlet opening and the outlet opening are arranged in a common plane.

[0019] As already explained, it may be advantageous that the electrosurgical instrument is sized or operated so that no irrigation fluid in the irrigation fluid stream leaves the flow chamber through the end opening. For example, this may be achieved so that the volume flow rate of the irrigation fluid through the irrigation channel is at most as large as the volume flow rate of the flow through the suction channel. In addition, the geometry of the flow chamber and / or the arrangement and orientation of the outlet opening of the irrigation channel and / or the arrangement and orientation of the inlet opening of the suction channel and / or the flow direction of the irrigation fluid stream in the flow chamber may also be selected so that the entry of the irrigation fluid into the suction channel is simplified. For example, the flow chamber may taper toward the end opening. Additionally or alternatively, the outlet opening and the inlet opening may be arranged and oriented so that the irrigation fluid stream includes a flow direction component from the outlet opening toward the inlet opening.

[0020] It is also advantageous if the light inlet surface of the light-conducting device is at a greater distance from the end opening in the longitudinal direction than the outlet opening of the flushing channel. In this way, the protection of the light inlet surface can be further improved.

[0021] In one embodiment, the light inlet surface or a distal end section of the light conducting device adjoining the light inlet surface can be arranged in the flushing channel and / or can be arranged directly adjacent to the outlet opening, so that the light inlet surface or the adjoining distal end section of the light conducting device is surrounded by the flushing fluid flow, in particular before the flushing fluid exits through the outlet opening. Also by means of this measure, an improved protection effect against contamination of the light inlet surface is achieved.

[0022] It may be advantageous if at least one sensor electrically connected to the connection device is arranged next to the suction channel. By means of the at least one sensor, a parameter of the flow or fluid in the suction channel may be detected, such as pressure, volume flow rate, flow velocity or another physical parameter or any combination of a plurality of listed parameters.

[0023] The electrosurgical device according to the invention comprises an electrosurgical instrument corresponding to one of the above-described embodiments. The electrosurgical instrument is connected to a supply device by means of a connecting device. The light analysis unit is optically connected to the light-conducting device or the light inlet surface and is configured to perform an analysis of the captured light, in particular a spectral analysis. The light analysis unit can be part of the electrosurgical instrument or the supply device, or can be constructed separately therefrom. If the light analysis unit is not part of the electrosurgical instrument, the light analysis unit is optically connected to the connecting device so that light can be transmitted to the light analysis unit via the connecting device.

[0024] The supply device has a voltage source electrically connected to the at least one electrode of the electrosurgical instrument. In this way, a voltage potential, in particular a radiofrequency alternating voltage potential, can be applied to the at least one electrode.

[0025] In addition, the supply device comprises an irrigation fluid source connected to the irrigation channel fluidly and a suction unit connected to the suction channel fluidly. By means of the irrigation fluid source, irrigation fluid can be supplied to the irrigation fluid channel and thus an irrigation fluid flow can be generated. By means of the suction unit, a suction flow can be generated through the suction channel in order to discharge at least a portion of the irrigation fluid or all of the irrigation fluid from the flow chamber.

[0026] Thereby, the volume flow rate of the irrigation fluid and the volume flow rate of the suction channel can be adapted to the application, wherein the volume flow rate of the suction flow is at least as great as the volume flow rate of the irrigation fluid and preferably greater. Preferably, the volume flow rate of the suction flow and / or the suction power of the suction unit are adjusted so that no irrigation fluid or only a small part of the irrigation fluid leaves through the end opening of the liner.

[0027] By means of the suction unit, the suction power and / or the volume flow rate of the suction flow can also be adjusted so that smoke or other gases generated during treatment of tissue by means of the electrosurgical instrument are extracted via the end opening, the inlet opening and the suction channel.

[0028] During operation of the electrosurgical device, a voltage potential is applied to the at least one electrode. An irrigation fluid is guided into the flow chamber via the irrigation channel and at least a portion thereof is discharged from the flow chamber via the inlet opening and the suction channel. During tissue treatment, such as cutting or coagulation of tissue, sparks are generated at the at least one light-emitting electrode. The spectrum is specific to the type of tissue being treated. Light can be incident via the light inlet surface and can further be conducted to the light analysis unit by means of the light conduction device, so that the type of tissue being treated can be evaluated in the light analysis unit. The result of the analysis can be indicated to the surgeon optically and / or acoustically and / or tactilely.

[0029] In all embodiments of the present invention, the flushing fluid may be a gas or a liquid. For example, carbon dioxide or air or argon or any combination thereof may be used as the flushing fluid. In particular, argon is suitable for endoscopic use of the apparatus, and carbon dioxide and / or air are suitable for open surgical use of the apparatus. BRIEF DESCRIPTION OF THE DRAWINGS

[0030] Preferred embodiments of the invention are derived from the dependent claims, the description and the drawings. In the following, preferred embodiments of the invention are explained based on the drawings. The drawings include the following figures:

[0031] Figure 1 is a block diagram of an electrosurgical apparatus including an electrosurgical instrument and a supply device,

[0032] Figure 2 is a perspective view of an embodiment of an electrosurgical instrument,

[0033] Figure 3 and 4 The distal end section of an electrosurgical instrument adjoining an embodiment of the electrosurgical instrument is shown in each case in a schematic sectional view,

[0034] Figure 5 is an end section adjacent to the distal end of the electrosurgical instrument of the modified embodiment, and

[0035] Figure 6 An end section of a further exemplary embodiment of an electrosurgical instrument adjoining the distal end of the electrosurgical instrument is shown in a schematic cross-sectional view. DETAILED DESCRIPTION

[0036] Figure 1An electrosurgical device 10 is illustrated in a block diagram. The electrosurgical device 10 comprises an electrosurgical instrument 11 and a supply device 12. The electrosurgical instrument 10 has a connection device 13, which is configured to establish an electrical connection and a fluid connection between the electrosurgical instrument 11 and the supply device 12, and in the embodiment illustrated here, also an optical connection. For this purpose, the connection device can include at least one connection element 14, by means of which a preferably releasable connection can be established with the supply device 12. For example, the at least one connection element 14 can be a plug of the connection device 13.

[0037] In this embodiment, the connection device 13 further comprises a plurality of lines 15, wherein the lines 15 comprise fluid lines, at least one electrical line and optionally at least one optical line. The lines 15 extend from the at least one connection element 14 into the lining 17 of the electrosurgical instrument 11. Figure 1-4 In the embodiment of FIG. 1 , the lining 17 is formed by the shell 16 .

[0038] In a modification of the illustrated embodiment, a plurality of separate connecting elements 14 may also be present, for example a connecting element 14 for connecting the fluid line 15 , a connecting element 14 for connecting the at least one electrical line and optionally a connecting element 14 for connecting the optical line 15 .

[0039] The supply device 12 is configured to supply the fluid necessary for the operation of the electrosurgical instrument 11, to supply electrical energy for the operation and to discharge the fluid. For this purpose, in this embodiment, the supply device 12 comprises a voltage source 18, by means of which a voltage, in particular a radio frequency alternating voltage, can be provided. The supply device 12 further has an irrigation fluid source 19 for supplying irrigation fluid to the electrosurgical instrument, and a suction unit 20. By means of the suction unit 20, the fluid can be discharged from the distal end section of the electrosurgical instrument 11.

[0040] Furthermore, in this embodiment, the electrosurgical device 10 comprises a light analyzing unit 21 arranged outside the housing 16 of the electrosurgical instrument 11. It can be part of the supply device 12, such as Figure 1 As an alternative, the light analyzing unit 21 may also be arranged outside the supply device 12 as a separate unit.

[0041] The electrosurgical instrument 11 has at least one electrode 25 which is electrically connected to the connection device 13. By means of a voltage source 18, a voltage potential and in particular a radiofrequency alternating voltage potential can be applied to the electrode 25 via the connection device 13. Figure 1An embodiment of an electrosurgical instrument 11 in the form of a monopolar instrument is illustrated which comprises only one electrode 25. In order to close the current circuit during the treatment of biological tissue 26 by means of the electrosurgical instrument 11, a separate counter-electrode 27 is electrically connected to the supply device 12 and in particular to the voltage source 18, so that a closed current circuit can be obtained via the biological tissue 26 to be treated. For this purpose, the counter-electrode 27 can be attached to the patient.

[0042] In the right Figure 1 In a modification of the embodiment shown, the electrosurgical instrument 11 can also be configured as a bipolar or multipolar instrument with at least two electrodes 25, so that the separate counter electrode 27 can be omitted. The current circuit can then be closed via the at least two electrodes 25 of the electrosurgical instrument 11 and via the biological tissue 26 to be treated.

[0043] exist Figure 1-4 In the embodiment shown, the electrosurgical instrument 11 is equipped with a handle 28, by means of which the surgeon holds or guides the electrosurgical instrument 11. As in the embodiment, the handle 28 can be formed by a part of the housing 16 or can be attached to the housing 16. In addition, near the handle 28, at least one operating element 29 can be arranged on the housing 16, for example in order to control the supply device 12. For example, by means of the at least one operating element 29, a desired voltage potential can be applied to the electrode 25 and / or the supply of irrigation fluid by means of the irrigation fluid source 19 can be controlled and / or the suction by means of the suction unit 20 can be controlled.

[0044] The liner 17 and, according to this example, the housing 16 have an end opening 30 at their distal end. Figure 1-4 In an embodiment of the present invention, the at least one electrode 25 extends beyond the distal end of the housing 16 or liner 17 in a longitudinal direction L and may extend through the end opening 30. The longitudinal direction L is particularly defined by the direction in which the electrode 25 extends from its distal end and / or the direction in which the longitudinal axis of the liner 17 or housing 16 extends. In this embodiment, the longitudinal direction L is oriented orthogonal to the plane in which the end opening 30 extends.

[0045] like Figure 2 As shown, shell 16 can be made up of a plurality of assembling parts. As its alternative, shell 16 also can be integral.

[0046] The distal end section 16a of the housing 16 adjacent to the end opening 30 is Figure 3 and 41 and 2. The housing 16 delimits a flow chamber 31 directly adjacent to an end opening 30 arranged at the distal end. A flushing channel 32, which preferably extends inside the housing 16 or the bushing 17, has an outlet opening 33 directly adjacent to the flow chamber 31. The flushing channel 32 thus opens into the flow chamber 31 at the outlet opening 33. The flushing fluid F leaving the outlet opening 33 generates a flushing fluid flow SF in the flow chamber 31.

[0047] According to this example, the outlet opening 33 and / or the section of the flushing channel 32 adjoining thereto are oriented at an acute angle with respect to the longitudinal direction L. According to this example, the main flow direction of the flushing fluid flow SF adjacent to the outlet opening 32 corresponds to the longitudinal center axis of the section of the flushing channel 32 adjoining the outlet opening 33, which section may be oriented at an angle of, for example, maximum 30°, maximum 20°, or maximum 10° with respect to the longitudinal direction L. In other embodiments, the main flow direction may also be oriented parallel to the longitudinal direction L.

[0048] In addition, the electrosurgical instrument 11 has a suction channel 34, which leads directly to the flow chamber 31 via an inlet opening 35. Fluid can be discharged from the flow chamber 31 via the suction channel 34, in particular irrigation fluid F. In addition, smoke R generated during the treatment of the biological tissue 26 can be extracted via the suction channel 34. This smoke R can be sucked into the flow chamber 31 via the end opening 30 and can enter the suction channel 34 via the inlet opening 35.

[0049] In this embodiment, the electrode 25 is arranged between the outlet opening 33 of the irrigation channel 32 and the inlet opening 35 of the suction channel 34 , wherein the view is orthogonal to the longitudinal direction.

[0050] In an operating condition of the electrosurgical instrument 11, the suction channel 34 is fluidly connected to the suction unit 20 and the irrigation channel 32 is fluidly connected to the irrigation fluid source 19. In addition, an electrical connection between the voltage source 18 and the electrode 25 is established.

[0051] The electrosurgical instrument further comprises a light-conducting device 40, which comprises a light entrance surface 41 facing the flow chamber 31 or the at least one electrode 25. The light-conducting device 40 can be formed, for example, by an optical fiber (such as a glass fiber). The light entrance surface 41 can be formed by the face of the optical fiber. As an alternative thereto, the optical fiber can be coupled to an optical device (e.g., a lens) arranged at the light entrance surface 41.

[0052] The light inlet surface 41 is oriented so that it can receive light emitted due to spark generation during the treatment of the biological tissue 26. This light is further guided to the light analysis unit 21 via the light conduction device 40 for evaluation, in particular spectral analysis. In this way, the type of treated tissue can be inferred.

[0053] The light inlet surface 41 is sensitive to contamination. By means of the flushing fluid F supplied into the flow chamber 31, contamination of the light inlet surface 41 can be avoided or at least reduced. For example, tissue particles, smoke particles, tissue fluids etc. can reach the light inlet surface 41 and can be collected there. It has been shown that the protection of the light inlet surface 41 from contamination can be improved if the flushing fluid F is at least substantially kept within the flow chamber 31 and does not flow out of the end opening 30 or only a small part flows out of the end opening 30. By the impact of the flushing fluid F on the tissue 26, contamination particles can be thrown out through the end opening 30 on the light inlet surface 41. Since the part of the flushing fluid F that impacts the biological tissue 26 is reduced, the risk of such contamination of the light inlet surface 41 is reduced.

[0054] To this end, in the inventive configuration of the electrosurgical instrument 11, a flow chamber 31 is formed within the bushing 17 or the housing 16, so that the irrigation fluid F can be discharged via the suction channel 34 before it leaves the bushing 17 or the housing 16. Advantageously, substantially all of the irrigation fluid F is discharged via the suction channel 34, which is fed via the irrigation channel 32 in the flow chamber 31. As explained, in addition, smoke R can also be conveyed away from the treatment location via the suction channel 34.

[0055] In order to protect the light inlet surface 41, the flushing fluid F surrounds the light inlet surface 41 and in particular the section of the light conducting device 40 adjoining thereto, in particular before the flushing fluid F enters the flow chamber 31 at the outlet opening 33. For this purpose, the distal end section of the light conducting device 40 adjoining the light inlet surface 41 is arranged directly adjacent to or within the flushing channel 32, e.g. Figure 3 and 4 Thus, advantageously, the light entry surface 41 is at a greater distance in the longitudinal direction L from the end opening 30 than the exit opening 33 .

[0056] It is also preferred that the outlet opening 33 comprises a distance in the longitudinal direction L to the distally arranged end opening 30 which is at least as great as the distance in the longitudinal direction between the inlet opening 35 and the end opening 30 of the suction channel 34. With this arrangement, extraction by suctioning the irrigation fluid F from the flow chamber 31 is simplified or improved.

[0057] During operation of the electrosurgical instrument 11, the mass or volume flow rate supplied to the flow chamber 31 via the irrigation channel 32 by means of the irrigation fluid source 19 is at most as great as the mass or volume flow rate of the flow into the suction channel 34 regulated by means of the suction unit 20. Preferably, the mass or volume flow rate of the flow into the suction channel 34 is greater than the mass or volume flow rate into the irrigation channel 32.

[0058] The embodiments of electrosurgical instrument 11 described thus far are particularly configured for open surgical use. Figure 5 Detailed description of the invention A modified embodiment of an electrosurgical instrument is shown which is also particularly suitable for laparoscopic interventions or interventions with a flexible endoscope or minimally invasive surgical interventions.

[0059] Figure 5 A schematic cross section of a distal end section 17a of a liner 17 of an electrosurgical instrument is shown. In this embodiment, the liner 17 is formed by a flexible hose 45 or a rigid tube 46. The liner 17 can also be configured as a flexible hose 45 in at least one section and as a rigid tube 46 in at least one section. In this embodiment, the liner 17 has a hollow cylindrical shape at least in the distal end section 17a.

[0060] Inside the liner 17, an electrode support 47 is arranged, which is electrically connected to at least one electrode 25 and an electrical conductor 48. The electrical conductor 48 extends inside the liner 17 and is electrically connected to the connection device 13. In this embodiment, the electrode support 47 is arranged in an inner hose 49 or an inner tube 50. A flexible inner hose 49 or a rigid inner tube 50 suitable for the liner 17 can be selected.

[0061] The irrigation channel 32 extends through an inner hose 49 or an inner tube 50, which extends, for example, along the longitudinal axis of the lining 17. In this embodiment, the light-conducting device 40 and the light inlet surface 41 are arranged in the irrigation channel 32. In the distal region of the irrigation channel 32, an electrode support 47 is arranged adjacent to the irrigation channel 32, which can, for example, coaxially surround the irrigation channel 32. A thermal barrier can be arranged between the electrode support 47 and the irrigation channel 32, which is, for example, part of a barrier element 51. According to this example, a first section of the barrier element 51 coaxially surrounds the distal end section of the irrigation channel 32 and forms the outlet opening 33. Adjoining this first section, which extends coaxially with the irrigation channel 32, the barrier element 51 comprises a cup-shaped second section arranged inside the flow chamber 31.

[0062] Starting from the electrode support 47, the at least one electrode 25 extends through the barrier element 51 into the interior of the cup-shaped second section of the barrier element 51. The at least one electrode 25 preferably ends with its distal end in the second section of the barrier element 51. According to the example, the distal end of the barrier element 51 is at the same level as the distal end of the inner hose 49 or the inner tube 50. According to the example, the distal end of the inner hose 49 or the inner tube 50 and / or the distal end of the barrier element 51 is arranged at a distance in the longitudinal direction L from the distally arranged end opening 30 in the liner 17.

[0063] According to this example, the suction channel 34 is formed by the radial distance between the inner hose 49 or inner tube 50 on one side and the liner 17 (hose 45 or tube 46). Preferably, a plurality of spacers 52 are arranged in the suction channel 34 distributed in the circumferential direction so as to define the relative position between the inner hose 49 or inner tube 50 on the one hand and the liner 17 on the other hand. The inner hose 49 or inner tube 50 can be arranged coaxially and / or in a non-coaxial manner at least in sections, coaxially and / or in a non-coaxial manner relative to each other at least in sections. The flow through the suction channel 34 can pass through the spacers 52. The size and / or shape and / or position and / or surface characteristics of one or more or all of the spacers 52 can be selected in order to influence the flow characteristics of the flow through the suction channel 34. For example, the volume flow rate through the suction channel 34 can be specifically adjusted or blocked.

[0064] Also according to Figure 5 In the embodiment of the present invention, the inlet opening 35 of the suction channel 34 and the outlet opening 33 of the flushing channel 32 are arranged inside the liner 17 and are at a certain distance from the end opening 30 of the liner 17 in the longitudinal direction L. Figure 5 It is evident that the distance between the outlet opening 33 and the end opening 30 is greater than the distance between the inlet opening 35 and the end opening 30 .

[0065] The above-described embodiment of the electrosurgical instrument 11 or electrosurgical device 10 operates during treatment of biological tissue 26 as follows:

[0066] The electrosurgical instrument 11 is connected to the supply device 12 by means of the connection means 13. If necessary, a counter electrode 27 is attached to the patient and is also connected to the supply device 12. As explained above, in the bipolar electrosurgical instrument 11 a separate counter electrode 27 is not necessary.

[0067] By means of the at least one operating element 29, the surgeon controls the operation of the electrosurgical instrument 11 and applies, for example, an alternating potential to the at least one electrode 25 in order to treat (for example, cut or seal) biological tissue 26. As a result, a spark is generated at the electrode 25, the light of which enters the light entry surface 41 and is further conducted to the light analysis unit 21 via the light conduction device 40. The light analysis unit 21 is configured to analyze the received light, in particular by means of a spectral analysis, in order to determine the type of tissue 26 actually treated by means of the electrosurgical instrument 11.

[0068] During the treatment, irrigation fluid F is introduced into the irrigation channel 32 by means of the irrigation fluid source 19 and flows into the flow chamber 31 via the outlet opening 33. Adjacent to the outlet opening 33, an irrigation fluid flow SF is formed in the flow chamber 31. In this embodiment, the main part of the irrigation fluid F flowing into the flow chamber 31, and in particular at least 75% or at least 80% or at least 90%, and further preferably all of the irrigation fluid F, is discharged from the flow chamber 31 via the suction channel 34. At most a small part of the irrigation fluid F can leave the flow chamber 31 through the end opening 30. Preferably, no irrigation fluid F leaves through the end opening 30. The extraction of the irrigation fluid F by suction from the flow chamber 31 is carried out by means of the suction unit 20, which adjusts a correspondingly large volume flow rate or partial vacuum and thus a correspondingly large suction power in order to obtain the desired effect. The smoke R generated during the treatment of the tissue 26 is also sucked into the suction channel 34 through the end opening 30 and the inlet opening 35 and discharged.

[0069] In all embodiments, at least one sensor 55 may be arranged in the suction channel 34. The at least one sensor 55 is preferably electrically connected to the connection device 13, so that the electrical sensor signal can be transmitted to the supply device 12 via the connection device 13. The at least one sensor 55 is configured to detect flow parameters within the suction channel 34, such as pressure, flow velocity, volume flow rate, etc. In order to measure different parameters, a plurality of different sensors 55 may be provided. In this embodiment, there is the possibility of controlling the suction unit 20 based on the desired value of the at least one flow parameter in a closed loop.

[0070] exist Figure 6 , a distal end section 16a of another modified embodiment of the electrosurgical instrument 11 is illustrated. The electrosurgical instrument 11 is provided with a distal end section 16a of another modified embodiment of the electrosurgical instrument 11. Figure 3 and 4 In the following, the following will explain about Figure 3 and Figure 4 The differences of the embodiments and apart from that, reference will be made to the above description.

[0071] According to Figure 3 and Figure 4 Unlike the first embodiment of the present invention, the housing 16 has a distal end section 16a in which a region 57 having a cross section that can be modified by means of an adjustment device 56 directly adjoins the end opening 30. The region 57 of the end section 16a of the housing 16 can consist, for example, of a flexible or elastic material that can be elastically deformed under the influence of the adjustment device 56. Thus, the flow cross section of the end opening 30 as well as the flow cross section in the region 57 can be adjusted by means of the adjustment device 56. According to this example, the adjustment device 56 can be actuated manually, for example by means of a finger 58.

[0072] An adjustment ring 59 movably supported around the region 57 in the longitudinal direction L is part of the adjustment device 56. The region 57 comprises a non-constant outer diameter and / or a non-constant outer circumferential portion. The position of the adjustment ring 59 relative to the region 57 defines its outer circumferential portion at this position. This, in turn, defines the inner cross section of the region 57 and therefore the flow cross section as well as the cross section of the end opening 30. In other words, depending on the relative position of the adjustment ring 59 and the region 57 in the longitudinal direction L, the region 57 of the distal end segment 16a becomes larger or smaller in the radial direction of the longitudinal direction L.

[0073] In this embodiment, the adjustment ring 59 is arranged on a bracket 60, which is movably supported on the housing 16 in the longitudinal direction L. For example, the bracket 60 can be movably arranged on a cylindrical support portion 61 along the longitudinal direction L. The support portion 61 can be at least partially formed by the housing 16 and / or an additional component connected to the housing 16. At least a portion of the bracket 60 can partially or completely surround the support portion 61 in the circumferential direction around the longitudinal direction L.

[0074] In the distal direction, a stop 62 may be provided on the support portion 61 in order to limit the movement of the bracket 60 in the longitudinal direction and, therefore, the movement of the adjustment ring 59 in the longitudinal direction L. In this embodiment, a single stop 62 is provided which limits the movement of the bracket 60 and the adjustment ring 59 in the distal direction. Additionally or alternatively, if necessary, further stops may be provided which limit the movement in the proximal direction. Figure 6 In the embodiment shown, the movement in the proximal direction is limited because the region 57 transitions at a point in the non-deformable, in particular inelastic, part of the housing 16 , so that the adjustment ring 59 can be moved at most into the non-deformable part of the housing 16 .

[0075] The invention relates to an electrosurgical instrument 11 which can be connected to a supply device 12 for operation. The electrosurgical instrument 11 has an end opening 30 at the distal end and supports at least one electrode 25 in the region of the end opening 30 to which an alternating potential can be applied. Directly adjacent to the end opening 30, a lining 17 of the electrosurgical instrument 11 delimits a flow chamber 31 within the lining 17. With the distance to the end opening 30, an irrigation channel 32 leads to the flow chamber 31 via an outlet opening 33 and a suction channel 34 leads to the flow chamber 31 via an inlet opening 35. An irrigation fluid F can be introduced into the flow chamber 31 via the irrigation channel 32 and can be extracted by suction via the suction channel 34. The main part of the irrigation fluid F flowing into the flow chamber 31 is discharged from the flow chamber 31 via the suction channel 34 and therefore cannot leave the flow chamber 31 via the end opening 30. In this way, a light inlet surface 41 of a light-conducting device 40 arranged inside the lining 17 can be effectively protected from contamination.

[0076] List of reference numerals:

[0077] 10 Electrosurgical Devices

[0078] 11 Electrosurgical instruments

[0079] 12 Supply Equipment

[0080] 13 Connection device

[0081] 14 Connecting elements

[0082] 15 lines

[0083] 16 Housing

[0084] 16a Distal end section of the housing

[0085] 17 Lining

[0086] 17a Distal end section of liner

[0087] 18 Voltage Source

[0088] 19 Flushing Fluid Source

[0089] 20 Suction unit

[0090] 21. Optical analysis unit

[0091] 25 Electrodes

[0092] 26 Biological tissue

[0093] 27 Counter electrode

[0094] 28 Handle

[0095] 29 Operating elements

[0096] 30 End Open

[0097] 31 Flow Chamber

[0098] 32 Flushing channel

[0099] 33 Exit opening

[0100] 34 Suction channel

[0101] 35 Entrance opening

[0102] 40 Light transmission device

[0103] 41 Light entry surface

[0104] 45 Hose

[0105] 46 tubes

[0106] 47 Electrode support

[0107] 48 Electrical conductors

[0108] 49 Inner hose

[0109] 50 Inner tube

[0110] 51 Barrier element

[0111] 52 Spacer

[0112] 55 Sensor

[0113] 56 Adjustment device

[0114] 57 The region of the distal end section of the housing

[0115] 58 fingers

[0116] 59 Adjustment ring

[0117] 60 Bracket

[0118] 61 Supporting part

[0119] 62 Stopper

[0120] F Flushing fluid

[0121] L Longitudinal direction

[0122] R - Smoke

[0123] SF Flushing Fluid Flow

Claims

1. An electrosurgical instrument (11) comprising: - a connecting device (13) which is designed to be connected to the supply device (12), - a liner (17) having an end opening (30) at a distal end of the liner (17), - at least one electrode (25) electrically connected to the connection device (13), the electrode being arranged adjacent to the end opening (30) or extending beyond the end opening (30) in the longitudinal direction (L), - a light conducting device (40) comprising a light entry surface (41) arranged inside the lining (17), - a flushing channel (32) fluidically connected to the connection device (13), the flushing channel comprising an outlet opening (33), the outlet opening opening opening into a flow chamber (31) defined by the liner (17), and the flushing channel being arranged at a distance from the distally arranged end opening (30) in the longitudinal direction (L), so that a flushing fluid (F) flowing through the flushing channel (32) flows out of the outlet opening (33) and generates a flushing fluid flow (SF) in the flow chamber (31) from the outlet opening (33) in the direction of the end opening (30), and - a suction channel (34) which is fluidically connected to the connection device (13), the suction channel comprising an inlet opening (35) leading to the flow chamber (31) and being configured to receive at least a portion of the flushing fluid (F) of the flushing fluid flow (SF) via the inlet opening (35) and to discharge it from the flow chamber (31), At least a distal end section of the light conducting device (40) adjoining the light inlet surface (41) is arranged in the flushing channel (32), the light inlet surface (41) of the light conducting device (40) being further away from the end opening (30) than the outlet opening (33) in the longitudinal direction (L).

2. The electrosurgical instrument according to claim 1, wherein: The inlet opening (35) of the suction channel (34) is arranged at a distance from the end opening (30) in the longitudinal direction (L).

3. The electrosurgical instrument according to claim 1, wherein: The inlet opening (35) of the suction channel (34) is arranged closer to the end opening (30) in the longitudinal direction (L) than the outlet opening (33) of the flushing channel (32), or wherein The inlet opening (35) and the outlet opening (33) are at an equal distance from the end opening (30) in the longitudinal direction (L).

4. An electrosurgical instrument according to any one of claims 1 to 3, wherein: The flow chamber (31) and / or the suction channel (34) are dimensioned such that the flushing fluid flow (SF) cannot flow out of the end opening (30).

5. The electrosurgical instrument according to any one of claims 1 to 3, wherein: At least one sensor (55) electrically connected to the connection device (13) is included in the suction channel (34) and is configured to detect pressure and / or flow parameters within the suction channel (34).

6. An electrosurgical instrument according to any one of claims 1 to 3, wherein: The lining (17) is part of a housing (16) on which the connection device (13) is arranged at the proximal end.

7. An electrosurgical instrument according to any one of claims 1 to 3, which is configured as a flexible endoscopic or laparoscopic instrument, and the liner (17) comprises a flexible hose (45) and / or a rigid tube (46).

8. An electrosurgical device (10) comprising an electrosurgical instrument (11) according to any of the preceding claims and a supply device (12) connected to the electrosurgical instrument (11) by means of the connection device (13), in, A light analysis unit (21) is provided, which is optically connected to the light conducting device (40) and is configured to analyze the light received via the light inlet surface (41). wherein the supply device (12) comprises a voltage source (18) which is electrically connected to the at least one electrode (25) of the electrosurgical instrument (11) so as to apply an electric potential to the at least one electrode (25), The supply device (12) comprises a flushing fluid source (19) which is fluidically connected to the flushing channel (32) so as to supply flushing fluid (F) to the flushing channel (32). And wherein the supply device (12) comprises a suction unit (20) configured to generate a suction flow and fluidically connected to a suction channel (34) of the electrosurgical instrument (11) so as to discharge at least a portion of the irrigation fluid (F) of the irrigation fluid flow (SF) from the flow chamber (31) via the inlet opening (35) and the suction channel (34).

9. The electrosurgical device according to claim 8, wherein: The supply device (12) is configured to adjust the volume flow rate of the flushing fluid (F) by means of the flushing fluid source (19) and to adjust the volume flow rate of the suction flow by means of the suction unit (20), wherein the volume flow rate of the suction flow is at least as great as the volume flow rate of the flushing fluid.

10. The electrosurgical device according to claim 8, wherein: The supply device (12) is configured to adjust the volume flow rate and / or the suction power of the suction flow by means of the suction unit (20) so that no flushing fluid (F) exits from the end opening (30) of the liner (17).

11. An electrosurgical device according to any one of claims 8 to 10, wherein: The supply device (12) is configured to adjust the volume flow rate and / or the suction power of the suction flow by means of the suction unit (20) so that smoke generated during the treatment of tissue (26) can be sucked through the end opening (30) of the liner (17).

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