Electrosurgical hand instrument and contact body for electrosurgical hand instrument

Description

[0001] The invention relates to a contact body for electrosurgical hand devices according to the preamble of claim 1. The invention also relates to an electrosurgical hand device according to claim 8.

[0002] Electrosurgical hand instruments, such as resectoscopes, are primarily used for endoscopic applications in urology and gynecology, particularly for treating the bladder, uterus, or prostate. However, the applications of these instruments are not limited to these areas of the body but also include the treatment of other organs in the lower abdomen.

[0003] The prior art documents US2001 / 011161A1, WO95 / 19142A1, US6974458B2 and US6105581A are known.

[0004] The instruments described here, such as resectoscopes, typically feature a transport mechanism. To treat diseased tissue, the resectoscope, with its elongated shaft, is inserted through an opening into the patient's body. Various medical instruments for treating and / or examining the patient can be arranged within this shaft. For example, in high-frequency surgery, an electrode capable of delivering high-frequency alternating current, positioned at the distal end of an electrode array, can be guided through the shaft. For manipulating or cutting the tissue, the electrode array with the electrode is movable relative to the shaft and along a shaft axis, allowing the tissue to be manipulated by moving the electrode along or through it.

[0005] The electrode carrier is coupled to the transporter at its proximal end. This positioning of the transporter enables the cutting motion of the electrode. The transporter has a movable contact body, also known as a slide. The electrode carrier can be mechanically coupled to this contact body via an electrical contact. This mechanical connection also allows the electrode carrier, or the electrode, to be supplied with electrical energy. For this purpose, the contact body has a blind hole or opening into which an electrical contact of the electrode carrier can be inserted for the detachable connection. This opening or blind hole is designed such that the RF voltage can be applied via an adjacent connector. Typically, a plug is inserted into the socket, which in turn can be connected to an RF generator via a cable.

[0006] The operation, or longitudinal movement, of the transporter, and thus also of the electrode, is performed by an operator. For this purpose, the transporter is equipped with a handle unit consisting of a first handle and a second handle. To operate the transporter, the operator grasps both the first handle and the second handle, which may include a finger unit or a thumb ring. The first handle may be attached to a stationary main body of the transporter. The second handle may be attached to the contact body.

[0007] The movement of the feed mechanism is achieved against the spring tension of a spring, which in this type of feed mechanism is typically designed as a leaf spring or a torsion spring. This spring is attached at one end to the contact body or slide and at the other end to an end body or optical guide plate of an intensifying tube. The type of spring and the method of actuation of this spring mechanism depend on whether the feed mechanism is active or passive. While the spring in an active feed mechanism is a compression spring, it is a tension spring in a passive feed mechanism.

[0008] Typically, the electrode is cut by a retracting movement of the transporter. With an active transporter, the electrode is retracted against the spring force (in a proximal direction). With a passive transporter, however, the electrode is first advanced against the spring force (in a distal direction), and then, during the retraction caused by the release of the spring, cuts through the tissue (in a proximal direction).

[0009] An optical system can also be guided through the shaft of the instruments described here. The rod-like or shaft-like optical system is guided from the proximal end through a reinforcing tube of the transporter into the shaft. Embodiments are known in which the optical system, either as a rod lens system or as an optical fiber, is guided from a proximal end through the shaft to the distal end. The distal end of the optical system is directed precisely at the area to be operated on or the site of action of the electrode. At the proximal end of the optical system, the surgeon can observe the treatment through an eyepiece or a camera.

[0010] The at least one electrical contact of the electrode system is then connected to the contact body and subsequently pushed through or into the shaft. By actuating the second handle relative to the first handle, the contact body, together with the electrode carrier, can be moved back and forth along the shaft axis via a reinforcing tube.

[0011] At the proximal end of the amplifier tube, it is welded to an optical guide plate. The contact body is movably mounted on the amplifier tube. For this purpose, the contact body has a corresponding bore for the amplifier tube parallel to the shaft axis. This bore is dimensioned such that the contact body, or rather the slide, can be easily slid over the amplifier tube.

[0012] The cleanability of the contact receptacle, or blind hole for the electrode holder contact, has proven to be a particular disadvantage. The small hole diameter and the use of electrical tulip contacts within the blind hole make cleaning extremely difficult. Even machine cleaning cannot guarantee the necessary level of cleanliness. In particular, residues of liquids or particles that enter the receptacle during treatment or the cleaning process are difficult or impossible to remove. Besides the problem of inadequate preparation or cleaning, particles and liquids remaining in the receptacle can lead to contact problems between the electrode holder and the contact within the receptacle.

[0013] Based on this, the invention aims to create an electrosurgical hand device and a contact body that is particularly easy, thorough and time-efficient to clean.

[0014] A contact body for solving this problem has the features of claim 1. Accordingly, the contact body for an electrosurgical hand device has at least one receptacle designed as a through-hole through the contact body. This through-hole, extending from one end face of the contact body to the opposite end face, can be cleaned particularly thoroughly and easily. This channel-like bore through the entire contact body can be rinsed particularly thoroughly with a cleaning medium, such that neither particles nor residual liquid remain in the receptacle. Such a selected receptacle for the electrical contact can also be dried particularly well, so that after the cleaning process the interior of the receptacle is residue-free.

[0015] Preferably, the contact body has two receptacles, each formed as a through-hole through the entire contact body. A contact body designed in this way is intended for receiving and electrically contacting an electrode carrier with two electrical contacts. These electrical contacts, each leading to the distally arranged electrode, particularly via electrode sheathing tubes, can be an active contact and a return contact, or the active electrode and the return electrode.

[0016] Preferably, the two receptacles for the aforementioned electrical contacts are aligned parallel to each other and parallel to a longitudinal axis of the handheld device or the electrode carrier, and lie in a common plane. This symmetry not only results in a particularly compact and space-saving design for the handheld device and the electrode carrier, but also in a favorable shape for the contact body. In particular, the parallel arrangement of the receptacles to a shaft axis, and thus potentially also to a bore for a reinforcing tube for the optics, makes coupling and decoupling the electrode carrier with the contact body especially advantageous. This relative arrangement thus enables not only reliable but also easy-to-use contacting.Even with minimal force, the two contacts can be inserted into and removed from the receptacles. Likewise, the mechanical coupling of the contacts within the contact body is sufficiently strong to withstand forces occurring parallel or perpendicular to the longitudinal axis during treatment.

[0017] In particular, the invention provides that at least one recess of an inner wall has an electrical contact that can be connected to a generator via a connector, in particular a socket, and an electrical connection, the connector preferably being integrated into the contact body. The connector can be arranged perpendicular or parallel to the recess in the contact body. Preferably, the connector is brought from below through the contact body to the channel-like recess. Additionally, it can be particularly advantageous to optionally contact both recesses via corresponding external connectors. This contacting of the two recesses allows a particularly defined and stable electrical potential to be generated at the electrode carrier ends. It is also conceivable that the two connectors or...Plug connections are inserted from the proximal end face into at least one receptacle of the contact body. Alternatively, it is also conceivable that a cable is led out of the contact body, on which a connector is arranged.

[0018] Furthermore, according to the invention, the electrical contact within the at least one receptacle can be designed as a cylindrical, hollow cylindrical, or ring-shaped electrical contact, preferably as a lamellar contact or spiral spring contact. These contact types allow for particularly reliable electrical contacting of the electrode carrier contacts. It is also conceivable that the receptacles are assigned a different contact form for electrical contacting. A particularly advantageous embodiment of the invention can further provide that the distance between the at least one contact and an end face of the contact body, in particular to an outlet of the at least one receptacle, is at least 2 mm, preferably at least 4 mm, and particularly at least 6 mm.

[0019] In another preferred embodiment of the invention, a mechanical locking element extends into at least one receptacle for the releasable coupling of at least one proximal end of the electrode carrier. The locking element is actuated, preferably lockable and / or releasable, by means of a handling device, in particular a spring-loaded button. Preferably, only one of the two contacts of the electrode carrier is locked with the locking element to prevent an electrical short circuit between the two contacts. It is conceivable that the corresponding proximal area on the electrode carrier, where the locking action is performed, has a deformation in cross-section, such as a notch or a recess, into which the locking element can engage. This locking connection is designed such that it can be performed by the operator with one hand.

[0020] Furthermore, an advantageous improvement can be seen in the fact that the bore of the at least one receptacle is funnel-shaped at a distal outlet, in particular that one end face of the contact body has a funnel-shaped depression around the bore of the at least one receptacle. This funnel-shaped form of the receptacle's inlet facilitates the insertion of the electrode carrier contacts into the receptacles. It is sufficient that, when the electrode carrier is brought together with the contact body, the two proximal ends of the electrode carrier are guided into the funnels. The angled shape of the funnel's inner walls then guides the contacts directly into the receptacles. This facilitates contacting the electrode carrier, especially during surgery.

[0021] Furthermore, according to the invention, a seal, in particular a fluid seal, can be arranged in the receptacles or bores in front of or behind the electrical contacts. This seal prevents rinsing fluid from flowing from the shaft through the receptacle of the contact body during treatment and potentially causing an electrical short circuit. This seal keeps the fluid at least largely out of the receptacle. This seal is particularly preferably arranged directly at the distal end of the receptacles.

[0022] It has been found that plastic, especially PTFE, is particularly advantageous for the contact body due to its material properties, such as low conductivity, high electrical resistance, smooth surface, and good machinability. However, it is also conceivable that the contact body could be manufactured from another fluoropolymer, such as PFA. PEEK has also proven to be advantageous. These materials are particularly well-suited because they are especially easy to clean.

[0023] Another solution to the aforementioned problem is described by the features of claim 8. Accordingly, it is provided that an electrosurgical hand device, such as a resectoscope, with an electrode carrier having an electrode at a distal end and at least one electrical contact at a proximal end, has a contact body according to at least one of claims 1-7 in which the at least one proximal end of the electrode carrier can be contacted.

[0024] Preferably, at least one component, in particular a stop, of the handheld device, which is arranged proximally or distally on or abuts the contact body, is made of an electrically non-conductive material or has an electrically non-conductive layer, preferably a coating. This prevents rinsing fluid from passing through the channel-like receptacle during patient treatment and creating an electrical connection between the electrode carrier contact and, for example, the return electrical potential. Alternatively, the receptacle can be extended, for example, by having the proximal end of the receptacle exit not at the proximal end face but at the underside.

[0025] Furthermore, it is conceivable that an electrically conductive component, in particular a stop, of the handheld device is separated from the contact body, preferably an outlet of at least one channel-like receptacle of the contact body, by an air gap, wherein the air gap has a width of at least 1 mm, in particular at least 2 mm. For example, it is conceivable that a stop surface is radially spaced from the outlet of the at least one channel-like receptacle of the contact body.

[0026] Furthermore, it is stipulated that the distance between the electrode and a distal end of a shaft, in particular the optics or an electrode sheath tube, is less than the distance between a proximal end of the electrode carrier and a proximal end face of the contact body and / or less than the distance between an electrical contact and at least one end face of the contact body. This is intended to ensure that during treatment, plasma ignites between the electrode and the neutral electrode and not in the contact body between the proximal end of the electrode carrier and the proximal end face of the contact body.

[0027] A preferred embodiment of the invention is explained in more detail below with reference to the drawing. This drawing shows: Fig. 1 a schematic representation of a resectoscope, Fig. 2 a side view of a contact body, Fig. 3 a view of an end face of the contact body according to Fig. 2 , and Fig. 4 a section through the contact body according to Fig. 2 .

[0028] One possible embodiment of an electrosurgical handheld device, namely a resectoscope 10, is highly schematically shown in the Fig. 1 The resectoscope 10 has a transporter 11 to which an elongated, tube-like shaft 12 can be attached. This shaft 12 is in the Fig. 1 shown hatched and is attached at a proximal end to a main body 13 of the transporter 11.

[0029] The conveyor 11 has a handle unit 14 in addition to the main body 13. This handle unit 14 has a first handle 15 and a second handle 16. While the first handle 15 is fixedly attached to the main body 13, in the embodiment of the conveyor 11 shown here, the second handle 16 is associated with a contact body 17. It is conceivable that the second handle 16 is screwed to the contact body 17. For this purpose, the contact body 17 has a corresponding bore 31 in one of its walls.

[0030] The contact body 17 is guided slidably on a tubular optical guide 18. For this purpose, the contact body 17 has a bore 19 whose diameter is slightly larger than the diameter of the optical guide 18. Since the contact body 17 can move back and forth on the optical guide 18 along a longitudinal direction of the resectoscope 10 or a longitudinal axis of the shaft 12, the contact body 17 is also referred to as a slide.

[0031] While the optical guide 18 is connected at a distal end to the main body 13 or an inner tube 22, an optical guide plate 20 is attached to a proximal end of the optical guide 18. The tubular optical guide 18 extends through the optical guide plate 20, so that the optical guide 18 is accessible from the proximal side.

[0032] The second grip element 16, or contact body 17, is connected to the optical guide plate 20 via a spring element 21. Depending on the design of the transporter 11, this spring element 21 can be a tension spring or a compression spring.

[0033] Starting from the main body 13, a tubular inner tube 22 extends distally. This inner tube 22 can also extend proximally through the main body 13 and be connected to the optical guide 18.

[0034] Parallel to the inner tube 22 extends an electrode carrier 23. This electrode carrier 23 is guided through the main body 13 and is mechanically coupled to the contact body 17 by at least one proximal contact. At a distal end, the electrode carrier 23 has an electrode 24. This electrode 24 can be subjected to an electrical RF voltage. The diseased tissue can be manipulated or cut by means of the thermal energy generated at the electrode 24. For this purpose, the surgeon moves the second handle 16, which has a thumb ring 25, relative to the first handle 15. To stabilize the electrode carrier 23, it can be guided on the inner tube 22 by guides 26.

[0035] To apply the RF voltage to the electrode 24, a receptacle 27 of the proximal contact of the electrode carrier 23 can be electrically contacted. For this purpose, the contact body 17 has at least one connector 29, in particular a plug socket. This connector 29 is in electrical contact with at least a portion of an inner wall of the receptacle 27. The contact body 17 can thus be connected to an RF generator via a cable using a connector (not shown here).

[0036] For the procedure, a rod-shaped optical system is guided through the inner tube 22 or optical guide 18. A distal end of this optical system, not visible here, is directed towards the electrode 24 so that the surgeon can visualize the manipulation of the tissue. This optical system can be a rod lens system or an optical fiber. At the proximal end of the optical system, as shown in the Fig. 1shown, an eyepiece 30 or a camera.

[0037] In the Fig. 2 Figure 17 shows a possible embodiment of a contact body 17. This contact body 17 can be either ring-shaped or cuboid-shaped. PTFE has proven to be a particularly preferred material for this contact body 17. However, other fluoropolymers with similar material properties are also conceivable. PTFE is suitable, among other reasons, because it exhibits particularly low sliding friction. The contact body 17 has a continuous bore 19 through which the optical guide 18 extends when the transporter 11 is assembled. When the transporter 11 is actuated, the contact body 17 is guided along the optical guide 18. To ensure that this guidance by the operator can be carried out without significant effort, the sliding resistance must be kept low.

[0038] The contact body 17 has a bore 31 on one outer wall, into which the second gripping element 16 can be inserted. However, this bore 31 is not strictly necessary. It is conceivable that the second gripping element 16 could also be connected to the contact body 17 in another way.

[0039] According to the invention, a channel-like receptacle 27 extends through the contact body 17 from one end face 32 to the other end face 33 of the contact body 17. The embodiment of the contact body 17 shown here has two of these channel-like receptacles 27, 28 ( Fig. 3, Fig. 4These two receptacles 27, 28 are aligned parallel to each other and parallel to the bore 19. The receptacles 27, 28 are located in the contact body 17 in the same plane and are spaced apart from each other such that the two proximal ends of the electrode carrier 23 can be guided into the receptacles 27, 28. These two proximal ends of the electrode carrier 23 each have an electrical contact, namely, for example, an active contact and a return contact.

[0040] In the receptacles 27, 28, these contacts of the electrode carrier 23 are not only mechanically fixed but also subjected to a predefined electrical potential. To facilitate insertion of the contacts into the receptacles 27, 28, the ends of the receptacles 27, 28 each have a funnel-shaped depression or funnel 34 on the end face 32. This funnel 34 significantly simplifies the coupling of the electrode carrier 23 with the contact body 17.

[0041] The inner walls of the receptacles 27, 28 have electrical contacts. These contacts can be, for example, lamellar contacts or spiral spring contacts. To enable these contacts within the receptacles 27, 28 to be supplied with electrical energy, both receptacles 27, 28 are connected to a connector 29, in particular a two-pole coaxial plug or a corresponding socket for a coaxial plug. These connectors 29 can be, as for example in the Fig. 2 and 3 As shown, the connector 29 is guided from below through the contact body 17 to the receptacles 27, 28. It is also conceivable that the connector 29 extends parallel to the receptacles 27, 28 through the contact body 17. To put the resectoscope 10 into operation, plugs are inserted into the connector 29, which are connected to the generator (not shown) via an electrical conductor or cable.

[0042] In order to not only electrically contact the electrode carrier 23 in the contact body 17, but also to provide mechanical locking to the contact body 17, at least one receptacle 28 is assigned a locking element 36. This locking element 36 is connected to a button 35 via a shaft-like pin 37 ( Fig. 4 The locking element 36 is spring-loaded and actuated by the button 35. Actuating the button 35 pushes the locking element 36 out of the receptacle 28, allowing the electrode carrier 23 with its two contacts to be inserted into the contact body 17. The contact inserted into the receptacle 28 has a recess into which the locking element 36 engages, thus establishing the mechanical coupling. It is equally conceivable that, when the electrode carrier 23 is inserted into the receptacle 28, the locking element 36 is pushed back and engages in the corresponding recess.

[0043] Preferably, the locking device 36 is assigned to only one receptacle 27, 28 in order to avoid the risk of an electrical short circuit between the two receptacles 27, 28.

[0044] The continuous, channel-like recesses 27, 28 are particularly easy to clean. This allows a rinsing fluid to be flushed simply and effectively from one end face 32 to the other end face 33 through the contact body 17. The disadvantage described above, namely that particles remain in a blind hole even after cleaning, is completely eliminated here. Subsequent drying of the contact body 17 is also easily possible.

[0045] To prevent leakage current or electrical breakdown, components of the resectoscope 10 facing an end face 32, 33 of the contact body 17 can be made of an electrically insulating material or have a corresponding coating. This prevents, for example, irrigation fluid that might pass through the images 27, 28 during the operation from establishing electrical contact with another electrical potential.

[0046] The contact body 17 is dimensioned such that the distance between a contact part of the electrode or the contact 38 and one of the end faces 32, 33 is greater than the distance between the electrode 24 and the nearest conductive component, in particular the optics or an electrode sheath tube, at return potential. This ensures that the plasma ignites at the electrode 24 and not in the contact body 17. Reference symbol list 10 Resectoscope 29 Connectors 11 carrier 30 eyepiece 12 shaft 31 Drilling 13 Main body 32 Front 14 Handle unit 33 Front 15 first means of grip 34 funnel 16 second grip 35 Button 17 Contact body 36 Resting agent 18 Optical guidance 37 Pen 19 Drilling 38 electrical contact 20 Optical guide plate 21 spring element 22 Inner tube 23 electrode carrier 24 electrode 25 thumb ring 26 guide 27 Recording 28 Recording

Claims

1. A contact body (17) for an electrosurgical handheld device, in particular a resectoscope (10), with at least one receptacle (27, 28) for a proximal end, having at least one electrical contact, of an electrode carrier (23) of the handheld device, wherein the contact is able to be mechanically and electrically coupled in the receptacle (27, 28), characterized by two receptacles (27, 28) each designed as a continuous bore through the contact body (17), wherein the two receptacles (27, 28) are oriented parallel to each other and also parallel to a longitudinal axis of the handheld device and lie in a common plane and at least one of the receptacles (27, 28) has, on an inner wall, an electrical contact (38) which is connectable to a generator via a plug connector (29) and an electrical connection, wherein the plug connector (29) is preferably integrated in the contact body (17).

2. The contact body (17) as claimed in claim 1, characterized in that the electrical contact (38) is designed, inside the at least one receptacle (27, 28), as a cylindrical, hollow cylindrical or annular electrical contact, preferably as a lamella contact or helical spring contact.

3. The contact body (17) as claimed in claim 1 or 2, characterized in that a distance of the at least one contact (38) from an end face (32, 33) of the contact body (17), in particular from an outlet of the at least one receptacle (27, 28), measures at least 2 mm, preferably at least 4 mm, in particular at least 6 mm.

4. The contact body (17) as claimed in one of the preceding claims, characterized in that a mechanical latching means (36), for releasably coupling at least a proximal end of the electrode carrier (23), extends into at least one receptacle (27, 28), wherein the latching element (36) is able to be actuated, preferably locked and / or released, via a manoeuvering means, in particular a spring-pretensioned button (35).

5. The contact body (17) as claimed in one of the preceding claims, characterized in that the bore of the at least one receptacle (27, 28) has a funnel-like shape at a distal outlet, in particular in that an end face (32) of the contact body (17) has a funnel-like depression or a funnel (34) around the bore of the at least one receptacle (27, 28).

6. The contact body (17) as claimed in one of the preceding claims, characterized in that a seal, in particular a fluid seal, is arranged in the bore, in front of or behind the electrical contact (38).

7. The contact body (17) for an electrosurgical handheld device as claimed in one of the preceding claims, characterized in that the contact body (17) is made of plastic, in particular PTFE, PFA, another fluoropolymer or PEEK.

8. An electrosurgical handheld device, in particular a resectoscope (10), with an electrode carrier (23) which at a distal end has an electrode (24) and at a proximal end has at least one electrical contact, with a grip unit (14) comprising a first gripping means (15) and a second gripping means (16), with a tubular shaft (12) which is coupled with a proximal end to the first gripping means (15), with an optical guide (18) for receiving an optical unit, and a contact body (17) through which the optical guide (18) can be guided, the second gripping means (16) can be fastened, and in which the at least one electrical contact of the electrode carrier (23) can be latched and / or electrically contacted, characterized by a contact body (17) as claimed in at least one of claims 1 through 7.

9. The electrosurgical handheld device as claimed in claim 8, characterized in that at least one component, in particular a stop, of the handheld device, which is arranged in the proximal or distal direction to the contact body (17) or strikes the contact body (17), is made of an electrically non-conductive material or has an electrically non-conductive layer, preferably a coating.

10. The electrosurgical handheld device as claimed in claim 8 or 9, characterized in that an electrically conductive component, in particular a stop, of the handheld device is separated by an air gap from the contact body (17), preferably from an outlet of at least one channel-like receptacle (27, 28) of the contact body (17), wherein the air gap has a width of at least 1 mm, in particular at least 2 mm.

11. The electrosurgical handheld device as claimed in one of claims 8 through 10, characterized in that a distance between the electrode (24) and a distal end of the shaft (12), in particular the optical unit or an electrode casing tube, is less than a distance between a proximal end of the electrode carrier (23) and a proximal end face (33) of the contact body (17) and / or less than a distance between an electrical contact (38) and at least one end face (32, 33) of the contact body (17).