Application cap of / for a plasma-surgical apparatus
Patent Information
- Application Number
- EP2023798385
- Authority / Receiving Office
- EP · EP
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2022-10-26
- Filing Date
- 2023-10-25
- Publication Date
- 2025-09-03
Smart Images
Figure 1.1
Abstract
Description
[0001] Application cap of a plasma surgical device(s)
[0002] Description
[0003] Technical area
[0004] The present disclosure relates to an application cap for a plasma surgical instrument(s) which is provided as a spacer, according to independent claim 1, and to a plasma surgical instrument for treating a target tissue with a plasma arc, comprising the application cap, according to independent claim 10.
[0005] Background of the invention
[0006] Plasma surgical procedures, as well as plasma applicators and similar devices / equipment for their application, are generally known. For example, a plasma surgical procedure known as figuration or spray coagulation has been used in surgical operations for more than 50 years, particularly for thermal hemostasis.
[0007] In this process, a plasma is generated exclusively in air, meaning that predominantly oxygen plasma and nitrogen plasma are produced. Both plasmas are known to be chemically highly reactive and produce carbonization effects, pyrolysis effects, and consequently vaporization of tissue and smoke on the tissue surface. These unintended side effects of figuration or spray coagulation disrupt or hinder the application of this plasma surgical procedure, especially in endoscopic operations. Therefore, the gas has generally been replaced with a noble gas, particularly argon, to avoid these disadvantages. State of the art
[0008] For example, DE 10 208 004 843 B4 discloses a plasma treatment device used for flexible endoscopy. Due to its design, this device can be used to perform plasma surgical treatment within a human body. In this known surgical device, a probe or catheter is placed within an endoscope or inserted into its working channel. The probe or catheter conducts electrical energy from a high-frequency current / voltage source or generator to an electrode at the distal end of the probe / catheter (hereinafter referred to simply as the probe) via a connecting cable placed inside the probe / catheter.
[0009] At the electrode, the applied electrical energy creates a plasma arc between the tip of the electrode and a nearby body tissue / target tissue. The electrode is located at the distal end of the probe and thus protrudes distally beyond the endoscope or out of its working channel.
[0010] According to DE 10 208 004 843 B4, an additional resistance element, specifically a capacitive resistance element, is arranged between the distal end of the connecting cable laid in the probe and the proximal end of the electrode, thus directly connecting it to the electrode. This resistance element is designed to limit the power supplied by the current-voltage source, hereinafter referred to as the "generator," which flows through the target tissue and thus the human body. This arrangement ensures that the resistance element is placed as close as possible to the proximal end of the electrode. This proximity prevents stray capacitances occurring in the system (due to cable sections between the resistance element and the electrode) from having an excessive influence on the voltage drop between the electrode tip and the target tissue.The current flowing through the target tissue is thus limited in a defined / definable manner primarily by the resistance between the connecting lead and the electrode. Description of the disclosure.
[0011] The present disclosure is based on the object of providing a spacer that enables safe and targeted treatment of target tissue. Furthermore, a particular aim of the present disclosure is to eliminate or at least improve disadvantages of the prior art.
[0012] This object is achieved by an application cap / attachment which is provided as a spacer with the features of claim 1 and a plasma surgical instrument with the features of claim 10.
[0013] Accordingly, the application cap / attachment for a plasma surgical instrument, preferably of a minimally invasive design, is provided as an (electrically insulating) spacer and is designed to be coupled / attached to a distal end of an endoscopic delivery device (endoscope) for the plasma surgical instrument. The application cap is provided and designed to form a spatial volume (at least partially enclosed by a preferably rigid outer wall / circumferential wall of the application cap) at its distal portion and to maintain at least a minimum distance between a distal end of an electrode that can be inserted or is inserted / inserted into the application cap and the target tissue.The application cap is further provided and configured to have at least one wall region, which in turn is provided and configured to come into contact with a target tissue and in which at least one treatment opening is formed. The at least one treatment opening forms a first treatment opening surface section and a second treatment opening surface section, wherein the first treatment opening surface section is oriented / points in a different direction than the second treatment opening surface section.
[0014] In other words, the application cap has a wall region / body edge designed to come into contact with a target tissue and to maintain a minimum distance between the distal end of the electrode and the target tissue. The application cap is designed at its distal portion to enclose a spatial volume and form a treatment opening with a defined treatment opening area.The treatment opening surface is positioned and / or aligned such that an electrode projecting into the spatial volume, and in particular its distal end, has a first predetermined minimum distance and a second predetermined minimum distance from the target tissue in the treatment opening surface for generating the arc, wherein the treatment opening is provided and designed such that the wall region / body edge rests proportionally on the target tissue such that either the first minimum distance or the second minimum distance is closer to the target tissue. In this case, the distance to the wall region / body edge does not change, but rather only when the endoscope is guided to the target tissue. This means that the distances between the treatment openings are different and thus the distance is predefined and cannot be changed.
[0015] In other words, the application cap provides at least one treatment opening which extends over two, preferably adjacent, sides (preferably in the radial Z-side direction and in the axial direction) of the application cap.
[0016] In other words, the basic idea of the present disclosure is to provide an application cap / spacer, preferably as a separate component / part from the delivery device / introduction aid / endoscope, which is adapted to be optionally mounted as an additional component to the distal end / end section of the delivery device, for example of the endoscope type. The spacer / attachment / application cap primarily has the function of keeping the distal end of the delivery device at a specific distance from a patient-side target tissue when the spacer rests on the target tissue against a designated contact section of the spacer.
[0017] The application cap / attachment is cap-shaped in such a way that a treatment surface / tissue contact surface of the application cap has a defined treatment opening / treatment opening surface, and a probe / electrode is arranged so as to protrude into the application cap / attachment or can be inserted into it. More specifically, the invention proposes a type of attachment / plug-on or slip-on (application) cap for a delivery device (an endoscope), with which a surgical instrument (electrode) for treating a target tissue / body tissue by means of a plasma arc can be introduced. The application cap / attachment is attached / attachable, in particular cap-shaped, to the distal end / end section of the delivery device or to its (endoscope) head. The electrode / probe has a distal end and a proximal end.Typically, the proximal end of the electrode is connected or connectable to a power source. The power source, alternatively a generator or current / voltage source, provides the energy to generate a plasma arc, thus enabling treatment of the target tissue.
[0018] The attachment is preferably rounded or convex, at least on the outside. The attachment is made of an electrically non-conductive—in other words, an electrically insulating—material, such as plastic or ceramic.
[0019] The treatment opening according to the invention in the application cap therefore has a section / area that is designed / intended to rest on the target tissue / body tissue of a patient. The treatment opening or its border can therefore come into contact with the target tissue and thus define a treatment region that defines an area of a certain size corresponding to the tissue region intended for treatment. In this case, the treatment opening is oriented both axially towards the distal end and radially towards the side, such that it can rest on the target tissue both distally and radially. At this point, it should be noted that in this case, reference is generally always made to a treatment opening that is oriented in two directions, whereby this can be understood to mean a single opening or at least two separate openings that are oriented in both directions.The application cap according to the invention offers the advantage that, in the case of a single treatment opening, only a part of the treatment opening, i.e. a first treatment opening section (in the distal direction) or a second treatment opening surface section (in the radial direction), rests on / against the target tissue, depending on which treatment opening (surface) section brings the target tissue closer to the distal end of the electrode. Thus, it is up to the user to guide the instrument with the application cap / attachment in such a way as to position a specific / desired part of the treatment opening or the treatment opening surface in contact with the target tissue. The option of choosing whether an arc is generated via the first or the second treatment opening surface section makes it significantly easier for the user to reach the target tissue to be treated.Furthermore, the application of only a part of the treatment opening has the advantage that the user is able to further simplify the positioning of a section of the treatment opening surface, since the attachment according to the invention offers more scope for exposing the target tissue.
[0020] Further aspects of the present disclosure according to the subclaims are described below.
[0021] It is advantageous if the first treatment opening surface section and the second treatment opening surface section are formed contiguously, so that they form a single treatment opening. In other words, the first treatment opening surface section together with the second treatment opening surface section forms a single treatment opening, which, however, extends over the sides of the application cap facing in different directions.
[0022] Alternatively, the first treatment opening section and the second treatment opening section can be separated from one another by a web, such that the first treatment opening surface section points in a first direction and the second treatment opening surface section points in a second direction, and the web forms a type of edge between the two treatment opening surface sections. According to a preferred embodiment, the first treatment opening surface section and / or the second treatment opening surface section can be surrounded by a support edge / border designed to come into surface contact with the target tissue. Preferably, the support edge / border and the treatment opening surface section surrounded thereby can lie substantially in one plane. This ensures a flat support surface.
[0023] According to a further development of the preferred embodiment, a first support edge / border surrounding the first treatment opening surface section and the first treatment opening surface section can lie in a flattened / planar (support) region which extends transversely, preferably perpendicularly, to the longitudinal axis of the application cap.
[0024] According to a further development of the preferred embodiment, a second support edge / border surrounding the second treatment opening surface section and the second treatment opening surface section can lie in a flattened / planar (support) region which extends off-center and at an acute angle in the distal direction to the longitudinal axis of the application cap.
[0025] According to a further development of the preferred embodiment, the support edge / border can enclose the respective treatment opening surface section by at least half of the circumference of the respective treatment opening surface section or completely. This provides a suitably large surface area for application.
[0026] According to a preferred embodiment, the application cap can have a spout (enclosing a through-hole), preferably arranged laterally with respect to the longitudinal axis of the application cap, or a through-hole arranged laterally through which the electrode can be inserted from the outside into the spatial volume of the application cap. This makes it possible to guide the electrode into the spatial volume. According to a further development of the preferred embodiment, the application cap can be designed to be essentially closed on the outside, in particular on the circumference and / or front side, apart from the treatment opening and / or the spout or the through-hole for the electrode. This ensures that the electrode only acts in the desired direction.
[0027] According to a further development of the preferred embodiment, the application cap can have a peripheral wall which encloses the spatial volume and in which the spout is arranged or the through-hole is formed.
[0028] According to a preferred embodiment, the grommet or through-hole can form a seal between the application cap and an electrode that can be inserted or plugged into the application cap through the grommet or through-hole. This has the advantage of sealing the electrode from the outside.
[0029] According to a further development of the preferred embodiment, the seal can be designed as an elastic component separate from the peripheral wall, preferably inserted into the peripheral wall and bonded to the peripheral wall. For example, the seal can be made of a thermoplastic elastomer.
[0030] It is preferred if the application cap has the spout or the through-hole, which is arranged and designed at a predetermined angle α, preferably between 20° and 90°, more preferably between 69° and 75°, and even more preferably (exactly) 72° inclined to the longitudinal axis of the application cap, such that an arc can be generated in the direction of the first treatment opening surface section or the second treatment opening surface section via the electrode which can be inserted into the application cap through the spout or the through-hole, preferably depending on whether the target tissue is arranged closer to the electrode in the first treatment opening surface section or in the second treatment opening surface section. Alternatively or additionally, it is preferred if the predetermined angle α is between 20° and 45° if an arc is directed “forward” in the frontal oris generated substantially in the direction toward the first treatment opening surface section. Alternatively or additionally, it is preferred if the predetermined angle a is between 45° and 90° when an arc is generated "downward" in the lateral direction or substantially in the direction toward the second treatment opening surface section.
[0031] It is advantageous if the first treatment opening surface section is arranged or formed at the distal end, preferably forming an orthogonal surface to the longitudinal axis of the application cap, and the second treatment opening surface section is arranged or formed substantially opposite the spout or the through-hole.
[0032] It is advantageous if the second treatment opening surface section is inclined by more than 90° and less than 115°, preferably by 107.57° (according to (ß) in Fig. 1) relative to the first treatment opening surface section. The angle of inclination of the second treatment opening surface section is inclined in such a way as to achieve optimal tightening / smoothing of the target tissue to be treated.
[0033] It is advantageous if the first treatment opening surface section has a first predetermined minimum distance from the electrode insertable through the nozzle, and the second treatment opening surface section has a second predetermined minimum distance from the electrode insertable through the nozzle, wherein the first minimum distance is greater than the second minimum distance. Alternatively, it is preferred if the electrode is permanently installed in the nozzle and thus functions as a single unit.
[0034] It is preferred if the application cap is designed in such a way as to self-retainingly fix the electrode to the outside of the application cap while maintaining the predetermined first minimum distance and the predetermined second minimum distance. In other words, it is preferred if no working channel is provided through which the electrode / probe runs, but rather the electrode / probe can be fixed externally and can be inserted / pushed directly into the application cap via the nozzle. Alternatively, it is advantageous if the electrode can be inserted into a conventional working channel. This allows the tissue surface to be taut and, during application in a forward direction through the first treatment opening surface section, the distance to the tissue surface can be better estimated.
[0035] It is advantageous if an edge is formed at the proximal end of the second treatment opening surface section, which edge is intended for abrading or scraping the target tissue. The edge is provided on the wall region provided at the proximal end of the second treatment opening surface section. The edge preferably has a radius of less than or equal to 0.5 mm.
[0036] It is preferred if the grommet is designed to be stretchable or flexible, at least when inserting the electrode.
[0037] Furthermore, it is advantageous if the application cap is designed to be attachable to the plasma surgery device via an adapter. In other words, the application cap can integrally comprise an adapter at its proximal end, which is intended and designed to be attached / slid onto / slipped onto the distal end of a plasma surgery device.
[0038] Alternatively, the application cap and adapter are designed as two parts / separately. In this case, the application cap and adapter can be plugged together and then, together, attached / slid onto / slipped onto the distal end of a plasma surgery device.
[0039] It is advantageous if both the application cap and the adapter have a guide groove for guiding the electrode / probe.
[0040] Furthermore, the present disclosure relates to a plasma surgical instrument, preferably of a minimally invasive design, wherein an electrode is provided at the distal end of the instrument, which electrode is adapted to generate an arc upon supply of electrical energy in a specific gas environment and at at least a predetermined minimum distance from a target tissue, with an application cap according to one of the preceding aspects.
[0041] Short description of the characters
[0042] Fig. 1 is a sectional view along a cross-sectional longitudinal axis AA according to Fig. 3 of a first embodiment of the application cap according to the present disclosure;
[0043] Fig. 2 is a diagram illustrating the first embodiment of the application cap according to the present disclosure;
[0044] Fig. 3 is a proximal to distal view of the application cap according to the present disclosure;
[0045] Fig. 4 is a bottom view of the application cap according to the present disclosure;
[0046] Fig. 5 is a side view of the application cap according to the present disclosure;
[0047] Fig. 6 is a plan view of the application cap according to the present disclosure;
[0048] Fig. 7 is a schematic view of a plasma surgical instrument with the application cap according to the present disclosure;
[0049] Fig. 8 is a schematic side view of a front portion of the plasma surgical instrument with the application cap according to the present disclosure; Fig. 9 is an exploded view of the application cap that can be attached to a plasma surgical instrument;
[0050] Fig. 10 is an exploded side view according to Fig. 9; and
[0051] Fig. 11 is a perspective view of a second embodiment of the application cap according to the present disclosure.
[0052] Description of the embodiments
[0053] An embodiment of the present disclosure will be described below based on the accompanying figures. Figures 1 to 10 show a first embodiment of an application cap 1 according to the present disclosure. Figure 11 shows a second embodiment of the application cap 1 according to the present disclosure.
[0054] Fig. 1 is a sectional view along a cross-sectional longitudinal axis AA according to Fig. 3 of the first embodiment of the application cap 1 according to the present disclosure. Fig. 1 shows the application cap 1 for a plasma surgical instrument or a plasma surgical instrument, which is provided as a spacer. The application cap 1 can be plugged onto or coupled to a distal end of an (endoscopic) delivery device / an endoscope. The application cap 1 forms a spatial volume 2 at its distal section. The spatial volume 2 can in particular be at least partially, preferably largely, enclosed by a preferably rigid outer wall / circumferential wall 17 of the application cap 1.
[0055] As shown in Fig. 1, the application cap 1 is provided and designed to receive or insert an electrode 3, wherein it is provided to maintain at least a minimum distance d1, d2 from a distal end of the electrode 3 inserted into the application cap 1 to a target tissue.
[0056] The application cap 1 has a wall section 4, which is intended and designed to come into contact with the target tissue. At least one treatment opening 5 is formed in the wall section / region 4. The treatment opening 5 is an opening provided in the application cap 1, which exposes / exposes an area of the target tissue. The at least one treatment opening 5 forms a first treatment opening surface section 6 and a second treatment opening surface section 7. The first treatment opening surface section 6 and the second treatment opening surface section 7 are oriented in different directions.
[0057] In other words, the application cap 1 has, on a distal cap section, essentially an outwardly convexly rounded hollow cone, the cone tip and a peripheral wall section of which are separated, resulting in a continuous opening which is oriented both in the axial direction distally (first treatment opening surface section 6) and in the radial direction to the side (second treatment opening surface section 7).
[0058] That is, as shown in Fig. 1, the first treatment opening surface section 6 points in the distal direction, and the second treatment opening surface section 7 points in the radial direction (downward according to Fig. 1). As already indicated, the first treatment opening surface section 6 and the second treatment opening surface section 7 are connected in order to form a single treatment opening 5. Alternatively, the first treatment opening surface section 6 and the second treatment opening surface section 7 can also be separated from one another by a web 11. In this case, the web 11 forms a type of edge between the first treatment opening surface section 6 and the second treatment opening surface section 7.
[0059] The application cap 1 has a through-hole 8 or a grommet 8 enclosing the through-hole, preferably radially opposite the second treatment opening surface section 7. The through-hole or grommet 8 is intended to accommodate the electrode / probe 3 so that it protrudes into the spatial volume 2 of the application cap in order to generate an arc with a target tissue in the direction of the first treatment opening surface section 6 or the second treatment opening surface section 7. The grommet or through-hole 8 forms a seal for sealing between the application cap 1 and an electrode 3 that can be inserted or inserted into the application cap 1 through the grommet 8 or through-hole 8.
[0060] The nozzle 8 or the through-hole is provided at a predetermined angle to the longitudinal axis 9 of the application cap 1, so that an arc can be generated via the electrode 3 and a target tissue in the first treatment opening surface section 6 and the treatment opening surface section 7 without having to change the position of the electrode 3. The predetermined minimum distance d1 between the electrode (tip) 3 and the first treatment opening surface section 6, as well as d2 between the electrode (tip) 3 and the second treatment opening surface section 7, is maintained.
[0061] It is preferred if the predetermined angle a of the grommet 8 to the longitudinal axis 9 is substantially between 10° and 80°, preferably 72°. Alternatively or additionally, it is preferred if the predetermined angle a is between 20° and 45° if an arc is generated "forward" in the frontal direction or substantially in the direction towards the first treatment opening surface section 6. Alternatively or additionally, it is preferred if the predetermined angle a is between 45° and 90° if an arc is generated "downward" in the lateral direction or substantially in the direction towards the second treatment opening surface section 7.
[0062] As shown in Fig. 1, the first treatment opening surface section 6 is arranged / formed at the distal end. This means that the first treatment opening surface section 6 forms a surface orthogonal to the longitudinal axis 9 of the application cap 1. The second treatment opening surface section 7 is arranged substantially opposite the spout 8. The second treatment opening surface section 7 is preferably inclined by more than 90° and less than 115° to the first treatment opening surface section 6. It is preferred if the angle β, which is between the first treatment opening surface section 6 and the second treatment opening surface section 7, is 107.57°. An angle γ is preferably between 20° and 110°, more preferably between 80° and 100°, more preferably (exactly) 89.57°. The angle γ indicates the inclination between the inclination of the second treatment opening surface section 7 and the inclination of the spout 8 orthe inserted electrode / probe 3.
[0063] The first treatment opening surface section 6 has the first predetermined minimum distance d1 from the electrode 3 insertable through the grommet or the through-hole 8. The first predetermined minimum distance d1 is preferably between 5.66 mm and 7.66 mm, more preferably 6.66 mm. The second treatment opening surface section 7 has the second predetermined minimum distance d2 from the electrode 3 insertable through the grommet or the through-hole 8. The second predetermined minimum distance d2 is preferably between 1 mm and 7.5 mm, more preferably 4.96 mm. It is essential that the first predetermined minimum distance d1 is greater than the second predetermined minimum distance d2.As a result, a user is forced to press the application cap 1 with the distal end against the target tissue in such a way that the distance between the distal end of the electrode 3 and the target tissue when generating an arc via the first treatment opening surface section 6 is smaller than to the target tissue via the second treatment opening surface section 7.
[0064] As shown in Fig. 1, the application cap 1 is designed to self-retainingly fix the electrode 3 to the outside of the application cap 1 while maintaining the first predetermined minimum distance d1 and the second predetermined minimum distance d2.
[0065] Fig. 2 is a representation to illustrate the application cap 1 according to the present disclosure. Fig. 2 is a schematic representation of the application cap 1 according to the above description of Fig. 1. Accordingly, Fig. 2 shows the application cap 1, which forms or defines a spatial volume 2 at its distal section. The treatment opening 5 is shown in Fig. 2 and is defined by a wall region / body edge 4. In Fig. 2, the first treatment opening surface section 6 and the second treatment opening surface section 7 are shown contiguously as a (single) treatment opening 5. For better clarity, the reference numerals 6 and 7 are omitted in Fig. 2. In Fig. 2, the treatment opening 5 is provided in the distal direction and in the downward direction of the application cap 1.
[0066] The wall region / body edge 4, which defines or delimits / surrounds the first treatment opening surface section 6, is semicircular in plan view. The wall region / body edge 4, which delimits the second treatment opening surface section 7, is thus formed in side view by two parallel, spaced-apart webs or strips that adjoin the semicircular wall region 4, forming a smooth transition.
[0067] Furthermore, it is preferred if a guide groove 12 is provided in the upper side of the application cap 1, extending from the spout 8 in the longitudinal direction of the cap. The guide groove 12 is designed to guide the electrode 3 on the outside of the application cap 1 and hold it in position. In other words, the guide groove 12 serves to prevent the electrode 3 from slipping laterally.
[0068] Fig. 3 is a proximal-to-distal view of the application cap 1 according to the present disclosure. Fig. 3 shows the electrode 3 located in the guide groove 12, which protrudes through the nozzle 8 into the volume 2 of the application cap 1.
[0069] Figs. 4 to 6 are various views of the application cap 1 with the wall region 4 and the spout or through-hole 8. Fig. 4 is a bottom view of the application cap 1 according to the present disclosure. Fig. 5 is a side view of the application cap 1 according to the present disclosure, and Fig. 6 is a top view of the application cap 1 according to the present disclosure.
[0070] Fig. 7 is a schematic view of a plasma surgical instrument 13 with the application cap 1 according to the present disclosure, and Fig. 8 is a schematic side view of a front part of the plasma surgical instrument 13 with the application cap 1 according to the present disclosure. Both Fig. 7 and Fig. 8 show the proximal end of the plasma surgical instrument 13. The application cap 1 is plugged / placed onto the plasma surgical instrument 13. The probe / electrode 3 is arranged / attached, preferably fixed, on the outside of the plasma surgical device 13. The distal end of the probe / electrode 3 is inserted into the application cap 1. To securely fix the electrode / probe 3, a fixation ring 14 is provided, which encloses the electrode / probe 3 and the distal end of the plasma surgical instrument 13 with the application cap 1 placed thereon.In other words, the fixing ring 14 is designed according to a banderole, preferably in the form of an adhesive strip or a rubber band, in order to hold / fix the electrode / probe 3 in its position.
[0071] Fig. 9 is an exploded view of the application cap 1, which can be plugged onto a plasma surgical instrument 13, and Fig. 10 is an exploded side view according to Fig. 9. In Figs. 9 and 10, seen from distal to proximal, the application cap 1, an adapter 15, the fixation ring 14 and the plasma surgical instrument 13, preferably an endoscope, with the probe / electrode 3 on its outer side. The probe / electrode 3 and the instrument 13 are preferably not formed as a single piece. The application cap 1 and the adapter 15 are formed separately from one another here, for example. The adapter 15 is designed such that it can be plugged together or connected to the application cap 1, preferably by means of an adhesive, so that alternatively the application cap 1 and the adapter 15 form a unit or become one piece.
[0072] Fig. 11 shows a second embodiment of the application cap 1. In contrast to the first embodiment, the application cap 1 has a seal 16, which is formed separately from an outer wall / circumferential wall 17 (or the adapter 15) surrounding the spatial volume 2. Preferably, the seal 16 can be inserted into a corresponding recess in the outer wall 17 and, in particular, glued to the outer wall 17. The seal 16 forms the through-hole 8 or the grommet 8 (enclosing the through-hole), through which the electrode 3 can be inserted from the outside into the spatial volume 2. The seal 16 serves to seal between the application cap 1 and the electrode 3.
[0073] The seal 16 can preferably be made of an elastic material. In contrast, the outer wall 17 enclosing the spatial volume 2 can preferably be made of a rigid plastic. The outer wall 17 can, for example, be made of a transparent plastic.
[0074] The adapter 15 can preferably be plugged onto the application cap 1 (or alternatively plugged in) and in particular glued to the application cap 1. In the second embodiment, the adapter 15 is designed as a connecting sleeve and can preferably be substantially annular in cross-section. The connecting sleeve is made of an elastic material, preferably the same material as the seal 16. The connecting sleeve forms a plug-in opening 18, with which it can be plugged onto an endoscope. Due to its elasticity, the connecting sleeve can be plugged onto endoscopes of different diameters.
[0075] As in the first embodiment, the guide groove 12, which is preferably semicircular in cross-section, is formed in the (outer) upper side of the application cap 1 in the longitudinal direction of the cap. The guide groove 12 extends from the through-hole 8 in a proximal direction. The guide groove 12 serves to guide, in particular to hold the electrode 3 laterally. In the second embodiment, the guide groove 12 is formed in sections by the seal 16, in sections by the outer wall 17, and in sections by the adapter 15. Reference numerals
[0076] 1 application cap
[0077] 2 Room volume
[0078] 3 Electrode / Probe
[0079] 4 Wall area / body edge
[0080] 5 Treatment opening
[0081] 6 first treatment opening area section
[0082] 7 second treatment opening area section
[0083] 8 Grommet / through hole
[0084] 9 Longitudinal axis
[0085] 10 edge
[0086] 11 jetty
[0087] 12 guide groove
[0088] 13 Plasma surgical instrument
[0089] 14 Fixation ring
[0090] 15 adapters
[0091] 16 Seal
[0092] 17 Exterior wall
[0093] 18 Mounting opening d1 first minimum distance d2 second minimum distance
Claims
Claims 1. Application cap (1) for a plasma surgical instrument (13), preferably of the minimally invasive type, which is provided as a spacer and is designed to be coupled / attached to a distal end of an endoscopic delivery device for the plasma surgical instrument, wherein the application cap (1) is provided and designed to - to form a spatial volume (2) at its distal section, - to maintain at least a minimum distance (d1, d2) of a distal end of an electrode (3) insertable into the application cap (1) from the target tissue, and - to have at least one wall region (4) which is provided and designed to come into contact with a target tissue and in which at least one treatment opening (5) is formed, characterized in that the at least one treatment opening (5) forms a first treatment opening surface section (6) and a second treatment opening surface section (7), wherein the first treatment opening surface section (6) is oriented in a different direction than the second treatment opening surface section (7).
2. Application cap (1) according to claim 1, characterized in that the first treatment opening surface section (6) and the second treatment opening surface section (7) are formed contiguously to form a single treatment opening (5).
3. Application cap (1) according to claim 1 or 2, characterized in that the first treatment opening surface section (6) and / or the second treatment opening surface section (7) is surrounded by a support edge which is designed to come into contact with the target tissue in a planar manner.
4. Application cap (1) according to claim 3, characterized in that the support edge and the treatment opening surface section (6, 7) surrounded thereby lie substantially in one plane.
5. Application cap (1) according to claim 3 or 4, characterized in that a first support edge surrounding the first treatment opening surface section (6) and the first treatment opening surface section (6) lie in a flattened region which extends transversely, preferably perpendicularly, to the longitudinal axis of the application cap (1).
6. Application cap (1) according to one of claims 3 to 5, characterized in that a second support edge surrounding the second treatment opening surface section (7) and the second treatment opening surface section (7) lie in a flattened region which extends off-center and at an acute angle in the distal direction inclined to the longitudinal axis of the application cap (1).
7. Application cap (1) according to one of claims 3 to 6, characterized in that the support edge encloses the respective treatment opening surface section at least by half the circumference of the respective treatment opening surface section (6, 7) or completely.
8. Application cap (1) according to one of claims 1 to 7, characterized in that the application cap (1) has a laterally arranged spout or a laterally arranged through-hole (8), preferably with respect to the longitudinal axis of the application cap (1), through which the electrode (3) can be inserted from the outside into the spatial volume (2) of the application cap (1).
9. Application cap (1) according to claim 8, characterized in that the grommet or the through-hole (8) forms a seal for sealing between the application cap (1) and the electrode (3) which can be inserted or inserted through the grommet or the through-hole (8).
10. Application cap (1) according to claim 8 or 9, characterized in that the application cap (1) is designed to be substantially closed on the outside, in particular on the peripheral side and / or on the front side, apart from the treatment opening (5) and / or the nozzle or the through-hole (8) for the electrode (3).
11. Application cap (1) according to claim 8 to 10, characterized in that the application cap (1) has a peripheral wall which encloses the space volume (2) and in which the spout is arranged or the through hole (8) is formed.
12. Application cap (1) according to claim 11, characterized in that the seal (16) is designed as an elastic component which is separate from the peripheral wall (17), preferably inserted into the peripheral wall (17) and glued to the peripheral wall (17).
13. Application cap (1) according to one of claims 8 to 12, characterized in that the grommet or the through-hole (8) is arranged and designed at a predetermined angle (α), preferably inclined at 72° to the longitudinal axis (9) of the application cap (9), such that an arc can be generated in the direction of the first treatment opening surface section (6) or the second treatment opening surface section (7) via the electrode (3) which can be inserted into the application cap (1) through the grommet or the through-hole (8) or is located therein, preferably depending on whether the target tissue is arranged closer to the electrode (3) in the first treatment opening surface section (6) or in the second treatment opening surface section (7).
14. Application cap (1) according to one of claims 1 to 13, characterized in that the first treatment opening surface section (6) is arranged or formed at the distal end, preferably forming an orthogonal surface to the longitudinal axis (9) of the application cap (1) and the second treatment opening surface section (7) is arranged or formed substantially opposite the spout or the through-hole (8).
15. Application cap (1) according to one of claims 1 to 14, characterized in that the second treatment opening surface section (7) is inclined by more than 90° and less than 115°, preferably by 107.57° to the first treatment opening surface section (6).
16. Application cap (1) according to one of claims 8 to 15, characterized in that the first treatment opening surface section (6) has a first predetermined minimum distance (d1) from the electrode (3) that can be inserted through the grommet or the through-hole (8) and the second treatment opening surface section (7) has a second predetermined minimum distance (d2) from the electrode (3) that can be inserted through the grommet or the through-hole (8), wherein the first minimum distance (d1) is greater than the second minimum distance (d2).
17. Application cap (1) according to one of claims 1 to 16, characterized in that the application cap (1) is designed to self-retainingly fix the electrode (3) on the outside of the application cap (1) while maintaining the predetermined first minimum distance (d1) and the predetermined second minimum distance (d2).
18. Application cap (1) according to one of claims 1 to 17, characterized in that an edge (10) is formed at the proximal end of the second treatment opening surface section (6), which edge is intended for abrading or scraping the target tissue.
19. Application cap (1) according to one of claims 8 to 20, characterized in that the grommet or the through-hole (8) is designed to be stretchable or flexible, at least when the electrode (3) is inserted.
20. Application cap (1) according to one of claims 1 to 19, characterized in that the application cap (1) distally has a tunnel section, in particular in the form of a wall with a semicircular cross section, which preferably increases in diameter from distal to proximal, with a, in particular in cross section a tunnel opening formed substantially perpendicular to the longitudinal axis of the application cap (1) and forming the first treatment opening surface section (6) and a tunnel base formed, in particular substantially perpendicular to the radial direction of the application cap (1), forming the second treatment opening surface section (7) and preferably having a ring section proximally.
21. Plasma surgical instrument (12), preferably of minimally invasive design, wherein an electrode (3) is provided at the distal end of the instrument, which electrode is adapted to generate an arc upon supply of electrical energy in a specific gas environment and at at least a predetermined minimum distance (d1, d2) from a target tissue, with an application cap (1) according to one of the preceding claims.