Interface joint

Abstract

Various embodiments provide an interface joint for interconnecting an electrosurgical generator, a fluid supply unit, and an electrosurgical instrument. The interface joint includes a housing having an electrical inlet for receiving radio frequency (RF) electromagnetic (EM) energy and / or microwave frequency EM energy from the electrosurgical generator, a fluid inlet for receiving fluid from the fluid supply unit, and an outlet. The interface joint also includes a single cable assembly for connecting the outlet to the instrument tip of the electrosurgical instrument. The single cable assembly includes a flexible shaft having a coaxial cable connected to the electrical inlet and a fluid channel in fluid communication with the fluid inlet. The housing includes a first portion and a second portion, the second portion being attached to the single cable assembly such that rotation of the second portion causes rotation of the single cable assembly, and the first portion being rotatable relative to the second portion. The first portion has a first inlet and the second portion has a second inlet, the first inlet being one of the fluid inlet or the electrical inlet and the second inlet being the other of the fluid inlet or the electrical inlet.

Description

Technical Field

[0001] The present invention relates to an interface joint for interconnecting an electrosurgical instrument to a fluid supply unit and an electrosurgical generator. Such an electrosurgical instrument may be for supplying high-frequency energy and / or microwave frequency energy to biological tissue.

Background Art

[0002] Surgical resection is a means of removing a part of an organ from the body of a human or animal. Such organs may have a large number of blood vessels. When tissue is cut (divided or transected), small blood vessels called arterioles are damaged or ruptured. Following initial bleeding, a coagulation cascade occurs in which the blood is changed into a blood clot in an attempt to seal the bleeding point. During surgery, it is desirable for the patient to lose as little blood as possible, and thus various devices have been developed in an attempt to provide a bloodless cut. Also, in the case of endoscopic surgery, blood flow can obstruct the surgeon's view, which can cause the surgery to be prolonged, aborted, and potentially require the use of another method such as an open surgery. Therefore, bleeding is undesirable and needs to be addressed in an appropriate manner.

[0003] Electrosurgical generators are widespread in hospital operating rooms and are often used in open surgery and laparoscopic surgery, and their use with surgical scoping devices such as endoscopes is also increasing. In endoscopic surgery, electrosurgical accessories are typically inserted through the lumen inside the endoscope. Considering an equivalent access channel in laparoscopic surgery, such a lumen has a relatively small inner diameter and a longer length.

[0004] Instead of a sharp blade, it is known to cut biological tissue using radio frequency (RF) energy. The method of cutting using RF energy is performed using the principle that heat is generated by the impedance to the flow of electrons across the tissue as the current passes through the tissue matrix (facilitated by the ionic content of the cells and intercellular electrolytes). In practice, the instrument is configured to apply an RF voltage sufficient to generate heat within the cells and evaporate the tissue moisture across the tissue matrix. However, as a result of this increased drying, there is a possibility of losing direct physical contact between the tissue and the instrument, especially adjacent to the RF emission region of the instrument (which has the highest current density of the current path through the tissue). The applied voltage then appears as a voltage drop across this small void, which causes ionization within the void leading to plasma. Plasma has a very high volume resistivity compared to tissue. The energy supplied to the instrument sustains the plasma, i.e., completes the electrical circuit between the instrument and the tissue. Since volatile substances entering the plasma can evaporate, the plasma is perceived as cutting the tissue.

[0005] GB2523246 describes an interface joint for integrating all of (i) a fluid supply section, (ii) a needle movement mechanism, and (iii) an energy supply section (e.g., a cable supplying RF and / or microwave energy) within a single cable assembly. The cable assembly can be sized to fit within the instrument channel of a conventional endoscope. Also described is a torque transmission unit for enabling controlled rotation of the cable assembly within the instrument channel of the endoscope. The interface joint and the torque transmission unit may be integrated as a single component. The interface joint can rotate together with the torque transmission unit under the control of the user.

[0006] The present invention has been devised in light of the above considerations.

Summary of the Invention

Means for Solving the Problems

[0007] The present invention provides an improvement on the concept described in GB2523246.

[0008] Most generally, the inventors have developed a modified interface joint that can integrate a fluid supply and an energy supply (e.g., a cable supplying RF and / or microwave energy) for an electrosurgical instrument within a single cable assembly. The single cable assembly can be sized to fit within the instrument channel of a conventional endoscope.

[0009] According to a first aspect of the present invention, there is provided an interface joint for interconnecting an electrosurgical generator, a fluid supply, and an electrosurgical instrument, the interface joint comprising: a housing having an electrical inlet for receiving high-frequency (RF) electromagnetic (EM) energy and / or microwave-frequency EM energy from the electrosurgical generator, a fluid inlet for receiving fluid from the fluid supply, and an outlet; and a single cable assembly for connecting the outlet to the instrument tip of the electrosurgical instrument, the single cable assembly having a coaxial cable connected to the electrical inlet and a fluid channel in fluid communication with the fluid inlet. The housing includes a first portion and a second portion, the second portion being attached to the single cable assembly such that rotation of the second portion causes rotation of the single cable assembly, the first portion being rotatable relative to the second portion, the first portion having a first inlet, the second portion having a second inlet, the first inlet being one of the fluid inlet or the electrical inlet, and the second inlet being the other of the fluid inlet or the electrical inlet.

[0010] This configuration provides several advantages that can improve the operability and rotational controllability of an electrosurgical instrument. Since the housing includes a first part and a second part that are rotatable relative to each other, it is possible to rotate the second part without rotating the first part to cause rotation of the instrument tip. Thus, the first part can remain relatively stationary during rotation of the instrument tip, and by holding the first part (e.g., by the surgeon's free hand or by an assistant), it is possible to assist in stabilizing and controlling the interface joint without interfering with the rotation of the second part and thus the instrument tip. Further, by providing the fluid inlet and the electrical inlet in the independently rotatable (first and second) parts of the housing, it is possible to reduce the risk that the supply cables will become entangled with each other or around the interface joint.

[0011] Since the first part can be held without interfering with the rotation of the second part, the first part can also be referred to as the "handle part". The second part can be said to include, in this specification, a "torque part", "torque", or "integral torque transmission unit". As will be further described in this specification, in this specification, the second part can be said to have a branch portion inside which the fluid and EM energy are integrated into a single cable assembly (or a tubular member for conveying into a single cable assembly). In some embodiments, the branch portion may be integral with the torque part that can rotate together with the first (handle) part (and thus can rotate with the torque part). In other embodiments, the branch portion may be rotatable not only relative to the torque part but also relative to the first (handle) part. These configurations will be further described in this specification.

[0012] Generally, since the second part can cause the rotation of a single cable assembly while holding the first part, the second part can be described herein as "rotatable", while the first part can be described as being in a "stationary state". However, these terms are used merely for convenience with respect to a reference frame in which the first part is in a stationary state. In reality, it will be understood that each part can rotate, even independently of each other.

[0013] The first part and the second part can be connected to each other by a freely rotating connector (e.g., by a rotatable snap fit connection). Optionally, the interface joint may include a low friction element between the first part and the second part. For example, the low friction element may include a polymeric O-ring (e.g., a PTFE O-ring) between the first part and the second part. The low friction element facilitates the relative rotation of these parts and can reduce the possibility that the rotation (or lack of rotation) of the first part causes the rotation of the second part (and thus the instrument tip).

[0014] Any part of the interface joint (the first / handle part, the torque part, and / or the branch part) may be rotatable completely (e.g., 360°) relative to another part of these parts. Alternatively, in some embodiments, the relative rotation between any of these parts can be limited to a maximum threshold, e.g., a maximum of 180°, optionally 120°, optionally 90°. For example, optionally, the first part and the second part can be rotatable only 180° relative to each other. For example, the first part may include a stopper element configured to prevent relative rotation by limiting the relative rotation by abutting against a corresponding surface of the second part. In one embodiment, the stopper element can be disposed on the second part and the corresponding surface can be on the first part. In one embodiment, the branch part and the torque part may have a stopper element and a corresponding surface for limiting relative rotation.

[0015] Optionally, the interface joint may further include a fluid supply cable connected to the fluid inlet for conveying fluid from the fluid supply unit to the interface joint. Further, optionally, the interface joint may include an electrical supply cable connected to the electrical inlet for conveying EM energy from the electrosurgical generator to the interface joint. Alternatively, the interface joint may be provided without a fluid supply cable and / or an electrical supply cable, which may be supplied separately. As described above, the independently rotatable first and second parts can help reduce the risk of the fluid supply cable and / or the electrical supply cable becoming entangled with each other or around the interface joint.

[0016] Optionally, the fluid inlet may include a connector (e.g., a freely rotatable fluid connector) for connecting to the fluid supply cable. Optionally, the electrical inlet may include a connector (e.g., a freely rotatable electrical connector) for connecting to the electrical supply cable. Examples of suitable freely rotatable connectors include QMA-type or MPX-type connectors. The use of a freely rotatable connector can help rotate the interface joint relative to the cable(s) without causing excessive tension or twisting of the cable(s).

[0017] The electrosurgical instrument may be any device configured to use RF EM energy or microwave frequency EM energy to treat biological tissue during use. The electrosurgical instrument can use RF EM energy and / or microwave frequency EM energy for any or all of resection, coagulation, and ablation. For example, the instrument may be a resection device as disclosed in GB2523246A or UK application No. 2119001.2, but alternatively, it may be any of a microwave forceps, a snare that emits microwave energy and / or couples RF energy, and an argon beam coagulation device.

[0018] As used herein, radio frequency (RF) may mean a fixed frequency that is invariant and in the range of 10 kilohertz to 300 megahertz, and microwave frequency may mean a fixed frequency that is invariant and in the range of 300 megahertz to 100 gigahertz. RF energy needs to have a frequency high enough to prevent the energy from causing nerve stimulation and a frequency low enough to prevent the energy from causing tissue branching, or unnecessary thermal margin or damage to the tissue structure. Preferred spot frequencies for RF energy include any one or more of 100 kilohertz, 250 kilohertz, 400 kilohertz, 500 kilohertz, 1 megahertz, and 5 megahertz. Preferred spot frequencies for microwave energy include 915 MHz, 2.45 GHz, 5.8 GHz, 14.5 GHz, and 24 GHz.

[0019] The electrosurgical generator can be any device capable of delivering RF EM energy or microwave frequency EM energy for the treatment of biological tissue. For example, the generator described in WO2012 / 076844 can be used.

[0020] The fluid supply unit can be a high-pressure fluid supply unit for supplying high-pressure fluid to the distal end of the instrument. Such a high-pressure configuration will be further described herein.

[0021] The interface joint can be particularly suitable for gathering a plurality of inputs into a single cable assembly prior to insertion through the instrument channel of the endoscope. To achieve this, the cable assembly may have an outer diameter of 9 millimeters or less, for example, 2.8 millimeters or less in the case of a flexible video colonoscope. In some embodiments, the fluid channel of a single cable assembly can carry a coaxial cable through its interior. Alternatively, the fluid can be carried through the insulating passage at the center of the coaxial cable, as described, for example, in UK application No. 2119001.2.

[0022] The first portion can be disposed in the proximal region of the interface joint, and the second portion can be disposed in the distal region of the interface joint. As used herein, the term "proximal" may refer to a region away from the distal end of the instrument, whereas, as used herein, the term "distal" may refer to a region closer to the distal end of the instrument. The first portion and the second portion can each be sized to be held by the user's hand (e.g., gripped between the user's thumb and other fingers). For example, the first portion and / or the second portion can each have a length of 3 cm or more, such as 3 - 10 cm, such as 5 - 8 cm. The housing can include (e.g., be composed of) an electrically insulating material. For example, the first portion and the second portion can each include (e.g., be composed of) an electrically insulating material.

[0023] Optionally, the first portion and / or the second portion may, for example, have a gripping surface, whereby the user can firmly hold the first portion / second portion. The gripping surface can include one or more depressions, protrusions, and / or a concave cross-sectional shape sized to facilitate gripping by the user. For example, the gripping surface can be sized to be gripped between the user's thumb and index finger. By providing one or more gripping surfaces in combination with the independently rotatable first and second portions, the interface joint can further assist in the independent operability of the first and second portions.

[0024] Optionally, the second portion can include a conduit that defines a branched passageway. The branched passageway can have a first length that is in line with the first inlet and outlet, and a second length that has a second inlet. By having a branched passageway that provides a connection in line with the first inlet and outlet, the interface joint can reduce the risk that a supply cable connected to the first inlet will wrap around the interface joint and limit its movement.

[0025] As used herein, the phrase "in-line" can refer to a connection in which a first inlet is oriented along (or parallel to) the longitudinal axis of the interface joint. For example, the first inlet can be disposed at the proximal end face of the first portion, and the outlet can be disposed at the distal end face (opposite the proximal end face) of the second portion.

[0026] The branch passage can have any suitable configuration. For example, a first length can terminate at a first inlet (or a port connected thereto) at its proximal end, and a second length can terminate at a second inlet at its end. Optionally, the second length can extend at a predetermined angle with respect to the first length. Thus, the second inlet can be angled with respect to the first inlet (i.e., not parallel to the first inlet). This can help further avoid entanglement of the supply cables at the first and second inlets since each cable will enter the device from a different direction. In an alternative embodiment not shown, the first length and the second length can extend substantially parallel to each other (the first inlet being parallel to the second inlet) before being integrated into a single passage extending towards the outlet (e.g., as a certain type of Y-shaped conduit).

[0027] Optionally, the second length can extend at an angle that is substantially perpendicular to the first length. A substantially perpendicular angle can help reduce the risk of entanglement between the fluid supply cable, the EM supply cable, and the single cable assembly by keeping the cables at an angle as far apart as possible.

[0028] As used herein, "substantially" with respect to an angle can allow for a variation of less than 15°, preferably less than 10°, more preferably less than 5°. Thus, the second length can be angled 75° - 105°, preferably 80° - 100°, more preferably 85° - 95° with respect to the first length. In a perpendicular configuration, the conduit can be referred to as a T-shaped conduit.

[0029] Optionally, the second length may extend at an acute angle with respect to the first length. For example, the second length can extend at an angle of 20° to 60°, more preferably 30° to 50°, and even more preferably 40° with respect to the first length. In such a configuration, the conduit can be called a certain type of "Y-shaped" conduit. Therefore, the end (proximal end) of the second length may be closer to the proximal end of the first length than the distal end of the first length. As a result, the supply cable (e.g., a fluid supply cable or an EM supply cable) entering the second length can form an angle away from the distal end of the interface joint. This helps reduce the risk of interfering with the rotation of the single cable assembly by reducing the entanglement or coiled winding at the distal end (which may include the torque portion) of the interface joint.

[0030] The housing can be an elongated capsule sized to fit within the operator's hand. The first length and the second length may have different lengths or the same length. Optionally, the housing may provide a double partition wall for the operator. That is, the housing can include an outer casing (first level of separation) enclosing a conduit that defines a branch passage (second level of separation) where various inputs are integrated into a single cable assembly inside. The branch passage is a watertight volume (fluid sealed cavity) that defines a fluid flow path between a fluid inlet and an outlet, and can provide a watertight volume having an electrical port for receiving a coaxial cable through the watertight volume. Both the electrical port and the outlet can include one or more plugs (also called "sealing plugs") that define a watertight passage for the coaxial cable. The one or more sealing plugs can be formed of an elastically deformable material, such as silicone rubber, whereby the coaxial cable is encapsulated by the material as it passes through the material. Sealing the watertight volume in this way means that the only path for the fluid exiting the interface joint is through the outlet along the fluid channel within the single cable assembly.

[0031] In some cases, the first inlet is an electrical inlet and the second inlet is a fluid inlet. This configuration can provide several advantages as described below.

[0032] First, this allows the power supply cable to remain relatively stationary during rotation of a single cable assembly, thereby reducing the interference of EM signals that can be caused by coiling or bending of the power supply cable around the interface joint (e.g., compared to an alternative configuration where the electrical inlet is constituted by a second part that rotates with the second part).

[0033] Second, in a configuration where the first inlet is in line with the outlet, this configuration provides a straight path for the coaxial cable through the housing, thereby further helping to avoid signal losses that can occur along a bent / coiled cable.

[0034] Third, in a configuration where the branch conduit includes a second length extending at a predetermined angle with respect to the first length, providing the fluid inlet along the second length can be particularly advantageous because the fluid cable can freely inject the fluid into the branch passage without having to wind around the angle between the first length and the second length to convey the fluid.

[0035] In some cases, the second portion includes a branching portion and a torque portion. The branching portion is rotatable relative to the torque portion. The branching portion includes a second inlet, and the torque portion includes an outlet. As a result, the fluid inlet, the electrical inlet, and the outlet can be arranged in different portions of the housing (i.e., the first portion, the torque portion, and the branching portion) that are rotatable independently of each other. Therefore, the fluid supply cable and the coaxial supply cable can be positioned independently during the rotation of a single cable assembly. Such a configuration can improve the operability by reducing the bending / coiling / tangling of the supply cable during the rotation of the instrument tip, and can be further useful in reducing signal loss. For example, the independently rotatable branching portion can be useful in preventing the supply cable from wrapping around the interface joint during the rotation of the instrument tip at the second inlet and not restricting its movement.

[0036] The branching portion may include any of the conduits (such as a Y-shaped or T-shaped conduit) described above for integrating the fluid and the EM energy conveyed to a single cable assembly.

[0037] The handle portion and the torque portion (which can be arranged at the proximal end and the distal end of the interface joint respectively) can alternatively be called the "proximal portion" and the "distal portion" respectively. The rotatable branching portion, if present, can be arranged between the handle portion and the torque portion and can thus be called the "intermediate portion".

[0038] In some cases, the branching portion is configured to integrate the fluid and the EM energy conveyed to the torque portion within a tubular member, and the tubular member is rotatable relative to the branching portion. By providing a tubular member rotatable relative to the branching portion, the single cable assembly and / or the tubular member can be rotated without rotating the branching portion. This can be further useful in improving the operability and the transmission of EM energy / fluid.

[0039] The tubular member can pass through the branch portion, extend beyond the branch portion, and protrude from the distal end of the branch portion. Specifically, the distal end of the tubular member can extend into a single cable assembly of the torque portion. Therefore, the rotation of the torque portion can cause the rotation of the tubular member via a single cable assembly. The proximal end of the tubular member is connected to an electrical inlet and can receive a coaxial cable through the tubular member.

[0040] Optionally, the interface joint can further include one or more plugs (e.g., the sealing plugs described above) within the branch portion to form a fluid seal around the tubular member. The one or more plugs can be provided at the distal end and / or proximal end of the branched portion. This can help seal the watertight volume (fluid seal cavity) between the fluid inlet and the fluid outlet and prevent leakage beyond the tubular member. The tubular member may be rotatable relative to the plug(s), and the plug(s) can be non-rotatable (fixed) relative to the branch portion. The tubular member and / or the plug(s) can include a low-friction material that helps facilitate the relative rotation of these components. For example, the plug(s) and / or the tubular member can be coated with an anti-friction coating or lubricant. Alternatively, the plug(s) can be formed of a low-friction material, such as silicone or polyisoprene rubber. Optionally, the plug(s) can be formed of a self-healing material or an elastically deformable material. Advantageously, the self-healing or elastically deformable material can help form a sealing seal around the tubular member while having relatively low friction.

[0041] Optionally, the tubular member is configured to carry a coaxial cable connected to an electrical inlet, and the tubular member includes one or more openings that allow fluid to flow into the tubular member. Thus, fluid is conveyed into the tubular member (from the fluid inlet through the fluid seal cavity) and further around the coaxial cable, thereby providing a simple mechanism for integrating fluid and EM energy within a single tubular member and subsequently within a single cable assembly.

[0042] The tubular member can include a hypodermic tube. The hypodermic tube can be a metal (e.g., stainless steel) tube having a blunt end. The hypodermic tube can extend within the torque portion and thus can bridge the joint between the branch portion and the torque portion. The metal hypodermic tube can be relatively robust and can be particularly useful in embodiments using high-pressure fluids. Specifically, in some embodiments, the electrosurgical instrument can omit the needle for puncturing tissue and, instead, use pressurized high-pressure fluid for the purpose of puncturing or lifting tissue at the distal end of the instrument. An example of a suitable instrument that can operate in this manner is described in UK Application No. 2119001.2, the entire contents of which are incorporated herein by reference. Thus, optionally, the interface joint is not configured to integrate the needle movement mechanism into a single cable assembly. For example, optionally, the interface joint does not include on the housing a needle actuator (e.g., a sliding trigger or a pivoting trigger) attached to a push rod that extends outside the housing through an outlet for controlling the needle at the distal end of the instrument. By omitting the needle movement mechanism from the interface joint, the interface joint itself can be made smaller and can be used in combination with an instrument that does not use a needle and a push rod (and thus can also be made smaller).

[0043] An electrosurgical instrument and an interface joint can be used to convey a wide range of pressures, such as high-pressure fluids. For example, the instrument and the interface joint can be used to convey fluids at pressures of at least 100 psi, optionally at least 150 psi, optionally at least 200 psi, optionally at least 250 psi. The specific pressure used can be selected considering the tissue characteristics in the target area. For example, to pierce a mucosa (e.g., to form an initial incision around a lesion), a higher pressure may be required than to pierce the submucosa (e.g., to replenish the lesion with liquid after piercing the mucosa). For example, 100 psi can provide a pressure useful for piercing submucosal tissue. Further, the tissue of some organs (e.g., the GI tract) may be easier to pierce than that of other organs (e.g., the stomach), and thus may require a lower pressure. For example, the instrument may convey fluids in the range of 250 - 300 psi to pierce tissue in the lower GI tract and fluids in the range of 400 - 500 psi to pierce tissue in the stomach. Further, the pressure may be controlled or reduced to avoid using a pressure that is too high for a particular application or body area, such as to reduce the risk of unintended perforation.

[0044] Optionally, two or more of the portions of the housing can be releasably attachable to each other. The releasable attachment can be provided via any suitable method, such as a rotatable snap-fit connection. This can facilitate assembly and ease of use. For example, any two or more of the first portion, the branch portion, and / or the torque portion can be made releasably attachable to each other.

[0045] Optionally, the interface joint may further include a cable management structure for securing a portion of the supply cable to the interface joint, where the supply cable may be either a fluid supply cable for conveying fluid from a fluid supply unit to a fluid inlet or an EM supply cable for conveying EM energy from an electrosurgical generator to an electrical inlet. For example, the cable management structure can secure the supply cable to the housing of the interface joint or to another supply cable of the interface joint.

[0046] The portion of the supply cable can be any portion of the supply cable spaced from the end of the supply cable attached to the interface joint. For example, this can be located in the proximal or central portion of the supply cable. The cable management structure may include a clip or other attachment device for securing the portion of the supply cable to the housing or to another supply cable. The cable management structure can help to cause a coiled wrap of the supply cable to occur in a preferred direction with respect to the interface joint. Further, the cable management structure can be used to secure the supply cable at a location that provides extra slack to a portion of the supply cable located between the cable management structure and the inlet. By providing this extra slack in the supply cable, when the interface joint is rotated, the supply cable forms a coiled wrap around the interface joint and does not tightly wind around and restrict it, thus improving operability.

[0047] Optionally, the cable management structure can be attachable to the supply cable at a location that allows a predetermined number of rotations of a second portion relative to a first portion. For example, the cable management structure can be arranged to provide the supply cable with enough slack to allow the second portion to rotate completely two times relative to the first portion. This can help to improve the operability of the instrument while balancing the amount of excessive slack at the interface joint.

[0048] In some cases, the cable management structure can be fixed to the supply cable entering the second inlet. This can be useful in preventing the supply cable at the second inlet from tightly wrapping around the interface joint during rotation of the torque portion, and can thus be particularly useful in embodiments where the second inlet rotates with the torque portion (rather than being on a separately rotatable branch portion).

[0049] The present disclosure also provides a kit of parts including an interface joint and a torque transmission unit attachable to a single cable assembly such that rotation of the torque transmission unit causes rotation of the single cable assembly. The torque transmission unit can be used to transmit the user's rotational force to the flexible shaft of a single cable assembly connected to an electrosurgical instrument. By providing a combination of an interface joint and a torque transmission unit as described herein, a surgeon can control the rotation of the instrument tip using the torque transmission unit, while an assistant can hold the first (handle) portion of the interface joint without interfering with the rotation being generated by the surgeon with the torque transmission unit. The first portion of the housing can rotate independently of the second portion (which rotates with the distal torque transmission unit, if present, for attachment to the single cable assembly), so the first portion of the interface joint can be conveniently held without interfering with the rotation the surgeon is trying to generate. The torque transmission unit can also be attachable to the single cable assembly at a position on the distal side of the housing (i.e., closer to the inlet of the scope device). Thus, the torque transmission unit can be spaced apart from the housing during use.

[0050] As used herein, the torque transmission unit may alternatively be referred to as the "distal torque" or "distal torque transmission unit", while the torque portion of the interface joint may alternatively be referred to as the "proximal torque", "proximal torque transmission unit", or "integral torque transmission unit".

[0051] In an alternative embodiment, the interface joint may be provided without a separate distal torque transmission unit. In such a configuration, the torque portion of the interface joint can be used to control the rotation of the instrument tip.

[0052] The torque transmission unit may be the torque transmission unit described in GB2523246A, the entire content of which is incorporated herein by reference. Thus, the torque transmission unit can include an elongate clamp configured to apply a gripping force along the length of the flexible sleeve, the elongate clamp including an upper elongate housing member and a lower elongate housing member pivotally connected to the upper elongate housing and defining a passage for the flexible sleeve, wherein the upper elongate housing member and the lower elongate housing member are pivotable between a release position in which the torque transmission unit is slidable along the flexible sleeve and a clamp position in which the flexible sleeve is gripped between the upper elongate housing member and the lower elongate housing member.

[0053] The present invention includes each of the described aspects and combinations of preferred features, except where such combinations are clearly inadmissible or clearly avoidable.

[0054] Exemplary embodiments showing the principles of the present invention will now be described with reference to the accompanying drawings in which like numerals represent like elements.

Brief Description of the Drawings

[0055]

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DETAILED DESCRIPTION OF THE INVENTION

[0056] Aspects and embodiments of the present invention will be described herein with reference to the accompanying drawings. Further aspects and embodiments will be apparent to those skilled in the art. All documents mentioned in the text are hereby incorporated by reference into this specification.

[0057] FIG. 1 is a schematic view of a complete electrosurgical system 100, which can selectively supply any or all of RF energy, microwave energy, and fluid, such as saline or hyaluronic acid, to the distal end of an invasive electrosurgical instrument. The system 100 includes a generator 102 for controllably supplying electromagnetic (EM) energy. In this embodiment, the EM energy includes RF EM energy and / or microwave frequency EM energy. A suitable generator for this purpose is described in WO2012 / 076844, which is incorporated herein by reference.

[0058] The generator 102 is connected to an interface joint 106 by an interface cable 104. The interface joint 106 is also connected to receive a supply of pressurized fluid from a fluid supply device 108 via a fluid supply cable 107. The function of the interface joint 106 is to combine the inputs from the generator 102 and the fluid supply device 108 into a single flexible shaft 112 that extends from the distal end of the interface joint 106. In this embodiment, the electrical inlet (for receiving EM energy from the generator 102) is in line with the outlet to the flexible shaft 112, and the fluid inlet (for receiving fluid from the fluid supply cable 107) is angled with respect to the outlet to the flexible shaft 112. It should be understood that the shaft 112 may form part of the interface joint 106. The configuration of the interface joint 106 will be described in more detail below.

[0059] The flexible shaft 112 is insertable through the entire length of the instrument (actuation) channel of the surgical scope device 114. A torque transmission unit 116 may be attached to the proximal length of the shaft 112 between the interface joint 106 and the surgical scoping device 114. When present, the torque transmission unit 116 engages the shaft to enable it to rotate within the instrument channel of the surgical scoping device 114.

[0060] The flexible shaft 112 passes through the instrument channel of a surgical scoping device 114 (e.g., an endoscope) and has an electrosurgical instrument tip 118 shaped to project at the distal end of the instrument channel (e.g., into a patient). The instrument tip includes an active tip for delivering RF EM energy and / or microwave EM energy into biological tissue and an aperture for delivering a pressurized fluid (e.g., saline, Gelofusine, and / or hyaluronic acid with added marker dye). These combined techniques provide a unique solution for cutting and destroying unwanted tissue and the ability to seal blood vessels surrounding the target area. The surgeon can inject fluid between tissue layers so that by applying pressure to the fluid, the location of the lesion being treated can be expanded and marked. Injecting the fluid in this way lifts and separates the tissue layers, facilitating both resection around the lesion and flattening of the submucosal layer, and reducing the risk of intestinal wall perforation and unwanted thermal damage to the muscular layer.

[0061] The instrument tip 118 further includes a protective outer shell disposed under the active tip, which aids in tissue flattening-type resection operations, also protects against inadvertent perforation, and helps ensure the survival rate of the remaining tissue, which in turn promotes more rapid healing and postoperative recovery.

[0062] The structure of the instrument tip 118 can be designed in particular for use with a conventional movable flexible endoscope having a working channel with an inner diameter of at least 2.2 mm and an operating length of 60 cm to 170 cm. In this way, most of the relatively small-diameter instrument is much larger and is mainly housed within the lumen of the flexible endoscope channel, the polymer insulation device. In practice, only 5 mm to 25 mm of the distal assembly projects from the distal end of the endoscope channel so as not to obstruct the field of view or adversely affect the focusing of the camera. The protruding portion of the distal assembly is the only part of the instrument that comes into direct contact with the patient.

[0063] Typically, at the proximal end of the working channel of an endoscope held at a distance of 50 cm to 80 cm from the patient, the flexible shaft 112 exits the working channel port and extends an additional 30 cm to 100 cm to the interface joint 106. During use, the interface joint 106 is typically held by a gloved assistant throughout the surgery. The interface cable 104 is connected to the generator 102 using a QMA type coaxial interface designed to allow continuous clockwise or counterclockwise rotation. Thereby, the interface joint 106 can rotate with the torque transmission unit 116 under the control of the user. The assistant supports the interface joint 106 throughout the surgery to assist the user in rotating the instrument and injecting fluid by resonance.

[0064] Figure 2 is a side view showing a system including an interface joint 120 and a distal torque transmission unit 122 of an embodiment. This system can be applied to the complete electrosurgical system 100 of FIG. 1. FIGS. 3, 4, and 5 show an exploded view, a cross-sectional view, and a side view of the interface joint 120, respectively.

[0065] The interface joint 120 has a housing (or shell) including a first portion 124 at the proximal end and a second portion 126 at the distal end. The housing may include an electrically insulating material (e.g., plastic). The housing at least partially houses several internal components, as most clearly shown in FIGS. 3 and 4.

[0066] The first portion 124 includes a first inlet in the form of an electrical inlet for receiving high-frequency (RF) electromagnetic (EM) energy and / or microwave frequency EM energy from an electrosurgical generator (e.g., the electrosurgical generator 102 of FIG. 1). In this embodiment, the electrical inlet includes a free-rotation connector 128 (e.g., an MPX connector) that allows rotation of a coaxial supply cable (e.g., the interface cable 104 of FIG. 1) relative to the first portion 124.

[0067] As can be seen from FIG. 3, the second portion 126 includes an outer casing formed from two releasably attachable (e.g., by snap fit or press fit) elongate casing elements 130A, 130B configured to fit together and enclose the conduit 132. This configuration provides the double isolation wall as described above. The conduit 132 defines a branched passageway in which a fluid input and an EM input are integrated within a single cable assembly 134 therein. The distal end of the single cable assembly 134 is attached to the instrument tip (e.g., the instrument tip 118 of FIG. 1).

[0068] The branched passageway of the conduit 132 has a first length and a second length. The first length provides a connection in a straight line between an electrical port 136 (for connection to the electrical inlet 128) and an outlet 138 (for connection to the single cable assembly 134). The second length extends at a predetermined angle with respect to the first length and terminates at a second inlet. In this embodiment, the second inlet is a fluid inlet 140 for receiving fluid from a fluid supply (e.g., from the fluid supply device 108). The fluid inlet 140 is connected to a fluid supply cable 141.

[0069] In this embodiment, the second length extends at an acute angle with respect to the first length, forming a Y-shaped conduit 132. Accordingly, the housing is in the shape of a pistol, i.e., having an upper barrel portion and a lower adjacent portion extending at an oblique angle away from the proximal end of the upper barrel portion.

[0070] A single cable assembly 134 includes a flexible shaft that conveys a coaxial cable 142 and a fluid channel therethrough. The coaxial cable 142 is connected to an electrical inlet 128, and the fluid channel is in fluid communication with a fluid inlet 140 through a conduit 132. A fluid supply cable 141 can be used to convey pressurized fluid to the interface joint. The fluid channel can be configured to pierce or lift tissue without the use of a needle, or to convey pressurized fluid to the instrument tip. Thus, the interface joint 120 does not require a needle actuator and a push rod for controlling the needle and can thus be relatively small.

[0071] The second portion 126 is configured to be attached (e.g., clamped) to the flexible shaft of the single cable assembly 134 and functions such that rotation of the second portion causes rotation of the single cable assembly 134. The second portion 126 includes a gripping element 144 that is configured to overlie the casing elements 130A, 130B and has a gripping surface for facilitating gripping by a user. In this embodiment, the gripping element 144 has a gripping surface that includes a series of (e.g., four) longitudinally extending grooves.

[0072] Similarly, the first portion 124 may also include a gripping surface that facilitates gripping by a user. For example, in this embodiment, the first portion 124 has a concave cross-sectional shape (e.g., as viewed from the side as in FIG. 4) configured to be gripped between an operator's thumb and forefinger. Further, the first portion 124 has a series of circumferentially extending ribs and protrusions that at least partially extend along the outer periphery of the first portion.

[0073] The first portion 124 is connected to the second portion 126 by a freely rotatable connector. Thus, the first portion 124 (including the electrical inlet 128) is rotatable relative to the second portion 126 (including the fluid inlet 140 and the fluid outlet 138). For example, in this embodiment, the first portion 124 is connected to the second portion 126 by a rotatable snap-fit engagement mechanism. Specifically, as shown in FIG. 4, the second portion 126 includes a snap-fit engagement structure 146 (e.g., a male snap-fit engagement structure), which is attachable to the elongated casing elements 130A, 130B and is configured to fit into a corresponding snap-fit engagement structure 148 (e.g., a female snap-fit engagement structure) of the first portion 124. Further, the freely rotatable connector may include a friction reducing element 150 (e.g., an O-ring such as a PTFE O-ring) at the interface between the first portion 124 and the second portion 126. This can help reduce the friction that may occur during relative rotation between the first portion and the second portion.

[0074] As shown in FIG. 5, in use, the second portion 126 can be rotated in the direction indicated by arrow A. On the other hand, the first portion 124 can remain stationary. Thus, the second portion 126 can be rotated to rotate a single cable assembly 134 while holding the first portion 124 without interfering with the rotation of the instrument tip. Thus, the first portion 124 can also be called a handle portion, and the second portion 126 can be called a torque portion.

[0075] Since the fluid inlet 140 and the electrical inlet 128 are located on the independently rotatable first part 124 and second part 126, respectively, the fluid supply cable 141 can be prevented from being entangled with the electrical supply cable. However, in some situations, during the rotation of the second part 126 (e.g., in the direction A), the fluid supply cable 141 may be coiled and wrapped around the housing. Therefore, optionally, the interface joint 120 can further include a cable management structure (e.g., a clip) 139 for fixing a part of the fluid supply cable 141 to the interface joint, as shown in FIG. 12. This is useful for fixing excessive slack of the cable and thus can be useful for reducing excessive friction caused by the fluid supply cable 141 being wrapped around the housing during the rotation of the instrument tip. For example, as shown in FIG. 12, the cable management structure 139 can fix the fluid supply cable 141 to a coaxial supply cable (e.g., the interface cable 104).

[0076] FIG. 6 shows an interface joint 152 according to another embodiment of the present invention. The interface joint 152 is similar to the interface joint 120, and like reference numerals indicate like elements unless otherwise described.

[0077] The interface joint 152 in FIG. 6 is different from the interface joint 120 in FIGS. 2-5 in that the second part 154 of the interface joint 152 includes an independently rotatable branch part 156 and a torque part 158. The fluid inlet 140 is part of the branch part 156, and the outlet 138 is part of the torque part 158. Each of the first part 124, the branch part 156, and the torque part 158 is rotatable relative to each other. As shown in FIG. 6, in use, for example, the torque part 158 and the shaft 134 can rotate together in the direction A, while the branch part 156 can independently rotate in the direction B, and the first part (handle) 124 can remain stationary.

[0078] As an advantage, this configuration enables each cable (fluid supply cable 141, EM energy supply cable, and flexible shaft 134) to be independently oriented. For example, the fluid supply cable 141 can remain stationary during rotation of the single cable assembly 134 without affecting the EM supply cable. Thus, this configuration can reduce the risk of the cables becoming entangled and / or wrapping around the interface joint 152 and can eliminate the need for a cable management structure.

[0079] FIG. 7 shows an alternative interface joint 160 according to another embodiment of the present invention. The interface joint 160 is similar to the interface joint 152 of the figure, and like reference numerals indicate like elements unless otherwise described.

[0080] FIG. 8 shows a cutaway view of the interface joint 160 of FIG. 7, with the fluid supply cable 141 and the single cable assembly 134 omitted.

[0081] Similar to the interface joint 152 of FIG. 6, the interface joints 160 of FIGS. 7 and 8 include a second portion 162 having a rotatable branch portion 164 and a torque portion 166 that are independently rotatable. In use, the branch portion 164 can remain stationary (thereby avoiding twisting of the fluid supply cable 141), while the torque portion rotates axially (with respect to the branch portion 164) to rotate the cable assembly 134.

[0082] The interface joints 160 of FIGS. 7 and 8 differ from the interface joint 152 of FIG. 6 in the configuration of the branch portion. FIGS. 9 - 11 show a perspective view, a cross-sectional view, and an exploded view of the branch portion 164, respectively.

[0083] The branch portion 164 includes a T-shaped conduit that defines a branch passage having a first length (which is on the same straight line as the outlet 138) and a second length perpendicular to the first length. Similar to the foregoing embodiment, the second length terminates at the fluid inlet 168. A tubular member in the form of a hypo tube 170 extends along the first length through the branch portion 164.

[0084] The branch portion 164 has an electrical port 172 at its proximal end for connecting the hypo tube 170 to the electrical inlet 128. The branch portion 164 has an outlet port 174 at its distal end for coupling the hypo tube 170 to the single cable assembly 134. Thus, a coaxial cable (not shown) can be connected to the electrical inlet 128 and extend through the hypo tube 170 and through the single cable assembly.

[0085] The hypo tube has one or more openings 176 (e.g., two openings) that allow fluid to flow into the hypo tube from the fluid inlet 168. A first plug 178A and a second plug 178B are mounted within the T-shaped conduit to seal the fluid-tight cavity around the openings 176 of the hypo tube 170. The plugs may also be referred to as seal inserts or sealing plugs. The plugs 178A and 178B are rotatably fixed to the housing. The hypo tube 170 is rotatable with respect to and within each of the plugs 178A and 178B. In this way, the hypo tube 170 can rotate with respect to the fluid inlet 168 and the electrical inlet 128.

[0086] In use, fluid from the fluid inlet 168 can flow into the fluid-tight cavity of the branch portion 164 and into the hypo tube 170 through the one or more openings 176. The fluid can flow within the hypo tube (around the coaxial cable) and can be further conveyed within the single cable assembly 134.

[0087] The features disclosed in the foregoing description, or in the following claims, or in the accompanying drawings, in their specific forms, or in the form of means for carrying out the disclosed functions, or the methods or processes for obtaining the disclosed results, can be used, if necessary, separately or in any combination of such features, to implement the present invention in its various forms.

[0088] For example, in some embodiments not shown, the connector configuration including the hypo tube and the plug described above in connection with FIGS. 9 - 11 can alternatively be implemented in a configuration where the torque portion and the branch portion are not independently rotatable (e.g., as shown in FIGS. 3 - 5).

[0089] Instead of or in addition to the above, in some embodiments, any of the components forming the housing of the interface joint (e.g., the first portion, the branch portion, or the torque portion) can be modified to have a plurality of casing elements that are integrally connected to each other in the same manner as the casing elements 130A, B (e.g., via a push - fit or snap - fit connection). For example, in some embodiments, the first portion 124 and / or the branch portion 164 can each be modified to include a plurality of (e.g., two) releasably attachable / fittable casing elements (e.g., two half - shells). By configuring one or more portions of the housing in this way, the assembly of the interface joint can be made more convenient.

[0090] The present invention has been described in conjunction with the above - mentioned exemplary embodiments, but many equivalent modifications and variations will be apparent to those skilled in the art in view of the present disclosure. Therefore, the above - mentioned exemplary embodiments of the present invention are considered to be illustrative and not limiting. Various changes to the described embodiments may be made without departing from the spirit and scope of the present invention.

[0091] To avoid misunderstanding, the theoretical explanations provided in this specification are offered for the purpose of enhancing the reader's understanding. The inventors do not wish to be bound by any of these theoretical explanations.

[0092] The heading of any section used in this specification is for the sole purpose of organization and should not be construed as a limitation of the subject matter described.

[0093] Throughout this specification, including the following claims, unless the context requires otherwise, the words "comprise", "comprising", and "include" and variations thereof (such as "comprises", "comprising", and "including") are to be construed as indicating the inclusion of a stated integer or step, or group of integers or steps, but not the exclusion of any other integer or step, or group of integers or steps.

[0094] It should be noted that, as used in this specification and the appended claims, the singular forms "a", "an", and "the" include plural referents unless the context clearly dictates otherwise. Ranges may be expressed in this specification as from "about" a particular value and / or to "about" another particular value. When such a range is expressed, another embodiment includes from one particular value and / or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent "about", it will be understood that the particular value forms another embodiment. The term "about" associated with a numerical value is optional and means, for example, + / - 10%.

Explanation of Reference Numerals

[0095] 100 Electrosurgical system 102 Generator 104 Interface cable 106 Interface joint Electrosurgical instrument 112 Flexible shaft 118 Instrument tip 107 Fluid supply cable 114 Surgical scope device 116 Torque transmission unit 108 Fluid supply device 120, 152, 160 Interface joint 124 First part 128 First inlet (e.g., electrical inlet) 148 Snap - fit engagement structure 150 O - ring 126, 154, 162 Second part 130A, B Casing elements 146 Snap - fit engagement structure 156 Branch part 132 Conduit 136 Electrical port 140 Second inlet (e.g., fluid inlet) 141 Fluid supply cable 139 Cable management structure 164 Branch part 168 Fluid inlet 170 Tubular member (e.g., hypodermic tube) 176 Opening 172 Electrical port 174 Outlet port 178A, B Plug bodies 158, 166 Torque part 144 Gripping element 138 Outlet 134 Single cable assembly 142 Coaxial cable 122 Torque transmission unit

Claims

1. An interface joint for interconnecting an electrosurgical generator, a fluid supply unit, and an electrosurgical instrument, An electrical input for receiving radio frequency (RF) electromagnetic (EM) energy and / or microwave frequency EM energy from the electrosurgical generator, A fluid inlet for receiving fluid from the aforementioned fluid supply unit, Exit and A housing having, A single cable assembly for connecting the outlet to the tip of the electrosurgical instrument, A coaxial cable connected to the aforementioned electrical inlet, The single cable assembly includes a flexible shaft having a fluid channel in fluid communication with the fluid inlet, The housing includes a first part and a second part, the second part being attached to the single cable assembly so that rotation of the second part causes rotation of the single cable assembly, and the first part is rotatable relative to the second part. The first portion has a first inlet, the second portion has a second inlet, the first inlet is either the fluid inlet or the electrical inlet, and the second inlet is the other of the fluid inlet or the electrical inlet. The interface joint wherein the second portion includes a conduit defining a branch passage, the branch passage having a first length collinear with the first inlet and the outlet, and a second length having the second inlet.

2. The interface joint according to claim 1, further comprising a fluid supply cable connected to the fluid inlet for transporting fluid from the fluid supply unit to the interface joint.

3. The interface joint according to claim 1 or 2, wherein the second length extends at a predetermined angle with respect to the first length.

4. The interface joint according to claim 3, wherein the second length extends at an angle substantially perpendicular to the first length.

5. The interface joint according to claim 1, wherein the first inlet is the electrical inlet and the second inlet is the fluid inlet.

6. The interface joint according to claim 1, wherein the second portion includes a branch portion and a torque portion, the branch portion is rotatable relative to the torque portion, the branch portion includes a second inlet, and the torque portion includes the outlet.

7. The interface joint according to claim 6, wherein the branching portion is configured to integrate the fluid and the EM energy within a tubular member so as to be transported to the torque portion, and the tubular member is rotatable relative to the branching portion.

8. The interface joint according to claim 7, further comprising one or more plugs within the branch portion to form a fluid seal around the tubular member.

9. The interface joint according to claim 7 or 8, wherein the tubular member is configured to carry the coaxial cable connected to the electrical inlet, and the tubular member includes one or more openings that allow fluid to flow into the tubular member.

10. The interface joint according to claim 1, wherein two or more of the portions of the housing are detachably attached to each other.

11. The cable management structure further includes a cable management structure for securing a portion of the supply cable to the interface joint, wherein the supply cable is A fluid supply cable for transporting fluid from the fluid supply unit to the fluid inlet, or The interface joint according to claim 1, which is any EM supply cable for transporting the EM energy from the electrosurgical generator to the electrical inlet.

12. The interface joint according to claim 11, wherein the supply cable is connected to the second inlet.

13. The interface joint according to Claim 1, A kit of parts, comprising: a torque transmission unit that is mountable to a single cable assembly such that the rotation of the torque transmission unit causes the rotation of the single cable assembly.

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