Application cap for plasma surgical equipment

Abstract

This disclosure relates to an application cap (1) for a plasma surgical instrument (13). [Solution] The application cap is provided as a spacer and is designed to be connected to / attached to the distal end of an endoscopic supply device for plasma surgical instruments. The application cap (1) is provided and designed to have at least one wall region (4) which is provided and designed to be provided to make contact with the target tissue and which has at least one treatment opening (5) formed inside it, forming a space volume (2) in its distal portion and maintaining at least a minimum distance (d1, d2) between the distal end of an electrode (3) that can be inserted into the application cap (1) and the target tissue. The at least one treatment opening (5) forms a first treatment opening area (6) and a second treatment opening area (7). The first treatment opening area (6) is oriented in a different direction from the second treatment opening area (7). The disclosure also relates to a plasma surgical instrument (12) having the application cap (1).

Description

Technical Field

[0001] The present disclosure relates to an application cap provided as a spacer for a plasma surgical instrument 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.

Background Art

[0002] Plasma surgical techniques as well as plasma applicators and similar devices / devices for using them are generally known. For example, for over 50 years, plasma surgical techniques known as radiofrequency therapy or spray coagulation have been used in surgery, especially for thermal hemostasis.

[0003] Plasma is generated only in air. That is, mainly oxygen plasma and nitrogen plasma are generated. Both of these plasmas are known to be highly chemically reactive, causing carbonization and pyrolysis, and as a result, also causing tissue evaporation and smoke at the tissue surface. These unintended side effects of radiofrequency therapy or spray coagulation hinder or interfere with the use of this plasma surgical technique, especially during endoscopic surgery. Therefore, in order to avoid these future drawbacks, this gas has generally been replaced with a noble gas, especially argon.

[0004] For example, Patent Document 1 discloses a plasma treatment device used for inspection of a flexible endoscope. This device can be used for performing plasma surgical procedures inside the human body due to its configuration. In this known surgical device, a probe or catheter is arranged inside the endoscope or inserted into the working channel, and electrical energy is conducted from a radiofrequency current / voltage source or generator to the electrode at the distal end of the probe / catheter (hereinafter simply referred to as the probe) through a connecting wire arranged inside the probe / catheter.

[0005] The electrical energy applied to the electrode creates a plasma arc between the electrode tip and the immediate surrounding tissue / target tissue. Because the electrode is located at the distal end of the probe, it protrudes distally from the endoscope or outside the working channel.

[0006] According to Patent Document 1, a resistive element, specifically a capacitive resistive element, is additionally placed between the distal end of the connecting wire and the proximal end of the electrode within the probe, and therefore connected immediately upstream of the electrode. The purpose of this resistive element is to limit the power supplied by the current / voltage source (hereinafter referred to as the "generator") that flows through the target tissue and consequently through the human body. This arrangement ensures that the resistive element is positioned as close as possible to the proximal end of the electrode. Because of this proximity, stray capacitance generated in the system (by the conductive portion between the resistive element and the electrode) is prevented from excessively affecting the voltage drop between the electrode tip and the target tissue. Therefore, the current flowing through the target tissue is primarily limited in a manner defined / definable by this resistive element between the connecting wire and the electrode. [Prior art documents] [Patent Documents]

[0007] [Patent Document 1] DE102008004843B4 [Overview of the Initiative] [Problems that the invention aims to solve]

[0008] The purpose of this disclosure is to provide a spacer that is safe for the target organization and enables the targeted procedure. Furthermore, the purpose of this disclosure is to eliminate or at least improve upon the shortcomings of the prior art.

[0009] This objective is achieved by an application cap / attachment provided as a spacer having the features of claim 1, and a plasma surgical instrument having the features of claim 10. [Means for solving the problem]

[0010] Therefore, the application cap / attachment for the minimally invasive type of plasma surgical instrument is preferably provided as an (electrically insulating) spacer and is configured to be plugged into the distal end of an endoscopic supply device (endoscope) for the plasma surgical instrument. The application cap is configured to form a spatial volume in its distal portion (preferably surrounded at least partially by the rigid outer wall / peripheral wall of the application cap) and to maintain at least a minimum distance from the target tissue to the distal end of an electrode that can be inserted into or introduced into the application cap. The application cap is further configured to have at least one wall region, which is configured to be in contact with the target tissue and has at least one treatment opening formed inside it, where the at least one treatment opening forms a first treatment opening surface portion and a second treatment opening surface portion, the first treatment opening surface portion facing / directed in a different direction from the second treatment opening surface portion.

[0011] In other words, the application cap has a wall region / body edge configured to contact the target tissue and maintain a minimum distance from the target tissue to the distal end of the electrode. Here, the application cap has a defined treatment opening surface in its distal portion to enclose a spatial volume and form a treatment opening. The treatment opening surface is positioned and / or directed such that the electrode protruding into the spatial volume, particularly its distal end, has a first predetermined minimum distance and a second predetermined minimum distance to the target tissue at the treatment opening surface for arc generation. The treatment opening is configured such that the wall region / body edge partially contacts the target tissue, thereby bringing either the first or second minimum distance closer to the target tissue. In this case, the distance to the wall region / body edge does not change, and the endoscope is simply guided to the target tissue. This means that the distance to each treatment opening is different, and therefore, that distance is predetermined and cannot be changed.

[0012] In other words, the application cap is provided with at least one treatment opening that extends across two preferably adjacent (preferably radial / lateral and axial) sides of the application cap.

[0013] In other words, the basic principle of this disclosure is to provide an application cap / spacer, preferably as a separate part from the feeding device / insertion aid / endoscope, that is suitable for optional attachment as an additional component to the distal end of, for example, an endoscope-type feeding device. When the spacer contacts the target tissue at the contact portion of the spacer provided for this purpose, the spacer / attachment / application cap first has the function of holding the distal end of the feeding device at a certain distance from the target tissue on the patient side.

[0014] An application cap / attachment is configured in a cap shape such that the treatment surface / tissue contact surface of the application cap has a defined treatment opening / treatment opening surface, and a probe / electrode is positioned within or insertable into the application cap / attachment. More specifically, according to the present invention, a type of attachment or (application) cap for a feeding device (endoscope) is proposed, which can be attached or mounted, thereby guiding a surgical instrument (electrode) to treat target tissue / body tissue via a plasma arc. The application cap / attachment is particularly configured in the shape of a cap and is attached to / attachable to the distal end / end of the feeding device or its (endoscope) head. The electrode / probe has a distal end and a proximal end. Typically, the proximal end of the electrode is connected to or connectable to an energy source. The energy source, or a generator or current / voltage source, also supplies energy to form a plasma arc, thus enabling treatment of the target tissue.

[0015] The attachment is preferably rounded or convex, at least outward. The attachment is made of a non-conductive material, in other words, an electrically insulating material such as plastic or ceramic material.

[0016] Therefore, the treatment opening of the application cap according to the present invention has a portion / area configured / provided to contact the patient's target tissue / body tissue. Thus, since the treatment opening or its edge is capable of contacting the target tissue, a treatment area can be defined that defines an area of ​​a certain size corresponding to the tissue area to be treated. The treatment opening is positioned both distally in the axial direction and laterally in the radial direction so that contact with the target tissue is possible in both the distal and radial directions. In this regard, the present invention also typically refers to a treatment opening aligned in two directions, which may mean a single opening or at least two separate openings aligned in two directions.

[0017] The application cap according to the present invention has the advantage that, when there is a single treatment opening, only one portion of the treatment opening (surface) is in contact with the target tissue, depending on which portion of the treatment opening (surface) is closer to the distal end of the electrode. This is because only one portion of the treatment opening, namely the first (distal) portion or the second (radial) portion of the treatment opening surface, is in contact with the target tissue. Therefore, the user guides the instrument with the application cap / attachment so that a specific / desired portion of the treatment opening or treatment opening surface is over the target tissue. The option to select whether to generate the arc via the first or second portion of the treatment opening surface makes it even easier for the user to reach the target tissue to be treated. Furthermore, since the attachment according to the present invention allows for a wider exposure of the target tissue, positioning only a portion of the treatment opening has the advantage for the user of simpler positioning of the treatment opening surface portion.

[0018] Further aspects of the disclosure described in the dependent claims are described below.

[0019] Advantageously, the first treatment opening portion and the second treatment opening portion are configured seamlessly to form a single treatment opening. In other words, the first treatment opening portion together with the second treatment opening portion forms a single treatment opening, which extends across the sides of the application cap facing different directions.

[0020] Alternatively, the first treatment opening and the second treatment opening may be configured separately from each other via a horizontal member, so that the first treatment opening surface faces a first direction, the second treatment opening surface faces a second direction, and the horizontal member forms a kind of edge between the two treatment opening surface surfaces.

[0021] According to a preferred embodiment, the first treatment opening surface portion and / or the second treatment opening surface portion may be surrounded by a support edge / rim configured to be in surface contact with the target tissue. Preferably, the support edge / rim and the treatment opening surface portion surrounded thereby may be substantially on one surface. This ensures a flat support surface.

[0022] According to a further development of the preferred embodiment, the first support edge / rim surrounding the first treatment opening surface portion and the first treatment opening surface portion may be in a flat / planar (support) region extending transversely, preferably perpendicularly, to the longitudinal axis of the application cap.

[0023] According to a further development of the preferred embodiment, the second support edge surrounding the second treatment opening surface portion and the second treatment opening surface portion may be in a flat / planar (support) region extending at a tip angle inclined distally and off-center with respect to the longitudinal axis of the application cap.

[0024] According to a further development of the preferred embodiment, the support edge / rim may surround each treatment opening surface portion over at least half or completely around the perimeter of each treatment opening surface portion. This provides a suitably large contact surface.

[0025] According to a preferred embodiment, the application cap may preferably have a sleeve (surrounding a through-hole) arranged laterally / transversely with respect to the longitudinal axis of the application cap, or a through-hole arranged laterally / transversely, through which an electrode can be inserted into the spatial volume of the application cap from the outside. This allows the electrode to be guided into the spatial volume.

[0026] According to a further development of the preferred embodiment, the application cap may be configured to be substantially closed on the outside, particularly on the circumferential side and / or the end face side, except for the treatment opening and / or the sleeve or through-hole for the electrode. Thereby, the electrode surely acts only in the desired direction.

[0027] According to a further development of the preferred embodiment, the application cap may have a peripheral wall that surrounds a spatial volume and in which a sleeve is arranged or a through-hole is formed inside.

[0028] According to the preferred embodiment, the sleeve or through-hole may form a seal for closing the gap between the electrode that can be inserted or mounted into the application cap through the sleeve or through-hole and the application cap. Thereby, there is an advantage that the electrode is sealed from the outside.

[0029] According to a further development of the preferred embodiment, the seal may be formed as an elastic component separate from the peripheral wall and preferably inserted into and coupled to the peripheral wall. For example, the seal may have a thermoplastic elastomer as the material.

[0030] Preferably, depending on whether the target tissue is closer to the electrode in either the first or second treatment opening portion, the application cap preferably has a sleeve or through-hole positioned and formed at a predetermined angle α with respect to the longitudinal axis of the application cap, preferably 20° to 90°, more preferably 69° to 75°, and even more preferably (exactly) 72°, so that an arc can be generated in the direction toward the first treatment opening portion or toward the second treatment opening portion via an electrode that can be inserted into the application cap via a sleeve or through-hole. Alternatively, when generating an arc in the forward direction, or substantially toward the first treatment opening portion, the predetermined angle α is preferably 20° to 45°. Alternatively, when generating an arc in the lateral direction, or substantially toward the second treatment opening portion, the predetermined angle α is preferably 45° to 90°.

[0031] Advantageously, the first treatment opening portion is positioned or formed at the distal end, preferably forming a plane perpendicular to the longitudinal axis of the application cap, and the second treatment opening portion is positioned or configured to substantially face the sleeve or through hole.

[0032] Advantageously, the second treatment opening portion is inclined with respect to the first treatment opening portion at an angle greater than 90° and less than 115°, preferably 107.57° (Figure 1(β)). The angle of inclination of the second treatment opening portion is such that the tissue being treated is optimally taut / smooth.

[0033] Advantageously, the first treatment opening portion has a first predetermined minimum distance to the electrode that can be inserted through the sleeve, and the second treatment opening portion has a second predetermined minimum distance to the electrode that can be inserted through the sleeve, where the first minimum distance is greater than the second minimum distance. Alternatively, preferably, the electrode is permanently installed in the sleeve and thus functions as a single unit.

[0034] Preferably, the application cap is configured to self-retain the electrode outside the application cap while maintaining a predetermined first minimum distance and a predetermined second minimum distance. In other words, preferably, there is no working channel through which the electrode / probe passes, and the electrode / probe is fixed externally and can be directly inserted / pushed into the application cap via a sleeve. Alternatively, advantageously, the electrode can be inserted into a conventional working channel. This keeps the tissue surface taut and allows for better estimation of the distance to the tissue surface when used forward through the first treatment opening portion.

[0035] Advantageously, the edge is located at the proximal end of the second treatment opening and is provided for scraping or removing the target tissue. The edge is located in a wall region at the proximal end of the second treatment opening. The radius of the edge is preferably 0.5 mm or less.

[0036] Preferably, the sleeve is configured to be at least stretchable or flexible when the electrode is inserted.

[0037] Furthermore, advantageously, the application cap is configured to be attachable to a plasma surgical device via an adapter. In other words, the application cap may have an adapter integrally provided at its proximal end and is configured to be attached to the distal end of the plasma surgical device.

[0038] Alternatively, the application cap and adapter can be formed in two separate parts. In this case, the application cap and adapter can be fitted together and then pressed into place on the distal end of the plasma surgical device.

[0039] Advantageously, both the application cap and the adapter have guide grooves for guiding the electrode / probe.

[0040] The disclosure further relates to a plasma surgical instrument, preferably of minimally invasive type, wherein an electrode is provided at the distal end of the instrument and is adapted to generate an arc with respect to a target tissue at least a predetermined minimum distance when electrical energy is supplied in a specific gaseous environment, and comprises an application cap as described in at least one of the above embodiments. [Brief explanation of the drawing]

[0041] [Figure 1] Figure 1 is a cross-sectional view of a first embodiment of the application cap according to this disclosure, along the longitudinal axis AA of the cross-section in Figure 3. [Figure 2] Figure 2 is a diagram illustrating a first embodiment of the application cap relating to this disclosure. [Figure 3] Figure 3 is a diagram of the application cap relating to this disclosure, viewed from the proximal to distal direction. [Figure 4] Figure 4 is a bottom view of the application cap related to this disclosure. [Figure 5] Figure 5 is a side view of the application cap related to this disclosure. [Figure 6] Figure 6 is a top view of the application cap related to this disclosure. [Figure 7] Figure 7 is a schematic diagram of a plasma surgical instrument equipped with an application cap according to this disclosure. [Figure 8] Figure 8 is a schematic side view of the front portion of a plasma surgical instrument equipped with an application cap according to this disclosure. [Figure 9] Figure 9 is an exploded view of an application cap that can be attached to a plasma surgical instrument. [Figure 10] Figure 10 is an exploded view of Figure 9 from the side. [Figure 11] Figure 11 is a perspective view of a second embodiment of the application cap according to this disclosure. [Modes for carrying out the invention]

[0042] The embodiments of this disclosure will be described below with reference to the attached drawings. Figures 1 to 10 show a first embodiment of application cap 1 according to this disclosure. Figure 11 shows a second embodiment of application cap 1 according to this disclosure.

[0043] Figure 1 is a cross-sectional view of a first embodiment of the application cap 1 according to the present disclosure, along the longitudinal axis AA of the cross-section in Figure 3. Figure 1 shows an application cap 1 for a plasma surgical instrument, provided as a spacer. The application cap 1 can be attached to or connected to the distal end of an (endoscope) supply device / endoscope. The application cap 1 forms a space volume 2 in its distal portion. In particular, the space volume 2 may be at least partially, preferably mostly, enclosed by a preferably rigid outer wall / circumferential wall 17 of the application cap 1.

[0044] As shown in Figure 1, the application cap 1 is configured to accommodate or insert the electrode 3, and is designed to maintain at least a minimum distance d1, d2 from the distal end of the electrode 3 inserted into the application cap 1 to the target tissue.

[0045] The application cap 1 has a wall portion 4 configured to be in contact with the target tissue. At least one treatment opening 5 is formed in the wall portion / region 4. The treatment opening 5 is an opening provided in the application cap 1 that exposes / reveals the region of the target tissue. At least one treatment opening 5 forms a first treatment opening surface portion 6 and a second treatment opening surface portion 7. The first treatment opening surface portion 6 and the second treatment opening surface portion 7 are oriented in different directions.

[0046] In other words, the application cap 1 has a substantially hollow cone at its distal cap portion, which is rounded outward in a convex shape, with the conical tip and peripheral wall portion being separate, and it has a continuous opening directed both distally in the axial direction (first treatment opening portion 6) and laterally in the radial direction (second treatment opening portion 7).

[0047] That is, as shown in Figure 1, the first treatment opening surface portion 6 faces distally, and the second treatment opening surface portion 7 faces radially (downward in Figure 1). The first treatment opening surface portion 6 and the second treatment opening surface portion 7 are formed seamlessly to form a single treatment opening 5, as already shown. Alternatively, the first treatment opening surface portion 6 and the second treatment opening surface portion 7 may be provided separately from each other by a horizontal member 11. In this case, the horizontal member 11 forms a kind of edge between the first treatment opening surface portion 6 and the second treatment opening surface portion 7.

[0048] The application cap 1 preferably has a through-hole 8 or a sleeve 8 surrounding a through-hole, radially facing the second treatment opening portion 7. To generate an arc against the target tissue in the direction of the first treatment opening portion 6 or the second treatment opening portion 7, the through-hole or sleeve 8 is provided to accommodate the electrode / probe 3 so that it protrudes into the spatial volume 2 of the application cap 1. The sleeve or through-hole 8 forms a seal to close the gap between the application cap 1 and the electrode 3, which can be introduced or inserted into the application cap 1 through the sleeve 8 or through-hole 8.

[0049] The sleeve 8 or through-hole is provided at a predetermined angle with respect to the longitudinal axis 9 of the application cap 1, thereby enabling the generation of an arc between the electrode 3 and the target tissue in the first treatment opening portion 6 and the treatment opening portion 7 without changing the position of the electrode 3. A predetermined minimum distance d1 between the electrode (tip) 3 and the first treatment opening portion 6, and a predetermined minimum distance d2 between the electrode (tip) 3 and the second treatment opening portion 7 are maintained.

[0050] Preferably, the predetermined angle α of the sleeve 8 with respect to the longitudinal axis 9 is approximately 10° to 80°, and preferably 72°. Alternatively, in addition, preferably, the predetermined angle α when generating an arc in the forward direction, or substantially toward the first treatment opening portion 6, is 20° to 45°. Alternatively, in addition, preferably, the predetermined angle α when generating an arc in the lateral direction, or substantially toward the second treatment opening portion 7, is 45° to 90°.

[0051] As shown in Figure 1, the first treatment opening portion 6 is positioned / configured at the distal end. This means that the first treatment opening portion 6 forms a plane perpendicular to the longitudinal axis 9 of the application cap 1. The second treatment opening portion 7 is positioned substantially opposite the sleeve 8. The second treatment opening portion 7 is preferably inclined with respect to the first treatment opening portion 6 by more than 90° and less than 115°. Preferably, the angle β between the first treatment opening portion 6 and the second treatment opening portion 7 is 107.57°.

[0052] The angle γ is preferably 20° to 110°, more preferably 80° to 100°, and even more preferably (exactly) 89.57°. The angle γ represents the inclination between the inclination of the second treatment opening portion 7 and the inclination of the sleeve 8 or the electrode / probe 3 inserted therein.

[0053] The first treatment opening portion 6 has a first predetermined minimum distance d1 to the electrode 3 that can be inserted through the sleeve or through hole 8. The first predetermined minimum distance d1 is preferably 5.66 mm to 7.66 mm, and more preferably 6.66 mm. The second treatment opening portion 7 has a second predetermined minimum distance d2 to the electrode 3 that can be inserted through the sleeve or through hole 8. The second predetermined minimum distance d2 is preferably 1 mm to 7.5 mm, and more preferably 4.96 mm. It is essential that the first predetermined minimum distance d1 is greater than the second predetermined minimum distance d2. This requires the user to press the distal end of the application cap 1 against the target tissue so that when generating an arc through the first treatment opening portion 6, the distance between the distal end of the electrode 3 and the target tissue is smaller than the distance to the target tissue through the second treatment opening portion 7.

[0054] As shown in Figure 1, the application cap 1 is configured to self-retain and fix the electrode 3 to the outside of the application cap 1 while maintaining a first predetermined minimum distance d1 and a second predetermined minimum distance d2.

[0055] Figure 2 is a diagram illustrating the application cap 1 according to this disclosure. Figure 2 is a schematic diagram of the application cap 1 based on the above description of Figure 1. Therefore, Figure 2 shows the application cap 1 that forms or defines a spatial volume 2 in its distal portion.

[0056] The treatment opening 5 is shown in Figure 2 and is defined by the wall region / body edge 4. In Figure 2, the first treatment opening surface portion 6 and the second treatment opening surface portion 7 are shown connected as a (single) treatment opening 5. For clarity, reference numerals 6 and 7 are omitted in Figure 2. In Figure 2, the treatment opening 5 is provided distally and downwards from the application cap 1.

[0057] The first treatment opening portion 6 is defined or limited by the adjacent wall region / main body edge 4, which is arranged in a semicircular shape in plan view. Therefore, the wall region / main body edge 4 that defines the range of the second treatment opening portion 7 is formed in the side view by two spaced-apart parallel horizontal members or elongated pieces, which connect to the semicircular wall region 4, forming a smooth transition.

[0058] Furthermore, preferably, a guide groove 12 starting from the sleeve 8 is provided on the upper side of the application cap 1 in the longitudinal direction of the cap. The guide groove 12 is configured to guide the electrode 3 on the outside of the application cap 1 and hold its position. In other words, the guide groove 12 serves to prevent lateral displacement of the electrode 3.

[0059] Figure 3 is a view of the application cap 1 according to this disclosure, from proximal to distal. Figure 3 shows the electrode 3 located in the guide groove 12, which protrudes into the spatial volume 2 of the application cap 1 via the sleeve 8.

[0060] Figures 4 to 6 show different views of the application cap 1, which includes a wall region 4 and a sleeve or through-hole 8. Figure 4 is a bottom view of the application cap 1 according to the disclosure. Figure 5 is a side view of the application cap 1 according to the disclosure, and Figure 6 is a top view of the application cap 1 according to the disclosure.

[0061] Figure 7 is a schematic diagram of a plasma surgical instrument 13 equipped with an application cap 1 according to the present disclosure, and Figure 8 is a schematic side view of the front portion of the plasma surgical instrument 13 equipped with the application cap 1 according to the present disclosure. Both Figures 7 and 8 show the proximal end of the plasma surgical instrument 13. The application cap 1 is attached to the plasma surgical instrument 13. The probe / electrode 3 is positioned / attached to the outside of the plasma surgical instrument 13 and preferably fixed in place. The distal end of the probe / electrode 3 is inserted into the application cap 1. To securely fix the electrode / probe 3, a fixing ring 14 is provided, surrounding the electrode / probe 3 and the distal end of the plasma surgical instrument 13 equipped with the attached application cap 1. In other words, the fixing ring 14 is configured as a band, preferably in the form of an adhesive elongated piece or a rubber band, to hold / fix the electrode / probe 3 in place.

[0062] Figure 9 is an exploded view of the application cap 1 that can be attached to the plasma surgical instrument 13, and Figure 10 is a side view of the exploded view of Figure 9. Figures 9 and 10 show the application cap 1, adapter 15, fixing ring 14, and the plasma surgical instrument 13, preferably an endoscope, with the probe / electrode 3 on the outside, viewed from distal to proximal. Preferably, the probe / electrode 3 and the instrument 13 are not integrally configured. In this example, the application cap 1 and adapter 15 are configured separately from each other. Alternatively, the application cap 1 and adapter 15 may form a single device or be integrally configured, since the adapter 15 is preferably configured to be attached to or connected to the application cap 1 with adhesive.

[0063] Figure 11 shows a second embodiment of the application cap 1. In contrast to the first embodiment, the application cap 1 has a seal 16 that is configured separately from the outer wall / peripheral wall 17 (or adapter 15) surrounding the spatial volume 2. Preferably, the seal 16 is insertable into a corresponding recess in the outer wall 17, or more particularly, can be coupled to the outer wall 17. The seal 16 forms a through hole 8 or a sleeve 8 (surrounding the through hole), through which the electrode 3 can be inserted into the spatial volume 2 from the outside. The seal 16 serves to seal the space between the application cap 1 and the electrode 3.

[0064] Preferably, the seal 16 may be formed of an elastic material. In contrast, preferably, the outer wall 17 surrounding the spatial volume 2 may be formed of a rigid plastic. The outer wall 17 may be formed of, for example, a transparent plastic.

[0065] The adapter 15 may preferably be attached to (or inserted into) the application cap 1, and in particular may be coupled to the application cap 1. In a second embodiment, the adapter 15 is configured as a connecting sleeve, preferably with a substantially annular cross-section. The connecting sleeve is made of an elastic material, preferably the same material as the seal 16. The connecting sleeve forms a push-on opening 18, thereby allowing it to be attached to an endoscope. Due to its elasticity, the connecting sleeve can be attached to endoscopes of different diameters.

[0066] As in the first embodiment, a guide groove 12, preferably having a semicircular cross-section, is formed on the upper (outer) side of the application cap 1 in the longitudinal direction of the cap. The guide groove 12 extends proximal from the through hole 8. The guide groove 12 guides the electrode 3 and, in particular, serves to hold the electrode 3 laterally. In the second embodiment, the guide groove 12 is formed partly by the seal 16, partly by the outer wall 17, and partly by the adapter 15. [Explanation of Symbols]

[0067] 1 Application Cap 2 Space volume 3 electrodes / probes 4. Wall area / Main body edge 5. Opening for treatment 6. First treatment opening portion 7. Second treatment opening portion 8 sleeves / through holes 9 Longitudinal axis 10 yen 11 Crosspiece 12 Guide groove 13 Plasma Surgical Instruments 14 Retaining ring 15 Adapters 16 stickers 17 Exterior Wall 18 Push-on opening d1 First minimum distance d2 Second minimum distance

Claims

1. Preferably, an application cap (1) is provided as a spacer for a minimally invasive type plasma surgical instrument (13) and is configured to be connected to / attached to the distal end of an endoscope supply device for the plasma surgical instrument, A spatial volume (2) is formed in the distal portion, Maintain at least a minimum distance (d1, d2) from the target tissue to the distal end of the electrode (3) that can be inserted into the application cap (1), and It is configured to be in contact with the target tissue and has at least one wall region (4) in which at least one treatment opening (5) is formed inside, Designed and configured for a specific purpose, In application cap (1), The at least one treatment opening (5) is characterized in that it forms a first treatment opening surface portion (6) and a second treatment opening surface portion (7), and the first treatment opening surface portion (6) is oriented in a different direction from the second treatment opening surface portion (7). Application cap (1).

2. The application cap (1) according to claim 1, characterized in that the first treatment opening portion (6) and the second treatment opening portion (7) are formed seamlessly to form a single treatment opening (5).

3. The application cap (1) according to claim 1 or 2, characterized in that the first treatment opening portion (6) and / or the second treatment opening portion (7) are surrounded by a support edge configured to make surface contact with the target tissue.

4. The application cap (1) according to claim 3, characterized in that the support edge and the treatment opening surface portion (6, 7) surrounded by it are substantially on a single plane.

5. The application cap (1) according to claim 3 or 4, characterized in that the first support edge surrounding the first treatment opening portion (6) and the first treatment opening portion (6) are in a flat region extending laterally, preferably perpendicularly, with respect to the longitudinal axis of the application cap (1).

6. The application cap (1) according to any one of claims 3 to 5, characterized in that the second support edge surrounding the second treatment opening portion (7) and the second treatment opening portion (7) are in a flat region that extends with a tip angle that is offset from the center and inclined distally with respect to the longitudinal axis of the application cap (1).

7. The application cap (1) according to any one of claims 3 to 6, characterized in that the support edge surrounds each of the treatment opening portions over at least half of the periphery of each of the treatment opening portions (6, 7) or completely.

8. The application cap (1) preferably has a sleeve or a through hole (8) arranged laterally with respect to the longitudinal axis of the application cap (1), and the electrode (3) can be inserted from the outside into the spatial volume (2) of the application cap (1) through the sleeve or the through hole (8), as described in any one of claims 1 to 7.

9. The application cap (1) according to claim 8, characterized in that the sleeve or the through hole (8) forms a seal for closing the space between the electrode (3) which can be inserted or is inserted through the sleeve or the through hole (8) and the application cap (1).

10. The application cap (1) according to claim 8 or 9, wherein the application cap (1) is configured to be substantially closed on the outside, particularly on the circumferential side and / or end face side, except for the treatment opening (5) and / or the sleeve or through hole (8) for the electrode (3).

11. The application cap (1) according to any one of claims 8 to 10, characterized in that the application cap (1) has a peripheral wall that surrounds the spatial volume (2) and in which the sleeve is disposed or the through hole (8) is formed.

12. The application cap (1) according to claim 11, characterized in that the seal (16) is formed as an elastic component separate from the peripheral wall (17), and preferably is inserted into the peripheral wall (17) and coupled to the peripheral wall (17).

13. Preferably, the application cap (1) according to any one of claims 8 to 12, characterized in that the sleeve or the through-hole (8) is positioned and configured at a predetermined angle (α), preferably 72°, with respect to the longitudinal axis (9) of the application cap (9), so that an arc can be generated in the direction toward the first treatment opening (6) or toward the second treatment opening (7) via the sleeve or the through-hole (8) through the electrode (3) which can be inserted into or located within the application cap (1) depending on whether the target tissue is closer to the electrode (3) in either the first treatment opening (6) or the second treatment opening (7).

14. The application cap (1) according to any one of claims 1 to 13, characterized in that the first treatment opening portion (6) is located or formed at the distal end and preferably forms a plane perpendicular to the longitudinal axis (9) of the application cap (1), and the second treatment opening portion (7) is located or formed substantially opposite the sleeve or the through hole (8).

15. The application cap (1) according to any one of claims 1 to 14, characterized in that the second treatment opening portion (7) is inclined with respect to the first treatment opening portion (6) at an angle greater than 90° and less than 115°, preferably 107.57°.

16. The application cap (1) according to any one of claims 8 to 15, characterized in that the first treatment opening portion (6) has a first predetermined minimum distance (d1) to the electrode (3) that can be inserted through the sleeve or the through hole (8), and the second treatment opening portion (7) has a second predetermined minimum distance (d2) to the electrode (3) that can be inserted through the sleeve or the through hole (8), and the first minimum distance (d1) is greater than the second minimum distance (d2).

17. The application cap (1) according to any one of claims 1 to 16, characterized in that the application cap (1) is configured to self-retain and fix the electrode (3) to the outside of the application cap (1) while maintaining the predetermined first minimum distance (d1) and the predetermined second minimum distance (d2).

18. The application cap (1) according to any one of claims 1 to 17, characterized in that a rim (10) is formed at the proximal end of the second treatment opening portion (7) and is provided for scraping or removing the target tissue.

19. The application cap (1) according to any one of claims 8 to 18, characterized in that the sleeve or the through hole (8) is at least stretchable or flexible when the electrode (3) is inserted.

20. The aforementioned application cap (1) is In particular, a tunnel opening that forms the first treatment opening portion (6), the cross-section of which is substantially perpendicular to the longitudinal axis of the application cap (1), In particular, the tunnel bottom, which forms the second treatment opening portion (7), is substantially perpendicular to the radial direction of the application cap (1), The cross-section is semicircular, preferably with a diameter that increases from distal to proximal, and in particular, it has a tunnel section in the distal direction that is the shape of a wall. The application cap (1) according to any one of claims 1 to 19, preferably having an annular portion in the proximal direction.

21. Preferably a minimally invasive type plasma surgical instrument (12), The electrode (3) is provided at the distal end of the apparatus and is suitable for generating an arc with respect to the target tissue at least a predetermined minimum distance (d1, d2) when electrical energy is supplied under a specific gas environment, and comprises the application cap (1) described in any one of claims 1 to 20. Plasma surgical instruments (12).

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