Resectoscopes and electrode devices for resectoscopes

Abstract

To provide a resectoscope that prevents the instrument tip from unintentionally slipping.SOLUTION: This is achieved by enlarging a cross-section of at least one electrode support in regions between the distal end of the electrode support and a guide element, which may be a guide plate, for example.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention 、 Electrode device for resectoscope 、 moreover 、 Regarding resectoscope. [Background technology]

[0002] Radiofrequency surgical instruments such as resectoscopes are used to remove or treat body tissue. A typical application is in urology. An example is prostatectomy. The radiofrequency tool used can be an electrode connected to a radiofrequency generator or an RF electrode, which the surgeon can activate and deactivate with a switch. A plasma is excited in the electrode by a radiofrequency current. RF electrodes are particularly suitable for pinpoint treatment of tissue, as the plasma interacts with the tissue.

[0003] To treat tissue, the electrodes can be designed as cutting loops or button electrodes, or even needles, rollers, tapes, etc., depending on the application; when the high-frequency voltage is turned on, the plasma allows these electrodes to be guided very easily through the body tissue to be ablated with almost no resistance.

[0004] The electrodes are removably anchored to a conveyor or operating element of the resectoscope via the electrode device. During treatment of the body tissue, the electrode device with the electrodes is moved along the longitudinal direction of the resectoscope. Depending on whether the resectoscope is an active or passive resectoscope, a transporter or carriage is connected to the body with the handle unit by a compression or tension spring.

[0005] The known electrode instrument is guided in a tube-like shaft of the resectoscope together with the optical system, which can be designed as a light guide system or a rod lens system. The shaft extends from the proximal end of the resectoscope to the distal end and is guided into the body to be treated. The electrode instrument is then movably coupled to the optical component or to the inner shaft in which the optical component is located. The coupling can take place, for example, via a guide tube or guide element which at least partially surrounds the optical component or the inner shaft. The guide element connects two substantially parallel electrode supports in each section. In known embodiments, a distal and a proximal guide element, and if necessary further guide elements, are assigned to the electrode support. The distal guide element is assigned to the distal region of the electrode support and the proximal guide element is assigned to the proximal region.

[0006] In order to prevent the electrodes, to which the HF current may be applied, from unintentionally coming into contact with the metallic inner shaft, the inner shaft has a plastic instrument tip, which is assigned to the distal end of the inner shaft. The distal end of the electrode support together with the electrode extends through the sleeve-like instrument tip, so that the electrode together with the electrode support can move back and forth relative to the instrument tip during operation along the longitudinal axis. The instrument tip can move freely in the distal parts of the two electrode supports. To that end, the two electrode supports are guided through receptacles or lumens of the instrument tip.

[0007] To couple the electrode support to the inner shaft, the inner shaft is placed on or under two U-shaped guide elements or guide plates, or the electrode support with the guide elements is placed on or under the inner shaft. When the inner shaft is clipped onto the guide elements, the guide elements are elastically deformed. When mounting the electrode instrument on the inner shaft, it may happen that the instrument tip, which moves freely on the electrode support, slides in the proximal direction against the guide elements, especially the distal guide element. If the guide element is now elastically bent to accommodate the inner shaft, this force is also transmitted to the instrument tip via the electrode support. The forces that can act on the plastic instrument tip via the electrode support are sufficient to plastically deform the instrument tip, i.e. irreversibly. If the instrument tip is deformed in this way, the electrode instrument may become unusable, since the instrument tip can no longer slide freely on the electrode support. Summary of the Invention

[0008] The present invention is based on the object of creating an electrode device and a resectoscope which solves the aforementioned problems.

[0009] The solution to the problem is described by the features of claim 1. Thereby, it is provided that in the region between the distal end of the electrode support and a guide element, for example a guide plate, the cross section of at least one electrode support is enlarged. According to the invention, it is further provided that an instrument tip is arranged on the distal part of the electrode support. The enlarged cross section of the at least one electrode support is arranged in front of the instrument tip, as viewed in the proximal direction. Another embodiment can provide that the enlarged cross section of the at least one electrode support is located between the instrument tip and at least one guide element, preferably the distal guide element. This enlarged cross section on the at least one electrode support prevents the instrument tip from slipping close to or just in front of the guide element. The greater the distance between the instrument tip and the guide element, in particular the distal guide element, the smaller the above-mentioned forces acting on the instrument tip during elastic deformation of the guide element. By enlarging the cross section, a sufficiently large distance between the instrument tip and the guide element can be created. At the same time, the distance between the enlarged cross section and the electrode is still large enough to move the electrode back and forth along the axis of the shaft during operation.

[0010] A preferred embodiment may provide that the enlarged cross-section portion of at least one electrode support has an oval shape, which has an oval shape relative to the cross-section of the electrode support. Preferably, this oval shape is oriented perpendicular to the plane defined by the two electrode supports. This shape and orientation of the enlarged cross-section portion ensures that the electrode support can move freely back and forth relative to the inner shaft, and in particular also relative to the outer shaft. In this way, the enlarged cross-section portion does not affect the functionality of the electrode device or the mobility of the electrode device relative to the inner shaft. It is also conceivable that the enlarged cross-section portion has a different shape, such as a crescent shape, in which case the crescent fits the shape of the inner shaft.

[0011] In particular, the invention provides that the enlarged cross-section of at least one electrode support is a sleeve crimped onto the electrode support, a solder point on the electrode support or the like, or a deformation or reconstruction of the electrode support. It is also conceivable that a pin, web or other protrusion is arranged on at least one electrode support and can be used to enlarge the cross-section. By increasing the cross-section in this way, the instrument tip can only move to a limited extent on the electrode support. This prevents the instrument tip from moving too close to the guide element. As a result, the instrument tip does not even reach the area where it can be plastically deformed by the elastic bending of the guide element.

[0012] It is conceivable that the instrument tip has two internal cavities, through which two electrode supports or electrode carriers are guided, so that the instrument tip is mounted so as to be freely movable on the two electrode supports. The cross-sectional enlargement is now dimensioned to be larger than at least one internal cavities passing through the instrument tip. Thus, when the instrument tip is moved back and forth on the electrode support, either planned or unplanned, it abuts on the enlargement and thus reaches a minimum distance from the guide element. The effect of the forces that the instrument tip experiences at that minimum distance while at least one guide element is bending is negligible or not detrimental to the shape of the instrument tip.

[0013] Furthermore, a preferred embodiment is provided in which both electrode supports have enlarged cross-section portions dimensioned such that the instrument tip cannot be displaced beyond them. Each of the enlarged cross-section portions is smaller than the diameter of the lumen. However, by arranging the enlarged cross-section portions, which may be pins for example, to be mirror images, the instrument tip cannot move beyond them. However, it is possible to align the enlarged cross-section portions by intentionally bending or compressing the electrode support so that the instrument tip can nevertheless be moved proximally close to the guide element. However, this is only possible by manual intervention by the operator. Otherwise, the enlarged cross-section portions prevent the instrument tip from reaching a critical area in front of the guide element, as described above.

[0014] Another embodiment can provide that the instrument tip slides over the enlarged cross-section section against slight resistance, where it is held in place by, for example, increased friction or elastic deformation. After clipping the electrode onto the inner shaft, the instrument tip is pushed proximally to lock it in. In the process, the instrument tip is coupled to the distal end of the inner shaft without further manipulation and is pushed down against the corresponding resistance of the enlarged cross-section section, so that it is again movable relative to the electrode.

[0015] It is preferably envisaged that the distal guide element is offset proximally from the distal end of the electrode support by 10 mm to 100 mm, in particular 25 mm to 85 mm, preferably 55 mm. It is further envisaged that the enlarged cross-section portion may have a distance of 10 mm to 60 mm, preferably 20 mm to 40 mm, or 30 mm, relative to the electrode. The distance between the enlarged cross-section portion and the distal end of the guide element, in particular the distal guide element, is 10 mm to 100 mm, preferably 45 mm.

[0016] Finally, claims 10 The resectoscope according to claim 1 describes a further solution of the aforementioned task.9 Furthermore, the resectoscope has an inner shaft on which the optical system is mounted, the electrode instrument being capable of being guided on the inner shaft by at least one guide element, preferably a guide plate.

[0017] Preferred embodiments of the invention are explained in more detail below with reference to the drawings. [Brief description of the drawings]

[0018] [Figure 1] FIG. 1 is a schematic diagram of a resectoscope. [Diagram 2] FIG. 1 is a schematic perspective view of an electrode device. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0019] 1 shows a possible embodiment of a resectoscope 10 in which an outer shaft 11, shown here only by dashed lines, is slid over an inner shaft 12. The inner shaft 12 serves to receive or guide an optic 13 that extends from a distal end 14 to a proximal end 15 of the resectoscope 10. At the proximal end 15, an eyepiece 16 is available for a user to view through the optic 13 the area to be operated on forward of the distal end 14.

[0020] An essential component of the resectoscope 10 is a transporter 17 or conveyor. Among other things, the transporter 17 has a first gripping means 18, which is connected via spring elements 19 to a second gripping means 20 and to an optical plate 21.

[0021] Additionally, an electrode apparatus 22 extends along the inner shaft 12 from the distal end 14 of the resectoscope 10 to the transporter 17. The electrode apparatus 22 shown in FIG. 2 represents only one possible embodiment. It is expressly noted that the invention described herein is not limited to the configuration shown. Rather, it is contemplated that the invention described may be used in conjunction with electrode apparatus of different shapes.

[0022] The electrode device 22 shown here can be anchored to the transporter 17 by means of the proximal end 24. In this way, the electrode device 22 can, on the one hand, be detached from or coupled to the transporter 17 in a simple manner, and, on the other hand, be moved together with the transporter 17 in the distal or proximal direction along the longitudinal axis of the resectoscope 10.

[0023] At its distal end 14, the electrode instrument 22 has an electrode 23. This electrode 23, or cutting electrode, can be supplied with electrical energy used to treat tissue via an HF generator, not shown. When an HF voltage is applied to the electrode, a plasma is excited around the electrode 23, shown here as a cutting loop. By moving the electrode instrument 22 axially back and forth, organic tissue can be treated or cut. In addition to the cutting loop shown in the figures, other electrode shapes are possible.

[0024] For pinpoint treatment of human tissue, it is of utmost importance to be able to manipulate the electrode 23 very precisely. Such precise manipulation is made particularly difficult by the length of the electrode device 22 or by the reduced cross-section of the device 22.

[0025] As can be seen in Fig. 2, the electrode 23 is or can be mechanically attached at its ends to two electrode supports 25 and 26 or to two electrode sheath tubes or fork tubes. The electrode 23 together with the electrode supports 25 and 26 constitute an integral component of the electrode device 22. In addition to the parallel guidance of the electrode supports 25 and 26 or the electrode sheath tubes shown here, it is also conceivable that the electrode supports 25 and 26 are fork-like and converge in the direction of the proximal end 15 to form one shaft.

[0026] In addition to mechanical coupling, the electrode supports 25 and 26 or the electrode sheath also provide electrical contact with the electrode 23. It is envisioned that the electrode supports 25 and 26 and any conductors within the supports 25 and 26 may serve as electrical leads or contacts.

[0027] In order to increase the stability of the electrode device 22 and also the associated safe and precise operation, the invention provides that the electrode supports 25, 26 are connected to one another by a guide element 27. Furthermore, it can be provided or is conceivable that the two electrode supports 25, 26 are connected to one another by at least one further guide element 27.

[0028] This guide element 27 serves not only to stabilize the electrode device 22 overall, but also to guide the electrode device 22 along the inner shaft 12. In that case, the at least one guide element 27 is arranged or clamped or clipped to the side of the inner shaft 12, with the at least one guide element 27 at least partially surrounding the inner shaft 12. As an alternative, it is also conceivable that the at least one guide element 27 can be attached to the electrode support 25, 26 from below, with the electrode device 22 then being located below the longitudinal axis 32 of the inner shaft 12.

[0029] When the inner shaft 12 is clamped or clipped to the at least one guide element 27, the two electrode supports 25, 26 are slightly bent so that the inner shaft 12 can be inserted such that its outer contour is between the electrode supports 25, 26 and the guide element 27. With the inner shaft 12 in the clamped state, the two electrode supports 25, 26 return to their original parallel or unbent shape. In that state, the electrode device 22 can be moved parallel to the longitudinal axis 32 against only slight frictional resistance.

[0030] To electrically insulate the electrode 23, to which the potential is applied, from the inner shaft 12 or to prevent the electrode 23 from coming into contact with the metallic inner shaft 12, and also to prevent flashovers occurring between the electrode 23 and the inner shaft 12, an instrument tip 30 is associated with the inner shaft 12. This instrument tip 30 is associated with the distal end 14 of the electrode instrument 22 during assembly. In this respect, an example of a possible embodiment is shown in very schematic form in FIG. 2. The instrument tip 30 has a central opening that substantially corresponds to the inner diameter of the inner shaft 12. Furthermore, the instrument tip 30 has two holes through which the sections 28 and 29 of the electrode supports 25, 26 are guided. As a result, the instrument tip 30 is free to slide back and forth along a longitudinal axis 32 on the two electrode supports 25, 26. After the inner shaft 12 is brought together with the at least one guide element 27 as described above, the instrument tip 30 and the inner shaft 12 can be displaced relative to one another along the longitudinal axis 32 so that they come into contact. A coupling mechanism allows the instrument tip 30 to be releasably coupled to the distal end of the inner shaft 12. Thus, the instrument tip 30 together with the inner shaft 12 can be displaced relative to the electrode instrument 22 along the longitudinal axis 32 in order to treat body tissue with the electrode 23 as described above.

[0031] As mentioned above, when the inner shaft 12 is coupled to the electrode instrument 22 or to the at least one guide element 27, the electrode supports 25, 26 are bent slightly outwards from their parallel position, which leads to an elastic bending of the guide element 27. The instrument tip 30 must be positioned on the electrode support 25, 26 at a sufficient distance from the guide element 27 so that the bending is not hindered by the instrument tip 30 or so that the forces applied during bending are not transmitted to the instrument tip 30 and plastically deform it. To prevent the instrument tip 30 from unintentionally slipping in the immediate vicinity of the guide element 27, the invention provides that the cross section of at least one electrode support 25, 26 has an expansion between the instrument tip 30 and the guide element 27. By such a local or regional expansion 31 of the cross section, the cross section of at least one electrode support 25, 26 is larger than one of the lumens passing through the instrument tip 30. In this manner, the instrument tip 30 can no longer move freely or as desired on the electrode supports 25, 26 close to the guide element 27. Rather, movement of the instrument tip 30 in the direction of the guide element 27 is prevented by the enlarged cross-section portion 31 (FIG. 2).

[0032] This enlarged cross-section portion 31 can be, for example, a crimping of at least one electrode support 25, 26. In that case, a sleeve is placed on at least one electrode support 25, 26 and it is crimped. Alternatively, the shape of at least one electrode support 25, 26 can be modified at that point so that the cross-section is larger than the lumen of the instrument tip 30. It is also conceivable that both electrode supports 25, 26 have a corresponding increase in the cross-section 31. In order to prevent the instrument tip 30 from being plastically deformed during the assembly of the inner shaft 12, the at least one enlarged cross-section portion 31 must be located at a sufficient distance from the guide element 27. The distance can be designed depending on the shape and configuration of the electrode instrument 22. Conceivable distances can be between 10 mm and 100 mm, preferably between 20 mm and 60 mm, or even 40 mm.

[0033] In order to ensure that the enlarged cross-section portion 31 does not affect the relative movement between the electrode device 22 and the inner shaft 12, the present invention provides that the shape of the enlarged cross-section portion 31 follows the outer contour of the inner shaft 12. In this respect, the enlarged cross-section portion 31 can, for example, conform to an oval or sickle-shaped cross-section. Likewise, the enlarged cross-section portion 31 is shaped or dimensioned so as not to come into contact with the shaft 11 either. [Explanation of symbols]

[0034] 10 Resectoscope 11 Shaft 12 Inner Shaft 13 Optical Components 14 Distal end 15 Proximal end 16 Eyepiece 17 Transporter 18 First holding means 19 Spring elements 20 Second holding means 21 Optical Plate 22 Electrode equipment 23 electrodes 24 Proximal end 25 Electrode support 26 Electrode support 27 Guide Elements 28 Section 29 Section 30 Instrument tip 31 Enlarged cross-section 32 Longitudinal axis

Claims

1. An electrode device (22) for a resectoscope (10) having an electrode (23), The electrode (23) is fixed to the two distal ends of two tubular electrode supports (25, 26) aligned parallel to one another, on which are arranged at least one guide element (27) connecting the two electrode supports (25, 26) to one another, 1. An electrode instrument, comprising: an instrument tip (30) slidably arranged on the electrode support (25, 26) in the region between the distal end of the electrode support (25, 26) and the guide element (27) proximal to the electrode support (25, 26); and a cross-section of at least one electrode support (25, 26) is enlarged between the instrument tip (30) and the guide element (27) to prevent the instrument tip (30) from approaching the guide element (27).

2. 2. An electrode device (22) for a resectoscope (10) according to claim 1, Electrode instrument, characterized in that the enlarged cross-sectional area (31) is located in front of the instrument tip (30) when viewed in the proximal direction.

3. 2. An electrode device (22) for a resectoscope (10) according to claim 1, characterized in that the cross-sectional enlargement portion (31) has an oval cross-sectional shape, the minor axis of the cross-sectional enlargement portion (31) being equal to the outer diameter of the electrode support (25, 26).

4. 4. An electrode apparatus (22) for a resectoscope (10) according to claim 3, characterized in that the oval cross-sectional shape has its major axis oriented perpendicular to a plane defined by the central axes of the two electrode supports (25, 26).

5. 2. The electrode device (22) for a resectoscope (10) according to claim 1, characterized in that the enlarged cross-sectional portion (31) of the at least one electrode support (25, 26) is constituted by a sleeve crimped to the electrode support (25, 26), by a solder dot applied to the electrode support (25, 26), or by a change in shape of the electrode support (25, 26).

6. 2. An electrode device (22) for a resectoscope (10) according to claim 1, Electrode instrument, characterized in that the instrument tip (30) has two internal cavities, the two electrode supports (25, 26) are guided through the internal cavities, and the instrument tip (30) is mounted so as to be freely movable on the two electrode supports (25, 26).

7. 7. An electrode device (22) for a resectoscope (10) according to claim 6, An electrode device, characterized in that the enlarged cross-sectional area (31) is larger than the lumen through the device tip (30).

8. 2. An electrode device (22) for a resectoscope (10) according to claim 1, Electrode instrument, characterized in that both electrode supports (25, 26) have an enlarged cross-sectional portion (31) dimensioned such that said instrument tip (30) cannot be displaced beyond said enlarged cross-sectional portion (31).

9. 2. An electrode device (22) for a resectoscope (10) according to claim 1, characterized in that the distal guide element (27) is offset in the proximal direction relative to the distal end of the electrode support (25, 26) by 10 mm to 100 mm.

10. A resectoscope comprising an electrode device (22) according to any one of claims 1 to 9 and an inner shaft (12) on which an optical system (13) is mounted, the electrode device (22) being guided on the inner shaft (12) by at least one guide element (27).

Images