Multi-operator surgical instrument

Abstract

A multifunctional surgical instrument (1) is provided, comprising a proximal portion (13) and two legs (14), each having a distal end (11, 12), the multifunctional surgical instrument having an open state as a default state, the distal ends (11, 12) of the legs (14) not touching each other in the open state, the legs (14) each comprising a suction half-flow bed (26, 27), the proximal portion (13) comprising a suction connection (29), at least one of the distal ends (11, 12) comprising at least one suction opening (28), the two half-flow beds (26, 27) configured to form an airtight and watertight continuous flow bed (25) connecting the at least one suction opening (28) to the suction connection (29) when the multifunctional surgical instrument is in a fully closed state, and configured to open the suction flow bed (25) when the multifunctional surgical instrument is not in a fully closed state.

Description

[Technical field]

[0001] The present invention relates to the field of surgical instruments, specifically to surgical suction instruments, and more specifically to multi-function surgical instruments that combine suction with any one or more of the following functions: irrigation, microdissection of tissue, blunt dissection of tissue, atraumatic tissue retention, coagulation, desiccation, radiofrequency therapy, and vaporization. [Background technology]

[0002] The use of surgical instruments for each of the following functions is known in the art: aspiration, irrigation, micro- and blunt dissection of tissue, atraumatic tissue holding, and electrosurgery. Traditionally, surgeons use different instruments to perform each of these functions. Each instrument change significantly impacts the operative time required to perform a surgical procedure.

[0003] According to a 2018 study by Cheng et al., "Extended operative time is associated with an increased risk of complications. A pooled analysis of 66 observational studies showed that the likelihood of complications increased significantly with longer operative time, nearly doubling at an operative time threshold of 2 hours or more. A meta-analysis also showed that the likelihood of complications increased by 14% for every 30-minute increase in operative time. Given the adverse effects of complications, reducing operative time should become a universal goal for surgeons, hospitals, and policymakers." (Chen et al., "Extended operative time is associated with complications: a systematic review and meta-analysis," Journal of Surgical Research, 2018, 229: pp. 134-144).

[0004] Tissue cutting (i.e., microdissection), blunt dissection of tissue, atraumatic tissue holding, bipolar tissue coagulation, irrigation and aspiration of the surgical field are examples of the most frequent surgical actions that consume most of the time in the majority of surgeries due to the continuous need for changing instruments. Currently, surgeons need to frequently change numerous instruments and need continuous interaction and coordination with each assistant, so a lot of time is lost to coordinate all the above mentioned functions. Especially when the surgical field is small and magnified (such as in neurosurgery and other microsurgeries), the above mentioned time loss is compounded by the complexity and frustration.

[0005] Central to all the above actions is the surgeon's good visibility and hence the importance of aspiration of blood, body fluids, debris and fumes. This aspiration is currently performed by a tubular hand-held probe, which is connected to a vacuum tube / collector and held on cotton putty to avoid continuous clogging and suction trauma to the tissue (cotton putty also irritates the tissue). In case of clogging, the assistant nurse provides a new probe connected to a tube and the previous probe is washed by injecting liquid with a syringe inside it. Each syringe held by the surgeon or assistant is used for cleaning the surgical field to improve visibility and to lower the overall risk of contamination to the tissue and to lower the risk of tissue damage due to the heat generated when using electrosurgical instruments.

[0006] An important factor in operative time is the frequent need to gently hold tissue with forceps or cut with scissors, because the surgeon's view must be kept clear by an assistant during cutting, with coordinated irrigation and suction.

[0007] Blunt dissection of tissue is another time-consuming operation in most surgeries and has not changed significantly over the centuries. Blunt dissection is the careful separation of tissue along tissue planes with either the fingers or a convenient blunt instrument during many diverse surgical procedures.

[0008] Control of blood loss is another time-consuming priority during surgery to avoid or minimize the need to introduce non-autologous blood or blood products into the patient. Coagulation of bleeding vessels is usually accomplished by applying high-frequency (radio frequency) alternating polarity currents to the tissue using bipolar electrosurgical forceps, because the use of such forceps involves only a limited amount of tissue in the circuit formed by the electrodes, reducing the risk of undesirable effects and the extent of thermal damage to that tissue.

[0009] However, these bipolar forceps lack the ability to effectively cut tissue, and surgeons must choose another instrument (e.g., scissors) to cut the coagulated tissue and complete the incision. Thus, existing surgical instruments each have limited functions and need to be changed frequently.

[0010] U.S. Patent Application Publication No. 2013 / 0066317 attempts to solve this problem by providing a bipolar electrosurgical forceps with a scalpel tip electrode and a counter electrode at the distal end of each leg of the forceps, one of the legs with an opening for the exit of irrigation fluid and the counter electrode with an opening for suction. By coordinating the position of the forceps legs and the electrical energy applied to the electrodes, tissue is cut or coagulated.

[0011] This may save some time since it combines electrosurgical forceps, evacuation means, and suction means in the same instrument. However, US2013 / 0066317 does not mention how the functions of the device are controlled to minimize the time required to change from one operating mode to another. Also, the instrument provided by US2013 / 0066317 is subject to the same limitations as a conventional suction instrument that periodically becomes clogged during use and must be periodically replaced by an assistant for cleaning. In this case, clogging of the suction means may require replacement of the entire instrument during surgery, further interrupting the surgeon's work. The forceps taught in this document have a tip that is not suitable for atraumatic tissue holding and blunt dissection of tissue due to its shape, which may require the selection of another instrument.

[0012] It would therefore be desirable to provide an improved surgical instrument that overcomes the limitations of the prior art. In particular, it would be beneficial to provide a surgical instrument that has the ability to atraumatically hold tissue, bluntly dissect tissue, and apply suction, while maintaining high visibility, thereby reducing surgical time and interruptions for the surgeon. It would also therefore be beneficial to provide a surgical instrument that can additionally cleanse tissue, perform micro-dissections of tissue, and perform various electrosurgical techniques on tissue, allowing the surgeon to efficiently control these procedures without the assistance of an assistant. Summary of the Invention

[0013] According to the present invention, a multifunctional surgical instrument is provided. The multifunctional surgical instrument comprises a proximal portion and two legs, each of which comprises a distal end. The default state of the multifunctional surgical instrument is an open state. In the open state, the distal ends of the legs do not contact each other. Preferably, there is a default gap of 2-3 cm between the distal ends of the legs. Each of the legs comprises a suction half-split flow bed (half channel). The proximal portion comprises a suction connection portion, and at least one of the distal ends of the legs comprises at least one suction opening. The two suction half-split flow beds are configured to form an airtight and watertight suction flow bed connecting at least one of the suction openings to the suction connection portion when the multifunctional surgical instrument is in a completely closed state, and are configured to open the suction flow bed when the multifunctional surgical instrument is not in a completely closed state, such as when suction is stopped. The fully closed state is achieved when the surgeon presses the two legs firmly together and the open state is achieved when the surgeon releases some pressure from the legs of the multi-functional surgical instrument, allowing the surgeon to immediately stop suction by releasing pressure, thus protecting tissue that should not be aspirated.

[0014] The suction half-split flow bed, when fully in the closed position, may taper to a blunt atraumatic tip at the distal end of the leg of the multi-functional surgical instrument, which may be used for blunt dissection of tissue.

[0015] The aspirating half-split flow bed may be made of a transparent material configured to allow viewing of its interior.

[0016] The multi-function surgical instrument may include a plurality of openings at its distal end, the dimensions of the openings configured to restrict tissue from entering the aspiration flow bed.

[0017] At least one leg of the multi-functional surgical instrument may further comprise at least one surgical probe element, which may be any elongated or substantially tubular element configured to surgically interact with tissue at its distal end. The additional one or more surgical probe elements may be configured to use energy supplied thereto in any suitable form to perform coagulation, desiccation, fulguration, vaporization, or any combination thereof. Energy may be supplied, for example, in the form of alternating current.

[0018] The surgical probe element may be a means for performing coagulation, desiccation, radiofrequency treatment, or vaporization.

[0019] The surgical probe elements may be configured to perform one or more surgical techniques including, but not limited to, bipolar electrosurgery, monopolar electrosurgery, electrocautery, hyphenated electrosurgery, cryosurgery, argon plasma surgery, laser surgery, ultrasonic surgery (harmonic scalpel), and microwave surgery.

[0020] The legs of the multi-function surgical instrument may each include a surgical probe element, the surgical probe elements including respective electrodes of a bipolar electrosurgical forceps.

[0021] The suction half-split flow beds may each be made of an electrically insulating material and may house at least one surgical probe element, such as each of the electrodes. The suction half-split flow beds may additionally or alternatively house a irrigation flow bed. If a irrigation flow bed is housed within the suction flow bed, the former may be used to clear a blockage in one or more of the suction openings. This may be done, for example, by activating an irrigation via a foot pedal and pump while keeping the multifunctional surgical instrument completely closed. By increasing the pressure within the suction flow bed, blockages of material may be rapidly expelled outwards without interrupting surgery.

[0022] Each of the electrodes can include a blunt atraumatic distal tip, which can each include an inner surface shaped to hold and / or electrosurgically coagulate, desiccate, vaporize and / or radiofrequency treat tissue.

[0023] The multifunctional surgical instrument may further comprise at least one irrigation flow bed configured to allow irrigation fluid to flow from an irrigation connection at the proximal portion to an irrigation opening at a distal end of the irrigation flow bed. The irrigation fluid may be used to cool the multifunctional surgical instrument and irrigate a surgical wound. The irrigation fluid may also be used to clear at least one of the suction openings when it becomes clogged by dislodging objects therefrom. The irrigation flow bed may be incorporated into the multifunctional surgical instrument independent of the presence of electrodes or other surgical probe elements. One or both of the suction half flow beds may contain an irrigation flow bed.

[0024] The irrigation opening may be located closer to the proximal portion of the multifunctional surgical instrument than the blunt atraumatic distal tips such that irrigation fluid tends to flow toward at least one of the blunt atraumatic distal tips when irrigation is activated, which may be used to cool the blunt atraumatic distal tips during electrosurgery.

[0025] The blunt atraumatic distal end may further comprise a convex, substantially rounded outer surface, which may have a smooth surface, which may be used for blunt dissection of tissue.

[0026] The electrodes may further comprise an opposing blade on the inner surface of each electrode. The opposing blade may be preferably positioned up to 5 mm, more preferably up to 3 mm, away from the blunt atraumatic distal end of each electrode so as not to interfere with tissue holding and electrosurgical procedures. The opposing blade may be housed in the transparent suction half bed to allow the surgeon a good view of the cutting process from various sides.

[0027] The suction connection of the multi-function surgical instrument may be configured to connect the suction flow bed to an external suction mechanism.

[0028] The proximal portion of the multi-functional surgical instrument may further comprise a plurality of energy connections configured to couple each of the surgical probe elements to a respective energy source, preferably to an electrical connection connecting each electrode to a power source, and a fluid-tight connection configured to couple at least one of the irrigation flow beds to an irrigation fluid source.

[0029] The energy sources may be configured to provide energy in any form suitable for coagulation, desiccation, radiofrequency treatment or vaporization using the electric probe elements. At least one energy source may be configured to provide energy in one of the following forms: microwaves, alternating current, direct current, laser beam, ultrasound, temperature change, and vibration.

[0030] The connections can be connected to a control unit to individually switch the electrical current, irrigation fluid flow, and aspiration on / off and control one or more of the following parameters: voltage, current, frequency, waveform, intensity, temperature, irrigation fluid flow rate, irrigation fluid pressure, aspiration rate, and aspiration negative pressure.

[0031] The control unit may include a first foot pedal for control of at least one surgical probe element, a second foot pedal for control of irrigation, and a third foot pedal for control of aspiration.

[0032] The control unit may additionally or alternatively include a first manual switch for control of at least one surgical probe element, a second manual switch for control of irrigation, and a third manual switch for control of aspiration. Other hand or foot controls may also be used, including but not limited to dials, handles, push rods, or levers. The same or additional controls may be configured for use by the surgeon or assistant. The controls may be conveniently located in close proximity to the surgeon and / or assistant. [Brief description of the drawings]

[0033] In order to elaborate the specification and to provide a better understanding of the invention, a series of drawings are provided. Said drawings form an integral part of the specification and illustrate embodiments of the invention, and should not be interpreted as limiting the scope of the invention, but merely as examples of how the invention can be carried out. The drawings consist of the following figures: [Figure 1] FIG. 1 is a perspective view of a multifunction surgical instrument according to a first preferred embodiment of the present invention. [Diagram 2] FIG. 2 is a perspective view of the distal end of an electrode of an electrosurgical forceps in an open position, shown isolated from other components of the multi-function surgical instrument of the first preferred embodiment; [Diagram 3] FIG. 13 is a perspective view of the distal end of each electrode of the first preferred embodiment in an open state; [Figure 4] FIG. 13 is a perspective view of the distal end of each electrode of the first preferred embodiment in a closed state; [Diagram 5] FIG. 13 is a perspective view of the proximal portion of each electrode and a portion of the control system of the first preferred embodiment; [Figure 6] 1 is a perspective view of the distal ends of the irrigation flow beds shown in isolation from other components of the multi-function surgical instrument of the first preferred embodiment; FIG. [Figure 7] FIG. 2 is a perspective view of the washing flow bed of the first preferred embodiment including the proximal portion but not the distal end. [Figure 8] FIG. 2 is another perspective view of the proximal portion of the cleaning flow bed and a portion of the control system of the first preferred embodiment. [Figure 9] FIG. 2 is a side view of the distal end of the aspiration flow bed in a closed configuration, shown isolated from other components of the device of the first preferred embodiment. [Figure 10] FIG. 2 is a front view of the aspirating flow bed of the first preferred embodiment in an open state; [Figure 11] FIG. 1 is a perspective view of a partially assembled multi-function surgical instrument of a first preferred embodiment including an electrode and an irrigation fluid bed. [Figure 12] 1A-1D are perspective views of the distal ends of a fully assembled multi-function surgical instrument according to a first preferred embodiment; [Figure 13] FIG. 1 is a perspective view of a proximal portion of a fully assembled multi-function surgical instrument according to a first preferred embodiment; [Figure 14] FIG. 1 is a diagram of a control system connected to a multifunction surgical instrument according to a first preferred embodiment of the present invention. [Figure 15] FIG. 13 is a diagram of blunt dissection of tissue using half-split flow beds for each aspiration of the multi-function surgical instrument according to the second preferred embodiment. [Figure 16] FIG. 13 is another view of blunt dissection of tissue using the multi-function surgical instrument according to the second preferred embodiment; [Figure 17] FIG. 13 illustrates the use of the multi-functional surgical instrument according to the second preferred embodiment to hold the blood vessel atraumatically. [Figure 18] FIG. 1 illustrates filling a surgical wound with fluid. [Figure 19] 13A-13C are diagrams of a process of preparing to aspirate fluid using a multi-function surgical instrument according to a second preferred embodiment; [Figure 20] 13A-13C illustrate a process of aspirating fluid using a multifunction surgical instrument according to a second preferred embodiment. [Figure 21] FIG. 13 is a close-up view of a vessel being held for coagulation using the multi-function surgical instrument according to the first preferred embodiment; [Figure 22] 13A-13C are diagrams of the process of preparing to operate coagulation and irrigation using a multifunction surgical instrument according to the first preferred embodiment; [Diagram 23] FIG. 1 is a diagram of a coagulation and irrigation process using a multifunctional surgical instrument according to a first preferred embodiment. [Figure 24] FIG. 13 is another view of the coagulation and irrigation process using the multi-function surgical instrument according to the first preferred embodiment, illustrating filling of the surgical wound with fluid. [Diagram 25] 1 is a diagram of a fume aspiration process using a multi-function surgical instrument according to a first preferred embodiment. FIG. [Figure 26]1A-1D are views of a fluid aspirating process using a multi-function surgical instrument according to a first preferred embodiment. [Figure 27] FIG. 1 illustrates a micro-dissection process using a multi-function surgical instrument according to a first preferred embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0034] FIG. 1 shows a multifunctional surgical instrument 1 according to a first preferred embodiment of the present invention. The multifunctional surgical instrument 1 comprises two distal ends 11, 12 and a proximal portion 13. The proximal portion 13 may be formed to bias the distal ends 11, 12 of the instrument away from each other. The instrument may be formed like a bayonet forceps. The distal end of the instrument is at the end of two legs 14 that may have a non-continuous shape. Thus, due to the bias, a user of the instrument applies pressure to bring the two legs together and releases this pressure to allow the instrument to return to its default open state where the distal ends are not in contact. The proximal portion 13 may be configured to rest on the user's hand during use. The user may apply and release pressure on the proximal portions of the instrument legs to open and close the instrument before the bayonet is displaced.

[0035] The multi-function surgical instrument of the first preferred embodiment comprises three main components, a pair of electrodes, an irrigation flow bed, and an aspiration flow bed, which will be described separately below. Each of these is connected to a control unit via wires or tubes. Each connection may be attached to the proximal portion 13 of the instrument. The control unit may, for example, include a foot pedal control system by which each electrode, irrigation step, or aspiration step may be activated by depressing the corresponding pedal.

[0036] FIG. 2 shows electrodes 15, 16 alone. The electrodes 15, 16 form a bipolar electrosurgical forceps. Both electrodes are preferably scalpel-tip electrodes, as is more common in electrosurgical forceps. Alternatively, one of the electrodes may be a scalpel-tip electrode and the other a dispersive electrode. Each electrode may have an atraumatic end 17, 18, each having a substantially flat inner surface and a substantially rounded, smooth (smooth, streamlined) outer surface, so that the atraumatic ends may be used for tissue holding and blunt dissection of tissue. The outer surface of the atraumatic ends is often very smooth or polished. On the inner surface of each electrode, for example 2-3 mm from the end, is a counter blade 19. The pair of counter blades 19 form a pair of scissors suitable for fine dissection of tissue. As an example, a blood vessel may first be selected and electrosurgically coagulated using the atraumatic ends 17, 18, and then the same blood vessel may be cut using the counter blade 19.

[0037] Figures 3 and 4 are front views of electrodes 15, 16 in the open and closed positions, respectively, which show that when closed, the opposing blades overlap slightly to create a shearing action, while the atraumatic ends 17, 18 fit tightly together.

[0038] FIG. 5 shows the proximal ends of the electrodes 15, 16. These are assembled as part of the first preferred embodiment multi-function surgical instrument such that they remain separated from one another and each includes an electrical connection 20 that is coupled to a control unit. The control unit may provide electrical current to each scalpel tip electrode while simultaneously controlling the flow of electrical current and switching it on or off. Alternatively, the connection 20 may provide other forms of energy such as ultrasound or a laser beam. The control unit preferably includes a foot pedal control for the electrodes such that pressing the foot pedal initiates and / or increases the flow of electrical current and releasing the foot pedal stops the current. Alternative means such as a manual switch may be used or additional electrosurgical parameters may be controlled.

[0039] Figure 6 is a front view of the fluidized beds 21, 22 for cleaning. These can be assembled substantially parallel to the electrodes 15, 16 within the multi-functional surgical instrument. The fluidized beds for cleaning are provided with openings 23 at their distal ends through which cleaning fluid can flow out. This can be, for example, isotonic saline solution.

[0040] Figures 7 and 8 show the proximal portions of the fluidized beds 21, 22 for cleaning. The fluidized beds are continuous with each other and are provided with a fluid connection 24 that can be coupled to a fluid source, a pump, and a control unit that can control the flow rate and other flow parameters by means of a foot pedal for switching the flow on and off.

[0041] Figure 9 is a side view of the fluidized bed 25 for suction. This consists of two half-divided fluidized beds 26, 27 that form an airtight fluidized bed 25 only when the multi-functional surgical instrument is in a completely closed state. The two half-divided fluidized beds form a sealing portion along their longitudinal edges. The half-divided fluidized beds 26, 27 can be configured to accommodate the fluidized bed for cleaning and the electrodes within a hollow portion. The half-divided fluidized beds 26, 27 can be configured to be electrically insulating. The half-divided fluidized beds 26, 27 are more preferably made of a transparent material that enables visualization of internal components and tissues during use. The half-divided fluidized bed is more preferably made of a transparent surgical-grade polycarbonate having both electrical insulation and transparency.

[0042] Figure 10 is a front view of the half-divided fluidized beds 26, 27 in an open state. The distal ends of the half-divided fluidized beds 26, 27 are provided with a plurality of fine openings 28, for example having a diameter of 0.1 to 0.2 mm, through which liquid or gas can be sucked into the fluidized bed. The dimensions and density of the openings can be such that unnecessary suction of tissue is avoided when the tissue is filtered from the fluidized bed 25. The openings 28 can function as an alternative to the cotton swab traditionally used for suction.

[0043] 11 shows a partially assembled multi-functional surgical instrument including the irrigation flow beds 21, 22 and electrode 15, 16 arrangement. The irrigation openings 23 are positioned slightly closer to the proximal portion of the instrument so that irrigation during the electrosurgical procedure will pump or drip fluid towards the atraumatic ends 17, 18 of the electrodes. For example, the irrigation openings 23 may be at least 0.1 mm away from the atraumatic ends 17, 18.

[0044] FIG. 12 shows the first preferred embodiment multi-function surgical instrument 1 fully assembled, with irrigation flow beds 21, 22 and electrodes 15, 16 housed within half suction flow beds 26, 27, respectively.

[0045] Figure 13 shows the connections at the proximal portion of the multifunctional surgical instrument 1. These include electrical connections 20, fluid connections 24 and air connections 29. This figure also shows that the suction flow bed is a continuous, liquid-tight tube that houses the irrigation flow bed and electrodes at the proximal portion of the multifunctional surgical instrument and is split lengthwise along the legs of the instrument.

[0046] Figure 14 shows an example of a control unit 30 with foot pedals 31, 32, 33 which may be used as described above to control coagulation, irrigation and aspiration respectively. In the case of aspiration, aspiration may be stopped when the foot pedal 33 is released. Aspiration may also be stopped immediately to protect tissue when pressure is released on each leg of the instrument so that the legs return to their open state.

[0047] 15-27 show optional steps that may be taken in a surgical procedure using the multi-functional surgical instrument 1 of the first and second preferred embodiments. These may be performed in any order, and any step may be repeated as necessary.

[0048] 15 shows the use of a multi-functional surgical instrument according to a second preferred embodiment to perform blunt dissection in an open wound. The instrument comprises transparent suction half beds 26, 27 tapered to a distal point with fine openings near each distal end of the half beds. This embodiment of the invention does not comprise electrodes or irrigation beds. The half beds 26, 27 can be used to manipulate tissue 40 in the wound and access blood vessels 41. Suction has not yet been initiated and the half beds are held in an intermediate state between open and closed while inserted into the wound.

[0049] 16 illustrates the process of using the half-split flow beds 26, 27 to open a portion of tissue 40 and expose a blood vessel 41. The user releases pressure from each leg adjacent the proximal portion of the multi-function surgical instrument, causing them to transition to an open state. The rounded outer surfaces of the half-split flow beds 26, 27 accomplish this function while minimizing undesirable tissue damage.

[0050] FIG. 17 illustrates the process of using the blunt distal ends of the half-split flow beds 26, 27 to hold and manipulate the blood vessel 41 where the desired electrosurgery is to be performed.

[0051] 18 shows another step in which a multi-functional surgical instrument is used to hold a blood vessel 41. The wound may fill with blood or other fluids used at this stage, which may obscure the tissues in the wound.

[0052] 19 shows the steps of preparing to aspirate excess liquid that has filled the wound using the multifunctional surgical instrument of the second preferred embodiment. The user applies firm hand pressure to bring the two legs together. The user then prepares to start the suction, for example by placing his / her foot on the foot pedal 33 as shown in the figure.

[0053] Figure 20 shows the process of aspirating fluid 42 from a wound. The user inserts the closed aspiration flow bed 25 into the liquid to be aspirated so that the fine openings 28 are submerged in the liquid. The user then places their foot on the aspiration foot pedal and presses down. A pump (not shown) in the control unit 30 can create a negative pressure in the tubing that is continuous with the flow bed 25. This causes the fluid to be aspirated into the transparent flow bed 25 and through a connection 29 (not shown) to a storage or drainage facility, preferably a collection bag.

[0054] Figure 21 shows the use of a multi-function surgical instrument according to a first preferred embodiment to hold a blood vessel 41 in a state ready to be coagulated to seal it. In this embodiment, the instrument comprises electrodes and irrigation fluid beds embedded within the voids of the suction half-split fluid bed, preferably embedded in the material of the walls of the half-split fluid bed. Foot pedals control each of the suction, coagulation and irrigation. The coagulation and irrigation foot pedals 31, 32 are adjacent to each other to allow the user to easily activate both simultaneously as is often required.

[0055] 22 illustrates the initiation of the coagulation and irrigation steps using foot pedals 31, 32. An electrical current arcs between the atraumatic ends 17, 18 of each electrode such that a portion of the blood vessel 41 is heated. Initiation of irrigation causes irrigation fluid to flow through the irrigation flow beds 21, 22 and out of the irrigation openings 23, for example using a pump. The irrigation fluid may be released primarily through gaps formed by the distal ends of the multifunctional surgical instrument when they are not completely closed, and / or through the fine openings 28.

[0056] 23 and 24 show a subsequent step in electrosurgery where both irrigation and coagulation are initiated and the surgical wound begins to fill with irrigation fluid 42. The irrigation fluid cools the atraumatic ends 17, 18 and surrounding tissue during electrosurgery, which may prevent unwanted thermal damage to healthy tissue. The fluid 42 within the wound may also include fluid that exudes from the wound, which may affect tissue visibility and must be aspirated.

[0057] Figure 25 shows the fumes aspiration step. As electrosurgical fumes are toxic and can impair visibility, it is preferable to aspiration them before aspirating the fluid 42. At this stage, the multifunctional surgical instrument 1 is again in a closed state and the opening 28 can be moved closer to the source of the fumes generated by the electrosurgical procedure.

[0058] FIG. 26 shows the liquid aspiration process. The multifunctional surgical instrument 1 can be in an open state to release the blood vessel 41. The instrument is moved and the two halves of the suction flow bed 25 are transformed into a completely closed state by applying manual pressure to the feet of the instrument so that they join together to form a water-tight and air-tight flow bed. The multifunctional surgical instrument 1 is then inserted into the fluid. The user can press the foot pedal 33 to start the suction and aspirate the material from the wound. The openings 28 of the suction flow bed are submerged in the fluid to be aspirated. These openings can prevent the aspiration of living tissue so that only the excess fluid 42 in the wound is removed if necessary. Also, the suction can be stopped immediately at any time by releasing the pressure used to close the instrument. This prevents unnecessary damage to the tissue. After the aspiration of both liquid and gas is completed and the surgical field is well visible, the foot pedal can be released to control the suction.

[0059] Figure 27 shows the cutting process. The multifunctional surgical instrument can be opened slightly by releasing the pressure of the hand a little. The opposing blades 19 of the instrument can then be placed on either side of the coagulated part of the blood vessel and the legs closed again to perform the shearing action. Thanks to the transparent material of the suction bed, the user can observe both the blood vessel 41 and the blades 19 in order to position both correctly and prevent unnecessary damage to the tissue. As a result, the blood vessel can be cut without bleeding.

[0060] In a third preferred embodiment of the present invention, not shown, the multi-function surgical instrument has only a single large opening 28 at its distal end, instead of multiple fine openings. This single opening may extend into one or both of the suction half-split flow beds 26, 27.

[0061] In a fourth preferred embodiment of the present invention, also not shown, a control system is configured to control the supply of energy in the form of electromagnetic waves in the microwave spectrum (300 MHz to 300 GHz) to one or two probe elements respectively integrated into one or both cavities of the half-split flow beds 26, 27 such that the multifunctional surgical instrument is suitable for performing microwave coagulation.

[0062] In this specification, the term "comprises" and its derivatives (such as "comprising") should not be understood in an exclusive sense, that is, these terms should not be interpreted as excluding the possibility that what is described or defined may include other elements, steps, etc.

[0063] On the other hand, the present invention is obviously not limited to the particular embodiment or embodiments described herein, but also encompasses any variations (e.g., with regard to the selection of materials, dimensions, configurations, etc.) that may occur to those skilled in the art within the general scope of the invention as defined by the claims.

Claims

1. two legs (14) each consisting of a rounded distal end (11, 12); a proximal portion (13) configured to bias the legs (14) away from each other, The default state of the surgical instrument is an open state in which the distal ends (11, 12) of the legs (14) are not in contact with each other; the rounded distal ends (11, 12) of the legs (14) do not touch in the open position; Each of the legs (14) is provided with a suction half-split flow bed (26, 27) tapering toward its tip, said proximal part (13) comprises a suction connection (29); At least one of the distal ends (11, 12) has at least one suction opening (28) disposed at its tip; the two suction half-flow beds (26, 27) are configured to form an air-tight and water-tight suction flow bed (25) that connects at least one of the suction openings (28) to the suction connection (29) for liquid aspiration when the surgical instrument is in a closed state in which the distal ends (11, 12) of the legs (14) are in contact with each other, The two suction half-flow beds (26, 27) are configured to open the suction flow bed (25) when the surgical instrument is not in the completely closed state; The surgical instrument (1) stops suction by opening the suction flow bed (25) during liquid suction. A surgical instrument characterized by:

2. The suction half-split flow beds (26, 27) taper to blunt ends at the distal ends of the legs (14) when fully in the closed position. A surgical instrument according to claim 1 .

3. The suction half-split flow beds (26, 27) are made of a transparent material that allows the interior to be seen. A surgical instrument according to claim 1 or 2.

4. The suction flow bed (25) is provided with a plurality of openings (28) at its distal end; The size of the openings is 0.1 mm to 0.2 mm in diameter. A surgical instrument according to any one of claims 1 to 3.

5. At least one leg (14) of the surgical instrument is formed as at least one surgical probe element, the surgical probe element functioning as an electrode. A surgical instrument according to any one of claims 1 to 4.

6. the legs (14) of the surgical instrument are each formed as a surgical probe element, the surgical probe elements functioning as electrodes (15, 16) of a bipolar electrosurgical forceps; The suction half-split flow beds (26, 27) are each made of an electrically insulating material and house the electrodes (15, 16). A surgical instrument according to claim 5.

7. The electrodes (15, 16) have rounded distal ends (17, 18), and the inner surfaces of the distal ends (17, 18) of the electrodes (15, 16) are each flat shaped. A surgical instrument according to claim 6.

8. The surgical instrument further comprises at least one irrigation flow bed (21, 22), the irrigation flow bed (21, 22) configured to allow irrigation fluid to flow from a fluid-tight irrigation connection (24) in the proximal portion (13) to an irrigation opening (23) at a distal end of the irrigation flow bed (21, 22), the fluid-tight irrigation connection (24) configured to couple the at least one irrigation flow bed (21, 22) to a source of irrigation fluid. A surgical instrument according to claim 7.

9. The irrigation opening (23) is positioned closer to the proximal portion (13) than to the distal ends (17, 18) of the electrodes (15, 16) so as to facilitate flow of irrigation fluid towards at least one of the distal ends (17, 18) of the electrodes (15, 16). A surgical instrument according to claim 8.

10. The distal ends (17, 18) of the electrodes (15, 16) further comprise outer surfaces that are convex and rounded in shape. A surgical instrument according to claim 8 or 9.

11. The electrodes (15, 16) further comprise opposing blades (19) on an inner surface of each electrode (15, 16), the opposing blades (19) being spaced apart from the distal ends (17, 18) of the electrodes (15, 16). A surgical instrument according to any one of claims 8 to 10.

12. The suction connection (29) consists of a tube and connects the suction opening (28) of the suction flow bed (25) to an external suction mechanism via the proximal part (13). A surgical instrument according to any one of claims 8 to 11.

13. The proximal portion (13) of the surgical instrument further comprises an energy connection (20) configured to couple each of the surgical probe elements to a respective energy source. A surgical instrument according to any one of claims 8 to 12.

14. A system comprising the surgical instrument (1) according to claim 13, a control unit (30), the energy source configured to supply energy to the surgical instrument (1) in the form of microwaves, alternating current, direct current, laser beam, ultrasound, vibrations, and an irrigation fluid source to supply irrigation fluid to the surgical instrument (1), The control unit (30) a first foot pedal for controlling on / off the supply of energy from said energy source to at least one of said surgical probe elements, a second foot pedal for controlling on / off the irrigation of the surgical wound with said irrigation fluid, and a third foot pedal for controlling on / off the aspiration of material from the surgical wound; or a first manual switch for controlling on / off of the supply of energy from the energy source to at least one surgical probe element; a second manual switch for controlling on / off of irrigation of the surgical wound with the irrigation fluid; and a third manual switch for controlling on / off of aspiration of material from the surgical wound; The suction connection (29), the irrigation connection (24) and the energy connection (20) are connected to the control unit (30). A system characterized by:

Images