Medical devices

Abstract

To provide instruments including a light-conducting device that is configured to conduct light away from a site of action of the instrument or conduct light toward a site of action of the instrument.SOLUTION: The instrument includes at least one tool suitable for influencing a patient located in the field of view of an optical element 26. The optical element is arranged inside a channel 20. A light passage window 27 of the optical element is offset relative to a distal opening 25 of the channel in a proximal direction. A closure device 28 is arranged between the light passage window and the opening of the channel, which blocks passage of substances from the opening to the light passage window as long as it is in a closed position. If the closure device is open, it unblocks a fluid path and a light path between the light passage window and the opening. Preferably the closure device is controlled pneumatically by means of a liquid or gaseous fluid flowing inside the channel. With this measure, contamination of the light passage window during operation of the instrument can be reliably avoided or at least reduced to a minor degree.SELECTED DRAWING: Figure 2

Description

Technical Field

[0001] The present invention relates to a medical device for treating a human or animal patient with a medical or surgical treatment. In particular, the present invention relates to a device comprising a light guiding device configured to guide light away from the working part of the device or, additionally or alternatively, to guide light towards the working part of the device.

Background Art

[0002] From Patent Document 1, a configuration is known which consists of a surgical instrument and a trocar, and the instrument can move through the working channel of the trocar. The instrument includes a light guiding device that can receive or emit light at the distal end of the instrument. At the distal end of the trocar, one or more protective elements are provided to block the working channel and thus prevent fluid from entering the working channel. When the instrument moves in the distal direction, it can move away from the protective element, and thus an unobstructed view in the target area of the instrument can be obtained.

[0003] In Patent Document 2, an instrument having a channel in which an optical fiber is movably arranged in the longitudinal direction is proposed. The optical fiber includes a light emitting surface at its distal end from which a laser beam can be emitted. At the distal end of the channel, a wiper element 2 is provided which closes the channel when the fiber retracts and prevents fine droplets from entering the channel or depositing on the light emitting surface of the fiber. During the forward movement of the fiber, the wiper element wipes the light emitting surface to clean it.

[0004] Further prior art consists of Patent Document 3 which shows an argon plasma coagulation device in which a closing member is provided in a gas guiding channel.

[0005] There are applications where a light guiding device or another optical element of the instrument must be fixedly supported or supported so that it cannot emerge from a contaminated area.

Prior Art Documents

Patent Documents

[0006] [Patent Document 1] European Patent Application Publication No. 2113190 [Patent Document 2] European Patent Application Publication No. 3195824 [Patent Document 3] European Patent No. 1773223 [Overview of the project] [Problems that the invention aims to solve]

[0007] From its application, the fundamental purpose of the present invention is derived, which provides the possibility of keeping the optical elements of the instrument as clean as possible during use. [Means for solving the problem]

[0008] This objective is achieved by the apparatus described in claim 1.

[0009] The instrument according to the present invention comprises an instrument body in which at least one channel having a distal end and a proximal end is formed. Alternatively, such a channel may be formed "on" the instrument, since it is formed in a separate element connected to the instrument body by, for example, one or more clamps (e.g., spring clips). The following description applies to both embodiments.

[0010] The channel may extend from the distal end to the proximal end of the appliance, and at the proximal end, a coupling device may be configured to connect the proximal end of the appliance and the channel together to a fluid source. The fluid source may be configured to supply a gaseous fluid, such as air, a pure gas, such as nitrogen, argon, carbon dioxide, or another desired gas, or a mixture of one or more gases. The fluid source may also be configured to supply a gaseous fluid having a predetermined pressure to regulate a predetermined gas pressure and / or predetermined gas flow in the channel. The appliance body may have multiple channels for receiving or discharging fluid at the distal end of the appliance. In particular, the appliance may have one or more gas supply channels and / or one or more suction channels.

[0011] At least one channel includes a fluid discharge opening at its distal end. This fluid discharge opening is also a light-passing opening in the apparatus according to the present invention, through which light can enter and / or exit. The light-passing opening is preferably facing the working part of the apparatus, which can be positioned to hold electrodes on the apparatus. Multiple electrodes can also be provided. One or more of such electrodes can be fixed or movable on the apparatus. Furthermore, at least one electrode can be connected to a power source, such as a high-frequency voltage source, to act on biological tissue by electric current. In particular, the power source is configured to supply a voltage and current high enough to generate a spark on the electrode. For example, the electrode is a cutting electrode, the voltage is a cutting voltage, and the current flowing from the electrode to the tissue is a cutting current. The generated spark emits illumination light into the channel through the light-passing opening.

[0012] Furthermore, an optical element, including a light-passing window, is positioned inside the channel at a distance from the distal end of the channel. The light-passing window and the optical element together are fixedly positioned inside the channel. For example, the optical element is fixedly connected to the body of the device. Moreover, the light-passing window of the optical element is positioned proximal to the light-passing opening realized by the gas exhaust opening.

[0013] Between the light-passing window and the light-passing opening, a closing device is positioned, which includes a closing member that can move between an open position and a closed position. In the closed position, the closing member is configured to block the channel from the passage of particles, especially droplets, and thereby protect the light-passing window of the optical element from contamination. In the open position, the closing member is further configured to open the channel for the passage of gas and light. In particular, the closing member is not controlled by the movement of the optical element, even if the optical element is movably positioned inside the channel. There is no operational coupling between the optical element and the closing device, especially its closing member. Preferably, the optical element and the closing member do not come into contact with each other.

[0014] It is even more preferable that the optical elements are positioned at a constant distance from the light exit aperture of the channel.

[0015] The optical element may include or be implemented by an optical guide. For example, the optical element may be a single optical fiber or a bundle of optical fibers, where one or more fibers each include one optical window at their distal end.

[0016] A light-passing window can be used to irradiate the tissue being treated with light for analytical and / or therapeutic purposes. The light-passing window can also be used to receive light generated during tissue treatment, such as the light from a spark burning between the electrode and the tissue, and to supply that light to an optical analyzer. Optical analysis can, for example, identify the tissue being treated. It can also determine other parameters (e.g., spark stability). For optical evaluation of the light, such as tissue analysis, emission spectroscopy (OES), optical coherence tomography (OCT), Raman spectroscopy, photoacoustic analysis, or other optical methods can be used.

[0017] In different embodiments, each closing member may have a single edge that is immovably supported on the fixture, from which the rest of the closing member extends away from. The supported edge may be immovably or movablely connected to the fixture, for example, pivotally connected. The rest of the closing member is so movablely supported on the fixture that it can reciprocate between an open position and a closed position. The closing member may be rigid or elastic, or stiff or flexible.

[0018] Embodiments are possible that operate with only a single closing member. Furthermore, there are embodiments having multiple closing members that spread apart from each other in the open position and come into contact with each other in the closed position. One or more closing members can be realized by bendable lamellae. The lamellae can be elastically pre-tensioned from each other to define a conical or pyramidal shape, thereby the contact line being the surface line of the conical or pyramidal edge. In the open position, the lamellae can spread apart from each other. This is advantageous if the lamellae are made of a flexurally elastic material for this purpose. Furthermore, or alternatively, the closing members can be made of an expandable material. For example, the closing member may have a conical or pyramidal shape with a small opening at its tip. The material stretches accordingly to open up so that the opening in the cone or pyramidal shape expands. The base of the pyramidal or conical shape can correspond to a channel cross section in all of these embodiments.

[0019] The closing member is preferably positioned to block the channel in a resting position, thereby allowing it to move to an open position by the pressure and / or flow of a fluid, particularly a gas, present inside the channel. The closing member can be configured to be pneumatically operated to this extent. The channel can be a purge gas channel, so that the gas pressure of the purge gas or other gas supplied by the fluid source is sufficient to open the closing member.

[0020] The light-transmitting window preferably has a field-of-view cone that extends through the fluid discharge opening and, consequently, the light-transmitting opening. The closing member of the closing device is preferably configured to block the field-of-view cone in the closed position, but to release the field-of-view cone in the open position.

[0021] As described above, the closing device can be controlled by the fluid guided through the channel, particularly by its pressure or flow velocity. The fluid acts directly on the closing member, which is automatically controlled to this extent. However, it is also possible to provide an externally controlled closing device connected to a mechanical actuation device. For example, the mechanical actuation device can be an electromagnetic actuation device, a pneumatic actuation device, or a manual actuation device. For example, the closing member can be mechanically connected to the operating base of the device so as to reciprocate between the open and closed positions in a controlled manner. Alternatively, an electromechanical or pneumatic actuator can be provided to move the closing member between the open and closed positions.

[0022] In all embodiments, the closing device is controlled by either a gas flow or another actuating element or working medium, so that the opening of the passage between the light-passing aperture and the light-passing window is performed in a controlled and manipulated manner. The unblocking, i.e., opening, of the closing device can be limited in particular to the stage where light passage is actually required. Furthermore, the instrument can be configured to open and close the closing device in synchronization with the supply of a fluid, such as a purge gas, to the working part of the instrument. Furthermore, the instrument and / or its supply device can be configured to start supplying gas through the channel before the operation of the RF electrode and to terminate the gas supply only after the operation of the RF electrode has ended. However, to largely avoid contamination of the light-passing window, it can be ensured that the passage between the light-passing window and the light-passing aperture is unblocked only when a gas flow distally flows away from the light-passing window. In the absence of gas flow, the closing device closes the passage from the light-passing aperture to the light-passing window, thus avoiding contamination of the light-passing window. When the closing device is open, contamination is avoided by the present gas flow, which carries away all contaminating particles or droplets from the light-passing aperture.

[0023] The closing device can include a closing member that is elastically pre-tensioned towards the closed position and can be moved or is moved to the open position by the actuator or the gas flow itself. Alternatively, a suction device can be configured to operate the closing device. For this purpose, the instrument can comprise a suction channel that opens near the distal end of the instrument. The actuator connected to the suction channel is then configured to open and close the closing device depending on whether a negative pressure exists in the suction channel. The suction channel can be connected to a suction device configured to start in synchronization with a generator that provides an electrode. Alternatively, the suction device can be configured to start before the generator starts and further to stop only after the generator has stopped. Generally, it is also possible to ensure that a) the closing device is open only while current is supplied to the electrode, b) the closing device is open only while a purge flow in the distal direction is established inside the purge channel, or c) the closing device is open only while a flow is established in the proximal direction inside the suction channel.

[0024] Further advantageous details of the invention are derived from the claims, the description, and the attached drawings shown below.

Brief Description of the Drawings

[0025] [Figure 1] Figure 1 is an overview of a supply device to which the instrument is connected. [Figure 2] Figure 2 is a schematic cross-sectional view at the distal end of the instrument according to Figure 1. [Figure 3a] Figure 3a is a partial schematic view of the instrument with the closing device in the closed state. [Figure 3b] Figure 3b is a partial schematic view of the instrument with the closing device in the open state. [Figure 4a] Figure 4a is a view of a further embodiment of the instrument and the closing device in the closed position. [Figure 4b] Figure 4b is a view of a further embodiment of the instrument and the closing device in the open position. [Figure 5a] Figure 5a shows a further embodiment of the device and the closing mechanism in the closed position. [Figure 5b] Figure 5b shows a further embodiment of the device and the closing device in the open position. [Figure 6a] Figure 6a shows a further embodiment of the device and the closing mechanism in the closed position. [Figure 6b] Figure 6b shows a further embodiment of the device and the closing device in the open position. [Figure 7a] Figure 7a shows a further embodiment of the device and the closing mechanism in the closed position. [Figure 7b] Figure 7b shows a further embodiment of the device and the closing device in the open position. [Figure 8a] Figure 8a shows a further embodiment of the appliance and the closing device in the closed position. [Figure 8b] Figure 8b shows a further embodiment of the device and the closing device in the open position. [Figure 9a] Figure 9a shows a further embodiment of the device and the closing mechanism in the closed position. [Figure 9b] Figure 9b shows a further embodiment of the device and the closing device in the open position. [Modes for carrying out the invention]

[0026] Figure 1 shows an instrument 10 according to the present invention connected to a supply device 11. The device 11 is connected to the instrument 10 via lines 12 and is configured to supply at least one working medium to the instrument 10. For this purpose, the device 11 may include one or more fluid sources 13, one or more generators 14 and / or one or more suction devices 15, the fluid sources 13, generators 14 and / or suction devices 15 each connected to lines 12 or the instrument 10 via one or more connectors 16. Figure 1 shows the instrument 10 as a handheld instrument for open surgery. However, the present invention also extends to instruments configured in other ways, such as laparoscopic or probe instruments that can be inserted into the patient's body through a working channel of an endoscope, trocar or other access.

[0027] The device 10 has a distal end 17 and a proximal end 18, the proximal end 18 of which can be realized by a connector 16 or a portion of a line 12.

[0028] The distal end 17 of the device 10 is shown separately in Figure 2. The distal end 17 includes the distal portion of the device body 19 through which at least one channel 20 extends. The channel 20 is in particular a fluid guide channel, such as a gas guide channel, which preferably extends from the distal end 17 through the entire device 10 and line 12 to the proximal end 18 or connector 16, where it connects to the gas source 13. Optionally, the device 10 may also include additional channels, such as a suction channel 21, which similarly extends from the distal end 17 of the device 10 to the proximal end 18 or connector 16, where it connects to a suction device 15. Optionally, other channels and / or additional channels may be provided to allow liquids and / or gases to be delivered to or away from the distal end 17 of the device 10, and to enter and exit the distal end 17.

[0029] The instrument 10 may be equipped with a tool that acts on biological tissue. Such a tool may be an electrode 22, for example, which is held within or on the distal end 17 of the instrument 10 and terminates at the distal end 17, or protrudes from or terminates a short distance before the gas passage opening. The electrode 22 is connected to the generator 14 via an electrical line 24 that passes through line 12 and extends to the proximal end 18 or connector 16. However, multiple electrodes or other tools such as a water jet tool or a laser tool may also be provided.

[0030] The channel 20 includes a distal opening which is both a gas exhaust opening and a light-passing opening 25. It is preferable that an optical element 26, for example in the form of an optical fiber, is immobilely positioned inside the channel 20, with an optical-passing window 27 at its distal end. The optical-passing window 27 can be formed by the surface of the optical element 26, for example, the surface of an optical fiber. It is preferable that the optical-passing window 27, together with the optical element 26, is immobilely positioned axially inside the channel 20. It is preferable that the optical-passing window 27 is positioned at a distance proximal to the light-passing opening 25.

[0031] A closing device 28 is positioned between the light-passing window 27 and the light-passing opening 25. The closing device 28 is configured to release or block the passage from the light-passing opening 25 to the light-passing window 27 in a controlled manner. The closing device 28 is controlled by the gas flow inside the channel 20 or by any other medium, but preferably never by the movement of the optical element 26 which is preferably fixed in place as described above.

[0032] A first embodiment of the closure device 28 is evident from Figures 3a and 3b. In Figures 3a and 3b, the closure device 28 is realized by a substantially conical closure member 29 made of a tensile elastic material, which includes an expandable opening at a tip 30. The tip 30 faces the light-passing opening 25. The opening at the tip 30 is very narrow or completely closed in the closed state. Because the tensile elasticity of the material of the closure member 29 is very high, the opening 30 can stretch very wide due to the pressure present inside the channel 20, so that the desired gas flow can exit from the light-passing opening 25, and thus the optical path from the light-passing opening 25 to the light-passing window 27 is also unblocked. When a gas flow is present, the closure member 29 is in the open position.

[0033] Figures 4a and 4b show the modified forms, and the above description applies, except for the details below.

[0034] The closing device 28 includes a plurality of closing members 29a, 29b, and 29c, which are flexible and form a cone when their edges come into contact with each other. At its tip 30, the lamellar closing members 29a, 29b, and 29c join together, thereby closing the passage from the light-passing opening 25 to the light-passing window 27. However, when gas is supplied to the channel 20, the closing members 29a, 29b, and 29c expand as shown in Figure 4b. In this way, the gas and light passages are released from being blocked by the closing device 28, and the closing members 29a, 29b, and others are in the open position.

[0035] The closing member 29 includes a portion that is fixedly held on the fixture 10. This portion is realized within the closing member 29 by a circular portion that defines the conical leg realized by the closing member 29. This portion is fixedly connected to the wall of the channel 20. The remaining portion of the conical closing member 29 is elastic or flexible and can be deformed to this extent, and is movable to this extent.

[0036] Figures 5a and 5b show further modifications of the closing device 28, in which the closing member 29 is realized by a foldable and flexible slack material such as a foil hose portion. The closing member 29 collapses in the absence of gas supply to the channel 20, blocking the channel 20 as an irregularly shaped body. In the presence of gas flow, the closing member 29 expands as shown in Figure 5b, thereby releasing the passage of light and gas between the light-passing window 27 and the light-passing opening 25. Otherwise, the above description applies mutatis mutandis.

[0037] In the embodiments described in Figures 3a to 5b, the illustrations are based on a channel having a circular cross-section. However, similarly in these embodiments, the channel 20 can have other cross-sections, such as polygonal cross-sections, including triangular, quadrilateral, hexagonal, or polygonal cross-sections with bent edges. Figures 6a and 6b show, as mere examples, the configuration of a channel 20 and a closure device 28 having a rectangular cross-section. Here, the closure device 28 includes a closure member configured as a flap, the circumference of which is equal to the cross-section of the channel 20. The flap-shaped closure member 29 is connected at one edge 31 to the wall of the fixture or channel 20. This allows the edge 31 to be rigidly fixed, or the closure member 29 to be configured to be flexible. Alternatively, the edge 31 can be implemented in a hinged manner. In the blocked position according to Figure 6a, the closure member 29 blocks the channel 20, and thus the passage between the light-passing window 27 and the light-out opening 25. The closure member 29 can be elastically pre-tensioned toward this position. This elastic pretension can be provided by the elasticity inherent in the closing member 29 or by a separate spring element. The closing member 29 can be assigned a stop portion to which it abuts in the closed position (not shown). This is particularly advantageous in embodiments in which the closing member 29 is held at the edge 31 by a hinge. Figure 6b shows the open position of the closing device 28, in which the closing member 29 is displaced from the resting position to the open position by gas flowing distally through the channel 20.

[0038] Figures 7a and 7b show another embodiment of the fluid-operated closure device 28. In this embodiment, a balloon-shaped hollow closure member 29 is part of the closure device 28 and is again positioned between the light-transmitting window 27 and the light-transmitting opening 25. The balloon-shaped closure member 29 is in fluid communication with a venturi opening 32 located in the gas path where the static pressure of the gas flow is effective. As the static pressure decreases due to the velocity of the gas flow, the balloon-shaped closure member 29 collapses to release the gas path, as shown in Figure 7b.

[0039] In a preferred embodiment, a balloon-shaped closing member 29, or an actuator for operating the closing member 29, is connected to the suction channel 21. This allows the closing device 28 to be operated using the negative pressure of the suction. For this purpose, a lateral hole can be provided from element 21 to element 28 (Figure 2). This creates a robust system. In particular, it is possible to generate a larger pressure difference and, consequently, a larger operating force.

[0040] In such embodiments, it is preferable that the suction device 15 and the purge gas source 13 be synchronized with the RF generator 14. This reduces the sound pressure load, which would otherwise be too high during continuous operation.

[0041] In all of the above embodiments, the closing member 29 of the closing device 28 is commonly controlled by pneumatic pressure due to the influence of gas or gas flow inside the channel 20. However, it is also possible to control the closing device 28 externally, as shown in Figures 8a and 8b of a simple first example. In those figures, the apparatus 10 is equipped with an actuator 33, which can be implemented by, for example, an operating button on the apparatus 10, as is simply schematically shown. Thus, the actuator 33 can be provided to start or stop the apparatus 10, and by extension, the connected generator 14. Additionally or alternatively, the actuator 33 can also be configured to trigger other starting or switching processes, for example, to trigger spectral analysis of light resulting from an electrode spark. At the same time, the actuator can move the closing member 29 via a suitable transmission, which is simply schematically shown here by a two-arm lever 34, to block the passage between the light-passing window 27 and the light-passing opening 25 in the closed position according to Figure 8a, and to release the passage in the operating position according to Figure 8b.

[0042] As is clear from the examples in Figures 9a and 9b, the closing device 28 can also be operated by another actuator, such as a magnetic actuator 35, which can be used to position the closing member 29 inside the channel 20 in the closed position shown in Figure 9a, and outside the channel 20 in the open position shown in Figure 9b.

[0043] The device 10 shown in Figure 1 according to the present invention operates as follows.

[0044] To apply the instrument to a patient, the instrument 10 is brought close to the surgical site and activated by the operation of an appropriate switch, such as an actuator 33. Alternatively, other switching means, such as a foot switch or other actuator, may also serve as the activation mechanism. The instrument 11 then receives the respective switch impulse and activates the respective addressed or present devices, such as the gas source 13, the generator 14, and / or the suction device 15. If the instrument 10 is an electrosurgical instrument, the gas source 13 is usually activated before the generator 14 is activated. The closure device 28 remains closed as long as the gas source 13 is not activated, i.e., as long as gas is not supplied to the channel 20. In at least one of the embodiments shown in Figures 3a to 7b, the closure device 28 opens as soon as sufficient gas pressure and / or gas flow are established inside the channel 20, respectively.

[0045] After the generator 14 is started, the optical element 26 receives the light generated from the electrode 22. Preferably, the electrode 22 is located within the field of view of the optical element 26, within a field of view cone that starts from the light-passing window 27 and extends through the light-passing aperture 25. The spark light generated from the electrode can be detected and further transmitted from the optical element 26 to an analytical device, such as a spectral analyzer, which may be part of the instrument 10 or configured and arranged separately.

[0046] The gas flow, delivered through channel 20 and discharged from the light-passing opening 25, effectively prevents the removal of particles, droplets, or other contaminants on the light-passing window 27. However, as soon as the gas flow stops, for example, due to the gas flow being blocked, the closing device 28 closes. Even if contaminants are continuously generated, such as by turbulence caused by the activation of the suction device 15, which sucks liquid or other substances from the operating area through the suction channel 21, the light-passing window 27 remains sealed and free from contaminants. This is also true when it continues to operate with the electrode 22 without a gas supply through channel 20, and particles are thus released.

[0047] Embodiments of the apparatus 10 shown in Figures 8a to 9b operate similarly. In the embodiments shown in Figures 8a and 8b, when the actuator 33 is activated, the closing device 28 is always de-blocked. Activation of the actuator 33 can be performed independently of activation of the apparatus 11 and the generator 14. For example, gas can be supplied to channel 20 under low pressure. When the closing device 28 is closed, it can simultaneously block the passage of gas flow and light. The closing device 28 also blocks the passage of contaminants. As soon as the closing device 28 is opened by the actuator 33, the light path is de-blocked. Simultaneously, a gas flow is released to prevent the intrusion of contaminants. If gas flow must also be possible when the closing device 28 is closed, a light-blocking bypass can be provided parallel to the closing device 28.

[0048] In the embodiments shown in Figures 9a and 9b, the closing device 28 is actuated by a magnetic actuator 35 or another suitable electric actuator. The application of current to the actuator 35 can be synchronized with or independent of the application of current to the electrode 22. The latter is the case, for example, when the electrode 22 only receives light occasionally. The device 11 connected to the instrument 10 is then configured so that the spectrometer and actuator 35 are activated simultaneously to receive light from the treatment site, for example, for spectral analysis of light. For this purpose, the light-passing window 27 is permanently protected from contamination. In the activated state, contamination is avoided by the gas flow through the channel 20. When stopped, the closing device 28 closes the light-passing window 27. This principle applies to all embodiments.

[0049] The present invention is not limited to electrosurgical instruments. The present invention can also be used in laser surgical instruments or cryosurgery instruments. In the case of laser surgery, the optical element 26 can be configured to emit a laser beam from the light-passing window 27 through the light-passing opening 25 toward the tissue. The gas flow inside the channel 20 keeps the light-passing window 27 free of contamination during startup. When stopped, the closing device 28 closes, for example, according to the principle shown in Figures 8a to 9b.

[0050] Instrument 10 may also be a water jet surgical instrument or other instrument. Water jet channels may then be provided, preferably within the field of view of the optical element 26, to treat the respective tissues of the surgical site, either in addition to or in place of the electrodes 22. Otherwise, the above description applies mutatis mutandis.

[0051] An instrument according to the present invention for medical or surgical procedures on a human or animal patient comprises at least one tool, such as an electrode 22, suitable for acting on the patient, located within the field of view of an optical element 26. The optical element 26 is positioned inside a channel 20 in which a fluid flow can be maintained or induced distally. The light-passing window 27 of the optical element 26 is offset proximal to the distal opening 25 of the channel 20. A closure device 28 is positioned between the light-passing window 27 and the opening 25 of the channel 20, and as long as the closure device 28 is in the closed position, it blocks the passage of material, particularly droplets and particles, from the opening 25 to the light-passing window 27. When the closure device 28 is open, it unblocks the flow path and optical path between the light-passing window 27 and the opening 25. The closure device 28 is preferably pneumatically controlled by the liquid or gaseous fluid flowing inside the channel 20. By using this method, contamination of the light-transmitting window 27 during the operation of the device 10 can be reliably avoided or at least reduced to a minimal extent. [Explanation of symbols]

[0052] 10 devices 11 Equipment 12 lines 13 Gas sources 14 Generators 15 Suction device 16 connectors 17 Distal end of device 10 18. Proximal end of device 10 19. Main body of the device 20 channels 21 Suction Channels 22 electrodes 23 Gas passage opening 24 Electrical lines 25 Distal aperture of channel 20, light-passing aperture 26 Optical elements / optical fibers 27 Light-transmitting window 28 Closing device 29 Closing member 30 Tip of closing member 29 31 Edge of the closing member 29 in Figures 6a and 6b 32 Venturi opening 33 Actuator 34 Lever 35 Actuators

Claims

1. An instrument (10) for performing medical or surgical procedures on a human or animal patient, The device comprises a body (19) having at least one channel (20) having a distal end (17) and a proximal end (18), wherein the channel (20) is formed within the body (19) or in contact with the body (19), The channel (20) is connectable to a fluid source (13) at its proximal end (18) and includes an opening (25) at its distal end. Furthermore, the aforementioned device, An optical element (26) including at least one light-passing window (27) fixedly positioned inside the channel (20), The system includes a closing device (28) which is disposed inside the channel (20) between the light-transmitting window (27) and the distal end (17) of the channel (20), and which includes at least one closing member (29) that can move between an open position and a closed position, The light-transmitting window (27) defines a field of view cone that extends through the opening (25), The closing member (29) is configured to block the field of view cone in the closed position, but to release the field of view cone in the open position. Equipment.

2. The closing member (29) has an edge that is immovably supported on the device (10). The apparatus according to claim 1.

3. The closing device (28) includes a plurality of closing members (29a, 29b) that are pivotably supported at one end of the instrument (10). The apparatus according to claim 1 or 2.

4. The closing device (28) includes a plurality of bendable lamellae, The lamellae can elastically pre-tension each other to define a conical or pyramidal shape, and in the open position, they can spread out so as to move away from each other. The apparatus according to claim 1.

5. The closing member (29) is an element made of an expandable material. The apparatus according to claim 1.

6. The closing member (29) is arranged to be actuated by the fluid flowing through the channel (20). The apparatus according to claim 1.

7. The channel (20) can be connected to a gas source (13) which serves as a fluid source. The apparatus according to claim 1.

8. The device (10) comprises at least one additional channel (20) for supplying or discharging fluid. The apparatus according to claim 1.

9. The aforementioned device (10) includes an electrode (22). The apparatus according to claim 1.

10. The electrode (22) is positioned inside the opening (25). The apparatus according to claim 9.

11. The electrode (22) is at least partially positioned within the field of view cone. The apparatus according to claim 9.

12. The closing device (28) is connected to a mechanical actuator (33). The apparatus according to claim 1.

13. The closing device (28) is connected to an electromagnetic actuator (35). The apparatus according to claim 1.

14. The closing device (28) is connected to a pneumatic venturi actuator (32). The apparatus according to claim 1.

Images