Bipolar Colpotomy Device with Integrated Electrodes
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Solution Overview
Problem
Monopolar electrosurgical instruments used in total laparoscopic hysterectomy procedures face challenges with poor energy control, leading to increased heat at the surgical site, potential damage to nearby tissues, and complications like over-shortening of the vagina and dehiscence due to the distance between the active and return electrodes.
Innovation Solution
A bipolar electrosurgical assembly with a colpotomy cup and integrated first and second electrodes, where the active electrode is annular and located radially outer, and the return electrode is radially inner, allowing for precise energy application and reduced voltage usage, combined with a uterine manipulator and pneumoperitoneum seal for enhanced control and safety during cervico-vaginal incisions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If monopolar electrosurgical elements are used with a separate return electrode placed at a distance, then the incision can be performed, but control over energy application deteriorates and heat at the surgical site increases
Solution Approach 1:
The patent combines the active electrode and return electrode into a single integrated electrosurgical instrument, with both electrodes positioned close together on the same shaft. This merging eliminates the need for a separate distant return electrode, enabling precise control over energy application while minimizing heat spread to surrounding tissues.
Solution Approach 2:
The patent introduces a colpotomy cup as an intermediary structure that houses both electrodes and positions them at the cervico-vaginal junction. The cup serves as a mediator that delivers controlled bipolar energy directly to the target tissue while the close electrode spacing acts as an intermediary mechanism to limit thermal spread.
2Ease of manufacture
If monopolar electrosurgical elements are used with distant return electrode, then incision can be performed, but tissue damage to nearby structures increases
Solution Approach 1:
By merging the active and return electrodes into one instrument with centimeter-scale separation, the patent confines electrical energy delivery to the immediate vicinity of the cervico-vaginal junction, preventing harmful thermal effects from reaching nearby structures such as nerves, ureters, or colon.
Solution Approach 2:
The bipolar configuration creates highly localized energy delivery at the tissue interface, where the electrical field is concentrated between the two closely spaced electrodes. This local quality of energy delivery ensures that cutting and coagulation effects are restricted to the immediate surgical site without affecting surrounding tissues.
3Ease of manufacture
If monopolar electrosurgical elements are used, then incision can be performed, but risk of over-shortening vagina increases due to uncontrolled heat
Solution Approach 1:
The integrated bipolar design allows the surgeon to perform incision and simultaneously control tissue retraction with precision, as the close electrode spacing provides predictable, localized energy delivery that prevents excessive thermal contraction of the vaginal tissue.
Solution Approach 2:
The bipolar configuration provides inherent feedback control through the close electrode spacing, where the electrical field is automatically confined to the tissue between the electrodes. This creates a self-regulating system that prevents runaway heat generation and allows precise control over the extent of tissue resection and vaginal length maintenance.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The bipolar configuration provides improved control over energy application, reducing thermal damage and the risk of tissue injury, enhancing the precision and safety of the surgical procedure by focusing cutting energy closer to the target area and maintaining pneumoperitoneum.
Implementation Method 1
a bipolar electrosurgical configuration reduces the risks associated with monopolar elements because a bipolar instrument has a shorter distance of electrical energy travel between the tissue to be excised and a return electrode. This enables the cutting energy to be more precisely focused. It also allows for lower cutting voltages to be used.
Implementation Method 2
a seal for maintaining pneumoperitoneum
Data Source
AI summary
A bipolar electrosurgical assembly is for use in female pelvic surgical procedures. A first shaft includes a uterine manipulator, a second shaft that fits over the first shaft includes a colpotomy cup and first and second electrodes, and a third shaft can be provided over the second shaft and carries a seal for maintaining pneumoperitoneum. The colpotomy cup uses the first and second electrodes for resecting uterine tissue. Incision and resection may be performed by positioning the colpotomy cup near the cervico-vaginal junction, activating the first electrode, and moving one or both of the electrodes.