Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
  • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
  • A61B18/14—Probes or electrodes therefor
  • A61B18/1485—Probes or electrodes therefor having a short rigid shaft for accessing the inner body through natural openings
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/32—Surgical cutting instruments
  • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
  • A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B2017/00017—Electrical control of surgical instruments
  • A61B2017/00022—Sensing or detecting at the treatment site
  • A61B2017/00057—Light
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B2017/00017—Electrical control of surgical instruments
  • A61B2017/00115—Electrical control of surgical instruments with audible or visual output
  • A61B2017/00119—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
  • A61B2017/00123—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation and automatic shutdown
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
  • A61B2017/00238—Type of minimally invasive operation
  • A61B2017/00274—Prostate operation, e.g. prostatectomy, turp, bhp treatment
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
  • A61B2018/00547—Prostate
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B2217/00—General characteristics of surgical instruments
  • A61B2217/002—Auxiliary appliance
  • A61B2217/005—Auxiliary appliance with suction drainage system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B2217/00—General characteristics of surgical instruments
  • A61B2217/002—Auxiliary appliance
  • A61B2217/007—Auxiliary appliance with irrigation system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
  • A61M1/71—Suction drainage systems
  • A61M1/77—Suction-irrigation systems
  • A61M1/774—Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2210/00—Anatomical parts of the body
  • A61M2210/16—Male reproductive, genital organs
  • A61M2210/166—Prostate

Definitions

• the present invention relates to a device for motorised endoscopical removal of tissue in a living body, particularly for operative treatment of the prostate gland, said device comprising a tube-shaped body having a handle, channels for inspection, illumination, influx of flushing liquid as well as removal of liquid and cut tissue and the like.
• the aim of the present invention is to overcome the problems explained supra and to achieve this the invention is characterized by a shaft extending through the instrument body, said shaft rotated by a motor arranged at one end of the shaft such that a knife arranged at the opposite end of the shaft adapted to be moved axially in relation to the body, is brought to rotate for carrying out the surgical treatment.
• the shaft is electrically isolated from the instrument body, such that electric current may pass through the shaft to the knife so as to facilitate the cutting and stop the bleeding. It is preferable to include a safety switch so as to prevent too deep a cutting.
• the body is certainly provided with an evacuation channel for the removal of liquid and cut tissue but it might nevertheless be of advantage to provide another channel for the same purpose preferably in addition to the channel in the instrument body. The flushing liquid may be injected continuously why the quantity of such liquid could be rather important and furthermore urine may be added to the bladder and has to be removed.
• FIG 1 is a perspective view of the device according to the invention
• FIG 2 is an end view of the body of the instrument with a knife and a safety switch;
• FIG 3 is a broken side elevation of the same part of the instrument;
• FIG 4 shows the instrument body with the motor arranged inside the same
• FIG 5 shows the connection of the motor to the shaft in the body by means of a flexible shaft
• FIGS 6 and 7 are views in different directions of a more detailed embodiment of the instrument according to the invention.
• FIG 8 shows a further embodiment of the invention.
• the instrument shown in Fig 1 and intended for surgical treatment in the first place of the prostate gland comprises a body 1 having four channels 2, 3, 4 and 5 for inspection, illumination, inflow of flushing liquid and for removal of liquid and cut tissue.
• Extending through the body 1 is a shaft 6 carrying on its end 7 extending out from the end of the instrument body 1 and according to the embodiment shown in Fig. 1 a cutting tool in i.e. a knife in the shape of a loop 8.
• the shaft 6 carries, according to the embodiment shown in Fig. 1, a motor 9 having on its mantle a handle 10 attached thereto.
• This operation tool functions such that when the body 1 has been inserted through the urethra to such an extent that the knife 8 is situated at the prostate gland, the motor 9 is started.
• the shaft 6 is then brought to rotate and makes the knife 8 to rotate so as to cut a layer of the prostate gland.
• the motor 9 with the shaft 6 and the knife 8 can be shifted as indicated whereby tissue is removed along the whole of the prostate gland.
• This sliding movement in the sleeve-shaped body means that fretting of the sleeve against sensitive tissue is avoided.
• the cutting operation can during the whole process be watched through the inspection channel 2 and flushing can be performed through the channels 4 and 5. Electrical current can easily be led through the knife and thereby bleeding can be stopped by burning of blood vessels.
• FIGs. 2 and 3 there is shown the end portion of the instrument body 1 with the knife 8.
• a safety switch 11 which is detecting if the knife 8 should sink to an unpermissible depth.
• the end of the instrument body 1 will be lowered such that the loop 11, i.e. the safety switch is swung about its fulcrum 12 to influence a contact means 13 so as to cut the current to the motor 9 and thus interrupt the cutting of the prostate gland.
• the motor 9 is shown arranged interiorly of the instrument body 1 and in Fig. 5 there is shown how the motor 9 may be arranged outside the instrument body 1 and connected to the shaft 6 by means of a flexible shaft 14.
• Figs. 1 - 5 have had for their purpose to show the invention principally.
• Figs. 6, 7 and 8 there is shown a concrete embodiment of the instrument according to the invention.
• This instrument shows at its upper - according to the drawing - and an inspection glass 15 and a connection 16 to a source of light (not shown).
• the inspection glass 15 further carries a thumb grip 17 and as a counterstay the instrument has been provided with a finger grip 36 such that the surgeon with one hand may bring the instrument into the position where the knife is ready for cutting while holding the instrument steadily.
• a motor is coupled to the flexible shaft 18 which via a gear 19 transmit a rotating movement to the shaft 20 and thus to the knife 8 as well so as to carry out the operative treatment of the prostate gland.
• the instrument further has a connection 21 for flushing liquid for the removal of cut tissue and of urine.
• Fig. 8 shows a further embodiment of the operation instrument according to the invention. Also in this case the instrument is provided with an inspection glass 15 with a connection 16 to a source of light, not shown.
• the inspection glass 15 is in this embodiment attached to the instrument by means of a bayonet clutch 22. As is the case in previously described embodiments also in this case there has been arranged a connection 16 to a source of light.
• the instrument has a central body 22, a gear 23 being arranged in said central body 22.
• This gear 23 is driven by a motor 24 which in turn is manoeuvered by means of a pedal 25 having an electrical connection plug 26.
• the motor 24 can be connected to the gear 23 by means of a bayonet clutch 27.
• the gear 23 drives a shaft 29 arranged in a mantle or guiding tube 28, said shaft 29 carrying at its outer end the operation knife 8.
• the shaft 29 comprises a tube and is housing an optical tube 30 which at its - in a way of speaking - end is provided with an optical device 31 which makes it possible for the surgeon to watch the activity of the knife 8.
• the guiding tube 28 also has a connection 31 for the inflow of flushing liquid and one connection 32 for the removal of the flushing liquid.
• the guiding tube 28 can as shown be connected in a proper manner by means of a bayonet clutch 33 and a liquid seal 34 ensures then that flushing liquid is prevented from leaking out at the inner end of the guiding tube 18.
• This embodiment of the instrument according to the invention has a cable 35 for the feeding of electricity serving to increase the cutting ability of the knife 8 and to stop the bleeding.
• the invention is not restricted to the shown and described embodiments but many modifications are possible within the scope of the appended claims. Thus, the intercoupling of the parts of the instrument may be carried out in another way than shown by means of bayonet clutches.
• the knife may have another form than the one shown in the drawings and described supra.
• the knife may be composed of blades extending from the shaft. It can also be replaceable.
• the knife may be rotated alternately in both directions parts of one rotation or several rotations in either direction.
• the endoscopic channel and other tubes may be completed or be replaced by means of video techniques.

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• Health & Medical Sciences (AREA)
• Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Engineering & Computer Science (AREA)
• Biomedical Technology (AREA)
• Public Health (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Veterinary Medicine (AREA)
• General Health & Medical Sciences (AREA)
• Heart & Thoracic Surgery (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• Physics & Mathematics (AREA)
• Otolaryngology (AREA)
• Plasma & Fusion (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Surgical Instruments (AREA)

Applications Claiming Priority (2)

Publications (1)

Family

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Family Applications (1)

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• 1992
  • 1992-11-12 SE SE9203375A patent/SE501876C2/sv not_active IP Right Cessation
• 1994
  • 1994-05-06 AU AU70106/94A patent/AU7010694A/en not_active Abandoned
  • 1994-05-06 EP EP94919029A patent/EP0774924A1/de not_active Withdrawn
  • 1994-05-06 WO PCT/SE1994/000413 patent/WO1995030377A1/en not_active Ceased

Non-Patent Citations (1)

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