WO2010057576A1 - Pince de coagulation - Google Patents

Pince de coagulation Download PDF

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Publication number
WO2010057576A1
WO2010057576A1 PCT/EP2009/007885 EP2009007885W WO2010057576A1 WO 2010057576 A1 WO2010057576 A1 WO 2010057576A1 EP 2009007885 W EP2009007885 W EP 2009007885W WO 2010057576 A1 WO2010057576 A1 WO 2010057576A1
Authority
WO
WIPO (PCT)
Prior art keywords
coagulation
electrodes
clamp according
rch
teeth
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/EP2009/007885
Other languages
German (de)
English (en)
Inventor
Jürgen HILLER
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Erbe Elecktromedizin GmbH
Original Assignee
Erbe Elecktromedizin GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Erbe Elecktromedizin GmbH filed Critical Erbe Elecktromedizin GmbH
Publication of WO2010057576A1 publication Critical patent/WO2010057576A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

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
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/0088—Material properties ceramic
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00059—Material properties
    • A61B2018/00071—Electrical conductivity
    • A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00107—Coatings on the energy applicator
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00107—Coatings on the energy applicator
    • A61B2018/00136—Coatings on the energy applicator with polymer
    • 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
    • A61B2018/00345—Vascular system
    • A61B2018/00404—Blood vessels other than those in or around the heart
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601—Cutting
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/0063—Sealing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself

Definitions

  • the invention relates to a coagulation clamp according to the preamble of claim 1.
  • Coagulation clamps for surgical purposes have gripping elements on which coagulation electrodes for clamping a tissue section, in particular a vessel, are provided opposite one another.
  • the gripping elements can be moved toward each other from an open to a closed state. So that no short circuit between the electrodes can occur, at least one spacer element is mounted in such a way that the coagulation electrodes in the closed state have a safety distance from each other.
  • a coagulation clamp is known, for example, from EP 1 747 762 A2.
  • a raised (insulating) portion is mounted on the coagulation electrodes near a hinge through which the gripping members are connected.
  • retaining teeth are provided in the known coagulation clamps over the entire electrode surface, which teeth are dimensioned so that they do not touch the opposing coagulation electrode in the closed state of the gripping elements.
  • the invention has for its object to provide a coagulation clamp of the type mentioned in that a secure hold of the tissue and a exactly defined residual gap between the coagulation electrodes are ensured even with reduced production costs.
  • a coagulation clamp with gripping elements and with opposing coagulation electrodes, which are movable toward each other for clamping a tissue section from an open to a closed state, with at least one spacer which is mounted such that the coagulation electrodes in the closed state a safety distance from each other, and with a plurality of holding teeth, which are mounted on the coagulation electrodes for holding the tissue and dimensioned so that they do not touch the opposing coagulation electrode in the closed state, achieved in that the holding teeth are arranged in groups and that each group at least one spatially adjacent spacer element is assigned.
  • An essential point of the invention lies in the fact that a plurality of spacer elements is provided over substantially the entire surface of the coagulation electrodes, so that the safety distance is absolutely guaranteed when closing the gripper elements.
  • the provided in the vicinity of the spacers retaining teeth then serve not only to hold the tissue, but rather represent additional security elements, which then, if associated spacers should fail, still ensure a safe distance between the coagulation electrodes.
  • the holding teeth have a dual function and increase the safety when operating the coagulation clamp.
  • the spacer elements additionally act to hold the grasped tissue.
  • coagulation clamp is to be understood not only those clamps as they are used in open surgery, but also such terminals, as they are performed in endoscopic operations.
  • the groups of retaining teeth to which in this case the associated spacer elements are to be added, preferably have a diameter that is smaller, preferably at most half the size of the distances between the groups.
  • a group consists of a single one Distance element and a single holding tooth.
  • the holding teeth or spacer elements or the groups formed should be distributed over the Koagulationselektroden inhabit so that the tissue to be gripped is securely detected by at least one group.
  • all spacer elements are attached to a coagulation electrode and all holding teeth are attached to the other coagulation electrode. This facilitates the production.
  • the spacer elements and the retaining teeth are preferably formed as ceramic components.
  • Such ceramic components are commercially available as prefabricated components and have the advantageous properties in terms of insulation and heat resistance.
  • the ceramic components are preferably rod-shaped and preferably secured in corresponding holes in the coagulation electrodes by gluing.
  • the connection between the ceramic component and the coagulation electrode is thus very easy to manufacture, so the production is simple.
  • the ceramic components preferably have edge-free end sections, that is to say they are "chamfered.” On the one hand, this facilitates insertion into the bores, on the other hand, no unintentional tissue injuries can occur.
  • the ceramic components all have the same length.
  • deeper holes then than in the other coagulation electrode are mounted so that the retaining teeth are formed on the coagulation electrode with the deeper holes and the spacer elements on the other coagulation electrode. This further facilitates the production of the coagulation clamp.
  • the ceramic components in a conventional coagulation clamp for open surgery have a length of about 2.5 mm and are inserted so deep into the coagulation electrodes that they are still about 200 microns protrude beyond the surface of the coagulation electrodes or slightly more if a spacer element is to be formed.
  • the gripping elements are provided with an insulating layer of PEEK (polyetheretherketone) outside of those areas in which the coagulation electrodes are located.
  • PEEK polyetheretherketone
  • This insulating material has proved to be particularly advantageous and in particular when this PEEK insulating layer comprises a filling of mica.
  • the filling preferably makes up 5 to 25%, better still 10 to 20%, but in particular 15% of the insulating layer.
  • the mica is present in a very small particle size and although the particle size should be less than 25 ⁇ m, but preferably less than 15 ⁇ m. As a result, the material properties of the insulating layer are further improved.
  • FIG. 1 is a side view of an end portion of a coagulation clamp
  • FIG. 2 is a front view taken along the line II-II of FIG. 1,
  • Fig. 3 is a section along the line III-III of Fig. 2 and
  • a coagulation clamp In Fig. 1, an end portion of a coagulation clamp is shown. This comprises gripping elements 10, 11, which are pivotally connected to one another via a joint 9 and merge into proximal arm sections or branches 7, 8. Instead of such proximal arm portions 7, 8, other actuating elements for opening and closing the gripping elements 10, 11 may be provided.
  • coagulation electrodes 12, 13 On inner surfaces of the gripping elements 10, 11 coagulation electrodes 12, 13 are arranged, as shown in FIGS. 2 and 3. From the surface of a coagulation electrode 13 protrude spacer elements 20-24, which are dimensioned so long that when closing the gripping elements 10, 11 the Coagulation electrodes 12, 13 have a safety distance d (see Fig. 2) from each other.
  • holding teeth 30-36 are provided, as shown in particular in Fig. 3. These can be individual holding teeth, as shown by the reference numerals 30-32, or a plurality of holding teeth, as shown by the reference numerals 33-36, each of which in turn may also comprise different arrangements in the region of the spacer elements 20-24.
  • the retaining teeth 30-36 are always assigned spacer elements 20-24. In this way, if spacers 20-24 fail in their function for some reason, it is ensured that this function can be taken over by holding teeth 30-36. In this case, although the safety distance d is slightly lower, with a suitable dimensioning it is still so large that a short circuit between the coagulation electrodes 12, 13 is avoided.
  • the spacer elements 20-24 and retaining teeth 30-36 are rod-shaped formed of ceramic material, and have, as shown in Fig. 4, end portions 25 which are rounded. In this way, these ceramic elements can be used in a simple manner in holes 16 which are provided in the coagulation electrodes 12, 13. For attachment in Koagulationselektroden 12, 13 is particularly suitable for gluing. On the other hand, this rounding of the end portions 25 leads to the fact that an unwanted mechanical injury of the tissue when using the coagulation clamp is reliably avoided.
  • the coagulation electrodes 12, 13 have insulation 14, 15, which completely surround the coagulation electrodes 12, 13 so that only the mutually facing surfaces of the coagulation electrodes are uninsulated.
  • the insulating material has already been described in more detail above.

Landscapes

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

Abstract

On connaît des pinces de coagulation comportant des éléments de saisie, qui présentent des électrodes de coagulation opposées l'une à l'autre, et qui, pour serrer un segment de tissu, peuvent être renfermées l'une sur l'autre, pour passer d'un état ouvert à un état fermé. Au moins un élément d'écartement est rapporté de façon que les électrodes de coagulation, à l'état fermé, se trouvent à une distance de sécurité l'une de l'autre. De nombreuses dents de maintien sont rapportées sur les électrodes de coagulation pour maintenir le tissu en place, et sont dimensionnées de façon qu'à l'état fermé, elles ne soient pas en contact avec l'électrode de coagulation opposée. Pour augmenter la sécurité fonctionnelle tout en simplifiant la fabrication, il est prévu de disposer les dents de maintien en groupes, et d'affecter à chaque groupe au moins un élément d'écartement, les éléments d'écartement étant spatialement étroitement voisins les uns des autres.
PCT/EP2009/007885 2008-11-19 2009-11-03 Pince de coagulation Ceased WO2010057576A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102008058019.8A DE102008058019B4 (de) 2008-11-19 2008-11-19 Koagulationsklemme
DE102008058019.8 2008-11-19

Publications (1)

Publication Number Publication Date
WO2010057576A1 true WO2010057576A1 (fr) 2010-05-27

Family

ID=41531668

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2009/007885 Ceased WO2010057576A1 (fr) 2008-11-19 2009-11-03 Pince de coagulation

Country Status (2)

Country Link
DE (1) DE102008058019B4 (fr)
WO (1) WO2010057576A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0986990A1 (fr) * 1997-06-18 2000-03-22 Eggers & Associates, Inc. Pince électrochirurgicale
US20030216733A1 (en) * 2002-05-16 2003-11-20 Mcclurken Michael E. Fluid-assisted medical devices, systems and methods
EP1747762A2 (fr) * 2005-07-26 2007-01-31 Aesculap AG & Co. KG Pince de coagulation pour procedures chirurgicales
US20070062017A1 (en) * 2001-04-06 2007-03-22 Dycus Sean T Vessel sealer and divider and method of manufacturing same

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0986990A1 (fr) * 1997-06-18 2000-03-22 Eggers & Associates, Inc. Pince électrochirurgicale
US20070062017A1 (en) * 2001-04-06 2007-03-22 Dycus Sean T Vessel sealer and divider and method of manufacturing same
US20030216733A1 (en) * 2002-05-16 2003-11-20 Mcclurken Michael E. Fluid-assisted medical devices, systems and methods
EP1747762A2 (fr) * 2005-07-26 2007-01-31 Aesculap AG & Co. KG Pince de coagulation pour procedures chirurgicales

Also Published As

Publication number Publication date
DE102008058019A1 (de) 2010-05-20
DE102008058019B4 (de) 2014-02-13

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