Chirurgische HF-KoagulationssondeDie Erfindung betriffteine chirurgische HF-Koagulationssonde mit einer Elektrodenzange an -einem-erstenEnde und einem Betätigungsgriff zum Betätigen der Elektrodenzange am zweiten Endeeines mindestens nach außen elektrisch isolierten Rohres, in dem zum Zuleiten vonelektrischem Strom an die Backen der Elektrodenzange ein Leiter angeordnet ist,der zum öffnen und Schließen der Elektrodenzange vom Betätigungsgriff in einer Richtunggegen eine Rückstellkraft axial verschiebbar ist.Surgical HF coagulation probeThe invention relates toa surgical HF coagulation probe with electrode forceps on -a-firstEnd and an operating handle for operating the electrode clamp at the second endat least one tube, which is electrically insulated to the outside, in which to feedelectric current is placed on the jaws of the electrode clamps,the one to open and close the electrode clamp from the operating handle in one directionis axially displaceable against a restoring force.
Bei einer bekannten Soagulationssonde der oben genannten Art für dieEileitersterilisation ist der drahtr-oder stabförmige elektrische Leiter am erstenEnde des Rohres durch einen Diametralschnitt in zwei federnde, über den Umfang desRohres auseinandergebogene Enden aufgeteilt, die die Backen der monopolaren Elektrodenzangebilden und die beim axialen Einziehen des Leiters zum Schließen der Elektrodenzangeaneinanderbewegt werden.In a known soagulation probe of the type mentioned above for theFallopian tube sterilization is the wire- or rod-shaped electrical conductor at firstEnd of the tube through a diametrical cut into two resilient, over the circumference of theThe tube's bent-apart ends split the jaws of the monopolar electrode forcepsform and the axial retraction of the conductor to close the electrode clampbe moved together.
Dadurch, daß der andere Pol dieser bekannten monopolaren HF-Koagulationssondevom Operationsgebiet entfernt am Körper des Patienten angreift, kann die Koagulationan einer treten unvorhersehbaren Stelle ein-/nämiich dort, wo die stärkste Erwärmungbeim Durchfluß des elektrischen Stromes eintritt. Dies kann z.B. an einer Verengungdes Eileiters der Fall sein, die in einem Abstand von der Koagulationssonde liegt.Damit der Operateur feststellen kann, ob die Koagulation mit Erfolg durchgeführtist oder nicht, ist es sehr wichtig, daß die Koagulation an der vom Operateur gewünschtenStelle eintritt, die er dann durch ein Endoskop betrachten kann. Hierbei werdendas Endoskop und die Koagulationssonde durch zwei verschiedene Trokare in die Bauchhöhleeingeführt. Da jedoch bei der bekannten HF-Koagulationssonde die Koagulationsstellenicht immer voraussehbar ist, kann sie auch nicht immer beobachtet werden, -so daßder Operateur beim Koagulieren mit der bekannten HF-Koagulationssonde in vielenFällen den Erfolg oder Mißerfolg der Operation nicht beobachten kann.Because the other pole of this known monopolar HF coagulation probeattacks the patient's body away from the surgical site, coagulation can occuroccur at an unpredictable point, namely there, where the strongest warming occursoccurs when the electric current flows through it. This can be due to a narrowing, for exampleof the fallopian tube, which is at a distance from the coagulation probe.So that the surgeon can determine whether the coagulation has been carried out successfullyor not, it is very important that the coagulation is at the rate desired by the surgeonThat he can then look at through an endoscope. Here will bethe endoscope and the coagulation probe through two different trocars into the abdominal cavityintroduced. However, as in the known HF coagulation probe, the coagulation pointcannot always be foreseen, it cannot always be observed, so thatthe surgeon during coagulation with the well-known HF coagulation probe in manyCases cannot observe the success or failure of the operation.
Der Erfindung liegt die Aufgabe zu Grunde, eine chirurgische HF-Koagulationssondemit einer Elektrodenzange, insbesondere für die Eileitersterilisation aber auchfür andere chirurgische Zwecke zu schaffen, mittels deren die Koagulation an einergewünschten eng begrenzten Stelle durchführbar ist.The invention is based on the object of a surgical HF coagulation probebut also with electrode forceps, especially for fallopian tube sterilizationfor other surgical purposes, by means of which coagulation on adesired narrowly limited place is feasible.
Diese Aufgabe ist bei einer chirurgischen HF-Koagulationssonde dereingangs genannten Art gemäß der Erfindung dadurch gelöst, daß zwei voneinanderelektrisch isolierte Leiter vorhanden sind, deren außerhalb des Rohres befindlichçfreien Enden die beiden Backen einer bipolaren Elektrodenzange bilden. Dadurch wirdeine durch ein Trokar in den Körper eines Patienten einführbare HF-Koagulationssondegeschaffen, mittels deren die Koagulation an einer ganz bestimmten, durch ein zweitesTrokar mittels eines Endoskopes beobachtbaren Stelle durchgeführt werden kann, Weilbei dieser bipolaren Ausbildung dieser Sonde die Koagulation unmittelbar zwischenden beiden Backen der Elektrodenzange erfolgt.In the case of a surgical HF coagulation probe, this task is theinitially mentioned type solved according to the invention in that two of each otherelectrically insulated conductors are present, whose outside of the pipe is locatedfree ends form the two jaws of a bipolar electrode forceps. This willan RF coagulation probe insertable into a patient's body through a trocarcreated, by means of which the coagulation on a very specific one, through a secondTrocar can be performed using an endoscope observable site becausewith this bipolar design of this probe, the coagulation immediately betweenthe two jaws of the electrode clamp.
Die beiden Leiter können im Rohr angeordnet sein, das in diesem Fallzweckmäßigerweise aus einem Isolierstoff, z.B. aus Nylon hergestellt werden kann.Es kann aber auch vorgesehen sein, daß als der eine Leiter und als Rohr ein nachaußen isoliertes Metallrohr vorgesehen ist, dessen freies Ende eine Verlängerungaufweist, die den feststehenden Backen der -Elektrodenzange bildet. In einem solchenFall ist dann der zweite Leiter vom Metall rohr isoliert und in diesem angeordnet.Das aus dem ersten Ende des Metallrohres herausragende Ende dieses zweiten Leitersbildet dann den zweiten Backen der Elektrodenzange.The two conductors can be arranged in the tube, which in this casecan expediently be made of an insulating material such as nylon.But it can also be provided that as a conductor and a tube afterexternally insulated metal tube is provided, the free end of which is an extensionwhich forms the fixed jaws of the electrode forceps. In such aCase is then the second conductor isolated from the metal pipe and arranged in this.The end of this second conductor protruding from the first end of the metal tubethen forms the second jaw of the electrode clamp.
Die Erfindung ist in der folgenden Beschreibung von in den Zeichnungendargestellten Ausführungsbeispielen von erfindungsgemäßen, - für die Eileitersterilisationvorgesehenen chirurgischen HF-Koagulationssonden im einzelnen erläutert.The invention is illustrated in the following description of the drawingsillustrated embodiments of the invention, - for fallopian tube sterilizationprovided surgical RF coagulation probes explained in detail.
Es zeigen: r-Fig. 1 eine teilweise im Schnitt dargestellte Seitenansichteines ersten Ausführungsbeispieles; Fig. 2 einen Schnitt nach der Linie II - IIin Fig. 1; Fig. 3 und 4 vergrößert dargestellte Schnitte durch das erste Ende desRohres und der Elektrodenzange eines zweiten Ausführungsbeispieles bei offener bzw.geschlossener Elektrodenzange; Fig. 5 einen Schnitt nach der Linie V - V in Fig.3; Fig. 6 eine der Fig. 4 entsprechende Darstellung eines dritten Ausführungsbeispieles.It shows: r-Fig. 1 is a partially sectioned side viewa first embodiment; Fig. 2 is a section along the line II - IIin Fig. 1; Fig. 3 and 4 enlarged sections through the first end of theTube and the electrode clamp of a second embodiment with open orclosed electrode forceps; FIG. 5 shows a section along the line V - V in FIG.3; 6 shows an illustration of a third exemplary embodiment corresponding to FIG. 4.
Das in den Fig. 1 und 2 dargestellte erste Ausführungsbeispiel einerfür die Eileitersterilisation vorgesehenen chirurgischen HF-Koagulationssonde weisteine Elektrodenzange 11 an einem ersten Ende 12 und einen Betätigungsgriff 13 zumBetätigen der Elektrodenzange 11 am zweiten Ende 14 eines Metallrohres 15 auf, dasaußen mit einer elektrischen Isolierschicht 16 versehen ist. Im Metallrohr 15 istein mit einer 17 Isolierhülleisolierter Leiter 18 angeordnet, der vom Betätigungsgriff13 im Metallrohr 15 axial verschieblb2ar ist. Der äußerste Endabschnitt des ausdem ersten Ende/des Metallrohres herausragenden Endes des Leiters 18 ist abisoliertundhakenförmig gebogen und bildet dadurch den bewegbaren Backen19 der Elektrodenzange 11. Das erste Ende 12 des Metallrohres weist eine draht-oder stabförmige Verlängerung 21 auf, deren äußerstes Ende als feststehender Backen22 in der Schließstellung der Elektrodenzange 117den hakenförmigen bewegbaren Backen19 eingreift und dort durch ein Isolierstück 23 in der Schließstellung im Abstandvon dem Backen 19 gehalten wird, um dadurch einen Kurzschluß zu vermeiden.The first embodiment shown in FIGS. 1 and 2Surgical HF coagulation probe intended for fallopian tube sterilizationan electrode forceps 11 at a first end 12 and an operating handle 13 forPressing the electrode tongs 11 at the second end 14 of a metal tube 15 thatis provided with an electrical insulating layer 16 on the outside. In the metal tube 15 isa conductor 18 insulated with a 17 insulating sheath is arranged, from the operating handle13 is axially verschieblb2ar in the metal tube 15. The extreme end portion of the outthe end of the conductor 18 protruding from the first end / the metal tube is strippedandCurved hook-shaped and thereby forms the movable jaw19 of the electrode tongs 11. The first end 12 of the metal tube has a wireor rod-shaped extension 21, the extreme end of which as a fixed jaw22 in the closed position of the electrode forceps 117 the hook-shaped movable jaws19 engages and there by an insulating piece 23 in the closed position at a distanceis held by the jaw 19, thereby avoiding a short circuit.
Der Betätigungsgriff 13 weist zwei elektrisch leitende Bandfedern24 und 25 auf. Die Band feder 24 ist durch auf ein Außengewinde des Metallrohres15 aufgeschraubte hülsenförmige Muttern 26 mechanisch fest und elektrisch leitendmit dem Metallrohr 15 verbunden. Die Bandfeder 25 ist mit dem äußersten abisoliertenEndabschnitt des aus dem zweiten Ende des Metallrohres 15 herausragenden Endes desLeiters 18 in bekannter Weise gelenkig verbunden. Die übrigen Teile der Bandfedern24 und 25 sind nach außen isoliert. Ihre dem zweiten Ende 14 des Metallrohres abgekehrtenEnden sind nahe aneinandergebogen und stecken in einem Isolierkörper 20, aus demsie mit ihren abisolierten Endabschnitten herausragen, so daß dadurch der Isolierkörper20 mit den Endabschnitten 27 einen Stecker für den Anschluß an eine elektrischeZuleitung bildet. Neben dem zweiten Ende 14 ist zwischen den Bandfedern 24 und 25eine Feder 28 angeordnet, die die dem ersten Ende 14 des Rohres benachbarten Endender Bandfedern 24 und 25 auseinanderdrückt und so die Elektrodenzange 11 in geschlossenerStellung hält. Bei einer abgewandelten Ausführungsform kann die Feder 28 weggelassenwerden, da die Federkraft,um die Elektrodenzange geschlossen zu halten, auch vonden Bandfedern 24 und 25 verursacht werden kann.The operating handle 13 has two electrically conductive ribbon springs24 and 25 on. The band spring 24 is through to an external thread of the metal tube15 screwed sleeve-shaped nuts 26 mechanically tight and electrically conductiveconnected to the metal pipe 15. The strip spring 25 is stripped to the extremeEnd portion of the protruding from the second end of the metal tube 15 end of theHead 18 articulated in a known manner. The remaining parts of the ribbon springs24 and 25 are isolated from the outside. Your turned away from the second end 14 of the metal tubeEnds are bent close to each other and stuck in an insulating body 20, from thethey protrude with their stripped end portions, so that thereby the insulating body20 with the end sections 27 a plug for connection to an electricalForms supply line. Next to the second end 14 is between the ribbon springs 24 and 25a spring 28 is arranged spanning the ends adjacent to the first end 14 of the tubethe band springs 24 and 25 pushes apart and so the electrode clamp 11 in closedHolds position. In a modified embodiment, the spring 28 can be omittedas the spring force to keep the electrode clamp closed, also fromthe ribbon springs 24 and 25 can be caused.
Wie das in Fig. 1 strichpunktiert dargestellt ist, ist das aus demMetallrohr 15 herausragende Ende des isolierten Leiters 18 so nach außen gebogen,daß es in die in Fig. 1 strichpunktiert dargestellte Stellung herausschwenkt, wenndie Bandfeder 25 gegen die Bandfeder 24 bewegt und dadurch der Leiter 18 im Metallrohr 15axial in Fig. 1 nach unten verschoben wird. Entsprechend wird durch diese Biegungdes herausragenden Endes des Leiters 18 erreicht, daß bei der in Fig. 1 nach obengerichteten Verschiebung des Leiters 18 im Metallrohr 15 das aus dem ersten Ende12 des Metallrohres herausragende Ende des Leiters 18 in die in Fig. 1 ausgezogendargestellte Schließstellung geschwenkt und verschoben wird.As shown in phantom in Fig. 1, this is from theMetal pipe 15 protruding end of the insulated conductor 18 bent outward sothat it swings out into the position shown in phantom in Fig. 1 whenthe band spring 25 moves against the band spring 24 and thereby the conductor 18 in the metal tube15this displaced axially in Fig. 1 downwards. This bend accordinglyof the protruding end of the conductor 18 achieved that in Fig. 1 upwardsdirected displacement of the conductor 18 in the metal tube 15 from the first end12 of the metal tube protruding end of the conductor 18 in the drawn out in FIGshown closed position is pivoted and shifted.
Bei einer Eileitersterilisation kann die dargestellte Koagulationssondeleicht durcheinenin die Bauchdecke der Patientin eingesetzten Trokar eingeführtwerden. Durch ein Endoskop, das durch einen zweiten Trokar ebenfalls in die Bauchhöhleeingeführt wird, wird nun die Stelle des Eileiters vom Operateur beobachtet, diekoaguliert werden soll. Diese Stelle kann nun mit der hakenförmigen Backe 19 derElektrodenzange erfaßt werden, so lange die Zange durch Zusammendrücken der Bandfedern24 und 25 geöffnet ist. Durch Schließen der Elektrodenzange 11 wird dann die gewünschteStelle des Eileiters genau zwischen die beiden Backen 19 und 22 eingeführt, so daßbeim anschließenden Einschalten des Koagulationsstromes die Koagulation an der gewünschtenStelle durchgeführt wird.In the case of fallopian tube sterilization, the shown coagulation probeeasily inserted through a trocar inserted into the patient's abdominal wallwill. Through an endoscope, which is also inserted into the abdominal cavity through a second trocaris inserted, the location of the fallopian tube is now observed by the surgeon, whichis to be coagulated. This point can now with the hook-shaped jaw 19 of theElectrode pliers are grasped as long as the pliers by compressing the ribbon springs24 and 25 is open. By closing the electrode clamps 11, the desiredPlace the fallopian tube exactly between the two jaws 19 and 22 so thatwhen the coagulation current is subsequently switched on, the coagulation takes place at the desired onePlace is carried out.
Bei dem in den Fig. 3 bis 5 dargestellten Ausführungsbeispiel sinddiejenigen Teile, die dem Ausführungsbeispiel nach den Fig.l und 2 entsprechen,mit um 100 vergrößerten Bezugszahlen bezeichnet, wodurch gleichzeitig auf die vorhergehendeBeschreibung Bezug genommen wird.In the embodiment shown in Figs. 3 to 5 arethose parts that correspond to the embodiment according to FIGS. 1 and 2,denoted by reference numerals increased by 100, thereby simultaneously referring to the precedingDescription is referred to.
Das Ausführungsbeispiel nach den Fig. 3 bis 5 unterscheidet sich vondem vorhergehenden Ausführungsbeispiel dadurch, daß hier als Rohr ein Isolierrohr115, z.B. aus. Nylon, vorgesehen ist, in dem ein mit einer Isolierhülle 117 isolierterLeiter 118 und ein nichtisolierter Leiter 121 beide gemeinsam axial verschiebbarangeordnet sind. Die herausragenden freien Enden dieser Leiter 118 und 121 sind,wie das aus Fig. 3 ersichtlich ist, so über denUmfang des Rohres115 auseinandergebogen, daß ihre Endabschnitte die in der öffnungsstellung der Elektrodenzange111 voneinander abgehobenen Backen 119 und 122 bilden. Am Backen 119 ist ein/solierstück123 befestigt, das dem Backen/119 eine Hakenform gibt, um dadurch einen Eileiter129 einfangen zu können. Außerdem ist das Isolierstück 123 mit einer Nut 131 fürden Backen 122 versehen.The embodiment according to FIGS. 3 to 5 differs fromthe previous embodiment in that here an insulating tube as a tube115, e.g. from. Nylon, is provided in which an insulated with an insulating sleeve 117Conductor 118 and a non-insulated conductor 121 are both axially displaceable togetherare arranged. The protruding free ends of these conductors 118 and 121 areas can be seen from Fig. 3, so onCircumference of the pipe115 bent apart that their end sections are in the open position of the electrode forceps111 jaws 119 and 122 raised from one another. On the cheek 119 is a / soling piece123, which gives the jaw 119 a hook shape to thereby create a fallopian tube129 to be able to capture. In addition, the insulating piece 123 is provided with a groove 131 forthe jaw 122 is provided.
Der Betätigungsgriff der Koagulationssonde nach den Fig. 3 bis 5ist ähnlich ausgebildet wie beim Ausführungsbeispiel nach den Fig. lund 2, nur daßhier die Bandfedemnicht als elektrische Leiter dienen und die eine Bandfeder elektrischisoliert mit beiden Leitern 118 und 121 zum gemeinsamen Bewegen derselben verbundenist. Die Zuführung des elektrischen SbDmes an die beiden Leiter 118 und 121 erfolgtbei diesem Ausführungsbeispiel durch in der Zeichnung nicht dargestellte Zuleitungen. The operating handle of the coagulation probe according to FIGS. 3 to 5is designed similarly to the embodiment of FIGS. 1 and 2, only thathere the ribbon springs do not serve as electrical conductors and one ribbon spring is electricalisolated connected to both conductors 118 and 121 for moving them togetheris. The electrical SbDmes is fed to the two conductors 118 and 121in this embodiment by supply lines not shown in the drawing.
Werden die beiden Leiter 118 und 121 so axial im Rohr 115 verschoben,daß ihre freien Enden in das Rohr 115 hineingezogen werden, dann werden die beidenBacken 119 und 122, wie das in #Fig. 4 dargestellt ist, aneinanderbewegt, so daßder Backen 122 in die Nut 131 eingreift und der zwischen den Backen liegende Eileiter129 genau an einer gewünschten Stelle koaguliert wird.If the two conductors 118 and 121 are shifted axially in the tube 115,that their free ends are drawn into the tube 115, then the twoJaws 119 and 122, like the one in #Fig. 4 is shown moved together so thatthe jaw 122 engages in the groove 131 and the fallopian tube lying between the jaws129 is coagulated exactly at a desired point.
Bei dem in Fig. 6-dargestellten Ausführungsbeispiel sind alle diejenigenTeile, die den Teilen des in den Fig. 1 und 2 dargestellten Ausführungsbeispielesentsprechen, mit um 200 vergrößerten Bezugszahlen bezeichnet, so daß durch diesenHinweis auf die Beschreibung des ersten Ausführungsbeispieles Bezug genommen wird.In the embodiment shown in Fig. 6, all are thoseParts that correspond to the parts of the embodiment shown in FIGScorrespond, denoted by reference numerals increased by 200, so that by thisReference is made to the description of the first exemplary embodiment.
Bei dem Ausführungsbeispiel nach Fig. 6 ist, ähnlich wie bei demersten Ausführungsbeispiel, wieder ein Metallrohr 215 vorgesehen, das an seinemersten- Ende eine Verlängerung 221 aufweist, die hier einen haket.örmigen Backen222 bildet. Der im Rohr 215 stabförmige axial verschiebbare/Leiter 218 ist auchhier mit einer Isolierhülle 217 versehen. Das äußerste freie Endedes Leiters 218 ist verdickt und bildet dadurch den bewegbaren, in diesem Fall axialverschiebbaren Backen 219, der bei der Schließstellung der Elektrodenzange 211 inden hakenförmigen festen Backen 222 eingreift. Bei diesem Ausführungsbeispiel kannder Betätigungsgriff wieder genau so ausgebildet sein wie beim Ausführungsbeispielnach den Fig. 1 und 2. In the embodiment of FIG. 6 is, similar to thatfirst embodiment, again a metal tube 215 is provided on histhe first end has an extension 221 which here has a hook-shaped jaw222 forms. The rod-shaped axially displaceable / conductor 218 in the tube 215 is alsohere with an insulating sleeve217 provided. The outermost free endof the conductor 218 is thickened and thereby forms the movable one, in this case axiallydisplaceable jaw 219, which in the closed position of the electrode clamp 211 inthe hook-shaped fixed jaw 222 engages. In this embodiment, canthe operating handle can again be designed exactly as in the exemplary embodimentaccording to FIGS. 1 and 2.
Bei diesem Ausführungsbeispiel werden jedoch die Backen durch dieKraft der Feder 28 in der Offenstellung der Elektrodenzange 211 gehalten. DurchZusammendrücken der Bandfedern 24 und 25 wird der Backen 219 in den hakenförmigenfeststehenden Backen 222 eingeführt.Um nun auch hier einen Kurzschluß zu vermeiden,ist bei dem für dieses Ausführungsbeispiel angepaßten Betätigungsgriff 13 zwischenden beiden Bandfedern 24 und 25 ein einstellbarer, die Schließbewegung der Bandfedernbegrenzender Anschlag vorgesehen.In this embodiment, however, the jaws are through theForce of the spring 28 held in the open position of the electrode tongs 211. ByCompression of the ribbon springs 24 and 25 turns the jaws 219 into the hook-shapedfixed jaws 222 introduced. In order to avoid a short circuit here, too,is in the adapted for this embodiment operating handle 13 betweenthe two band springs 24 and 25 an adjustable, the closing movement of the band springslimiting stop provided.
Bei einer weiteren, nichts dargestellten Ausführungsform kann dieVerlängerung 21 des Ausführungsbeispieles nach Fig. 1 mit einem hakenförmig ausgebildetenIsolierstück (entsprechend dem Isolierstück 123 in Fig. 4) fest verbunden sein.Das dem hakenförmigen Backen 19 des Ausführungsbeispieles nach Fig. 1 entsprechendeEnde des im Metallrohr beweglich und isoliert angeordneten Leiters 18 kann dannwie der Backen 122 in Fig. 4 geformt sein.In a further, not shown embodiment, theExtension 21 of the embodiment of FIG. 1 with a hook-shapedInsulating piece (corresponding to the insulating piece 123 in Fig. 4) be firmly connected.The corresponding to the hook-shaped jaw 19 of the embodiment of FIGThe end of the conductor 18, which is arranged movably and insulated in the metal tube, can thenshaped like the jaw 122 in FIG.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE2415263ADE2415263A1 (en) | 1974-03-29 | 1974-03-29 | Surgical H.F. coagulation probe has electrode tongs - with exposed ends of insulated conductors forming tong-jaws |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE2415263ADE2415263A1 (en) | 1974-03-29 | 1974-03-29 | Surgical H.F. coagulation probe has electrode tongs - with exposed ends of insulated conductors forming tong-jaws |
| Publication Number | Publication Date |
|---|---|
| DE2415263A1true DE2415263A1 (en) | 1975-10-02 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| DE2415263APendingDE2415263A1 (en) | 1974-03-29 | 1974-03-29 | Surgical H.F. coagulation probe has electrode tongs - with exposed ends of insulated conductors forming tong-jaws |
| Country | Link |
|---|---|
| DE (1) | DE2415263A1 (en) |
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| Date | Code | Title | Description |
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