Note: Descriptions are shown in the official language in which they were submitted.
BACKGROUND OF THE INVENTION
Field of the Invention
This invention relates to medical instruments and,
more particularly, to a device for treating living tissue with
an electric current suitable for use in laparoscopic tubal
cauterization.
Background of the Invention
The procedure of female sterili~ation by laparoscopic~
tubular cauterization has provided the most efficient and
least painful method of sterilization of women. Under this
procedure, the fallopian tubes are cauterized with an electri-
cal current from an electrical power source. Both monopolar
and bipolar treatment have been used in the cauterization of
fallopian tubes.
In the monopolar cauterization, the patient is
physically placed upon a metallic base plate connected to one
side of the electrical power source. An electrode which is
connected to the other side of the power source is inserted
into the abdomen of the patient through the use of a trochar
or the like. Accordingly, the electric current passes between
the inserted electrode and the metallic base plate through ~he
living tissue. The monopolar device had the distinct dis-
advantage of controlling the flow of current between the
inserted electrode and the base plate. In addition, the
surgeon is required t,o take great care to insure that the
device is not activated prior to proper positionin~ within
the abdomen of the patient. Otherwise, the electrical current
from the device will flow in an undesirable direction thereby
damaging adjacent tissue.
This disadvantage of the monopolar device was
overcome with the introduction of a bipolar device comprising
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a first and a second electrode insertable into the abdomen of
the patient. An example of a bipolar device may be found
described in applicant's U.S. patent No. 4,016,881 issued
April 12, 1977. In such bipolar device, the living tissue is :~
grasped between the first and second electrode thereby
controlling the electrical current through the living tissue
between the first and second electrodes.
It has been found that certain bipolar devices of
the prior art are difficult to control by the surgeon and
require the surgeon to physically grasp the living tissue by
the use of a trigger, lever or the like against the urging of
a spring. Simultaneously therewith, a switch must be depressed
to pass electrical current between the first and second
electrodes. These two movements make the prior art devices
awkward to use by a surgeon. Also, the prior art bipolar
devices do not provide for a safety interlock to prevent the
accidental activation of the device prior to proper positioning
within the abdomen of the patient.
Therefore, it is an object of th;s invention to
provide an apparatus which overcomes the aforementioned
inadequacies of the prior art devices and provides an im-
provement which is a signif;cant contr;but;on to the
advancement of the sterilization art.
Another object of this invention is to provide a
devlce for treating living tissue w;th an electr;cal current
from an electr;cal power source wherein the dev;ce may be
used either as a bipolar or a monopolar device and capable
of e;ther cauterizing or severing liv;ng t;ssue.
Another object of this invention is to provide a
device for treating living tissue with an electrical current
from an electrical power source comprising a pis~on slidably
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p~
mounted in a body with urging means urging the piston to a
first position with a first and a second electrode disposed
to grasp the living tissue when the piston is urged to the
first position. The urging means of the device will con-
tinually grasp the living tissue disposed between the firstand the second electrode elements in the first position.
Another obiect of this invention is to provide a
device for treating living tissue with an electrical current
from an electrical power source comprising circuit breaker
means for terminatiny continuity to the electrodes when the
piston is in the second position thereby making the device
incapable of operation until the electrodes are grasping the
tissue.
Another object of this invention is to provide a
device for treating living tissue with an electrical current
from an electrical power source including a switch for
activating electrical power to the electrodes with means for
disabling the switch when the piston is in the second position.
Another object of this invention is to provide a
device for treating living tissue with an electrical current
from an electrical power source wherein the device may be
easily manufactured as a disposable single use item.
The foregoing has outlined some of the more pertinent
objects of the invention. These objects should be construed
to be merely illustrative of some of the more promlnent
features and applications of the intended invention. Many
other beneficial results can be attained by applying the
disclosed invention in a different manner or modifying the
invention within the scope of the disclosure. ~ccordingly,
other objects and a fuller understanding of the invention may
be had by referring to the summary of the invention and the
detailed description describing the preferred embodiment, in
addition to the scope of the invention defined by the claims
taken in conjunction with the accompanying drawings.
SUMMARY OF THE INVENTION
The invention is defined by the appended claims to
cover the disclosed embodiments shown in the attached drawings
and the equ;valent thereof as set forth in the detailed dis-
cussion. For the purpose of summarizing the invention, the
invention may be incorporated into a device for treating
living tissue with an electric current from an electrical
power source. The device comprises a body member and a piston
slidably mounted relative to the body member. Urging means,
such as a spring, urges the piston to a first position relative
to the body member. Means are provided for moving the piston
to a second position relative to the body member against the
urging means. A first and a second electrode element is
mounted with the first electrode element moving in accordance
with the movement of the piston. The first and second
; electrode elements are disposed to grasp the living tissue
when the piston is in the first position whereas the
electrodes release the living tissue when the piston is in
the second position. The-first and-second electrodes are-
connected to the electrical power source to provide an
clectrical current P10w relative to the living tissue.
In a more specif-ic example of the invention, a
circuit breaker is included for terminating continuity to the
electrocie elements when the piston is in the second position.
This eliminates the possibility of accidental triggering of
the device. The first and second electrodes may be moved into
the open position by a button extending from a first end of
the body member for moving the piston to the second position.
In this embodiment, the first and the second electrodes extend
from the second end of the body member such that the piston
slidably extends along the axis of a substantially cylindrical
body member. A switch is disposed on one surface of the body
member for connecting the electrical power source to the
electrode elements. Means such as a projection on the piston
is provided for disabling the switch when the piston is in the
second position. This configuration provides a second safety
interlock for preventing accidental electrification of the
electrodes when the first and second electrode elements are
in the open position. In one embodiment, the switch means is
connected in electrical series with the circuit breaker thereby
providing a series switch interconnection system. In another
embodiment, the switch means is connected in electrical series
directly with the electrodes.
The foregoing has outlined rather broadly the more
pertinent and important features of the present in~ention in
order that the detailed description of the invention that
follows may be better understood so that the present contri-
bution to the art can be more fully appreciated. Additionalfeatures of the invention will be described hereinafter which
form the subject of-the claims of the invention. It should be
appreciated by those skilled in the art that the conception
and the specific embodiment disclosed may be readily utilized
as a basis for modifyiny or des;gn;ng other structures for
carry;ng out the same purposes of the present invent;on. It
should also be real;zed by those sk111ed in the art that such
equivalent constructions do not depart from the $pirit and
scope of the inYention as set forth in the appended cla;ms.
BRIEF DESCRIPTION OF THE DRAWINGS
.
For a fuller understanding of the nature and objects
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of the inventi~n, reference should be had to the following
detailed description taken in connection wi~h the accompanying
drawings in which:
Figure l is an elevational view o~ a surgeon utilizing
S the new improved device in a laparoscopic cauterization process;
Figure 2 is a magnifie~ elevational view of the device
shown in Fig. l;
Figure 3 is a sectional view o~ the device shown in
Fig. 2 illustrating the piston in a second position;
Figure 4 is a sectional view of the device shown in
F;g. 2 ;llustrating the pistnn in a first position;
Figure 5 is a sectional view showing another embodi-
ment of the device made in accordance with the presen~
invention, illustrating the piston in the second position;
Figure 6 is an enlarged view of the piston shown in
the devices in Figs. 1-5; and ~
Figure 7 is a view along line 7-7 in Fig. 6. ; --
DETAILED DESCRIPTION
Figs. 1-7 illustrate a device 10 for treating living
tissue 12, such as the blocking of a fallopian tube 12 of a
patient 14 by laparoscopic tubal cauterization. The device 10
is specifically designed to enable a physician 16 to
conveniently hold the device lO and grasp the tissue 12 by
the manlpulation of a button 18 conveniently located at a
termlnal end of the device 10. The specific position of the
button 18 and an ac~ivation switch 20 permits the physician
16 to easily manipulate the device 10 while viewin~ the
fallopian tube 12 through an abdominal optical device 22.
The device lO is primarily designed to be a disposable device
which is convenient to operate and inexpensive to manufacture.
Although the device lO is disclosed with reference to the
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laparoscopic tubal cauterization for blocking fallopian tubes
of a patient, it should be understood that the principles of the
inYention set forth herein are applicable to other electrical
surgical treatments and the application disclosed herein
should not be construed as a limitation on the claimed subject
matter.
Fig. 2 illustrates an enlarged view of the device 10
with Figs. 3 and 4 being sectional views of the device of
Fig. 2. Fig. 3 illustrates the electrode elements of the
~; 10 device 10 in an open position whereas Fig. 4 illustrates the
electrode elements in a closed position and grasping the
fallopian tube 12. The device 10 comprises a substantially
cylindrical body member 24 with the button 18 extending from
a first end 24A of the body member 24 and with the electrodes
26 extending from a second end 24B of the body member 24. A
piston 28 shown enlarged in Fig. 6 is slidably received
within the body member 24 by guides 30, 32 and 34. An urging
means biases the piston 28 into a first position shown in
Fig. 4. The urging means includes a spring 36 coacting
between guide 32 and a flange 38 extending from piston 28 to
urge the p;ston 28 into the first position shown in Fig. 4.
Depressing button 18 causes the piston 28 to move into a
second position, shown in Fig. 3, against the urging of spring
36. The piston 28 may be integrally molded to contain the
' 25 electrode means 26. In this example, a first and a second
' electrode'41 and 42 extends along an internal reg;on of piston
; 28 and terminate as contact arms 44 and 46 extending perpendi-
cularly to the axis of piston 28~ Each of the el,ectrodes 41
and 42 has an inwardly projecting tab 48 and 50 for grasping
the fallopian tube 12. Fig. 7 is an elevational view along
line 7-7 showing in greater detail the specific configuration
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of the electrodes 41 and 42.
Piston 28 also comprises an elevated region 52 having
a tapered ramp 54 interconnectin~ the elevated region 52 with
the surface o~ the piston 28. The function of the elevated
region 52 w;ll be explained hereinafter. The piston 28 and
the electrodes 41 and 42 may be united in a single
injection molding process. The formed electrodes 41 and 42
may be positioned within a mold cavity prior to introduction
of a plastic material into the mold cavity. ~
A sleeve 56 has an outwardly projecting annular ~.
flange 58 which abuts guide 30 as the sleeve 56 extends through
an aperture 60 in the second end 24B of the body member 24. -
The piston 2~ is slidably received within the sleeYe ~6 such
that terminal end 62 of sleeve 56 controls the biased
divergence of the ~irst and second electrodes 41 and 42. A
first and a second contact pad 64 and 66 are secured to guide
32 and connected to wires 68 and 70-which extend through power
cable 72 to an electrical power source (not shown~. It will
be evident to the person skilled in the art that the wires of
cable 72 can be arranged to have the device of the present
invention adapted for either monopolar or bipolar treatment
of the livi-ng tissue. Wire 70 extends directly into cable 72
whereas wire 68, which is preferably connected to the ungrounded
terminal of the electr~cal power source, extends through the
swltch 20. In the embodiment illustrated in Fig. 5, the
device is structurally and operatively identical to the device
shown in Fig. 3 except that wires 68 and 70 are connected
directly to the arms 44 and 46, respectively. H.ence, the
contact pads 64 and 66 are eliminated in this embodiment.
Switch 20 comprises a switch activator 76 shown as a b~tton
having a stem 78 which extends through an aperture in the body
member 24. A suitable resilient material 84 biases the
activator 76 into the outward position. The switch 20
com~rises a first and a second contact element 86 and 88
separated by an electrical insulator 90. The first and second
contact elements 86 and 88 are interposed in wire 68 shown in
Figs. 3 and 4 to enable electrical continuity only upon
physical contact of the first and second contact elements
86 and 88. The second contact element 88 ;s biased toward
a position shown in Fig. 3 whereas depression of activator 76
will not cause physical contact between the first and second
contact elements 86 and 88. When piston 28 is in the first
position the elevated region 52 moves the second contact
element 88 into the position shown in Fig. 4. Accordingly,
depression of activator 76 will cause physical contact
between first and second contact elements 86 and ~.
The operation of the device 10 may be explained with
reference to Figs. 1-4. The first and second electrodes 41
and 42 and sleeve 56 are inserted înto the abdomen of the
patient 14 through the use of a trochar or similar device. The
physician l~ depresses button 18 into the second position
shown in Fig. 3 while invest;gating the abdominal cavity.
When piston 28 is in the second position, the contact arms 44
and 46 are displaced from contact pads 64 and 66. This circuit
breaker reduces the possibility of accidental activation of the
device lO. Elevated region 52 -is also moved ;nto the position
to disable switch 20. The comb;nation of a circuit breaker 1n
series with a disabled switch reduces the possibility of
accidental discharge of the device 10 during the preliminary
steps of identifying the proper tissue by the physician. The
problem of accidental activation in the prior art has been a
substantial area of concern for the treating physic;an.
g
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Inadvertent activation of the device 10 can cause severe damage
to adjacent tissue which can result in substantial liability '~
for the treating physician. The use of plural switching ''
elements in e'lectrical series substantially reduces this ' -
5 hazard. ', -
The first and second electrodes 41 and 42 diverge
upon a longitudinal movement of piston 2B to the second position
in Fig. 3 to enable the fallopian tube 12 to be grasped by the ,~
physician 16. Upon identifying the fallopian tube 12; the
physician releases button 18 enabling spring 36 to return
piston 28 to the first position shown in Fig. 4. The first
and second electrodes 41 and 42 and the inwardly projecting
- tabs 48 and 50'withdraw and grasp the fallopian tube 12. ~,~
Contact arms 44 and 46 engage the contact pads 64 and 66 while
15~ the ~levated region 52 moves the second contact element 88
nto the position shown in Fig. 4. The treating physician
merel~y depresses activator 76 to produce electrical current
flow between the first and se'cond electrodes 41 and 42 to seal
the fallopian tubes 12.
It should be appreciated that the device 10 maintains
the grasp on the tissue during the electrical current flow
process. The prior art devices required the treating physician
to actively maintain tension to hold the fallopian tubes while
activating the device. The combination of these two hand
movements made the prior art devices difficult to operate.
The present invention ellminates the need of compound Function
by the treating physician. During the grasping process, only
button 18 is manipulated by the physician. After grasplng the
tissue, only activator 76 is manipulated by the physician.
After treatment of the fallopian tube 12, button 18
is depressed to release the treated tissue from the electrodes
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41 and 42. The device 10 may then be withdrawn from the
abdomen of the patient 14. Depression of button 18 opens the
electrical circuit at contact arms 4~ and 46 and disables
switch 20.
It should be appreciated that the device 10 shown in
Figs. 1-7 is constructed of only a few relatively simple
components. The molded plastic piston 28 and electrodes 41
and 42 are slidably received in plastic body member 2~. The
sleeve 56 ;s held into position by flange 58 and aperture 60.
The contact pads 64 and 66 are pressed into slots ~not shown)
in guide 32 with the switch 20 being preassembled for quick
installation into the body member 24. The configuration set
forth in Figs. 1-7 provides a simple, reliable, safe and
inexpensive disposable unit for the electr;cal treatment of
living tissue.
; The embodiment shown in Figs. 1-7 illustrate various unique features of the invention. It should be understood
that various aspects of each of the specific embodiments may
be utilized and interchanged with other embodiments to obtain
additional advantages and benefits which are within the
ordinary scope of those skilled in the art. Further, various
types of physical arrangements of parts and component
structures may be modified and utilized For adapting the device
for other applications and uses. These modifications are also
considered to be within the scope of the invent~on and the
appended cla~ms. For example, the f;rst electrode element may
move relative to the second electrode element upon movement of
the piston. The movement of the first and second electrodes
may be in a diverse direction upon longitudinal movement of
the piston. The first and second electrode elements may both
be mounted on the piston. In another form, only the first
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electrode element may be mounted to the piston and the second
electrode e1ement is secured to the body member. The piston
rnay be integrally molded to contain a first electrode element
with the piston slidably received in a sleeve extending from
the second end of the body. The first element may be biased
to diverge relative to the second electrode element upon a
longitudinal movement of the piston toward the second position.
Each of the first and second electrodes may be secured to the
piston with an inwardly projecting tab extending from~the
terminal end thereof. The electrodes open upon movement o~
the piston to the second position and grasp the living tissue
by releasing of the button. Furthermore, the second electrode
may be secured to the body member in fixed spatial relation-
~ ship, the first electrode element diverging relative to the
;~ 15 second electrode element upon 10ngitudinal movement of the
piston relative to the body member. Still, the first electrode
element may terminate in a hook whereas the second electrode
element terminates in a pro~ection, the hook having a greater
electrode area than the projection for cutting tissue between
j 20 the first and second electrode elements.
The present disclosure includes that contained in theappended claims, as-wel-l--as -that of the foregoing descript10n.
Although this invention has been described in its preferred
form with a certain degree of particularity, it is understood
that the present disclosure of ~he preferred form has been
made only by way of example and that numerous changes in the
details of the circuit and the combination and arrangement
of c~rcuit elements may be resorted to without depart~ng from
the spirit and scope of the invention.
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