Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
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MULTIFUNCTIONAL ELECTROSURGICAL INSTRUMENT, AND
METHOD THEREFOR
BACKGROUND OF THE INVENTION
J
Field of the Invention
The present invention relates generally to an electrosurgical unit
(ESU) pencil. More specifically, the present invention relates to an ESU
pencil having a bipolar electrode wherein the active and return electrode
are contained within the same tip of the ESU pencil and are separated by a
high temperature resistant radio frequency (RF) dielectric. The ESU pencil
having a bipolar electrode is designed for use with a monopolar ESU
device in a bipolar function for cutting and coagulation in medical
procedures. When used with a monopolar ESU device, the ESU pencil
having a bipolar electrode can also be used for monopolar application
wherein a separate electrode is applied to a part of the patient's body,
usually on the patient's leg, to function as the return electrode. This
monopolar function is prevalent in the prior art.
The present invention also relates to a telescopic laparoscopic
monopolar/bipolar ESU pencil having an adjustable length electrode
capable of accommodating different depths and/or different sizes of adults
and children. The telescopic laparoscopic monopolar/bipolar ESU pencil
can also be used with an integrated smoke evacuator system such as that
previously described in U.S. Patent Number 5,199,944. Also, the ESU
pencil of the present invention having a bipolar electrode may be combined
with a suction/irrigation system and apparatus.
Finally, the ESU pencil of the present invention having a bipolar
electrode can be combined with attachments so that it can also be used for
argon beam coagulation.
Description of the Prior Art
In the past, electrosurgical devices had an active electrode that was
used for performing cutting and coagulation, and a return electrode which
usually comprised an adhesive for attachment to a patient's skin. When the
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electrosurgery unit surgery pencil was activated, the RF energy circulated
from the active electrode to the return electrode through the patient's body
with the distances between the active and return electrodes being fairly
significant.
This prior art system presents several deficiencies and creates a
number of problems that can be dangerous for the patient. First, because
of the significant distance between the active and return electrodes, high
voltages at high frequencies traverse through the body in order to close the
circuit between the active and return electrodes. These high voltages and
frequencies can be very dangerous to the patient. Second, due to the fact
that the body has an electrical resistance, the cutting and coagulation
effects are significantly diminished as the distance between the active and
return electrodes is increased. Accordingly, high power from the ESU is
needed in order to obtain effective cutting and coagulation performance.
Again, the high power required from the ESU can be dangerous to the
patient.
Third, in many cases, patients have incurred significant burns
because of poor contact between the return electrode and the patient's
skin. Finally, dangerous capacitive coupling has occurred in laparoscopic
surgery which has resulted in dangerous bums to the patient. These bums
could not be detected because they are out of the field of view of the
laparoscope thereby putting the patient's life in danger.
A bipolar function for open and laparoscopic procedures is presently
being used with the bipolar suction of the ESU. However, this system and
the related instruments are used only to stop bleeding within a patient and
is not capable of performing a cutting operation.
Other prior art references include U.S. Patent No. 5,496,314 which
is directed to an electrically powered endoscopic probe capable of
supplying suction and irrigation to a surgical site. The probe may employ a
bipolar electrosurgical probe tip and may include an extendable shroud for
selectively covering the tip of the probe while positioning or manipulating
the probe at the surgical site. Further, U.S. Patent No. 5,218,216 discloses
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an electrosurgical apparatus having a bipolar electrode attached to a hand
piece.
The apparatus of the present invention provides a surgeon with
easier access to the coagulation with an electrosurgery instrument.
Applicant's apparatus specifically provides for a telescopic electrical
surgical pencil having an electrical connection to the electrode located
along a length of the telescopic apparatus thereby enabling a surgeon to
extend the electrode a great distance to position it at a surgical site while
simultaneously extending a tubular member positioned around the
electrode which functions to provide suction and/or irrigation.
The ESU pencil of the present invention has an electrode which
comprises two contacts, one which is used as an active electrode and
another which is used as a return electrode when the instrument is used as
a bipolar functioning instrument for a monopolar/bipolar functioning
instrument. Alternatively, when the instrument is only used as a monopolar
functioning instrument, a separate electrode is applied to a different part of
the patient's body, usually on the patients leg. This separate electrode
functions as the return electrode.
SUMMARY OF THE INVENTION
A principal object of the present invention is to provide an
electrosurgery electrode for performing cutting and coagulation for open
and closed endoscopic and laparoscopic procedures wherein the
electrosurgery electrode contains both the active electrode and the return
electrode on the same tip.
It is a further object of the present invention to provide a
monopolar/bipolar electrode which can be used on the monopolar section
of an electrosurgery unit to perform a bipolar function thereby eliminating
the need for a separate return electrode.
It is yet a further object of the present invention to provide a
multifunctional ESU pencil that can be used for open and laparoscopic
electrosurgery that is also capable of performing suction and irrigation, and
for argon beam coagulation when used with respective attachments.
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Optionally, the present invention may provide a telescopic aspect
wherein the distance between the operating tip of the electrode and the
hand piece is adjustable to accommodate desired lengths associated with
different patients. This aspect, however, being optional, is not essential to
the invention, and the description of embodiments hereafter must be read
in this context.
It is still a further object of the present invention to provide an
electrosurgery pencil for use in association with an electrosurgery unit
(ESU) having a hand piece with a distal end and a proximal end and a
channel therein, together with an electrode contained within a least a
portion of the hand piece such that it is in electrical contact with the ESU,
and a connector element near the proximal end of the hand piece for
connecting the channel to a smoke evacuator.
Accordingly, the multifunctional, optionally telescopic,
monopolar/bipolar surgical device of the present invention includes a
bipolar electrode and a hand piece having electrical contacts wherein the
bipolar electrode is connected to the electrical contacts of the hand piece
and the electrical contacts of the hand piece are connected to an energy
source for activating the device. An electrosurgery unit may be used as the
energy source. The bipolar electrode includes an active electrode, a return
electrode and an insulator which is sandwiched between the active and
return electrodes. The multifunctional telescopic monopolar/bipolar surgical
device may further include a telescopic member coupled to the bipolar
electrode and the hand piece for adjusting the length of the bipolar
electrode. Further, the multifunctional telescopic monopolar/bipolar surgical
device may. include a smoke evacuation means coupled to the bipolar
electrode for removing smoke and other debris that is produced during
electrosurgery.
The present invention is also directed to a optionally telescopic
suction/irrigation apparatus for open and endoscopic laparoscopic
procedures which includes a hollow hand piece member having an open
end and an open proximal end and connection means for connecting the
hand piece to an energy source for activating suction and irrigation, an
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elongated hollow tubular member having distal and proximal open ends
wherein the proximal open end is introduced into the open distal end of the
hand piece so that the elongated hollow tubular member is concentrically
contained within the channel of the hand piece, and locking means for
locking the elongated hollow tubular member within the hand piece.
Another embodiment of the telescopic suction/irrigation apparatus
comprises a hand piece member having connection means to an energy
source and means for effectuating suction and irrigation functions, a double
channel telescopic suction/irrigation tube having an inner channel and outer
channel wherein the double channel telescopic suction/irrigation tube is
introduced into the hand piece member such that a portion of the double
channel telescopic suction/irrigation tube is concentrically retained within
the hand piece, connection means for connecting the inner channel or said
double channel telescopic suction/irrigation tube with an irrigation port and
the outer channel of the double channel telescopic suction/irrigation tube
with a suctioning port, and locking means for locating the double channel
telescopic suction/irrigation tube within the hand piece member.
The present invention is also directed to a method for performing
electrosurgery on a patient which comprises the steps of connecting a
bipolar electrode having an active electrode and a return electrode to a
hand piece with means for alternatively effectuating cutting and coagulation
with the bipolar electrode, connecting both the active and return electrodes
to an energy source, and activating either the cutting or coagulation
function using the bipolar electrode.
The foregoing and other objections, features and advantages of the
present invention, as well as details of the preferred embodiments thereof,
will be more fully understood from the following descriptions made in
conjunction with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 a is a diagrammatic view of electrosurgery being performed on
a patient using a prior art ESU pencil having a monopolar electrode which
requires a separate return electrode.
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FIG. 1 b is a diagrammatic view of electrosurgery being performed on
a patient using the monopolar/bipolar surgical device of the present
invention for electrosurgery.
FIG. 2a is a perspective view of a first embodiment of a bipolar
electrode for use within the monopolar/bipolar surgical device of the
present invention for electrosurgery which can also function as a
monopolar electrode.
FIG. 2b is a perspective view of a second embodiment of a bipolar
electrode for use within the monopolar/bipolar surgical device of the
present invention for electrosurgery which can also function as a
monopolar electrode.
FIG. 2c is a perspective view of a third embodiment of a bipolar
electrode for use within the monopolar/bipolar surgical device of the
present invention for electrosurgery which can also function as a
monopolar electrode.
FIG. 2d is a perspective view of a first embodiment of a bipolar
electrode used in the multifunctional monopolar/bipolar surgical device of
the present invention for endoscopic and/or laparoscopic procedures
wherein the bipolar electrode is capable of a monopolar function.
FIG. 2e is a perspective view of a second embodiment of a bipolar
electrode used in the multifunctional monopolar/bipolar surgical device of
the present invention for endoscopic and/or laparoscopic procedures
wherein the bipolar electrode is capable of a monopolar function.
FIG. 2f is a perspective view of a third embodiment of a bipolar
electrode used in the multifunctional monopolar/bipolar surgical device of
the present invention for endoscopic and/or laparoscopic procedures
wherein the bipolar electrode is capable of a monopolar function.
FIG. 3a is a perspective view of a multifunctional monopolar/bipolar
telescopic electrosurgical device of the present invention.
FIG. 3b is a perspective exploded view of the device in FIG. 3a
shown without the electrical cord.
FIG. 3c is a cross-sectional view of the device in FIG. 3a shown
without the electrical cord.
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FIG. 3d is a perspective view of an endoscopic and/or laparoscopic
telescope element which can replace the telescopic element of the
multifunctional monopolar/bipolar telescopic electrosurgical device shown
in FIG. 3c to create a multifunctional monopolar/bipolar telescopic
electrosurgical device for endoscopic and/or laparoscopic procedures.
FIG. 4a is a perspective view of a suction/irrigation telescope which
can replace the electrosurgery telescope in FIG. 3c or the laparoscopic
telescope in FIG. 3d to provide a telescopic surgical device with
suction/irrigation means capable of performing either suction or irrigation.
FIG. 4a1 is a perspective view of an optional nozzle for the
telescope of FIG. 4a.
FIG. 4b is a perspective exploded view and partial cross-sectional
view of a second embodiment of a suction/irrigation telescope which can
replace the electrosurgery telescope in FIG. 3c or the laparoscopic
telescope in FIG. 3d to provide a telescopic device with suction/irrigation
means capable of performing suction and irrigation simultaneously.
FIG. 4c is a partial cross-sectional view or a hydra dissection nozzle
wherein the internal tube of the nozzle is shown retracted.
FIG. 4d is a partial cross-sectional view of the hydro dissection
nozzle shown in FIG. 4c with the internal tube shown extended.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
The present system for performing electrosurgery with an ESU
pencil having a monopolar electrode is shown in FIG. la. The
electrosurgery pencil 10 comprises an active electrode 12 which performs
cutting or coagulation on a patient 14. The ESU pencil 10 comprising active
electrode 12 is connected to the electrosurgery unit 16 which provides the
energy source to activate the ESU pencil 10. A return electrode 18
comprises an adhesive patch 20 which is positioned and applied to the
patient 14 at a considerable distance 22 away from the active electrode 12.
The return electrode 18 is also connected to the electrosurgery unit 16
thereby creating a closed circuit wherein the voltage and frequency emitted
from the active electrode 12 is transmitted through the body of the
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patient 14 and received by return electrode 20. FIG. la illustrates how
monopolar electrosurgery is presently performed.
Electrosurgery performed on a patient using the multifunctional
telescopic monopolar/bipolar surgical embodiment of the present invention
is shown in FIG. 1 b. With the present invention, the electrosurgery pencil
comprises a bipolar electrode 11 which comprises an active electrode
12 and a return electrode 18 which are separated by a material dielectric
13 which functions as an insulator. Both the active electrode 12 and the
return electrode 18 are connected to the electrosurgery unit 16 thereby
10 performing a completed circuit. When the electrosurgery unit 16 is
activated
and the bipolar electrode 11 touches the tissue of the patient 14, the circuit
is closed through a very small portion of the patient's tissue between the
active electrode 12 and the return electrode 18. This shortened distance
between the active electrode 12 and return electrode 18 results in decrease
of the power requirement from that previously needed in association with
the monopolar electrode of the prior art in order to effectuate cutting and
coagulation. This decreased distance between the two electrodes 12, 18
also results in decreasing the dangers associated with passing high
voltages at high frequencies throughout a substantial portion of the
patient's body, one of those risks being an increased possibility of burns to
the patient.
FIGS. 2a - c show perspective views of different embodiments of
bipolar electrodes which comprise part of the multifunctional telescopic
monopolar/bipolar surgical device of the present invention for open
electrosurgery procedures. These electrodes are capable of exhibiting both
bipolar and monopolar functioning in conjunction with an electrosurgery
unit.
FIG. 2a represents a perspective view of a bipolar blade electrode.
An insulator 26 is sandwiched between the active electrode 28 and the
return electrode 30. Active electrode 28 further comprises an active
prong 32 which is designed to come in contact with an active conductor
contained within the telescopic element of the device of the present
invention which is shown and described later with reference to FIGS. 3b
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and 3c. Further, the return electrode 30 comprises a return prong 34 which
is designed to make contact with a return conductor contained within the
telescopic element of the device of the present invention which is also
shown and described later with reference to FIGS. 3b - 3c.
FIG. 2b represents a perspective view of a bipolar needle electrode.
Again, an insulator 26 is sandwiched between the active electrode 28 and
the return electrode 30 wherein the active electrode 28 and return electrode
30 further comprise an active prong 32 and return prong 34, respectively,
for connection to conductor elements contained within a telescopic element
of a device of the present invention as shown in FIGS. 3b - 3c.
FIG. 2c represents a perspective view of a special single bipolar
electrode that can be used for cutting and/or coagulation, as well as for
surface coagulation or ablation. An insulator 26 is sandwiched between
active and return electrodes wherein one of each of an active electrode 28
and a return electrode 30 are positioned on opposite sides of the insulator
26. More specifically, on a first side 36 of insulator 26 there is a top
active
electrode 28A and a bottom return electrode 30B and on a second side 38
of insulator 26 there is a top return electrode 30A and a bottom active
electrode 28B. Active prong 32 connects top active electrode 28A to bottom
active electrode 28B while return prong 34 serves to connect top return
electrode 30A to bottom return electrode 30B thereby forming connection
means for the active electrode 28 and return electrode 30, respectively,
when connecting the active and return electrodes 28, 30 to conductors
contained within the telescopic elements of the device of the present
invention as further explained with reference to FIGS. 3b - 3c. The
previously described electrodes may further vary by comprising a variety of
different shapes without detracting from the purpose of the invention.
FIGS. 2d - 2f depict perspective views of bipolar electrodes which
comprise part of the multifunctional telescopic monopolar/bipolar surgical
device of the present invention for performing endoscopic and/or
laparoscopic procedures wherein the electrode is also capable of
monopolar functioning alone. FIGS. 2d and 2e represent hook-shaped
bipolar electrodes for use in endoscopic and laparoscopic procedures
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wherein the bipolar electrodes are also capable of functioning as
monopolar electrodes. FIG. 2f shows a paddle-shaped bipolar electrode for
use in endoscopic and/or laparoscopic procedures which may also function
as a monopolar electrode. All of the bipolar electrodes depicted in
FIGS. 2d - 2f comprise an insulator 26 which is sandwiched between an
active electrode 28 and a return electrode 30. Further, the active electrode
28 comprises an active prong 32 while the return electrode 30 comprises a
return prong 34 wherein both the active prong 32 and return prong 34 serve
as connection means for connecting the active electrode 28 and return
electrode 30 to conductors contained within a laparoscopic/endoscopic
telescope element of the device of the present invention as further detailed
in reference to FIG. 3d.
Other electrode shapes and forms may be used with respect to the
bipolar electrodes for endoscopic and/or laparoscopic procedures without
detracting from the purpose of the invention. Further, the active electrode
28 and return electrode 30 on all of the previously described bipolar
electrodes in reference to FIGS. 2a - 2f may be reversed such that the
active electrode 28 and return electrode 30 are on opposite sides of the
insulator 26 than those on which they are depicted in the Figures.
Active electrode 28 is preferably comprised of stainless steel or
other suitable conductors and return electrode 30 is preferably comprised
of a ceramic or other suitable material which can function as an insulator.
The insulator 26 is preferably comprised of a dielectric material which is
suitable for use as a dielectric in radio frequency applications and at very
high temperatures such as certain types of ceramics. However, any
dielectric materials that can meet the conditions for RF applications at very
high temperatures may be used.
As previously explained with reference to FIG. 1 b, the circuit created
by the active electrode 28 and return electrode 30 is closed when the ESU
is activated and the electrode touches the tissue of a patient. This very
small portion of the patient's tissue closes the gap between the active
electrode 28 and the return electrode 30. As a result, much less power is
needed to traverse the patient's tissue in order to close the circuit and
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effectuate the cutting and coagulation operations. A load resistor can be
installed in series to avoid an accidental short circuit in between the two
electrodes.
Turning now to FIG. 3a, there is shown a perspective view of the
multifunctional telescopic monopolar/bipolar electrosurgical device of the
present invention. In brief, the multifunctional telescopic monopolar/bipolar
electrosurgical device 40 of the present invention comprises a main
body 42, a telescopic body 44 circumferentially contained within the main
body 42 such that it can be extended outward from, and retracted into, the
main body 42, a locking element 46 which locks the telescopic body 44 to
the main body 42 at a predetermined extracted length, a bipolar electrode
48 contained within the telescopic body and main body such that it is
capable of being in electrical contact with an electrosurgery unit, and a
connector element 50 for connecting the main body 42 of the device 40 to a
smoke evacuator tubing (not shown). The main body 42 of the device 40
further comprises a series of selection buttons, one selection button for
cutting 52, one selection button for coagulation 54, and one selection
button for argon beam coagulation 56. The selection button for argon beam
coagulation is optional. The main body may be provided with only cutting
and coagulation selection buttons 52, 54.
An exploded view of the multifunctional telescopic monopolar/bipolar
electrosurgical device 40 of the present invention is illustrated in FIG. 3b.
The main body 42 of the device 40 comprises a distal thread 58 and a
proximal thread 60 which are connected by a channel 62. The main
body 42 further comprises an active contact 64 and a return contact 66
which are located parallel to one another on an interior surface of the
channel 62 having a gap located therebetween which resembles an
elongated slot 68. The telescopic body 44 comprises a distal end 70 and a
proximal end 72 which are separated by a second channel 74 that is
smaller in diameter than the channel 62 contained within the main body 42.
The telescopic body 44 further comprises a pair of elongated
conductors 76, 78 located within the second channel 74 of the telescopic
body 44. Each of the elongated conductors 76, 78 terminate in contact
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prongs 80, 82, respectively, such that the contact prongs 80, 82 are located
on the external surface of the telescopic body 44 near its proximal end 72.
A hollow nozzle 84 may be connected to the distal end 70 of the
telescopic body 44.
The bipolar electrode 48 is connected to the telescopic body 44 such
that the active electrode 86 and return electrode 88 are in contact with the
elongated conductors 76, 78, respectively. Finally, the locking element 46
comprises a hollow interior having a distal end 90 and proximal end 92.
The locking element 46 further comprises a ridge 94 contained within its
hollow interior and an "0" ring 96 which is seated on the ridge 94. As a
result, the locking element 46 can be slid over the telescopic body 44 and
connected to the distal thread 58 of the main body 42 to enable the
telescopic body 44 to be locked in position within the main body 42.
FIG. 3c shows a cross-sectional view of the multifunctional
telescopic monopolar/bipolar electrosurgery unit pencil shown in FIG. 3a.
As previously described, the main body 42 contains active contact 64 and
patient return contact 66 which are parallel to one another so that they are
separated by the same distance along their entire lengths. Contact
prongs 80, 82 contained on the external surface of the telescopic body 44
are slightably engaged and maintained within the elongated slot 68 which
separates the active contact 64 from the patient return contact 66. The
bipolar electrode 48 is connected to the contact prongs 80, 82 via the
elongated conductors 76, 78. The telescopic body 44 is extracted or
retracted within the main body 42 to adjust for the desired length of the
bipolar electrode 48.
Argon beam coagulation attachments (not shown) replace the
telescopic body 44 described above with a special telescope and end
attachment similar to those described in applicant's previous patent
application entitled "A Telescopic Surgical Device and Method Therefor"
and may be attached to the proximal thread 60 of the main body 42 of the
device 40. A suction/irrigation attachment such as that later described and
shown in FIGS. 4a - 4b, as well as a connector for smoke evacuation
tubing (not shown) may also be connected to proximal thread 60 of the
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main body 42 of the device 40. The locking element 46 is threaded onto the
distal thread 58 of the main body 42 of the device 40 in order to lock the
telescopic body 44 in place. The telescopic body 44 is locked in position by
tightening the locking element 46 against the distal thread 58 of the main
body 42. As a result, the ridge 94 contained within the looking element 46
is pushed forward such that it presses over the "0" ring 96 which in turn
presses over the telescopic body 44 thereby locking it in place.
During use, when either the cutting button 52 or the coagulation
button 54 is depressed, the active contact 64 is energized and the return
contact 66 acts to return current from the patient to the electrosurgery unit.
Contact prongs 80, 82 function to pass the radio frequency energy through
elongated conductor 76 to the bipolar electrode 48 and then return the RF
energy through elongated conductor 78 back to contact prong 82. If the
multifunctional telescopic monopolar/bipolar surgical pencil device of the
present invention is used for monopolar only, then the active contact 64
and return contact 66 will both conduct the active energy and a separate
return electrode will be provided and utilized as represented in FIG. la.
Energy is brought to the multifunctional telescopic monopolar/bipolar
surgical pencil device of the present invention by electrical cord 49 (See
FIG. 3a) which is connected to an electrosurgery unit (not shown).
Turning now to FIG. 3d, there is shown an endoscopic/laparoscopic
telescopic body 98 which replaces the telescopic body 44 shown in
FIGS. 3b - 3c in order to perform endoscopic and/or laparoscopic
procedures. The second locking element 100 works similar to the locking
element 46 described with reference to FIGS. 3b - 3c. The cutting operation
is activated when the cutting button 52 is depressed and coagulation is
activated when the coagulation button 54 is depressed. Argon beam
coagulation button number 56 is optional and, if used, the
endoscopic/laparoscopic telescope body 98 is replaced with a different
telescope and an adaptor is attached to the end of the device 40 at the
proximal thread 60 of the main body 42 of the device 40. The adaptor is
very similar to the adaptor for suction/irrigation that is later shown and
described with reference to FIG. 4a - 4d.
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FIGS. 4a - 4c show another embodiment of the electrosurgery pencil
of the present invention which is directed toward a telescopic
suction/irrigation pencil for electrosurgery. The telescopic
monopolar/bipolar surgical pencil depicted and described in FIGS. 3a - 3d
will become a telescopic suction/irrigation pencil by replacing the telescopic
body 14 in FIGS. 3b - 3c and the endoscopic/laparoscopic telescopic
body 98 in FIG. 3d with the attachments presented in FIGS. 4a and 4b. The
resulting telescopic suction/irrigation pencil is advantageous in that it
permits the surgeon to adjust the lengths of the suction/irrigation tip
without
the need for removing and reattaching tips of different lengths.
FIG. 4a shows a perspective view of a first embodiment or a
suction/irrigation attachment 102 comprising a singular hollow tube 104
having a distal end 106 and a proximal end 108. The suction/irrigation
attachment 102 further comprises a sliding guide 110 which Is
circumferentially fit about the proximal end 108 of the singular hollow
tube 104 thereby allowing the suction/irrigation attachment 102 to be
slidably engaged within the main body 42 of the telescopic
monopolar/bipolar electrosurgery device 40 shown in FIG. 3b. The locking
element 45 shown in FIG. 3b is also used in conjunction with the
suction/irrigation attachment 102 shown in FIG. 4a in order to lock the
suction/irrigation attachment 102 in place at a predetermined extracted
length from the main body 42 shown in FIG. 3b. The resulting device is a
telescopic suction/irrigation pencil for use with electrosurgery as well as
laparoscopic and endoscopic procedures.
Suction and irrigation are activated by using the cutting button 52
shown in FIG. 3a for irrigation and the coagulation button 54 shown in
FIG. 3a for suction. During irrigation, the irrigation fluid enters the
telescopic suction/irrigation pencil through connector element 50, then
passes through the proximal end 108 of the singular hollow tube 104
shown in FIG. 4a and then exits the telescopic suction/irrigation pencil
through the distal end 106 of the singular hollow tube 104 shown in
FIG. 4a. In contrast, when suction is activated, fluid is drawn from the
patient, and enters the telescopic suction/irrigation pencil at the distal
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end 106 of the singular hollow tube 104, is further drawn past the proximal
end 108 of the singular hollow tube 104, and finally exits the telescopic
suction/irrigation pencil through the connector element 50 shown in
FIG. 3b.
The distal end 106 of the suction/irrigation attachment 102 may be
narrowed to form a nozzle 112 such as that shown in FIG. 4a1. The
nozzle 112 configuration of the distal end 106 facilitates the use of the
telescopic suction/irrigation pencil for hydro-dissection by enabling the
irrigation fluid to exit the distal end 106 of the suction/irrigation
attachment
102 with high pressure and velocity.
FIG. 4b illustrates an exploded perspective view of a second
embodiment of a suction/irrigation attachment 114 which is capable of
performing suction and irrigation simultaneously. The lengths of the
telescopic suction and irrigation tubes may also be adjusted. The second
embodiment of the suction/irrigation attachment 114 comprises a double
channelled tube 116 and a singular connection tube 118. The double
channelled tube 116 comprises a first hollow tube 120 circumferentially
contained within a second hollow tube 122 wherein the first and second
hollow tubes 120, 122 are of substantially the same length. The double
channelled tube 116 further includes a distal end 124, a proximal end 126,
a spacer element located at the proximal end 126 of the double channelled
tube 116, and a locking element 46 which functions like the locking
element 46 shown and described with reference to FIG. 3b.
The double channelled tube 116 contains a central inner
channel 130 which is defined by the hollow inner area of the first hollow
tube 120 and an outer ring-shaped channel 132 which is defined by the
opening generated by the difference between the inner diameter of the
second hollow tube 122 and the outer diameter of the inner hollow
tube 120. Irrigation is conducted through the central inner channel 130
while suction is conducted through the outer ring-shaped channel 132.
The second hollow tube 122 is closed about the first hollow tube 120
at the proximal end 126 of the double channelled tube 116 but a plurality of
apertures 134 are contained about the circumference of the second hollow
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tube 122 near proximal end 126 thereby creating an opening through which
fluid can pass from the outer ring-shaped channel 132. The spacer
element 128 comprises a shortened hollow cylinder having a proximal open
end and a plurality of wings 136 located within its opposite open end. The
plurality of wings 136 are positioned within the outer ring-shaped
channel 132 located between the first hollow tube 120 and the second
hollow tube 122 to maintain the distance between the tubes 120, 122 and
support the outer ring-shaped channel 132 while still allowing irrigation
fluid
to pass through the outer ring-shaped channel 132 with minimal resistance.
The singular connection tube 118 comprises a tube 138 having an
open distal end 140 and an open proximal end 142 wherein the open
proximal end 142 is seated within a multi-connector piece 144.
Multi-connector piece 144 comprises a hollow piece having a large open
distal end 146 with grooves 148 for receiving threads and two smaller
channels 150, 152 each having threads 154 located at its proximal
end 156. Threaded channel 150 is designed to be attached to an irrigation
means while threaded channel 152 is designed for attachment to a
suctioning means.
During use, the grooves 148 at the large open distal end 146 of the
multi-connector piece 144 are connected to the proximal thread 60 of the
main body 42 of the device 40 shown in FIG. 3b while the tube 138 is
inserted through the channel 62 of the main body 42 such that tube 138 will
exit the channel 62 and enter the central inner channel 130 of the first
hollow tube 120 of the double channelled tubes 116 when the spacer
element 128 is slid within the main body 42 of the device 40 shown in
FIG. 3b. Tube 138 has an outer diameter that is slightly smaller than the
inner diameter of the first hollow tube 120 so that hollow tube 120 and
tube 138 form a telescope when concentrically enjoined.
When irrigation is activated, irrigation fluid will be introduced under
pressure through the open proximal end 142 of tube 138 and will traverse
the telescopic configuration resulting from joining tube 138 inside of first
hollow tube 120, and will then exit at the distal end 124 of the double
channelled tube 116 through the first hollow tube 120. When suction is
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CA 02524529 2008-07-11
activated, suctioning means is applied at suctioning channel 152 and fluid
is drawn from the patient through the plurality of apertures 134 contained
within the second hollow tube 122. The fluid is drawn through the
ring-shaped outer channel 132 and then exits at the suctioning
channel 152. Spacer element 128 slides within the main body 42 of the
device 40 shown in FIG. 3b and the second hollow tube 122 is locked into
place by connecting locking element 46 to distal thread 58 of the main
body 42 of the device 40.
The distal end 124 of the double channelled tube 116 of the
suction/irrigation attachment shown in FIG. 4b may comprise an alternative
configuration such as that shown in FIGS. 4c - 4d. FIGS. 4c - 4d depict a
nozzle configuration in which the distal open end 158 of first hollow
tube 120 forms a needle nose 158 which is capable of being extracted and
retracted from within the second hollow tube 122 thereby allowing the
operator or surgeon to adjust the length of the irrigation means such that it
extends beyond the length of the suctioning means of the site of
application.
While the invention has been particularly shown and described with
reference to the preferred embodiments thereof, it will be understood by
those skilled in the art that changes in form and detail of the foregoing may
be made while still failing within the claims of the present invention. For
example, if a different shape or form is given to the monopolar/bipolar
electrodes but they are still capable of functioning with a monopolar ESU
suction to provide a bipolar function, this new configuration is believed to
be included within the scope of the present invention. Further, the
telescopic aspect of the pencil is a desirable, but non-essential element. If
the telescopic aspect is utilized, different locking means for locking the
telescopic functioning elements in place as well as different configurations
for providing electrical contact means within the telescopic body and main
body of the device are believed to be included within the spirit and scope of
the present invention.
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