RESECTOSCOPE, ELECTRODE INSTRUMENT FOR A RESECTOSCOPE, AND GUIDE ELEMENT FOR AN ELECTRODE INSTRUMENT

Abstract

A surgical radiofrequency instruments such as resectoscopes, for example, are used for removing or manipulating body tissue. A particular disadvantage of known instruments has been that the arrangement of an electrode instrument in an inner shaft can influence a flow behavior of an irrigation liquid. The invention makes available an electrode instrument by which the irrigation liquid is not disturbed. This is achieved by the fact that an electrode instrument has two electrode carriers which are arranged parallel to each other and are connected to each other by at least one guide element, and this at least one guide element extends, at least in part, convexly away from a longitudinal axis.

Claims

1. An electrode instrument for a resectoscope with an electrode, the electrode being fastened to two distal ends of two tubular portions, spaced apart from each other and parallel to each other, of a respective electrode carrier, and the portions being oriented at least substantially parallel to a longitudinal axis of the electrode instrument, wherein at least one guide element is arranged on the electrode carriers, which guide element connects the two portions to each other, is convex at least in part, and extends away from the longitudinal axis.

2. The electrode instrument as claimed in claim 1, wherein the two portions are designed as electrode casing tubes which extend parallel to each other from the distal end to the proximal end of the electrode instrument, or in that the two portions have a fork-like design and converge in the direction of the proximal end of the electrode instrument to form an electrode shaft.

3. The electrode instrument as claimed in claim 2, wherein two or more guide elements are arranged on the two electrode casing tubes.

4. The electrode instrument as claimed in claim 1, wherein the guide element has, perpendicular to the longitudinal axis, an arc-like cross section.

5. The electrode instrument as claimed in claim 4, wherein the cross section corresponds, with its shape or its radius, to the shape or the radius of a component, of the resectoscope, such that the guide element can be placed, on and/or under this component.

6. The electrode instrument as claimed in claim 1, wherein an undercut for a latching connection to the inner shaft or the optical unit is formed from the guide element and the electrode casing tubes.

7. The electrode instrument as claimed in claim 1, wherein the guide element can be joined around or onto a component, of the resectoscope, such that the electrode instrument is movable relative to the component along the longitudinal axis.

8. The electrode instrument as claimed in claim 1, wherein the guide element has, at two opposite sides, circular-segment-like receptacles which correspond to the shape of the portions or the electrode casing tubes, wherein these receptacles engage at least partially around the portions or electrode casing tubes from the outside or inside.

9. The electrode instrument as claimed in claim 1, wherein the guide element can be arranged on the portions above or below the longitudinal axis of the electrode instrument, the guide element being arranged above the longitudinal axis of the electrode instrument and being open toward the bottom, or the guide element being arranged below the longitudinal axis of the electrode instrument and being open toward the top.

10. The electrode instrument as claimed in claim 1, wherein a distance between two opposite sides of the guide element measures 3 mm to 8 mm.

11. A guide element for an electrode instrument of a resectoscope as claimed in claim 1, wherein an arc-like cross section, which corresponds, with its shape or its radius, to the shape or the radius of a component, of the resectoscope, such that the guide element can be placed on and/or under this component.

12. The guide element for an electrode instrument as claimed in claim 11, wherein the guide element has, at two opposite sides, circular-segment-like receptacles which are oriented parallel to each other and which are guided outward or inward, and wherein a distance between the two opposite sides or the receptacles of the guide element measures 3 mm to 8 mm.

13. The guide element for an electrode instrument as claimed in claim 11, wherein at least one end face, formed with an arc-like or circular-segment-like cross section, is perpendicular to a longitudinal axis of the guide element, or in that the at least one end face has a recess that extends in the direction of an opposite end face.

14. The guide element for an electrode instrument as claimed in claim 13, wherein the recess is shaped like an arc of a circle, or like a polygon.

15. The guide element for an electrode instrument as claimed in claim 13, wherein a tangent to the recess encloses, with the longitudinal axis along the entire length of the end face, an angle α not equal to 90°.

16. The guide element for an electrode instrument as claimed in claim 11, wherein the guide element is symmetrical, wherein the two side edges and the two end faces with the recesses are symmetrical to one another.

17. A resectoscope with an electrode instrument as claimed in claim 1 and with an inner shaft in which an optical unit is mounted, wherein the electrode instrument can be guided on the inner shaft with at least one guide element.

18. The resectoscope as claimed in claim 17, wherein a longitudinal axis of the electrode instrument lies above or below a longitudinal axis of the inner shaft, or in that a longitudinal axis of the electrode instrument and a longitudinal axis of the inner shaft lie in one plane.

Description

[0027] A preferred illustrative embodiment of the invention is described in more detail below with reference to the drawing, in which:

[0028] FIG. 1 shows a schematic view of a resectoscope,

[0029] FIG. 2 shows a schematic perspective view of an electrode instrument,

[0030] FIG. 3 shows a view of the electrode instrument according to FIG. 2,

[0031] FIG. 4 shows a side view of the electrode instrument according to FIG. 2,

[0032] FIG. 5 shows a view of the distal end of the electrode instrument according to FIG. 2,

[0033] FIG. 6 shows a perspective view of a guide element,

[0034] FIG. 7 shows a perspective view of a further illustrative embodiment of a guide element,

[0035] FIG. 8 shows a view of the guide element according to FIG. 7,

[0036] FIG. 9 shows a view of the distal end of the electrode instrument according to FIG. 7, and

[0037] FIG. 10 shows a schematic perspective view of an electrode instrument with the guide element according to FIG. 7.

[0038] FIG. 1 shows a possible illustrative embodiment of a resectoscope 10. In this resectoscope 10, an outer shaft 11, only symbolized here by dashed lines, is pushed over an inner shaft 12. The inner shaft 12 serves to receive and/or guide an optical unit 13, which extends from a distal end 14 to a proximal end 15 of the resectoscope 10. At the proximal end 15, an eyepiece 16 is available to allow a user to observe, through the optical unit 13, the region in which surgery is to be performed in front of the distal end 14.

[0039] An essential component of the resectoscope 10 is the working element 17. This working element 17 has a first gripping means 18, among other things, and is connected by a spring element 19 to a second gripping means 20 and to an optical plate 21.

[0040] Moreover, an electrode instrument 22 extends along the inner shaft 12 from the distal end 14 of the resectoscope 10 as far as the working element 17. The electrode instrument 22 shown in FIGS. 2 to 4 is just one possible illustrative embodiment. It is expressly noted that the invention described here is not intended to be limited to the form that is presented here. Instead, it is conceivable that the described invention can also be used in connection with electrode instruments of another form.

[0041] The electrode instrument 22 shown here can be latched with a proximal end 24 in the working element 17. In this way, on the one hand, the electrode instrument 22 can be easily uncoupled from the working element 17 or coupled to the working element 17 and, on the other hand, can move together with the working element 17 along the longitudinal axis of the resectoscope 10 in the distal or proximal direction.

[0042] At the distal end 14 of the electrode instrument 22, the latter has an electrode 23. Electrical energy is able to be applied to this electrode 23, or cutting electrode, by means of an RF generator (not shown) and serves to manipulate tissue. By applying an RF voltage to the electrode, a plasma forms around the electrode 23, here shown as a cutting loop. The organic tissue can be manipulated or cut by an axial forward and backward movement of the electrode instrument 22. In addition to the cutting loop shown in the figures, other electrode forms are also conceivable.

[0043] For manipulating human tissue with pinpoint accuracy, it is crucially important that the electrode 23 can be handled in a very precise manner. This precision handling is made difficult in particular by a lengthening of the electrode instrument 22 or by a reduction of the cross section of the instrument 22.

[0044] As can be seen in FIGS. 2 to 5, the electrode 23, by way of its ends, is mechanically fastened or able to be mechanically fastened to two electrode carriers 25 and 26 or to two electrode casing tubes. The electrode 23 and the electrode carriers 25 and 26 represent the essential constituent parts of the electrode instrument 22. In addition to the parallel arrangement (shown here) of the electrode carriers 25 and 26 or electrode casing tubes, it is also conceivable for the electrode carriers 25 and 26 to have a fork-like design and to converge in the direction of the proximal end 15 to form a shaft.

[0045] In addition to the mechanical connection, the electrode carriers 25 and 26 or the electrode casing tubes also serve to electrically contact the electrode 23. Provision is made that the electrode carriers 25 and 26, or electrode casing tubes, and also electrical leads within the carriers 25 and 26 serve as electrical lines or contacts.

[0046] In order to increase the stability of the electrode instrument 22, and the associated secure and precise handling thereof, the invention proposes that at least distal portions 28, 29 of the electrode carriers 25, 26 be connected to each other by a guide element 27. Furthermore, provision can be made, or it is conceivable, that the two electrode carriers 25, 26 are connected to each other by at least one further guide element 27.

[0047] This guide element 27 serves not only for the stabilizing of the whole electrode instrument 22, but also for the guiding along the inner shaft 12. According to the invention, the at least one guide element 27 is placed on a jacket surface of the inner shaft 12, the guide element 27 at least partially enclosing the inner shaft 12. Thus, in contrast to the prior art, the electrode instrument 22 is no longer mounted on the optical unit 13 inside the inner shaft 12, but instead outside the shaft 12. In this way, the interior of the inner shaft 12 is free for undisturbed flow of the irrigation liquid. This has a particularly advantageous effect on the flow behavior of the irrigation liquid in the region in front of the optical unit 13 outside the shaft 11. The generated laminar flow of the irrigation liquid provides the operator with optimal viewing of the treatment region. Equally, relocating the electrode instrument 22 to outside the inner shaft 12 permits a reduction of the diameter of the inner shaft 12. This reduction of the diameter of the inner shaft 12 has a positive impact on the overall design of the resectoscope 10, for example because the diameter of an outer shaft of the resectoscope 10 can thus also be reduced. Miniaturization of the instruments allows treatment to be performed in a way that is particularly gentle on the body.

[0048] According to the invention, provision can also be made that, for example as is shown in FIG. 1, the electrode instrument 22 is placed onto the inner shaft 12 via the guide elements 27 in such a way that it is arranged above a longitudinal axis of the inner shaft 12. It has been shown that this arrangement is particularly effective in saving space and equally permits precise positioning of the electrode 23 in front of the distal end of the inner shaft 12.

[0049] However, it is also conceivable that the guide element 32 can be fastened onto the electrode carriers 25, 26 from below, the electrode instrument 22 then being located underneath the longitudinal axis of the inner shaft 12 (FIGS. 7 to 10). This has the advantage that the shape of the guide element 32 is simpler, since the circular-segment-like receptacles 30, 31 can be smaller. The receptacles 30, 31 are moreover curved in the same direction, like the guide element 32 itself, which makes production easier.

[0050] Provision is preferably made that the free ends of the guide elements 27, 32 point in the same spatial direction. Thus, when welding the guide elements 27, 32 to the electrode carriers 25, 26, both sides can be welded one directly after the other, specifically without the components having to be turned for this purpose. As a result, the production method proves particularly efficient.

[0051] To ensure that the electrode instrument 22 can be moved particularly reliably along the inner shaft 12, the guide element 27 is convex or forms, in its cross section, a segment of a circle (FIGS. 5 and 6), the convex curvature facing away from the electrode carriers. The radius of curvature of the guide element corresponds here to the shape or the radius of curvature of the inner shaft 12. In this way, the guide element 27 or guide elements 27 join particularly advantageously to the outer face of the inner shaft 12.

[0052] In addition to the embodiment of the guide element 27 shown in FIGS. 5 and 6, it is also conceivable that the cross section of the guide element 27 describes a segment of a circle greater than 180°. A guide element 27 of this shape can be clamped or clipped onto the inner shaft 12. A guide element 27 of this shape can also be releasably connected to the inner shaft 12 from below (see above). It is accordingly conceivable that different embodiments of electrode instruments with the guide elements 27, 32 described here are positioned on the inner shaft 12 from above or from below.

[0053] In order to connect the guide element 27 reliably to the electrode carriers 25, 26, it has circular-segment-like receptacles 30, 31 at two opposite sides (FIGS. 5, 6 and 9). These receptacles 30, 31 close at least partially, preferably completely, around the tubular electrode carriers 25, 26. It is conceivable here that the receptacles 30, 31 are connected to the electrode carriers 25, 26 by adhesive bonding, welding or crimping, for example.

[0054] The illustrative embodiment of a guide element 27 shown in FIG. 6 is designed in such a way that it can be placed onto the two electrode carriers 25, 26 from above, and the receptacles 30, 31 engage around the electrode carriers 25, 26. This connection of the guide element 27 to the electrode carriers 25, 26 ensures that the electrode instrument 22 can be moved relative to the inner shaft 12 in a safe and well defined manner.

[0055] In a preferred illustrative embodiment, provision is made that the receptacles 30, 31 of the guide element 27 are at a distance of between 3 and 8 mm from each other. It is equally conceivable that this distance is greater or smaller. The guide element 27 is preferably made from a plastic or a metal, the wall thickness being 0.1 mm to 1.0 mm, preferably 0.1 mm to 0.3 mm. A wall thickness of greater than 2 mm is also conceivable.

[0056] A further illustrative embodiment of a guide element 32 according to the invention is shown in FIGS. 7 to 10. Just like the guide element 27, this illustrative embodiment also has elongate receptacles 30, 31 arranged parallel to a longitudinal axis 34. The guide element 32 is also connectable to the electrode instrument 22 via these receptacles 30, 31. The guide element 32 can be pushed over the inner shaft 12 both above and also below the longitudinal axis 38 of the electrode instrument 22. Exactly as described before for the guide element 27, the guide element 32 is also pushed over the electrode carriers 25, 26 are fixedly connected to these, for example by welding.

[0057] The guide element 32 shown in FIGS. 7 and 8 has a recess 35 at both end faces 33, 36. However, it is also conceivable that only one of the two end faces 33, 36 has such a recess 35. As can be seen in FIG. 8, the end faces 33, 36 are configured in an arc shape to form the recess 35. This arc is preferably configured in such a way that a tangent 37 to the end faces 33, 36 encloses, at almost every point of the end faces 33, 36, a non-90° angle α with the longitudinal axis 34. The angle α can be equal to 90° only at an imaginary intersection between the longitudinal axis 34 and the end faces 33, 36. In addition to the arc-shaped configuration of the recess 35 shown here, other shapes are also conceivable. Thus, provision can also be made that the end faces 33, 36 have the shape of a triangle.

[0058] By virtue of the arc-shaped configuration of the end faces 33, 36 and by virtue of the recesses 35, the mounting of the guide element 32 on the electrode instrument 22 and the mounting of the electrode instrument 22 with guide element 32 on the inner shaft 12 prove particularly advantageous. By virtue of the recess 35, the contact area between the guide element 32 and the inner shaft 12 is reduced, and therefore the danger of wedging or catching is likewise reduced.

TABLE-US-00001 List of reference signs 10 resectoscope 11 shaft 12 inner shaft 13 optical unit 14 distal end 15 proximal end 16 eyepiece 17 working element 18 first gripping means 19 spring element 20 second gripping means 21 optical plate 22 electrode instrument 23 electrode 24 proximal end 25 electrode carrier 26 electrode carrier 27 guide element 28 portion 29 portion 30 receptacle 31 receptacle 32 guide element 33 end face 34 longitudinal axis 35 recess 36 end face 37 tangent 38 longitudinal axis of the electrode instrument