Instrument for Electrosurgical Treatment

Abstract

An instrument for thermal treatment of tissue (34), particularly for electrosurgical treatment and particularly for argon plasma coagulation, is disclosed. The instrument has an instrument body (25) extending between a proximal end (27) and a distal end (28). In an end section (38) adjoining a distal end (28) the instrument body (25) comprises at least one color mark (39) in a defined color. This color corresponds to the color of a treated tissue (34) that is created, if the dosage of an energy introduction for achieving a desired depth effect in the tissue (34) has been selected correctly. Preferably the instrument is configured as probe (17), particularly as endoscope probe and has a flexible bendable instrument body (25) that can be referenced as instrument hose (26).

Claims

1. An instrument for thermal treatment of tissue (34), comprising: an instrument body (25) that extends from a proximal end (27) to a distal end (28), an electrode (32) configured for application of an electric voltage, wherein in an area of the distal end (28) at least one color mark (39) is arranged on the instrument body (25), wherein a color of the color mark (39) is selected such that it corresponds to a color of a tissue (34) treated with a desired dosage and/or depth effect.

2. The instrument according to claim 1, wherein the color of the at least one color mark (39) is brown or brown-beige.

3. The instrument according to claim 1, wherein the color of the at least one color mark (39) is a RAL-color.

4. The instrument according to claim 1, wherein the at least one color mark (39) has a length in an extension direction of the instrument body (25) of at least 2 mm.

5. The instrument according to claim 1, wherein the at least one color mark (39) is provided at a shell surface (40) of the instrument body (25).

6. The instrument according to claim 5, wherein at least a section of the at least one color mark (39) indicates a predetermined minimum distance (d) from the distal end (28).

7. The instrument according to claim 6, wherein an edge of the at least one color mark (39) that is furthest away from the distal end (28) indicates the predetermined minimum distance (d) from the distal end (28).

8. The instrument according to claim 5, wherein the at least one color mark (39) extends in a circumferential direction about at least 50% of a circumference of the instrument body (25).

9. The instrument according to claim 8, wherein the at least one color mark (39) extends completely around the circumference of the instrument body (25).

10. The instrument according to claim 1, wherein the at least one color mark (39) is spaced from an exit opening (31).

11. The instrument according to claim 1, wherein the at least one color mark (39) is provided on an end piece (41) of the instrument body (25), wherein the end piece (41) includes an exit opening (31).

12. The instrument according to claim 1, wherein the instrument body (25) is configured as an instrument hose (26).

13. The instrument according to claim 12, wherein the instrument hose (26) is configured to be guided through an operation channel (18) of an endoscope (15).

14. The instrument according to claim 1, wherein the instrument is configured for plasma treatment of tissue (34).

15. The instrument according to claim 1, wherein a fluid channel (30) is provided in the instrument body (25) that is fluidically connected with an exit opening (31) in an area of the distal end (28), whereby the electrode (32) is arranged inside the instrument body (25) adjacent to the exit opening (31).

16. The instrument according to claim 1, wherein the desired dosage and/or depth effect corresponds to at least one of an amount of a radio frequency AC-voltage applied to the electrode, a time-dependent progress of the radio frequency AC-voltage applied to the electrode, and a thermal influence duration on the tissue.

17. The instrument according to claim 1, wherein the at least one color mark is visible from an exterior of the instrument body.

18. The instrument according to claim 1, wherein the color of the at least one color mark is equivalent to a color identified by one of RAL-numbers 1001, 1005, 1011, 1024, 8001, 8003, 8007 or 8011.

19. The instrument according to claim 1, wherein the instrument body has at least one other color different from the color of the at least one color mark.

20. The instrument according to claim 19, wherein the at least one other color of the instrument body adjacent to the at least one color mark is darker than the color of the at least one color mark.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0028] The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee. Preferred embodiments of the invention are apparent from the dependent claims, the description and the drawings. Subsequently, preferred embodiments of the invention are explained in detail with reference to the attached drawings. The drawings show:

[0029] FIG. 1 a schematic principle illustration of an endoscope as well as an instrument forming a probe that is guided through an operating channel of the endoscope,

[0030] FIG. 2 an end section of the probe of FIG. 1 projecting out of the operating channel of the endoscope in a schematic block diagram-like illustration,

[0031] FIGS. 3-5 an embodiment of exit openings of a probe for a plasma or a fluid in different configurations in each case in a schematic side view,

[0032] FIG. 6a a schematic illustration of a modified embodiment of the end section of a probe,

[0033] FIG. 6b a schematic illustration of a modified embodiment of the end section having a color mark that extends along the end section of a probe,

[0034] FIGS. 7-9 a schematic principle illustration of a color mark of a probe in comparison to the color of an application area of treated biological tissue,

[0035] FIG. 10 is a photographic illustration of an end section of a probe having a color mark and multiple application areas of a tissue with different application dosages of the probe and

[0036] FIGS. 11 and 12 further embodiments of a probe in each case in a schematic partial illustration.

DETAILED DESCRIPTION

[0037] The invention refers to an instrument for thermal and for example, electrosurgical treatment of biological tissue 34. In the following embodiments illustrated in the drawings the instrument is configured as probe 17 that is preferably configured to be used in combination with an endoscope 15.

[0038] FIG. 1 shows the endoscope 15 in the manner of a block diagram. The endoscope 15 comprises an operating part 16 that can be handled by a surgeon. The probe can be inserted into an operation channel 18 of the endoscope 15 at the operating part 16. The operation channel 18 has a port at the endoscope end 19 opposite the operating part 16, out of which at least a section of the probe 17 can be extended. Adjoining the port of the operation channel 18 a light source 20 and an objective lens 21 are arranged at the distal endoscope end 19. By means of the light source 20 the environment in front of the endoscope end 19 and particularly the tissue to be treated is illuminated. By means of the objective lens 21 and optics or camera an image of the environment in front of the endoscope end 19 and particularly the tissue to be treated is detected. The camera and/or the optics of the endoscope 15 forwards the images to an ocular and/or an external monitor.

[0039] The instrument configured as probe 17 has an instrument body 25 that is configured as instrument hose 26 in the embodiment that can be bent transverse to its extension direction by the occurring forces. Because the instrument is a probe 17, the instrument body 25 could also be referenced as probe body and the instrument hose could also be referenced as probe hose. The instrument body 25 and according to the example, the instrument hose 26 extends from a proximal end 27 to a distal end 28. At the proximal end 27 a supply and operating unit 29 is connected with the instrument hose 26.

[0040] In the illustrated embodiments the instrument and according to the example, the probe 17 is configured for plasma coagulation and according to the example, for argon plasma coagulation. Alternatively, the instrument could also be configured for cauterization or for carrying out of another thermal treatment of biological tissue.

[0041] The probe 17 comprises an electrode 32 in the area of the distal end 28 of the instrument body 25. The electrode 32 can be configured, for example, to directly contact the biological tissue 34 to be treated. In the preferred embodiment the electrode 32 is configured to carry out a thermal influence of the biological tissue 34 indirectly via an electric conductible medium.

[0042] A voltage, particularly a radio frequency AC-voltage, can be applied to the electrode 32. The electrode 32 is connected with an electric terminal via a not illustrated electric conductor extending in the instrument body 25, wherein the electric terminal is particularly arranged at the proximal end of the instrument or the probe. An electric connection can be established to the supply and operating unit 29 via the electric terminal in order to be able to apply the voltage to the electrode 32.

[0043] In the configuration of the probe 17 for plasma coagulation a fluid channel 30 is formed inside the instrument body 25 or the instrument hose 26 (FIG. 2). By means of the supply and operating unit 29, a fluid G such as for example an inert gas, e.g. argon, can be introduced. The fluid G flows through the fluid channel 30 to an exit opening 31 in the area of the distal end 28 of the instrument hose 26.

[0044] The electrode 32 is arranged inside the instrument hose 26 and adjacent to the exit opening 31. As explained, the electrode 32 is electrically connectable with the supply and operating unit 29 such that a radio frequency AC-voltage can be applied to the electrode 32. By means of the radio frequency AC-voltage the fluid, e.g. an inert gas G, can be ionized and a plasma 35 can be formed. As highly schematically illustrated in FIG. 2, energy is transferred on the tissue 34 to be treated within an application area 33 by means of the plasma—and according to the example the argon plasma—in direction E of the applied electric field. Depending on the dosage, e.g. on the amount and/or the time-dependent progress of the radio frequency AC-voltage and/or the influence duration on the application area 33, a depth effect is achieved in the tissue 34 to be treated due to the energy introduction by means of the plasma. The dosage of the energy introduction in the tissue 34 to be treated is optimum, particularly if during the treatment about two thirds of the desired depth effect is achieved. Due to aftereffects within about 72 hours after the treatment, the depth effect increases about the still missing third.

[0045] By means of the probe 17, a thermal or electrosurgical treatment and according to the example, an argon plasma coagulation of tissue 34 to be treated can thus be carried out. The argon plasma coagulation is contactless. Thus, the probe 17 does not get in contact with the tissue 34 in the application area 33.

[0046] In an end section 38 of the instrument body 25 and according to the example, of the instrument hose 26, at least one color mark 39 is present adjacent to its distal end 28, wherein the color mark 39 has a color with a defined color shade and/or a defined color saturation and/or a defined brightness. The color shade can be, e.g. a brown color shade. The color of the color mark 39 corresponds to the color that the treated tissue 34 adopts in the application area 33, if the energy introduced by the selected dosage results in the desired depth effect in the tissue 34. Therefore, the color of the treated tissue 34 in the application area 33 is an indicator for the achieved depth effect and the dosage, particularly the energy introduced per unit area. Based on the color mark 39, an optical comparison between the color of the color mark and the color of the tissue 34 in the application area 33 can be carried out after the argon plasma coagulation. Then it can be recognized whether the dosage has been correctly selected.

[0047] According to the example, the color of the color mark 39 is brown or brown-beige. In the embodiment the color of the at least one color mark 39 is the RAL-color with the number 1011.

[0048] The one color mark 39 or at least one of multiple color marks 39 comprise one or more continuous colored areas. One single continuous colored area is sufficient.

[0049] The one color mark 39 or at least one of multiple color marks 39 can have, as an option, also a texture and/or surface structure and/or frosted surface. In doing so, the real tissue structure can be represented better and the comparison between the textured color mark 39 and the color and/or structure of the tissue 34 can be simplified. In addition, a rough and/or frosted surface of the color mark 39 can avoid reflections, whereby the color comparison can be simplified.

[0050] As far as the one color mark 39 or at least one of multiple color marks 39 comprises one or more textures, they can be realized following VDI 3400 (surface reference sample measurement) according to the VDI-classes 33-42 with a maximum depth of roughness Rmax=18-49 μm and an arithmetic average roughness value Ra=4.5-12.5 μm, particularly VDI-class 36, Rmax=25 μm, Ra=6.3 μm.

[0051] In the embodiment at least one color mark 39 is provided on the shell surface 40 or the circumferential surface of the instrument hose 26 in the end section 38, e.g. by means of a printing process. For example, the color mark 39 can be a ring area that surrounds the shell surface 40 partly and preferably completely. In extension direction of the instrument hose 26 or the end section 38 the at least one color mark 39 comprises a length of at least 2 mm or at least 3 mm. Preferably the length of a color mark 39 in extension direction of the end section 38 is not larger than 5 mm or 6 mm or 7 mm or 10 mm.

[0052] For a surgeon additional markings can be provided on the instrument hose 26 and particularly on the shell surface 40 that can be configured in arbitrary colors and shapes.

[0053] Instead of a ring shape the at least one color mark 39 can also have any other arbitrary configuration. For example, the at least one color mark 39 can comprise at least one symbol and/or at least one sign (digit or letter) and/or at least one geometric figure. Thus, also a company lettering and/or a company logo can be used as color mark 39. FIG. 6a schematically illustrates a print of a color mark 39 in the form of symbols.

[0054] In the end section 38 of a further embodiment of the probe 17 illustrated in FIG. 6b, at least one of the color marks 39 is arranged, e.g. printed, directly adjoining the distal end 28 on the shell surface 40. This color mark can be completely or partly formed by a hollow cylindrical end piece 41. One or more additional ring-shaped color marks can be provided as an option that are, for example, arranged with different distances to the distal end 28.

[0055] In the embodiment of the probe 17 according to FIGS. 2, 3 and 6a, the one color mark 39 or all of the color marks 39 are arranged with distance to the distal end 28 of the instrument hose 26. Preferably the instrument hose 26 has a color apart from the at least one color mark 39 that is optically in contrast to the surrounding tissue, such that the instrument hose 26 can be recognized well during surgery and according to the example, the endoscopic intervention. Due to the distance of the at least one color mark 39 from the distal end 28, the exit opening 31 can be positioned in the desired distance from the application area 33 of the tissue 34.

[0056] By means of the at least one color mark 39 or—provided that multiple color marks 39 are present—one of the present color marks 39, a minimum distance d from the distal end 28 of the instrument hose 26 can be marked. For example, an edge of the color mark 39, particularly the edge of the color mark 39 opposite the distal end 28, can be arranged at a position of the end section 38 of the instrument hose 26 that defines the minimum distance d to the distal end 28. During the endoscopy the surgeon can recognize whether the probe 17 or its end section 38 is pushed out sufficiently far out of the operation channel 18 of the endoscope 15 in order to not damage the endoscope 15 and particularly the optics during treatment of the tissue 34.

[0057] In all embodiments of the instrument or the probe 17 the color mark 39 or one of the color marks 39 can be arranged directly adjacent to the distal end of the instrument body 25. Alternatively, the at least one color mark 39 can have a distance to the distal end 28. Both variations have their own advantages.

[0058] In FIGS. 3-5, 11 and 12 different configurations of the instrument body 25 or the instrument hose 26 are illustrated. The embodiment according to FIG. 3 corresponds to the embodiment shown in FIG. 2, in which the fluid G or the plasma is ejected in extension to the end section 38. Different thereto the instrument body 25 and according to the example, the instrument hose 26 comprises an end piece 41 in the embodiments according to FIGS. 4 and 5 that comprises the exit opening 31. By means of the end piece 41, the direction of the exiting fluid G or plasma can be varied. In the embodiment according to FIG. 4, the fluid G or the plasma exits substantially orthogonal to the extension direction of the end section 38 in all directions. In contrast thereto the exit opening 31 of the end piece 41 of FIG. 5 is configured such that the inert gas G or the plasma is ejected selectively laterally in one direction substantially orthogonal to the extension direction of the end section 38.

[0059] FIGS. 11 and 12 schematically show embodiments of the probe in which the electrode 32 projects from the distal end 28 of the instrument body 25. These probes can be configured without fluid channel 30. The electrode 32 can be brought in direct contact with the tissue 34 during the thermal treatment or influence the tissue 34 by spark creation without additional medium.

[0060] In the embodiments in which an end piece 41 is provided, the end piece 41 can form a color mark 39. For this it can be colored in the defined brown color of the color mark 39 or can be coated completely or partly. For example, the end piece 41 can be made of a ceramic material.

[0061] Based on FIG. 7-10, the function of the at least one color mark 39 is schematically explained. By positioning of the at least one color mark 39 directly adjacent to an application area 33 in which a tissue 34 has already been treated, a color comparison can be carried out. The brightness of the color is schematically illustrated in FIGS. 7-9 by the density of the dots.

[0062] It is apparent from FIG. 7 that the color of the color mark 39 is darker than the color of the tissue 34 in the application area 33. An underdosage exists and the tissue has to be further treated in the application area 33 in order to achieve the desired depth effect.

[0063] In contrast the color of the tissue 34 in the application area 33 according to FIG. 9 is darker than the color of the at least one color mark 39, such that an overdosage exists. The tissue 34 has been damaged or influenced in the application area 33 beyond the desired depth effect. The surgeon can recognize this and estimate the consequences or initiate necessary measures, if applicable.

[0064] FIG. 8 schematically illustrates the situation in which the color of the color mark 39 and the color of the treated tissue in the application area 33 correspond approximately and the surgeon recognizes that the dosage for achieving the desired depth effect in the tissue 34 directly after the treatment is correct (about two third of the depth effect achieved under consideration of the aftereffect).

[0065] The situations illustrated schematically in FIGS. 7-9 are again illustrated based on the photographic picture in FIG. 10. On the left side in the picture a first application area 33a can be seen, the color of which is darker than the color of the color mark 39. An overdosage exists. The color in the second application area 33b corresponds substantially to the color of the at least one color mark 39. In the second application area 33b the correct dosage of the introduced energy has been achieved. In a third application area 33c comprising a clearly brighter color than the color of the color mark 39, the energy introduction has been underdosed. By a further treatment of this third application area 33c, the desired dosage or depth effect can still be reached.

[0066] The invention refers to an instrument for thermal treatment of tissue 34, particularly for electrosurgical treatment and particularly for argon plasma coagulation. The instrument has an instrument body 25 extending between a proximal end 27 and a distal end 28. In an end section 38 adjoining a distal end 28 the instrument body 25 comprises at least one color mark 39 in a defined color. This color corresponds to the color of a treated tissue 34 that is created, if the dosage of an energy introduction for achieving a desired depth effect in the tissue 34 has been selected correctly. Preferably the instrument is configured as probe 17, particularly as endoscope probe and has a flexible bendable instrument body 25 that can be referenced as instrument hose 26.

LIST OF REFERENCE SIGNS

[0067] 15 endoscope [0068] 16 operating part [0069] 17 probe [0070] 18 operation channel [0071] 19 distal endoscope end [0072] 20 light source [0073] 21 objective lens [0074] 25 instrument body [0075] 26 instrument hose [0076] 27 proximal end of instrument hose [0077] 28 distal end of instrument hose [0078] 29 supply and operating unit [0079] 30 fluid channel [0080] 31 exit opening [0081] 32 electrode [0082] 33 application area [0083] 33a first application area [0084] 33b second application area [0085] 33c third application area [0086] 34 tissue [0087] 35 plasma [0088] 38 end section [0089] 39 color mark [0090] 40 shell surface [0091] 41 end piece [0092] d minimum distance [0093] E direction of electric field [0094] G fluid