RESECTOSCOPE WITH ILLUMINATION MODE FOR SUPPORTING ELECTROSURGICAL COAGULATION

Abstract

A resectoscope for endoscopic surgery with a tubular shaft and a handle, wherein the shaft includes a longitudinally displaceable electrode instrument and an illuminating device, with an electrode to which high-frequency current can be applied being arranged in the distal end region of the electrode instrument, characterized in that the illuminating device in the distal end region of the resectoscope can emit UV radiation in the wavelength range from 200 nm to 400 nm.

Claims

1. A resectoscope for endoscopic surgery with a tubular shaft and a handle, wherein the shaft comprising a longitudinally displaceable electrode instrument and an illuminating device, with an electrode to which high-frequency current can be applied being arranged in the distal end region of the electrode instrument, wherein the illuminating device in the distal end region of the resectoscope can emit UV radiation in the wavelength range from 200 nm to 400 nm.

2. The resectoscope as set forth in claim 1, wherein the electrode comprises a material that is selected from the group consisting of: metals of the 4th period of the periodic table (Sc, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn) and metals of subgroup VI of the periodic table (Cr, Mo, W, Sg), as well as alloys that comprise the above materials.

3. The resectoscope as set forth in claim 1, wherein the electrode comprises a steel that is suitable for use in surgical instruments.

4. The resectoscope as set forth in claim 1, wherein the wavelength spectrum of the radiation emitted by the illuminating device has one or more radiant flux peaks in the range from 200 nm to 400 nm.

5. The resectoscope as set forth in claim 1, wherein the wavelength spectrum of the radiation that is emitted by the illuminating device has one or more radiant flux peaks in the range from 200 nm to 315 nm.

6. The resectoscope as set forth in claim 1, wherein the illuminating device emits in the distal direction.

7. The resectoscope as set forth in claim 1, wherein the direction of radiation of the illuminating device is adjustable.

8. The resectoscope as set forth in claim 1, wherein the direction of radiation of the illuminating device is substantially identical to the viewing direction of an optical system of the resectoscope.

9. The resectoscope as set forth in claim 1, wherein the light emitted by the illuminating device can be guided in the direction of the electrode.

10. The resectoscope as set forth in claim 1, wherein the illuminating device comprises a diode in the distal end region of the resectoscope.

11. The resectoscope as set forth in claim 1, wherein the illuminating device comprises an optical fiber bundle that is arranged in the shaft.

12. The resectoscope as set forth in claim 1, wherein the handle comprises an actuating device for actuating and/or controlling the illuminating device.

Description

BRIEF DESCRIPTION OF THE FIGURES

[0032] Exemplary embodiments of the invention are shown schematically in the drawings, in which:

[0033] FIG. 1 shows a sectional view of a resectoscope according to the invention with an electrode instrument that can be moved longitudinally in the shaft and has an electrode at its distal end; and

[0034] FIG. 2 shows a front view of the shaft of the resectoscope according to the invention shown in FIG. 1.

EXEMPLARY EMBODIMENTS

[0035] Additional advantages, characteristics, and features of the present invention will become clear from the following detailed description of exemplary embodiments with reference to the attached drawings. However, the invention is not restricted to these exemplary embodiments.

[0036] FIGS. 1 and 2 show a sectional view of a resectoscope 10 according to the invention and a front view of the shaft 12 of this resectoscope 10. The resectoscope 10 has an electrode 20, which is embodied as a loop electrode, and an illuminating device 18, which comprises an optical fiber bundle 24.

[0037] The illuminating device 18 can emit radiation in the UV range in the distal end region of the resectoscope 10. In particular, a provision is made that the illuminating device 18 emits UV radiation between 200 nm and 400 nm. In addition to a radiant flux peak in this range between 200 nm and 400 nm, the illustrated illuminating device 18 has an additional radiant flux peak in the range of light that is visible to humans. Therefore, in the illustrated embodiment, it is not necessary to provide a second illuminating device in order to illuminate the site of intervention.

[0038] As can be seen in FIG. 1, the resectoscope 10 has a shaft 12 that comprises a cladding tube 30 (outer tube), which is shown in broken lines. An inner tube 28 runs inside the cladding tube 30, and the electrode instrument 16, the optics 44, and the illuminating device 18 run inside the inner tube 28. Furthermore, additional elements such as an irrigation tube or a second illuminating device (not shown here) can run inside the cladding tube 30, insofar as the lighting with visible light is to be provided separately from the irradiation with UV light.

[0039] In the embodiment shown here, the optics 44 and the illuminating device 18 are supported against one another and secured against radial displacement and displacement in the longitudinal direction of the shaft 12 by means of a stabilizing element 46. The stabilizing element 46 has two portions that are fastened to one another, each with a partially circular cross section, one of which is complementary in shape and size to the outer wall of the optics and one which is complementary in shape and size to the outside of the optical fiber bundle 24.

[0040] The electrode instrument 16 is arranged so as to be longitudinally displaceable in the inner tube 28 and is protected against transverse displacementsi.e., displacements in the radial directionby a holding element 32 (guide element). The holding element 32 is complementary in shape to the inner wall of the inner tube 28 or to the outer wall of the optics 44 and has a partially cylindrical shape. The holding element 32 is fastened to two fork tubes 48 in a shaft portion of the electrode instrument 16. The fork tubes 48 run closely together within the shaft 12 and diverge only in the distal end region of the shaft 12 in order to receive and carry the loop electrode between their ends.

[0041] The electrode instrument 16 can be moved in an axially guided manner in the distal and proximal direction through actuation of a handle part 40. It can be pushed over the distal end of the inner tube 28 and the cladding tube 30. This enables the surgeon to manipulate tissue that is farther away from the resectoscope tip. For this purpose, the inner tube 28 and/or the electrode instrument 16 are also supported so as to be rotatable about their longitudinal axes. The electrode instrument 16 has at its distal end an electrode 20 that is embodied as a cutting loop and by means of which tissue can be removed by electrosurgical ablation. Here, a high-frequency electrical voltage is applied to the electrode 20 in order to cut tissue.

[0042] The resectoscope 10 shown has a passive transporter in which the slide 36 is displaced in the distal direction against the distal, first handle part 38 through a relative movement of the handle parts 38 and 40 that are arranged proximally from the shaft 12 against a spring force that is applied by a spring bridge 42. When the slide 36 is displaced in the distal direction against the handle part 38, the electrode instrument 16 is positively guided to the distal in a manner not shown. When the handle parts 38, 40 are released, the spring force generated by the spring bridge 42 forces the slide 36 back into its resting position, the shaft 12 and hence the electrode instrument 16 as well being pulled in the proximal direction. When the slide 36 is moved back, an electrosurgical intervention with the electrode instrument 16 can be carried out without manual force on the part of the surgeonthat is, passively.

[0043] The electrode instrument 20 that is arranged at the distal end of the electrode instrument 16 is a metallic electrode and is made of steel (stainless steel) of the alloy 1.4301. This is stainless steel with the short name X5CrNi18-10, available from specialty retailers. It is also conceivable for the electrode 20 to be made from steel of the alloy 1.4542. This is stainless steel with the short name X5CrNiCuNb17 44. As explained elsewhere, it is of course also possible to make the electrode 20 from other metallic compounds, particularly from other steels, in particular from stainless steels.

[0044] As can be seen in FIGS. 1 and 2, the resectoscope 10 according to the invention has an illuminating device 18. The illuminating device 18 has an elongate shaft part that runs through the shaft 12 of the resectoscope. The illuminating device 18 comprises an optical fiber bundle 24 with a substantially round cross section. Alternatively, it is also conceivable for the optical fiber bundle 24 to have a different cross section. The optical fiber bundle 24 comprises a plurality of individual optical fibers that transport light from the proximal end to the distal end of the shaft.

[0045] In the embodiment that is shown, the optical fiber bundle 24 is not surrounded by its own sleeve. The desired cross-sectional shape is secured by gluing the fibers. Alternatively, however, it is also conceivable for the optical fiber bundle 24 to be enclosed with a sheath, for example with a hose-shaped or tubular sheath.

[0046] The UV radiation emitted at the distal end by the illuminating device 18 releases iron ions that are bound as Fe(OH).sup.2+ under simultaneous release of hydroxyl radicals according to the following reaction: Fe(OH).sup.2++hv.fwdarw.Fe.sup.2++OH.. The iron ions released in this way are then again available for trapping further hydroxyl ions (OH.sup.), while the hydroxyl radicals (OH.) can contribute to tissue resection or coagulation. This significantly increases the coagulating or severing effect of the electrode on the tissue to be resected or coagulated. As set out above, a diode such as an LED, for example, can also be provided at the distal end of the shaft 12 instead of an optical fiber bundle 24. This diode would only need to be connected to a proximal power source via a line, thereby enlarging the available space in the shaft 12.

[0047] Depending on the embodiment, the illuminating device 18 is connected at its proximal end to a light source (in the case of an optical fiber bundle 24) or to a power source (in the case of a diode-containing illuminating device 18) via a connector cable (not shown here).

[0048] Although the present invention has been described in detail with reference to the exemplary embodiments, it is obvious to those skilled in the art that the invention is not restricted to these exemplary embodiments, but rather that modifications can be made in such a way that individual features are omitted or other combinations of the individual features presented are realized, provided that the scope of protection of the appended claims is not exceeded. The present disclosure includes any and all combinations of the individual features presented.

LIST OF REFERENCE SYMBOLS

[0049] 10 resectoscope [0050] 12 shaft [0051] 14 handle [0052] 16 electrode instrument [0053] 18 illuminating device [0054] 20 electrode [0055] 24 optical fiber bundle [0056] 28 inner tube [0057] 30 cladding tube [0058] 32 holding element [0059] 34 insulating tip [0060] 36 slide [0061] 38 handle part [0062] 40 handle part [0063] 42 spring bridge [0064] 44 optics [0065] 46 stabilizing element [0066] 48 fork tube