MEDICAL INSTRUMENT

Abstract

An instrument according to the invention for medical or surgical treatment of a human or animal patient comprises at least one tool suitable for influencing a patient, e.g. an electrode, which is or are located in the field of view of an optical element. The optical element is arranged inside a channel in which a fluid flow can be maintained or can be caused in distal direction. The light passage window of optical element is offset relative to the distal opening of channel in proximal direction. A closure device is arranged between light passage window and opening of channel, which blocks passage of substances, particularly passage of liquid droplets and particles, from the opening to the light passage window as long as it is in closed position. If the closure device is open, it unblocks the fluid path and the light path between the light passage window to the opening. Preferably the closure device is controlled pneumatically by means of the liquid or gaseous fluid flowing inside channel. With this measure a contamination of the light passage window during operation of the instrument can be reliably avoided or at least reduced to a minor degree.

Claims

1. An instrument for medical or surgical treatment of a human or animal patient, comprising: an instrument body in or on which at least one channel is formed that comprises a distal end and a proximal end, wherein the channel can be connected to a fluid source at its proximal end and comprises an opening at its distal end; an optical element that comprises at least one light passage window that is immovably arranged inside the channel; and a closure device that is arranged inside the channel between the light passage window and the distal end of the fluid channel and that comprises at least one closure member that can be moved between an open position and a closed position.

2. Instrument according to claim 1, characterized in that the closure member comprises an end immovably supported on the instrument.

3. Instrument according to claim 1, characterized in that the closure device comprises multiple closure members that are respectively pivotably supported at one end on the instrument.

4. Instrument according to claim 1, characterized in that the closure device comprises multiple bending elastic lamellae.

5. Instrument according to claim 1, characterized in that the closure member is an element made of a stretchable material.

6. Instrument according to claim 1, characterized in that the closure member is arranged such that it can be actuated by fluid flowing through the fluid channel.

7. Instrument according to claim 1, characterized in that the channel can be connected to a gas source as fluid source.

8. Instrument according to claim 1, characterized in that the instrument comprises at least one additional channel for supply or discharge of fluids.

9. Instrument according to claim 1, characterized in that a sight cone is defined by the light passage window that extends through the opening.

10. Instrument according to claim 1, characterized in that the instrument comprises an electrode.

11. Instrument according to claim 10, characterized in that the electrode is arranged within or in front of the opening.

12. Instrument according to claim 9, characterized in that the electrode is arranged at least partly within the sight cone.

13. Instrument according to claim 1, characterized in that the closure device is connected with a mechanical actuating device.

14. Instrument according to claim 1, characterized in that the closure device is connected with an electromagnetic actuating device.

15. Instrument according to claim 1, characterized in that the closure device is connected to a pneumatic Venturi actuating device.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0024] Further advantageous details relating to embodiments of the invention are derived from the claims as well as the description and the assigned drawing with its figures that show the following:

[0025] FIG. 1 a supplying apparatus with an instrument connected thereto in an overview illustration,

[0026] FIG. 2 the distal end of the instrument according to FIG. 1 in a schematic cross-sectional illustration,

[0027] FIGS. 3a and 3b a schematic illustration in part of the instrument with closure device in closed and open condition, and

[0028] FIGS. 4a to 9b further embodiments of the instrument and its closure device in open position and closed position respectively.

DETAILED DESCRIPTION

[0029] FIG. 1 illustrates an instrument 10 according to the invention that is connected to a supplying apparatus 11. The apparatus 11 is connected with the instrument 10 via a respective line 12 and configured to supply the instrument 10 with at least one operating media. For this purpose the apparatus 11 can comprise one or more fluid sources 13, one or more electrical generators 14 and/or one or more suction devices 15 that are connected with line 12 or the instrument 10 respectively via one or more connectors 16. FIG. 1 illustrates instrument 10 as hand-held instrument for the open surgical use. The invention, however, also extends to otherwise configured instruments, e.g., instruments for laparoscopic use or probes, which can be inserted into the body of a patient through a working channel of an endoscope, a trocar or another access.

[0030] The instrument 10 comprises a distal end 17 as well as a proximal end 18, which proximal end 18 can be realized by connector 16 or a section of its line 12.

[0031] The distal end 17 of instrument 10 is separately illustrated in FIG. 2. It comprises the distal section of an instrument body 19 through which at least one channel 20 extends. The channel 20 is particularly a fluid-guiding channel, e.g., gas-guiding channel, which extends preferably from the distal end 17 through the instrument 10 (FIG. 1) and the entire line 12 (FIG. 1) up to the proximal end 18 (FIG. 1) or connector 16 (FIG. 1) and is connected to the gas source 13 (FIG. 1) there. As an option, instrument 10 can comprise additional channels, such as a suction channel 21 that also extends from the distal end 17 of instrument 10 up to its proximal end 18 or connector 16 and is connected to the suction device 15 there. As an option, other channels and/or additional channels can be provided to convey liquids and/or gases to the distal end 17 of instrument 10 or away therefrom and can let them enter or exit there.

[0032] The instrument 10 can comprise tools for influencing biological tissue. Such a tool can be an electrode 22, for example, that is held in or on the distal end 17 of instrument 10 and ends there or that projects from a gas passage opening or ends in short distance before the latter. The electrode 22 is coupled to generator 14 (FIG. 1) via an electrical line 24 that extends through the line 12 up to the proximal end 18 or connector 16. However, also multiple electrodes or other tools, such as a water jet tool, a laser tool or the like, can be provided.

[0033] The channel 20 comprises the distal opening that is a gas discharge opening and concurrently a light passage opening 25. Inside channel 20 an optical element 26, e.g., in form of an optical fiber, is preferably immovably arranged, which comprises a light passage window 27 at its distal end. The light passage window 27 can be formed by the face of the optical element 26, that is e.g., by the face of an optical fiber. The light passage window 27 and together with it the optical element 26 are preferably axially immovably arranged inside the channel 20. Preferably, the light passage window 27 is arranged with distance in proximal direction relative to the light passage opening 25.

[0034] A closure device 28 is arranged between the light passage window 27 and the light passage opening 25. The closure device 28 is configured to unblock or block the passage from the light passage opening 25 to the light passage window 27 in a controlled manner. Preferably, the closure device 28 is controlled by the gas flow inside channel 20 or also by other media, however, never by any movement of the optical element 26, which is preferably immovably arranged as mentioned.

[0035] A first embodiment of the closure device 28 is apparent from FIGS. 3a and 3b. The closure device 28 is realized there by a substantially cone-shaped closure member 29 made of tensile elastic material that comprises an expandable opening at its tip 30. The tip 30 is facing the light passage opening 25. The opening at the tip 30 is very narrow or completely closed in the closed condition. The tensile elasticity of the material of closure member 29 is so high that the opening 30 can be stretched so wide by means of the pressure present inside channel 20 that the desired gas flow can exit from the light passage opening 25 and thus also the light path from the light passage opening 25 to the light passage window 27 is unblocked. If the gas flow is present, the closure member 29 is in open position.

[0036] The closure member 29 comprises a section immovably held on instrument 10. This section is realized in the closure member 29 by a circular section that defines the foot of the cone realized by the closure member 29. This section is immovably connected with the wall of channel 20. The remaining parts of the cone-shaped closure member 29 can be deformed in an elastic or flexible manner and are movable to this extent.

[0037] A modified embodiment is illustrated in FIGS. 4a and 4b to which the description above applies, except for the following particularities:

[0038] The closure device 28 comprises multiple closure members 29a, 29b, 29c, etc. that are flexible and form a cone, if they abut against one another with their edges. At its tip 30 the lamella-like closure members 29a, 29b, 29c, etc. join each other and therefore close the passage from the light passage opening 25 to the light passage window 27. However, if channel 20 is supplied with gas, the closure members 29a, 29b, 29c etc. spread as shown in FIG. 4b. Thus, the passage for gas as well as for light is unblocked by the closure device 28, the closure members 29a, 29b etc. are in open position.

[0039] The closure members 29a, 29b, 29c, etc. comprise a section immovably held on instrument 10. This section is realized in the closure members 29a, 29b, 29c, etc. by a portion of a circular section that defines the foot of the cone realized by the closure members 29a, 29b, 29c, etc. This section is immovably connected with the wall of channel 20. The remaining parts of the cone-shaped closure members 29a, 29b, 29c, etc. can be deformed in an elastic or flexible manner and are movable to this extent.

[0040] A further modified embodiment of the closure device 28 is illustrated in FIGS. 5a and 5b in which the closure member 129 is realized by a foldable, flexible, slack material, such as a foil hose section. Closure member 129 collapses without gas supply of channel 20 and blocks channel 20 as irregular-shaped body. In case of a gas flow, closure member 29′ unfolds, as illustrated in FIG. 5b, and therefore unblocks the passage for light and gas between light passage window 27 and light passage opening 25. Apart therefrom, the description above applies accordingly.

[0041] The closure member 129 comprises a section immovably held on instrument 10. This section is realized in the closure member 129 by a section that defines the foot of the unfolded through-hole realized by the closure member 129. This section is immovably connected with the wall of channel 20. The remaining parts of the closure member 129 can be deformed in an elastic or flexible manner and are movable to this extent.

[0042] In the described embodiments of FIGS. 3a to 5b a channel with round cross-section has been taken as basis for graphical illustration. Just as well, however, in these embodiments channel 20 can have other cross-sections, e.g. polygonal cross-sections, such as triangle, rectangle, hexagon or polygon with curved edges. Only by way of example in FIGS. 6a and 6b a configuration of channel 20 and the closure device 28 having a rectangular cross-section is illustrated. Here closure device 28 comprises a closure member configured as flap, the circumference of which is equal to the cross-section of channel 20. The flap-like closure member 229 is connected with one edge 31 with the instrument or the wall of channel 20. Thereby edge 31 can be rigidly anchored and the closure member 229 can be configured to be flexible. Alternatively, the edge 31 can be realized in a hinge-like manner. In the blocking position according to FIG. 6a, the closure member 229 blocks channel 20 and thus the passage between the light passage window 27 and the light exit opening 25. The closure member 229 can be resiliently pretensioned toward this position. This resilient pretension can be provided by intrinsic elasticity of closure member 229 or by a separate spring element. A stop can be assigned to the closure member 229 against which it abuts in the blocking position (not illustrated). This is particularly advantageous in embodiments in which the closure member 229 is held at the edge 31 by means of a hinge. In FIG. 6b the open position of the closure device 28 is illustrated in which closure member 229 is displaced out of its rest position into the open position by means of gas flowing through the channel 20 in distal direction.

[0043] FIGS. 7a and 7b illustrate another embodiment of a fluid-actuated closure device 28. In this a balloon-like hollow closure member 329 is part of the closure device 28, wherein the closure member 329 is again arranged between the light passage window 27 and the light passage opening 25. The balloon-like closure member 329 is in fluid connection with a Venturi opening 32 arranged in the gas path through which the static pressure of the gas flow becomes effective. If the static pressure decreases, due to the velocity of the gas flow, collapse of the balloon-like closure member 29 results such that the closure member 329 unblocks the gas path, as illustrated in FIG. 7b.

[0044] In a preferred embodiment the balloon-like closure member 329 or an actuator for actuating the closure member 329 is connected to the suction channel 21. Thereby a negative pressure of the suction can be used for actuating the closure device 28. For this purpose a transverse bore can be provided on the level of element 28 to element 21 (FIG. 2). Thereby a robust system is created. Particularly, larger pressure differences and thus large actuating forces can be created.

[0045] In such an embodiment, preferably the suction device 15 and the purge gas source 13 are synchronized with the RF generator 14. This reduces the sound pressure load that would be otherwise too high during continuous operation.

[0046] All embodiments described above have in common that the closure members (FIGS. 3a through 7b) of the closure device 28 is controlled pneumatically due to the effect of the gas or its flow inside channel 20. It is however also possible to externally control the closure device 28, as shown in FIGS. 8a and 8b in a simple first example. There, instrument 10 comprises an actuating device 33 that is only illustrated schematically and that can be realized by means of an actuating button on the instrument 10, for example. The actuating device 33 can thereby be provided to activate or deactivate instrument 10 and thus the connected generator 14. The actuating device 33 can additionally or alternatively also be configured for triggering other activation or switching processes, e.g. for triggering a spectral analysis of the light originating from the spark of the electrode. Concurrently the actuating device can move the closure member 29 via a suitable transmission, that is here only schematically illustrated by means of a two-arm lever 34, such that it blocks the passage between the light passage window 27 and the light passage opening 25 in the closed position according to FIG. 8a and unblocks it in the actuated position according to FIG. 8b.

[0047] As apparent from the example of FIGS. 9a and 9b, the actuation of the closure device 28 can also be carried out by means of other actuators, e.g. by means of a magnetic actuator 35 with which the closure member 29 can be positioned in the closed position according to FIG. 9a inside channel 20 and in open position, as shown in FIG. 9b, outside channel 20.

[0048] The instrument 10 of FIG. 1 according to the invention operates as follows:

[0049] For application on a patient instrument 10 is moved toward the operation site and is activated by actuation of a suitable switch, e.g., the actuating device 33. Alternatively, other switching means can serve for activation, e.g., foot switches or other operating devices. The apparatus 11 thereby receives a respective switching impulse and activates the respectively addressed or present devices, such as gas source 13, electrical generator 14 and/or suction device 15. If the instrument 10 is an electrosurgical instrument, typically the gas source 13 is activated before the generator 14 is activated. As long as the gas source 13 is not activated, i.e., channel 20 is not supplied with gas, the closure device 28 is closed. As soon as a respectively sufficient gas pressure and/or a gas flow is established inside channel 20, the closure device 28 opens at least, if one of the embodiments according to FIGS. 3a to 7b is used.

[0050] After activation of generator 14 light originating from electrode 22 is received by optical element 26. Electrode 22 is preferably located in the field of view of the optical element 26 that is in the sight cone originating from the light passage window 27 and extending through the light passage opening 25. Spark light originating from the electrode can be detected and can be further conveyed from the optical element 26 to an analysis device, e.g. a spectral analysis device, that can be part of instrument 10 or that can be configured and arranged separately.

[0051] The gas flow forwarded through channel 20 and discharged from light passage opening 25 effectively avoids disposal of particles, droplets or other contamination on the light passage window 27. However, as soon as the gas flow comes to a halt, e.g. because it has been interrupted, the closure device 28 closes. Even if contamination is continuously created due to turbulences or the like, e.g. due to the activation of the suction device 15, that sucks liquids or other matter from the operation area via suction channel 21, the light passage window 27 remains sealed off and spared from contamination. This also applies, if it is continued to operate with electrode 22 without gas supply through channel 20 and particles are released in this manner.

[0052] The embodiments of instrument 10 illustrated in FIGS. 8a to 9b operate in similar manner. In the embodiments according to FIGS. 8a and 8b, the closure device 28 is always unblocked, if the actuating device 33 is activated. The activation of actuating device 33 can be carried out independent from the activation of apparatus 11 (FIG. 1) and generator 14 (FIG. 1). For example, channel. 20 can be supplied with gas under low pressure. If closure device 28 is closed, it can concurrently block the gas flow and the light passage. The closure device 28 also blocks the passage of contamination. As soon as the closure device 28 is opened by means of the actuating device 33, the light path is unblocked. Concurrently, the gas flow is released that avoids entering of contamination. If a gas flow shall also be possible, if the closure device 28 is closed, a bypass can be provided parallel to the closure device 28 that is opaque to light.

[0053] In embodiments according to FIGS. 9a and 9b, closure device 28 is actuated by means of the magnetic actuator 35 or another suitable electrical actuator. Application of current to actuator 35 can be carried out synchronously with the application of current of electrode 22 or independent therefrom. The latter, for example, if light from the electrode 22 shall be received only occasionally. The apparatus 11 in connection with instrument 10 is then configured such that spectrometer and actuator 35 are concurrently activated for receiving light from the treatment site, e.g. for spectral analysis of light. Thereby the light passage window 27 is permanently protected from contamination. In the activated condition the gas flow flowing through channel 20 avoids contamination. In case of deactivation, closure device 28 closes and closes the light passage window 27. This principle applies for all embodiments.

[0054] The invention is not limited to electrosurgical instruments. It can also be used for laser surgical instruments or cryosurgical instruments. In the case of laser surgery, the optical element 26 can be configured to emit a laser beam out of the light passage window 27 through the light passage opening 25 toward the tissue. The gas flow inside channel 20 keeps the light passage window 27 free from contamination in the activated case. In the case of deactivation the closure device 28 closes, e.g. according to the principles of FIGS. 8a to 9b.

[0055] Instrument 10 can also be a water jet surgical or other instrument. In addition or as an alternative to the electrode 22, then a water injection channel can be provided in order to treat respective tissue at the operation site, preferably in the field of view of optical element 26. Apart therefrom the description above applies accordingly.

[0056] An instrument according to the invention for medical or surgical treatment of a human or animal patient comprises at least one tool suitable for influencing a patient, e.g. an electrode 22, which is or are located in the field of view of an optical element 26. The optical element 26 is arranged inside a channel 20 in which a fluid flow can be maintained or can be caused in distal direction. The light passage window 27 of optical element 26 is offset in proximal direction relative to the distal opening 25 of channel 20. A closure device 28 is arranged between light passage window 27 and opening 25 of channel 20, which blocks passage of substances, particularly passage of liquid droplets and particles, from the opening 25 to the light passage window 27 as long as it is in closed position. If the closure device 28 is open, it unblocks the fluid path and the light path between the light passage window 27 and the opening 25. Preferably the closure device 28 is controlled pneumatically by means of the liquid or gaseous fluid flowing inside channel 20. With this measure a contamination of the light passage window 27 during operation of the instrument 10 can be reliably avoided or at least reduced to a minor degree.