摘要:
An apparatus and method are provided for precisely isolating a target lesion in a patient's body tissue, resulting in a high likelihood of 'clean' margins about the lesion when it is removed for diagnosis and/or therapy. This approach advantageously will often result in the ability to both diagnose and treat a malignant lesion with only a single percutaneous procedure, with no follow-up percutaneous or surgical procedure required, while minimizing the risk of migration of possible cancerous cells from the lesion to surrounding tissue or the bloodstream. In particular, the apparatus comprises a biopsy instrument having a distal end adapted for entry into the patient's body, a longitudinal shaft, and a cutting element disposed along the shaft. The cutting element is actuatable between a radially retracted position and a radially extended position. Advantageously, the instrument is rotatable about its axis in the radially extended position to isolate a desired tissue specimen from surrounding tissue by defining a peripheral margin about the tissue specimen. Once the tissue specimen is isolated, it may be segmented by further manipulation of the cutting element, after which the tissue segments are preferably individually removed from the patient's body through a cannula or the like. Alternatively, the specimen may be encapsulated and removed as an intact piece.
摘要:
Methods and apparatus are provided for cauterizing predetermined volumes of biological tissue using a user selectable, or adjustable energy applicator including two or more electrodes (28, 29) having electrode parameters configured to cause cauterization of predetermined volumes when operated in a bipolar mode. The energy applicators (21) are employed with a control device (22) that couples the energy applicators to a power source (11), and includes circuitry (39) for interrupting activation of the energy applicator when the current between the two or more electrodes decreases more than a predetermined amount from the current sensed upon initial activation of the energy applicator.
摘要:
An improved electrosurgical instrument for use with a specially adapted electrosurgical trocar. The improved electrosurgical instrument including a handle, an end effector and an elongated closure tube connecting the handle to the end effector. The elongated closure tube including one or more electrical contacts adapted to provide electrical contact to the interior of a trocar cannula as the electrosurgical instrument is passed through the cannula. The contacts being electrically connected to the end effector of the electrosurgical instrument such that electrosurgical energy passes through the contacts to the end effector.
摘要:
This invention is a method for morselating and removing the morselated tissue (14) through a small incision (10) comprising in general inserting a tissue container (12) into the body cavity of a patient through an incision (10), placing resected tissue (14) in the vessel (12), inserting a morselator (16) having a rotatable electrode thereon through the incision (10) and into the vessel (12), morcelating the tissue and removing the tissue from the containment vessel (12) and the body. An apparatus (16) for morselating and removing tissue through a small incision (10) within the body cavity of a patient is also disclosed and may comprise a tissue container (12) having an inner chamber for containing resected tissue (14), and a morselator (16) having a proximal end (21) and a distal end (17) carrying an electrode (36) wherein the distal end (17) is insertable into the body cavity and containment vessel (12) for morselating resected tissue (14).
摘要:
Ein Trokar für laparoskopische Operationen von Patienten weist ein Rohr 11 und an einen Hochfrequenzgenerator 16 anschließbare Hochfrequenzanschlüsse 12, 13 im Bereich des vorderen Endes des Rohres 11 auf. Im Rohr 11 ist ein Schneidstab 14 axial verschiebbar und in einer Schneidposition feststellbar anbringbar, an dessen vorderen Ende die Hochfrequenzanschlüsse 12, 13 und an diese angeschlossene elektrochirurgische Schneidmittel 15, 16' angeordnet sind.
摘要:
The invention provides an electrosurgical tissue penetrating probe (e.g., a trocar) (24) for use with surgical procedures such as a laparoscopy. The trocar (24) has a stylet (36) disposed within the housing member (34), having an active electrode (42) disposed on a distal end thereof to deliver electrosurgical energy to the target tissue in contact with the stylet (36). A return electrode (48) is disposed on the housing member to form part of a return electrical path to the delivery electrosurgical energy. The invention also provides an electrosurgical trocar system having an impedance monitor and associated power regulating circuitry to control the amount of electrosurgical energy delivered to tissue so that the measured tissue impedance is maintained within a preselected range.
摘要:
A surgical trocar (10) includes an operative sleeve (32) adapted for disposition across a tissue barrier and an obturator (36) removably disposed in the sleeve (32). A source of energy is introduced to a cutting element (42) disposed at the distal end (43) of the obturator (36) for energizing the cutting element (42) to cut the tissue barrier (18). The distal end (43) of the obturator (36) and the distal end of the operative sleeve (32) can be advanced through the cut tissue and the obturator (36) removed leaving the sleeve (32) operatively disposed for further surgery.
摘要:
A device for dissipating electrical energy from a surgical device is provided. The electrical energy is induced on the surgical device when a charge-inducing instrument, e.g. an unipolar electrocautery device, is energized in proximity thereto. The induced energy is dissipated by conveying the energy along an electrically conductive element 34 to an energy dissipation region. In a preferred embodiment of the invention, the surgical device is a cannula 26 fabricated from a dielectric material, e.g., fiberglass, and induced electrical energy is dissipated by contacting the energy dissipation 36 region, e.g., a conductive band 36 around the periphery of the cannula, with the body wall of the patient. An alternative means for grounding is achieved by providing an electrical fitting on a cannula housing which remains external to the patient's body, and securing a grounding wire thereto.
摘要:
A device (1; 1') for treating the ligamentum flavum by radio frequency comprises: a hand grip (2; 2') to be held by an operator; a cannula (10; 10') fixed at its proximal end (31) to the hand grip (2; 2') and extending longitudinally from said hand grip (2; 2') to an opposed distal end of the cannula (10; 10'), designed to reach the ligamentum flavum; at least one electrode (11; 11') which is electrically connectable to a radio frequency generator and is slidably housed in the cannula (10; 10'); the cannula (10; 10') being provided with a hole (13) to allow the electrode (11; 11') to emerge from the cannula (10; 10'); an actuating device (26; 26') of the electrode (11; 11') provided in the hand grip (2; 2') for moving the electrode (11; 11'), wherein the actuating device (26; 26') comprises a slider (28; 94) along a sliding guide (27; 27') having a first (29; 91) and a second (30; 90) sliding portion placed in succession, the first portion (29; 91) being shaped so as to allow an axial translation of the slider (28; 94) along the guide (27; 27') to generate a consequent translation of the electrode in the cannula (10; 10'), the second portion (30; 90) being configured so as to allow a rotational translation of the slider (28; 94) along the guide (27; 27') so as to generate a corresponding rotational translation of the electrode (11; 11') outside the cannula (10; 10').
摘要:
An CUSA having a cannula with an ultrasonic frequency vibrating tip with a flue disposed around the cannula. A first electrode is disposed on an outside of the flue and an RF generator provides current to the first electrode. A current flow is formed between the electrode and the tip and the tip acts as a ground. The first electrode can take the shape of a complete circumferential ring or a partially circumferential ring. The first electrode can be removably disposed on and/or movable along a length of the flue to allow the surgeon to "clip-on" or adjust the electrode at the position of their choice. A second electrode can be disposed on the outside of the flue and proximal to the first. A second current flow can be formed between the first electrode and the second electrode.