CN1205620A

CN1205620A - Resectoscope electrode assembly with simultaneous cutting and coagulation

Info

Publication number: CN1205620A
Application number: CN 96199280
Authority: CN
Inventors: 穆塔·M·伊萨
Original assignee: Advanced Closure Systems Inc
Current assignee: Advanced Closure Systems Inc
Priority date: 1995-12-22
Filing date: 1996-12-19
Publication date: 1999-01-20

Abstract

An electrode assembly for a resectoscope (18) includes a cutting electrode (1) with a loop distal tip and a first power density. A coagulation electrode (2) has a loop distal tip and a second power density that is smaller than the first power density. A support frame is connected to the cutting and coagulation electrodes (1, 2) and to an energy source (24) to supply energy from the energy source (24) to the cutting and coagulation electrodes (1, 2). The coagulation electrode (2) provides tissue coagulation simultaneously while the cutting electrode (1) cuts tissue. A resectoscope (18) is disclosed which includes the electrode assembly. The resectoscope includes a sheath (14) with a sheath lumen (14a, 14b), a working element (15), and a visualization apparatus (16).

Description

Has the resectoscope electrode assemblie that excises simultaneously and solidify function

Background of invention

Invention field

The present invention relates generally to the resectoscope electrode, the invention particularly relates to the resectoscope electrode assemblie that excises simultaneously and solidify and only use a power supply.

The description of relevant technologies

Prostate is positioned at the exit of bladder, and benign prostatauxe (BPH) is prostatic optimum overgrowth.BPH is one of the most general situation that influences the people of age above 50 years old.Incidence rate increases with age growth, reaches 80 to 90% in the time of 80 years old.For most patient, BPH does not cause symptom.Yet for the patient of certain percentage, BPH will slowly and little by little hinder and urinate the symptom of urinating that causes bladder to block and stimulate.More have sub-fraction patient's symptom constantly to develop, causing completely, urine retention, urinary tract infection, vesical calculus and kidney damage.Make the decision of whether patient being treated and to see if there is the symptom and the order of severity thereof.Therefore, greatly (about 70%) keeps asymptomatic patient BPH need not treat.For Symptomatic patient BPH, many kind treatment ways are arranged.

According to the anesthesia requirement, the surgical treatment of two classes based on BPH arranged.The first kind needs whole body or spinal anesthesia and comprises open prostatectomy, transurethral prostatic resection (TURP), transurethral incision of prostate (TUIP), per urethra prostate vaporization art (TVP), the auxiliary prostatectomy (V-LAP) of visual laser, contact Lasar prostate excision art, prostate balloon dilation and the inner art that stretches of prostate.TURP is " gold standard " therapy.It once was a most effective and persistent Therapeutic Method in all surgical intervention, and success rate is 80-90%.

Prostate is euangiotic organ, can be hemorrhage when it is implemented excision (TURP).The hemorrhage vision definition that makes reduces, and this causes operation (intra-operative) difficulty in the various bodies again, causes undesired result.Hemorrhage is that the principal element that causes most problems: Fig. 1 is a complicated flow chart of listing standard TURP.

The resectoscope of typical transurethral resection comprises four major parts.First is an inflexible endoscope, is used for observing carrying out operating urethra inside.Endoscope comprises object lens and a series of relay lens that is contained in endoscope's tube, and this endoscope's lens barrel links to each other with an eyepiece case, is receiving in eyepiece case content to be used for the suitably lens of amplification.Second portion takes to handle the form of assembly (handle assembly), is referred to as working portion usually.Working portion can be used as the device that electrosurgical current is connected to third part (electrode assemblie) from Electrosurgical generator.Working portion can also make electrode assemblie slide along the longitudinal axis of resectoscope.The combination lock of endoscope, working portion and electrode assemblie is fixed in the 4th part (resectoscope sheath cover).The sheath cover comprises pipe, union body and locked component.In operation process, whole resectoscope is put into urethra.

Common resectoscope electrode assemblie has the form of U-shaped tungsten wire loops, and its two ends are connected to one or more tinsel, and this tinsel is contained in the socket of working portion of resectoscope, is used for conductive electric current.Wire arm is converged and is connected to contact conductor at their approach end usually, and this lead-in wire extends the working portion that is back to instrument.Be to support resecting loop, thus make its keep with the endoscope tube at interval evenly, between endoscope's tube and parallel horn or distal portions, intermetallic spacer ring is set usually near the contact conductor of those arms.When electrode assemblie forward and when mobile backward, this intermetallic spacer ring can slide along endoscope's lens barrel, and because therefore directly contact between the collar and the endoscope's lens barrel at interval need guarantee suitable insulation between the electrode and the collar in this part.

So far, though all new generally can not present similar effectiveness and persistency with interchangeable surgical intervention, yet, they reduce ailing, reduce the aspects such as blood loss that stood and demonstrate some advantage, and than being easier to carry out these treatments.Need a kind of not only more saferly and bring slight illness still less but also to present the method for similar lasting effectiveness than TURP.

The second class surgical intervention only needs local anesthesia and does not need whole body or spinal anesthesia.These treatments utilize different energy that prostate is carried out thermotherapy.They comprise thermotherapy at intermittence (LDIT) and the per urethra prostate spicule elimination (TUNA) that transurethral microwave thermotherapy (TUMT), per urethra heat elimination treatment (T3), high intensity focused ultrasound (HIFU), laser provide.These treatments are ailing littler than traditional TURP's.These thermotherapies are studied at present, and made them also need finish phase III test (phase threetrials) before coming into the market for the first time and FDA ratifies.

The TURP equipment that needs a kind of depletion of blood of performing the operation, as shown in Figure 1, so alleviate all problems of standard TURP equipment in fact.The TURP equipment that excision is provided simultaneously and solidifies can be accomplished this point.

Summary of the invention

Correspondingly, an object of the present invention is to provide the electrode assemblie that a kind of resectoscope is used, this electrode assemblie comprises the coag electrodes ring with resection electrode ring while (in about one second) work.

Another object of the present invention provides the electrode assemblie that a kind of resectoscope is used, and this electrode assemblie comprises coag electrodes, resection electrode and the single power supply of electric power is provided to these two electrodes.

Another purpose of the present invention provides the electrode assemblie that a kind of resectoscope is used, and this electrode assemblie comprises excising simultaneously with the monocycle with different electric current densities that solidifies and solidifies and resection electrode and single power supply.

A further object of the present invention provides the electrode assemblie that a kind of resectoscope is used, and this electrode assemblie comprises coag electrodes and resection electrode, and each electrode all has the distal loop structure, and each electrode has different electric current densities.

Of the present invention also have a purpose to provide the electrode assemblie that a kind of resectoscope is used, and this electrode assemblie comprises that one has the excision of first and second electric current densities and solidifies ring, and wherein, this ring provides and excises simultaneously and solidify.

Of the present invention also have a purpose to provide the electrode assemblie that a kind of resectoscope is used, and this electrode assemblie comprises and solidify ring and resecting loop, and solidify ring have insulation on contact surface, with provide be lower than the resecting loop electric current density solidify circular current density.

Of the present invention also have a purpose to provide the electrode assemblie that a kind of resectoscope is used, and this electrode assemblie comprises and solidify ring and resecting loop, and solidify ring and have bigger surface area, with provide be lower than the resecting loop electric current density solidify circular current density.

Of the present invention also have a purpose to provide the electrode assemblie that a kind of resectoscope is used, this electrode assemblie comprise solidify the ring and resecting loop, and solidify ring and on contact surface, comprise coil, resistive element or printed circuit, with provide be lower than the resecting loop electric current density solidify circular current density.

Of the present invention also have a purpose to provide a kind of electrode system, and to improve the TURP process, this process is depletion of blood basically.

Of the present invention also have a purpose to provide a kind of electrode system, and to improve the TURP process, this process provides higher visual definition.

These and other purpose of the present invention is provided in the electrode assemblie that a kind of resectoscope is used.The electrode assemblie that resectoscope is used comprises resection electrode and coag electrodes, and the both has distal loop.The resection electrode ring has the electric current density higher than the electric current density of solidifying ring.This allows to use the single energy, and does not need converter case.Carriage is connected to the energy to excision and coag electrodes, and this energy provides energy from power supply to electrode.The various energy be can use, RF, microwave and heat energy or the like included but not limited to.When resection electrode resection organization, coag electrodes provides tissue coagulation simultaneously.

In another embodiment of the present invention, electrode assemblie has only a ring, and this ring excises simultaneously and solidifies.This ring has the part of solidifying, and this power density of solidifying part is lower than the power density of cut-out.Can accomplish this point by the whole bag of tricks, these methods include but not limited to use different (i) materials, (ii) geometry, (iii) size or (iv) insulation.

In another embodiment of the present invention, disclosed a kind of resectoscope that comprises electrode assemblie.This resectoscope comprises sheath cover, working portion and the visual equipment that has the sheath mantle cavity.

Resectoscope comprises the sheath cover, and this sheath cover has sheath mantle cavity, far-end and near-end.Electrode assemblie comprises resection electrode and coag electrodes, and resection electrode has cyclic far-end, and coag electrodes has far-end, and when resection electrode resection organization, the coag electrodes far-end is solidified structure simultaneously.Working portion is attached to the near-end of sheath cover.In addition, also provide visual equipment, it is contained in the sheath mantle cavity by working portion, the near-end from sheath cover remote extension to the handle of working portion.

The invention provides the interior procedures electrode assembly of body that resectoscope is used, thereby resectoscope provides: directly excising simultaneously and solidifying for visual time; The urologist is easier to the operation carried out; The less danger that enters vein recess (venous sinus); Less danger of bleeding again; Less blood transfusion probability; Less liquid wash and expansion of the bladder; The danger of less TURP complication; Less capsule penetrates the danger of (capsularpenetration), thereby less liquid infiltrates underbelly danger; The danger of less urinary system sphincter damage, thereby the incontinent danger of less urine; The danger of less ureteric orifice damage, thereby the danger that less ureter blocks and vesicoureteral flows backwards (vesicoureteral reflux); Short operating time; Less catheterization of bladder and the postoperative Foley of needing draws; The danger of cicatrization and bladder neck contracture after the less operation; The less operation back bladder irrigation that needs; The Foley conduit inserts the time after the short operation; The short hospital stays; And the relevant expense that is lower than standard TURP.

Only need a kind of energy.Electrode assemblie can comprise one or several electrode retaining collars.When a ring excised, second ring solidified simultaneously.Perhaps, single ring can provide two kinds of functions simultaneously.In all case, only need a kind of energy, because with solidifying different electric current densities is arranged for excision.Electrode system of the present invention and resectoscope can use with all commercial RF power supplys basically.

Another object of the present invention provides a kind of electrical conduits device of cable form, includes a transformator (transformer) within it.Transformator is divided into two kinds of given energy level to the energy that the energy produces, and cable transfers energy to the electrode assemblie of resectoscope.Also can make an independent transformator (changer (converter)) to this device for transformer, and it is not included in the cable.The function of device for transformer and changer is that energy is divided into two kinds of given energy level, and the suitable dual function of excising simultaneously and solidifying for electrode assemblie can change and regulate energy level.

Description of drawings

Fig. 1 is the flow chart of the complexity of description standard TURP process.

Fig. 2 (a) is the perspective view of an embodiment of electrode assemblie of the present invention.

Fig. 2 (b) be electrode assemblie 2 (a) along straight line 2 (b)-2 (b) see side view.

Fig. 2 (c) is the profile of electrode assemblie 2 (a) along straight line 2 (c)-2 (c) intercepting.

Fig. 2 (d) be embodiment of electrode assemblie 2 (a) along the profile of watching line 2-2 intercepting, by in the contact area that reduces under the given power level between electrode and the tissue, its excision has different electric current densities with the far-end of coag electrodes.

Fig. 2 (e) be embodiment of electrode assemblie 2 (a) along the profile of watching line 2-2 intercepting, by in the contact area that reduces under the given power level between electrode and the tissue, its excision has different electric current densities with the far-end of coag electrodes.

Fig. 2 (f) be embodiment of electrode assemblie 2 (a) along the profile of watching line 2-2 intercepting, by in the contact area that reduces under the given power level between electrode and the tissue, its excision has different electric current densities with the far-end of coag electrodes.

Fig. 2 (g) be embodiment of electrode assemblie 2 (a) along the profile of watching line 2-2 intercepting, the material by changing electrode is with the flow through electric current of electrode of restriction, its excision has different electric current densities with the far-end of coag electrodes.

Fig. 2 (h) excises and single excision of solidifying and the profile that solidifies far-end simultaneously, and by having a sectional electrode (it is made of alternative metal of multilamellar and insulant), the excision of single far-end partly has different electric current densities with solidifying.

Fig. 3 (a) is the perspective view of second embodiment of electrode assemblie of the present invention.

Fig. 3 (b) be electrode assemblie 3 (a) along straight line 3 (b)-3 (b) see side view.

Fig. 3 (c) is the profile of electrode assemblie 3 (a) along straight line 3 (c)-3 (c) intercepting.

Fig. 3 (d) is the profile of electrode assemblie 3 (a) along straight line 3 (d)-3 (d) intercepting.

Fig. 3 (e) is the profile of electrode assemblie 3 (a) along straight line 3 (e)-3 (e) intercepting.

Fig. 4 (a) is the perspective view of resectoscope.

Fig. 4 (b) be resectoscope 4 (a) along straight line 4 (b)-4 (b) see side view.

Fig. 5 (a) is the figure of resectoscope of the present invention, power supply and changer.

Fig. 5 (b) is resectoscope of the present invention, power supply and transformator pipe guide (no changer).

Fig. 6 is the electronic-circuit diagram of the changer of the present invention (23) of Fig. 5 (a).

Fig. 7 is the electronic circuit sketch map of embodiment of the transformator (20) of Fig. 5 (a), and this transformator is the single-pole device that is coupled to the bipolar outfan of RF power supply.

Fig. 8 is the electronic circuit sketch map of second embodiment of the transformator (20) of Fig. 5 (a), and this transformator is the single-pole device that is coupled to the bipolar outfan of RF power supply.

Fig. 9 (a), 9 (b), 9 (c) and 9 (d) are the electronic circuit sketch maps of the 3rd, the 4th, the 5th and the 6th embodiment of the transformator (20) of Fig. 5 (a), and this transformator is the bipolar devices that is coupled to the bipolar outfan of RF power supply.

The detailed description of preferred embodiment

The present invention is the electrode assemblie that a kind of resectoscope is used, and comprises resection electrode and coag electrodes, and the both has distal loop.The functional objective of this electrode assemblie is to carry out cutting tissue simultaneously and solidify at the surgery intra-operative.Electrode assemblie obtains its energy from power supply.The traditional primary energy that is produced by power supply is converted and is divided into two independent energy, and each energy is used for each distal loop of electrode assemblie.The energy transducer of particular design or transformator pipe guide are born this work.Do allowing to provide two given power with the single energy to two electrode assemblie rings like this, so that they have different functional characteristics when working at the same time, one is used for cutting tissue, and another is used for tissue coagulation.In addition, the design of various electrode assemblie distal loops has been proposed, they based on but be not limited to (i) material, (ii) geometry, (iii) size or (iv) insulant, regulate and change to allow additional function.Can use the various energy, comprising but be not limited to RF, microwave and heat or the like.

In another embodiment of the present invention, electrode assemblie has only a ring, and it excises simultaneously and solidifies.This ring has one and solidifies part, and the power density of this part is lower than the power density of cut-out.Accomplish this point by the whole bag of tricks, these methods include but not limited to use different (i) materials, (ii) geometry, (iii) size or (iv) insulant.

In yet another embodiment of the present invention, disclosed a kind of resectoscope, it comprises electrode assemblie, resectoscope sheath cover, working portion and visual equipment.

In addition, compare with the device that is used for standard TURP at present, the present invention has: higher visual definition; The urologist is easier to the operation carried out; The less danger that enters the vein recess; Less danger of bleeding again; Less blood transfusion probability; Less liquid wash and expansion of the bladder; The danger of less TURP complication; The danger that less capsule penetrates, thereby less liquid infiltrates underbelly danger; The danger of less urinary system sphincter damage, thereby the incontinent danger of less urine; The danger of less ureteric orifice damage, thereby the danger that less ureter blocks and vesicoureteral flows backwards; Short operating time; Less catheterization of bladder and the postoperative Foley of needing draws; The danger of cicatrization and bladder neck contracture after the less operation; The less operation back bladder irrigation that needs; The short postoperative Foley conduit that is subjected to inserts the time; The short hospital stays; And the relevant expense that is lower than standard TURP.

For the purpose that discloses, " simultaneously " this speech means: (i) at synchronization the RF energy is offered excision and coag electrodes distal loop, (ii) the RF energy is offered two distal loops being shorter than in time of 1 second, (iii) among identical manual work, for example, move for front and back, energy only provides with excision model, and for other actions, energy only provides with excision model, (iv) when energy is sent to distal loop, when the excision distal loop excises, solidify ring and have heat energy or a RF energy that expands to the Dutch division ring, (v) arrive two distal loops, and (vi) heat energy is passed to the resection electrode position from coag electrodes and occurs in less than in 1 millisecond time at two electric currents of synchronization.Should be appreciated that come the heat expansion of spontaneous coagulation ring to control, energy is high more, expands strong more.Energy is low more, expands weak more.Can make the RF energy spread extend to such an extent that exceed the physical location of resection electrode.

Electrode system of the present invention and resectoscope can be worked under bipolar or monopolar mode.When two electrodes are close together, and in hope those occasions that the expansion between two electrodes is limited or controls to the RF energy, double pole mode is suitable especially.Two interelectrode distances are short more, then not obvious these electrodes that extends beyond of RF energy spread.The RF energy spread to around or adjacent tissue or structure can cause not wanting through those occasions of result, this is particularly useful.

In addition, the present invention can be used for gastrointestinal endoscope surgical operation, common laparoscopically surgical operation, thoracoscopy, head and neck surgeries, orthopedics and gynecological or the like.Be used for the gastrointestinal resectoscope and can under endoscope, excise intestinal neoplasms and other infringements.Electrode system of the present invention and resectoscope excise these tumors and infringement more safely with visualization preferably and lower M ﹠ M.Can more easily finish laparoscopically infringement excisional biopsy, excision and dissection and the smooth internal of comprising of surgery (such as liver etc.), and complication is less.Head and cervical region are used and are included but not limited to oral cavity, throat, larynx, pharyngeal, hole, ear and pulmonary system.The biopsy that may be hemorrhage and the excision of infringement include but not limited to hemangioma, nasal polyp, cancer or the like, and their available the present invention finish.Endoscope's orthopedic applications includes but not limited to excise and disruptive vertebra dish, the articular cartilage of tearing, cicatrix and bony spur or the like.Gynecological operation comprises hysterectomize inner membrance ectopic lesion, tumor, lymph node or the like.

With reference now to Fig. 2 (a), 2 (b) and 2 (c),, these figure have described electrode assemblie.At the electrode assemblie far-end, comprise two electrode retaining collars, that is, resecting loop 1 encircles 2 with solidifying.That suitable electrode retaining collar geometry includes, but is not limited to is radial, circular, oval, shaped form, dome-shaped, arc, arc, camber arch shape, crescent, semicircle, malleable and rolling thing (roller) (whirler, rotator, rotation) cylinder, also comprises spin.In one embodiment, comprise a plurality of spin to form a ring, this ring has any shape of aforementioned geometry.The diameter of ring size can be 3mm (No. 9, French specification (French gauge)) to 10mm (No. 30, French specification), the perhaps virtually any size that can match with commercially availabie resectoscope (French specification 8-28 number).Cross sectional shape wiry comprises any part of circle, semicircle, circle, square, triangle, such as the combination of shapes such as hexagon, octagon, flat board and above-mentioned shape.Tinsel can comprise level or cannelure.Diameter of section wiry can be from about 0.25 to 4mm.The size of rolling thing can be from 0.25 to 4mm.The solidifying ring 2 and can be in fixed range relation of resecting loop 1.Distance between two rings can be between 1 to 6mm.Do allowing resecting loop 1 that time enough resection organization is arranged like this, and solidify ring 2 at the very near local solidified structure simultaneously of distance.Suitable spacing allows these two rings to excise effectively simultaneously and solidified structure does not interfere with each other again.

Resecting loop 1 is successive, has tinsel edge (limb) 1a and 1b.It is successive solidifying ring 2, has tinsel edge 2a and 2b.Tinsel 1a and 2a are terminated at

end cap

7 and 8 respectively, and this

end cap

7 and 8 is used for tinsel 1a and 2a are connected to the energy.Tinsel 1b and 2b be along electrode assemblie body termination blindly, there the remainder of they and electrode assemblie insulated respectively.Energy is sent to tinsel 1a to arrive resecting loop 1 by end cap 7.Energy is sent to tinsel 2a by end cap 8 and solidifies ring 2 with arrival.Electrode metal silk 1b and 2a are assembled with inner steel pipe 3 and exterior insulation cover 4 separately, and they are all encased by overcoat 5.Electrode metal silk 1a and 2b are assembled with inner steel pipe 3 and exterior insulation cover 4 similarly, and be enclosed in the overcoat 5.The thickness of insulation sleeve is in 0.001 to 0.100 inch scope.Overcoat 5 extends to variable distance along electrode assemblie, to allow that its content is had enough supports and rigidity.

Photoconduction sleeve pipe (6) is the part of electrode assemblie, and it is the optical element (conduit that comprises (but being not limited to relay lens etc.), and provide support framework for

electrode retaining collar

1 and 2, electrode metal silk 1a, 2a, 1b, 2b, steel pipe 3 and overcoat 5.Photoconduction sleeve pipe 6 can be the part of cylindrical, annular or cylinder or pipe.In addition, the photoconduction sleeve pipe can be single or many.Its scope is from 0.1mm to 30cm, that is, it can be from the proximal extension of electrode assemblie to far-end.According to the design of resectoscope, can the photoconduction sleeve pipe be contained on the overcoat 5 along the length of electrode assemblie.

Resecting loop 1 and solidify ring 2 and can make of various conductive materials, these materials include, but is not limited to tungsten, tungsten alloy, rustless steel or the like, and material is a tungsten filament preferably.Their corresponding electrode tinsel 1a, 2a, 1b and 2b can make with various conductive materials similarly.Insulated sleeve 4 can be made with dielectric substance, and these materials include, but is not limited to (i) fluoropolymer, (ii) polyimides, (iii) polyamide, (iv) poly (arylene ether) sulfone and (v) silicone material.Steel pipe 3, overcoat 5 and photoconduction sleeve pipe 6 can be made with antirust or etch-proof material (such as rustless steel etc.).

Referring now to Fig. 2 (d), to 2 (g), these figure have described resecting loop 1 in various embodiments and the sectional view that solidifies ring 2.To 2 (g), form two rings at Fig. 2 (d) by applying insulant (for example, politef, oxide, paint) selectively with different capacity level.In two embodiment, the electric current density of solidifying ring 2 is lower than the electric current density of resecting loop 1.In Fig. 2 (d), insulant is put on the contact surface that solidifies ring 2.In Fig. 2 (d), electrode size is identical, and in Fig. 2 (e), electrode is of different sizes.In Fig. 2 (e), solidify ring 2 and have bigger surface area.In Fig. 2 (f), solidify ring 2 substantially around it around applying insulant.In Fig. 2 (f), bigger size and long path are arranged.Referring now to Fig. 2 (g),,, coil increases area by being provided.

Referring now to Fig. 2 (h),, excision with solidify function combinations in single distal loop, this ring has a sharp margins of excision (it be the point of heat), and is bigger coagulation surface at opposite side.

Referring now to Fig. 3 (a), 3 (b), 3 (c), 3 (d) and 3 (e),, these figure have described another electrode assemblie.The single armed conductor rods is sent to human body to two electric currents by bar 1c and 2c by means of resection electrode 1 and coag electrodes 2 in this embodiment.Among frame in shell 10 (crimp) a, bar 1c is connected to the electrode metal silk 1a that at a distance extends and return as electrode metal silk 1b, to form resecting loop 1.In a similar fashion, in the frame 9 in shell 10, bar 2c is connected to the electrode 2a that at a distance extends and return as electrode metal silk 2b to form resecting loop 2.Electrode metal silk 1b and 2b are back into frame 9, and they stop in inside blindly there, and with the remainder insulation of electrode assemblie parts.Their form resection electrode 1 and coag electrodes 2 away from route on, every electrode metal silk is positioned at steel pipe 3 and insulant 4 separately.

On hand, bar 1c is arranged in the bar 2c of hollow, and inner core insulated sleeve 11 is arranged therebetween.External insulation casing pipe 12 covers the outside of bar 2c.Overcoat 3 surrounds external insulation thing 12 parts increases the object rigidity to allow support and counter electrode assembly.At the near-end of electrode assemblie, make bar 1c and 2c expose insulated

sleeve

11 and 12, to allow to be connected to the energy.The purpose of near-end single armed electrode assemblie is to allow it to use the resectoscope that can buy on the various markets.Insulant can be plastics or other non electrically conductive material of the acceptable any common use of medical treatment device.It also comprises locking device 10 and photoconduction sleeve pipe 6.

Referring now to Fig. 4 (a) and 4 (b),, these figure depict resectoscope.Resectoscope comprises following part: sheath cover 14, working portion 15 and visual equipment 16.These parts are worked in coordination together with electrode assemblie, constitute the resectoscope that works.In when assembling, the excision of electrode assemblie and solidify

ring

1 and 2 and be positioned at sheath mantle cavity 14a is at the far-end of prostate sheath cover 14.

Resectoscope sheath cover 14 has sheath mantle cavity 14b, and it extends to the near-end 14e of sheath cover substantially along the whole length of sheath cover from the far-end 14a of sheath cover.Near its near-end 14e place, be equipped with and flow into socket 14c and outflow socket 14d, be used for circulating fluid flushing when carrying out surgical operation.

Prostate excision working portion 15 comprises following parts: (i) thumb joystick 15a; (ii) point joystick 15b; The (iii) spring mechanism 15c between these two handles, it is used to keep these two handles separately, that is and, the electrode assemblie end is in the sheath cover; In addition, spring mechanism 15c is also manually recovering this position behind the scheduling electrode assemblie distal loop; (iv) inner socket 15d, the near-end of electrode assemblie insert this socket and fixing, and electric current connects and transmission to do; And (v) external receptacle 15e is used to insert external cable, and this cable transmits electric current from the transducer and the energy.All connections all are insulating, to avoid current sinking.Make electrode assemblie insert and pass working portion 15.

The visual equipment 16 of resectoscope comprises the near-end 16a that has eyepiece, the socket 16b that is used to adhere to light source cable, bar lens (rod lens) 16c and far-end 16d.Bar lens 16c is the entity of visual equipment 16, and extends to far-end 16d from near-end 16a.

The placement of photoconduction sleeve pipe 6 (i) the line guide rod lens counter electrode assembly of electrode assemblie and adhering to, and both are stabilized in together, (ii) maintenance and support electrode assembly pass the correct and suitable position of sheath mantle cavity 14b, and (iii) allow electrode assemblie to be parallel to the vertical shift-in of lens bar 16c in use to shift out, and in whole surgical procedures, keep this position relation.

Referring to Fig. 5 (a), resectoscope 18 is from the energy 24 received powers.The energy is started by step controller 26.The energy that is produced by the energy 24 is sent to changer 23 through cable 17, and therefrom, energy is divided into two kinds of given power levels.Splitted ratio of energy and the power level of leaving changer 23 can go up manual adjustments at its front panel 23 (a), excise simultaneously and solidify allowing.The raw mode that electric current transmits is excision and solidifies, but also can comprise other patterns, such as (i) excision excision again, (ii) solidifies resolidification, and by other combinations of the decision of the control knob on the front panel 23 (a).Cable 19 is sent splitted energy into resectoscope 18, to carry out excision simultaneously to two rings (ring 1 and 2) power supply of its electrode assemblie and to solidify.By in ring 1 and 2 or as embodiment 2 (h), in single ring, using different electric current densities, only need an energy.Changer 23 allows any basically commercially available energy to can be used for the present invention.Can buy suitable R F power supply from Valley Labs, Erbe and other suppliers.Also other energy be can use, microwave, ultrasonic, hot and other electromagnet sources included, but is not limited to.

Referring now to Fig. 5 (b),, resectoscope 18 passes through transformator/pipe guide 20 received powers from the energy 24.The energy is started by step controller 26.Transformator/pipe guide 20 comprises conductivity cell (cable) 20 (b), and it inserts power supply 24 by its proximal adapter 20c.The far-end of conductivity cell inserts resectoscope 18.Device for transformer 20 (a) is placed and is incorporated in wherein along conductivity cell.In Fig. 5 (b), device for transformer 20 (a) is located towards the far-end of transformator/pipe guide 20, but is not limited to this position.Device for transformer 20 (a) can be positioned at along the length of transformator/pipe guide 20 Anywhere.Ground mat 22 (a) places on patient's the skin, and earth cable 22 (b) is linked to each other with ground mat 22 (a).Earth cable 22 (b) has adapter 22 (c) at its near-end, and it is connected to the energy 24.Adapter 22 (c) also is connected to the adapter 20 (c) of transformator/pipe guide 20 by connection cord 21.

As shown in Figure 6, bridge circuit 30 rectified RF signal then by wave filter 31 filtering, and by manostat 32 voltage stabilizings, provide supply voltage to the control electronic circuit of two passages.Two control channels are identical.From the RF of external generator deliver to symmetrically the first and second FET devices to 40 and 40 ', they play a part the Control of Voltage power resistor.By to from current sensor 41 and 41 ' and bridge rectifier 42 and 42 ' the output sampling, and with the level ratio that presets, produce gate voltage.By six position switch 43 and 43 ' and resistor network 44 and 44 ' (being connected to the Vcc power supply) as potentiometer obtain preset level.These two level of amplifier 45 and 45 ' comparison, and by difference drive FET to

gate circuit

40 and 40 '.By isolating transformer 46 and 46 ' (they also setover first and second FET to 40 and 40 ') RF is exported to resecting loop 1 and solidifies ring 2.The capacitor of outfan provides stopping direct current to do in order to further protection patient.

Referring now to Fig. 7, cable sketch map.Only, keep power level without Electronic Control with a power supply 24.Excision or coag electrodes have a variable centre cap 52, allow optionally to divide the given power from power supply 24.In Fig. 8, cable allows the one pole remote control.Comprise a remote switch 50.The conductor of the position of switch 50 in cable reaches relay driver 51, and its main dispatching centre tap 52 is to obtain required combination.

Fig. 9 (a), 9 (b), 9 (c) and 9 (d) describe bipolar embodiment.Embodiment among Fig. 9 (a) and 9 (b) is line (pre-wired) in advance not, and the cable in Fig. 9 (b) and 9 (c) is a line in advance.Fig. 9 (a), 9 (b), 9 (c) and 9 (d) point out that even work in the monopolar mode that has ground mat, power also can be received by bipolar outfan.

The principle of the embodiment institute foundation of Fig. 7,8,9 (a), 9 (b), 9 (c) and 9 (d) is according to the ratio of each secondary windings to elementary winding, will split into two or more secondary outputs in the RF power level with given at primary place.Because in this discloses, secondary windings is delivered to the monopolar electrode of resectoscope with RF power, when by ground being connected to reference tap 21 among Fig. 5 (b) when using the bipolar output of ESG, provide a ground connection return path.

In operation, power supply 24 will be set to the power level than the big at least 5W of required maximum, so that electronic circuit is powered.Preset each passage power level separately by gauge tap.When power supply 24 power supply, each passage is provided with the power level of transmission through decay according to switch.

For purpose of description, provided the foregoing description of preferred embodiment of the present invention.Do not plan those forms of limiting the invention to disclose.Obviously, for the practitioner who is familiar with this area, many changes and variation are tangible.Therefore, scope of the present invention will be limited by following claims and equivalent thereof.

Claims

1. the electrode assemblie that resectoscope is used is characterized in that, comprising:

A) resection electrode, it has the distal loop that is used to provide first power density;

B) coag electrodes, it has the distal loop that is used to provide second power density that is lower than described first power density;

C) conductor means, it is connected to described excision and the coag electrodes and the energy, and to provide energy from the described energy to described excision and coag electrodes, wherein, when described resection electrode resection organization, described coag electrodes provides tissue coagulation simultaneously.

2. the electrode assemblie that resectoscope as claimed in claim 1 is used is characterized in that, described resection electrode distal loop has and solidifies less excision contact surface zone, contact surface zone than described coag electrodes distal loop.

3. the electrode assemblie that resectoscope as claimed in claim 1 is used is characterized in that, the above solidifies distal loop and has insulant solidifying contact surface zone.

4. the electrode assemblie that resectoscope as claimed in claim 1 is used is characterized in that, has resistive material in its surface at the described distal loop that solidifies.

5. the electrode assemblie that resectoscope as claimed in claim 1 is used is characterized in that, describedly solidifies the geometry that distal loop has provides described second power density, and described second power density is lower than described first power density of described excision distal loop.

6. the electrode assemblie that resectoscope as claimed in claim 1 is used is characterized in that, the described energy is coupled to describedly solidifies and excise distal loop, the described energy identical energy send to described each solidify and excise distal loop.

7. the electrode assemblie that resectoscope as claimed in claim 6 is used is characterized in that, described conductor means comprises two electric conductors.

8. the electrode assemblie that resectoscope as claimed in claim 7 is used is characterized in that described conductor means comprises at least two kinds of materials, and they offer described each coag electrodes distal loop and resection electrode distal loop to different electric current densities.

9. the electrode assemblie that resectoscope as claimed in claim 1 is used is characterized in that, described coag electrodes is providing tissue coagulation within the second after the described resection electrode resection organization.

10. a resectoscope is characterized in that, comprising:

A) sheath cover, it comprises sheath mantle cavity, far-end and near-end;

B) electrode assemblie comprises:

Resection electrode, it has the geometry of distal loop, is used to provide first power density;

Coag electrodes, it has distal loop, is used to provide second power density that is lower than described first power density, and when described resection electrode distal loop resection organization, described coag electrodes distal loop can solidify described tissue simultaneously;

C) be attached to the working portion that described sheath overlaps near-end; And

D) visual equipment, it is contained in described sheath cover intracavity, the near-end from described sheath cover remote extension to working portion.

11. resectoscope as claimed in claim 10 is characterized in that, described resection electrode distal loop have than described solidify distal loop solidify little excision contact surface zone, contact surface zone.

12. resectoscope as claimed in claim 11 is characterized in that, solidifies on the contact surface zone described, the described distal loop that solidifies has insulant.

13. resectoscope as claimed in claim 10 is characterized in that, the described distal loop that solidifies has resistive material in its surface.

14. resectoscope as claimed in claim 10 is characterized in that, describedly solidifies the geometry that distal loop has provides described second power density, described second power density is lower than described first power density of described excision distal loop.

15. resectoscope as claimed in claim 13 is characterized in that, also comprises:

Power source, it is coupled to describedly solidifies and excises distal loop, wherein, described power source is connected to each describedly solidifies and excise distal loop.

16. resectoscope as claimed in claim 15 is characterized in that, also comprises: the energy transfer equipment, it is coupled to described power source and describedly solidifies and excise distal loop.

17. resectoscope as claimed in claim 16 is characterized in that, described energy transfer equipment comprises at least one electric conductor.

18. resectoscope as claimed in claim 17 is characterized in that, described energy transfer equipment is made by at least two kinds of materials, and described two kinds of materials provide different electric current density describedly to solidify and excise distal loop to each.

19. resectoscope as claimed in claim 16 is characterized in that, described energy transfer equipment comprises two electric conductors.

20. resectoscope as claimed in claim 19 is characterized in that, described two electric conductors are made by different materials.

21. resectoscope as claimed in claim 19 is characterized in that, described energy transfer equipment also comprises the device of conversion from the power of external power source, power put on described resecting loop and to solidify ring.

22. resectoscope as claimed in claim 21 is characterized in that, the described device that is used for transform power comprises the one pole adjustable transformer, is used to change be sent to described resecting loop and the described ratio that solidifies the electric rate of ring.

23. resectoscope as claimed in claim 21 is characterized in that, the described device that is used for transform power comprises bipolar elementary winding.

24. resectoscope as claimed in claim 10 is characterized in that, described resection electrode far-end and coag electrodes far-end are mutually fixed relationship.

25. resectoscope as claimed in claim 10 is characterized in that, described visual equipment is the endoscope assembly that has optical element.

26. resectoscope as claimed in claim 25 is characterized in that, described endoscope assembly comprises optical fiber.

27. resectoscope as claimed in claim 10 is characterized in that, the near-end of described visual equipment comprises magnification eyepiece.

28. the electrode assemblie that resectoscope is used is characterized in that, comprising:

A) single excision and coag electrodes have a distal loop, cut-out and one and solidify part, and wherein, described cut-out provides first electric current density and the described part of solidifying provides second electric current density that is lower than described first electric current density; And

B) conductor means, it is connected to excision and the coag electrodes and the energy, and so that the energy from the energy is offered excision and coag electrodes, wherein, excision and coag electrodes provide excision simultaneously and solidify.

29. the electrode assemblie that resectoscope as claimed in claim 28 is used is characterized in that, described cut-out has the little removal surface zone, coagulation surface zone of solidifying part than described.

30. the electrode assemblie that resectoscope as claimed in claim 29 is used is characterized in that, the described part of solidifying has such geometry, and the power density that it provides is lower than the power density of described cut-out.

31. a resectoscope is characterized in that, comprising:

The sheath cover;

Endoscope, it has eyepiece at the near-end of described resectoscope in described sheath cover;

Electrode assemblie, it is in described sheath cover, and it comprises that a resecting loop and one solidifies ring at the far-end of described resectoscope, is used for resection organization and solidified structure simultaneously, and the power density that described resecting loop provides is solidified the power density that ring provides greater than described;

Conductor means extends through described sheath cover, is used for described electrode assemblie is connected to external power source; And

Handleset, it is coupled to described electrode assemblie at the described near-end of described resectoscope, is used for moving described electrode assemblie at described sheath cover.

32. resectoscope as claimed in claim 31 is characterized in that, described conductor means comprises and is used for the device of conversion from external power source power, is used for to described resecting loop and describedly solidifies circulating application and add power.

33. resectoscope as claimed in claim 32 is characterized in that, the described device that is used for conversion comprises the one pole adjustable transformer, is used to change deliver to described resecting loop and the described ratio that solidifies the power of ring.

34. resectoscope as claimed in claim 32 is characterized in that, the described device that is used for conversion comprises bipolar elementary winding.

35. the excision and the method for solidified structure simultaneously comprise the steps:

A) provide the electrode assemblie that comprises resecting loop and solidify ring;

B) energize to described electrode assemblie, thereby described resecting loop has first power density, and the described ring that solidifies has second power density, described second power density is less than described first power density;

C) move described resecting loop and the described ring that solidifies through tissue, thus described excision and solidify ring and excise simultaneously and solidify described tissue.

36. method as claimed in claim 35 is characterized in that, when also being included in step c) described tissue is applied the step of liquid wash.

37. method as claimed in claim 35 is characterized in that, power supply directly is applied to described resection electrode and described coag electrodes, determines first power density and second power density by electrode structure.

38. method as claimed in claim 35 is characterized in that, power supply is coupled to described resection electrode and described coag electrodes by device for transformer.

39. method as claimed in claim 35 is characterized in that, in by a described about second of solidifying the ring solidified structure, by described resecting loop resection organization.