Endoscopic surgical instrument

• US 5,562,703 A
• Filed: 06/14/1994
• Issued: 10/08/1996
• Est. Priority Date: 06/14/1994
• Status: Expired due to Fees

• Current Assignee: Ashvin H. Desai
• Original Assignee: Ashvin H. Desai
• Inventors: Desai, Ashvin H.
• Primary Examiner(s): Brown, Michael A.
• Application Number:
  US08/259,712
• Time in Patent Office: 847 Days
• Field of Search: 606/21, 606/27, 606/30, 606/32, 606/33, 606/34, 606/35, 606/167, 606/249, 606/902, 604/39, 604/40, 604/41, 604/45, 604/46
• US Class Current: 606/210
• CPC Class Codes: A61B 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/149 bow shaped or with rotatable body at cantilever end, e.g. for resectoscopes, or coagulating rollers
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2018/0091 Handpieces of the surgical instrument or device
• CPC Class Codes: A61B 2018/00916 with means for switching or controlling the main function of the instrument or device
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1253 monopolar
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration
• CPC Class Codes: A61M 1/772 operating alternately
• CPC Class Codes: A61M 1/774 Handpieces specially adapted for providing suction as well as irrigation, either simultaneously or independently
• CPC Class Codes: A61N 5/0601 Apparatus for use inside the body
• CPC Class Codes: A61N 5/062 Photodynamic therapy, i.e. excitation of an agent

Abstract

An endoscopic surgical instrument includes a housing, single access conduit formed in the housing, an irrigation port and an evacuation port, each port being connected through independent valves to the single access conduit. The single access conduit has a first end and a second end which is terminated in an aperture formed in the housing. A closure is provided for the aperture. A viewing device, such as an endoscope, is insertable through the aperture and the single access conduit, and is extended slightly beyond the first end. An electrode assembly having two or more retractable RF electrodes spaced a predetermined distance and angle apart, is also insertable through the aperture and the single access conduit, and is extendable beyond the first end. Each RF electrode is in electrical communication with a means for supplying R.F. energy and for continuously measuring impedance across the electrodes. Also, each RF electrode is extendable beyond and completely retractable into a guiding sheath. Each RF electrode is extendable beyond its guiding sheath by a predetermined length. Also, each RF electrode may be extended in such a manner to form a predetermined angular value with the longitudinal centerline of the single access conduit.

Claims

1. An endoscopic surgical instrument comprising:

a) housing;

b) a single access conduit being disposed within said housing, and having a proximal end and a distal end;

c) an irrigation port formed in said housing;

d) an evacuation port formed in said housing, each of said irrigation and said evacuation ports being in fluid communication, through independent valves, with said proximal end of said single access conduit;

e) an aperture and a closure therefor, said aperture being formed in said housing, and said closure being openable to allow the ingress of microsurgical instrumentation into said proximal end of said single access conduit; and

f) RF electrode means insertable into said aperture and into said single access conduit and having a length so as to protrude beyond said distal end of said single access conduit, said RF electrode means for engaging a body tissue portion, and for simultaneously ablating said body tissue portion and measuring an impedance value associated with said body tissue portion, said RF electrode means including

i) a first RF electrode having a distal end and a proximal end, said first RF electrode being disposed within an insulating sheath;

ii) elongated guide means encasing said first RF electrode and said insulating sheath, for guiding said first RF electrode to a predetermined angle value from the longitudinal axis of said single access conduit;

iii) electrode movement mechanism means, attached to said proximal end of said first RF electrode, for moving said first RF electrode within said guide means, said distal end of said first RF electrode is extendable beyond an open end of said guide means up to a predetermined length value and engagable with and insertable into said body tissue portion;

iv) energy source means, in electrical communication with said proximal end of said first RF electrode, for transmitting energy into said distal end of said first RF electrode when it is extended beyond said guide means and into said body tissue portion to ablate said body tissue portion; and

v) tissue impedance measurement means, in electrical communication with said proximal end of said first RF electrode, for measuring an impedance associated with said body tissue portion engaged with said distal end of said first RF electrode when it is extended beyond said guide means.

2. An endoscopic surgical instrument as recited in claim 1 which further includes:

a) at least one other second RF electrode having a distal end and a proximal end, said second RF electrode being disposed within a second insulating sheath;

b) elongated second guide means encasing said second RF electrode and said second insulating sheath, for guiding said second RF electrode into a second predetermined angle value from the longitudinal axis of said single access conduit said second RF electrode separated from said first RF electrode by a predetermined width value;

c) said proximal end of said second RF electrode is attached to said electrode movement mechanism means, and said distal end of said second RF electrode is extendable beyond an open end of said second guide means up to a second predetermined length value so as to be engagable with and insertable into said body tissue portion;

d) said distal end of said second RF electrode is in electrical communication with said energy source means and said tissue impedance measurement means; and

e) whereby said electrode movement mechanism means moves each of said first RF and said second RF electrodes within each of associated guide means, and said distal ends of each of said first RF electrode and said second RF electrode is extendable beyond and retractable within each of said associated guide means, and when each of said distal ends of each RF electrode is extended beyond said associated guide means said energy source means is energized to pass electrical current from one RF electrode to the other and said tissue impedance measurement means measures the impedance of tissue engaged between each of said distal ends of each RF electrode.

3. An endoscopic surgical instrument as recited in claim 2, wherein:

a) said predetermined angle value is greater than 0 degrees and is less than 360 degrees;

b) said second predetermined angle value is greater than 0 degrees and is less than 360 degrees;

c) said predetermined length value is greater than 0 cm and is less than 3 cm;

d) said second predetermined length value is greater than 0 cm and is less than 3 cm; and

e) said predetermined width value is greater than 0.1 cm and is less than 2.0 cm.

4. An endoscopic surgical instrument as recited in claim 2, wherein:

a) said predetermined angle value is equal to said second predetermined angle value; and

b) said predetermined length value is equal to said second predetermined depth value.

5. An endoscopic surgical instrument as recited in claim 2, further including:

a) means for bending each of said guide means for each of said first RF electrode and said second RF electrode to vary each of said predetermined and said second predetermined angle values.

6. An endoscopic surgical instrument as recited in claim 1, further including:

a) means for bending said guide means to vary said predetermined angle value.

7. An endoscopic surgical instrument as recited in claim 6, wherein

a) said guide means includes a bendable bellows portion disposed at a distal end of said guide means;

b) said bending means includes

i) a lever attached to said housing;

ii) a guide disposed within said guide means and having a first end attached to said bellows portion of said guide means; and

c) whereby actuating said lever tensions said guide wire and varies said predetermined angle value.

8. An endoscopic surgical instrument as recited in claim 6, wherein

a) each of said guide means for each said first and said second RF electrodes includes a bendable bellows portion disposed at a distal end of each of said guide means;

b) each of said bending means for each of said guide means includes

i) a lever attached to said housing;

ii) a guide wire disposed within each of said guide means and having a first end attached to each said bellows portion of each of said guide means; and

c) whereby actuating said lever tensions each of said guide wires and varies each of said predetermined and said second predetermined angle value.

9. A retractable RF electrode assembly for ablating and measuring the impedance of a body tissue portion, comprising:

a) a first RF electrode having a distal end and a proximal end, said first RF electrode being disposed within an insulating sheath;

b) elongated guide means encasing said first RF electrode and said insulating sheath, for guiding said first RF electrode into a predetermined angle value from the longitudinal axis of said single access conduit;

c) electrode movement mechanism means, attached to said proximal end of said first RF electrode, for moving said first RF electrode within said guide means, said distal end of said first RF electrode is extendable beyond and open end of said guide means up to a predetermined length value and engagable with and insertable into said body tissue portion;

d) energy source means, in electrical communication with said proximal end of said first RF electrode, for transmitting energy into said distal end of said first RF electrode when it is extended beyond said guide means and into said body tissue portion so as to ablate said body tissue portion; and

e) tissue impedance measurement means, in electrical communication with said proximal end of said first RF electrode, for measuring an impedance associated with said body tissue portion engaged with said distal end of said first RF electrode when it is extended beyond said guide means.

10. A retractable RF electrode assembly as recited in claim 9 which further includes:

a) at least one other second RF electrode having a distal end and a proximal end, said second RF electrode being disposed within a second insulating sheath;

b) elongated second guide means encasing said second RF electrode and said second insulating sheath, for guiding said second RF electrode into a second predetermined angle value from the longitudinal axis of said single access conduit, said second RF electrode separated from said first RF electrode by a predetermined width value;

c) said proximal end of said second RF electrode is attached to said electrode movement mechanism means, and said distal end of said second RF electrode is extendable beyond an open end of said second guide means up to a second predetermined length value so as to be engagable with and insertable into said body tissue portion;

d) said proximal end of said second RF electrode is in electrical communication with said energy source means and said tissue impedance measurement means; and

e) whereby said electrode movement mechanism means moves each of said first RF and said second RF electrodes within each of associated guide means, and said distal ends of each of said first RF electrode and said second RF electrode is extendable beyond and retractable within each of said associated guide means, and when each of said distal ends of each RF electrode is extended beyond said associated guide means said energy source means is energized to pass electrical current form one RF electrode to the other and said tissue impedance measurement means measures the impedance of tissue engaged between each of said distal ends of each RF electrode.

11. A retractable RF electrode assembly as recited in claim 10, wherein:

a) said predetermined angle value is greater than 0 degrees and is less than 360 degrees;

b) said second predetermined angle value is greater than 0 degrees and is less than 360 degrees;

c) said predetermined length value is greater than 0 cm and is less than 3 cm;

d) said second predetermined length value is greater than 0 cm and is less than 3 cm; and

e) said predetermined width value is greater than 0.1 cm and is less than 2.0 cm.

12. A retractable RF electrode assembly as recited in claim 11, wherein:

a) said predetermined angle value is equal to said second predetermined angle value; and

b) said predetermined length value is equal to said second predetermined depth value.

13. A retractable RF electrode assembly as recited in claim 9, further including:

a) means for bending said guide means to vary said predetermined angle value.

14. A retractable RF electrode assembly as recited in claim 13, wherein

a) said guide means includes a bendable bellows portion disposed at a distal end of said guide means;

b) said bending means includes

i) a lever attached to said housing;

ii) a guide wire disposed within said guide means and having a first end attached to said bellows portion of said guide means; and

c) whereby actuating said lever tensions said guide wire and varies said predetermined angle value.

15. A retractable RF electrode assembly as recited in claim 10, further including:

a) means for bending each of said guide means for each of said first RF electrode and said second RF electrode to vary each of said predetermined and said second predetermined angle values.

16. A retractable RF electrode assembly as recited in claim 15, wherein

a) each of said guide means for each said first and said second RF electrodes includes a bendable bellows portion disposed at a distal end of each of said guide means;

b) each of said bending means for each of said guide means includes

i) a lever attached to said housing;

ii) a guide wire disposed within each of said guide means and having a first end attached to each said bellows portion of each of said guide means; and

c) whereby actuating said lever tensions each of said guide wires and varies each of said predetermined and said second predetermined angle value.