Instrument and method employing snare electrode windable about rotatable spool for minimally invasive electrosurgical resection

• US 6,346,106 B1
• Filed: 08/23/1999
• Issued: 02/12/2002
• Est. Priority Date: 08/23/1999
• Status: Expired due to Fees

• Current Assignee: Geza J. Jako
• Original Assignee: Geza J. Jako
• Inventors: Jako, Geza J
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US09/379,084
• Time in Patent Office: 904 Days
• Field of Search: 606/41, 606/45-49
• US Class Current: 606/47
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 2017/4216 Operations on uterus, e.g. endometrium
• CPC Class Codes: A61B 2018/1407 Loop

Abstract

A surgical instrument includes a body, a snare electrode, a spool and an electrical connector. A distal part of the body includes a passageway extending axially therethrough. The snare electrode is adapted to telescope in the passageway. The distal part of the body has an outward surface electrically insulated from the snare electrode. A second portion of the snare electrode is extendable from a second port of the passageway for forming a loop sized to be placed over tissue (e.g., portion(s) of the uterus and/or kidney(s), spleen, pancreas, gallbladder, remnant from the liver, and/or vascular aneurysm) to be removed from a patient. The spool is rotatably supported in a proximal part of the body. A first portion of the snare electrode is windable about the spool. A rotation of the spool in a winding direction causes retraction of the first portion of the snare electrode from a first port of the passageway, thereby closing the loop to engage the tissue. The electrical connector is for allowing the snare electrode to be coupled to an electrical source. An electrical current is passed from the electrical source to the loop to cauterize the tissue.

Claims

1. A surgical instrument, comprising:

a body having proximal and distal parts, said distal part including a passageway extending axially therethrough, said passageway having first and second ports;

with slots;

a snare electrode adapted to telescope in said passageway, said distal part having an outward surface electrically insulated from said snare electrode;

said snare electrode including first and second portions, said second portion being extendable from said second port for forming a loop sized to be placed over tissue to be removed from a patient;

a spool rotatably supported in said proximal part with port, said first portion of said snare electrode being windable about said spool, wherein a rotation of said spool in a winding direction causes retraction of said first portion of said snare electrode from said first port, thereby closing

said loop to engage said tissue; and

an electrical connector connecting said snare electrode to be coupled to an electrical source, wherein an electrical current is passed from said electrical source to said loop to cauterize said tissue.

2. The instrument of claim 1, wherein an outward surface of said proximal part is at least one of electrically insulated from said snare electrode and adapted for handling.

3. The instrument of claim 1, further comprising a driver adapted for engagement with said spool, wherein said driver can motivate rotation of said spool.

4. The instrument of claim 3, wherein said driver allows user switching among operating modes, wherein said operating modes include at least one of first and second selections, wherein said first selection allows winding of a section of said snare electrode about said spool for closing said loop to engage said tissue, wherein said second selection allows unwinding of a section of said snare electrode from said spool for at least one of placing said loop over said tissue and relocating said loop.

5. The instrument of claim 3, wherein said proximal part at least one of includes and is removably engaged with said driver.

6. The instrument of claim 3, wherein said driver is adapted to be coupled with a power source, and wherein said power source includes at least one of an electrical source, a battery, and physical input.

7. The instrument of claim 3, wherein said driver includes at least one of a electromechanical driver and a manual winding mechanism, wherein said manual winding mechanism comprises said proximal part.

8. The instrument of claim 3, further comprising a casing for said driver, wherein said casing includes at least one of an outward surface electrically insulated from said snare electrode and a handle.

9. The instrument of claim 3, wherein said spool includes at least one of a socket and a slot for receiving a shaft of said driver.

10. The instrument of claim 1, wherein at least one of said proximal and distal parts includes an autoclavable portion.

11. The instrument of claim 1, wherein at least one of said proximal and distal parts includes a disposable portion.

12. The instrument of claim 1, wherein said snare electrode includes at least one of solid wire, braided wire, and fine line cutting wire.

13. The instrument of claim 1 in combination with said electrical source, wherein said electrical source allows a selection of at least one electrical frequency for at least one of a cauterization of said tissue and a coagulation of blood vessels of said patient.

14. An instrument of claim 1 having proximal port for aspiration of smoke or insufflation of gases.

15. The instrument of claim 1 in combination with a companion electrode selectively coupled to said electrical source and adapted to be coupled to said patient.

16. The instrument of claim 15, wherein said companion electrode is removably attachable to at least one of a shield and a cap.

17. The instrument of claim 1, wherein a portion of said spool is at least one of slidably engaged with and frictionally engaged with a sidewall of said proximal part.

18. The instrument of claim 1, wherein said distal part includes a tube, wherein said tube forms said passageway, and wherein said distal part is formed with non-conductive material.

19. The instrument of claim 18, wherein said tube includes an opening for at least one of accessing, adjusting, and severing said snare electrode.

20. The instrument of claim 17, wherein said tube includes slots for aspiration of smoke.

32. The instrument of claim 19, wherein said snare electrode includes at least one of solid wire, braided wire, and fine line cutting wire.

21. A surgical instrument, comprising:

a body having proximal and distal parts, said distal part including a passageway extending axially therethrough, said passageway having first and second ports;

a snare electrode adapted to telescope in said passageway, said distal part having an outward surface electrically insulated from said snare electrode;

said snare electrode including first and second portions, said second portion being extendable from said second port for forming a loop sized to be placed over a resection portion of a uterus, wherein said resection portion is to be is removed from a patient;

a spool rotatably supported in said proximal part, said first portion of said snare electrode being windable about said spool, wherein a rotation of said spool in a winding direction causes retraction of said first portion of said snare electrode from said first port, thereby closing said loop to engage said resection portion of said uterus; and

an electrical connector connecting said snare electrode to be coupled to an electrical source, wherein an electrical current is passed from said electrical source to said loop to cauterize said resection portion of said uterus.

22. The instrument of claim 21, wherein an outward surface of said proximal part is at least one of electrically insulated from said snare electrode and adapted for handling.

23. The instrument of claim 21, further comprising a driver adapted for engagement with said spool, wherein said driver can motivate rotation of said spool.

24. The instrument of claim 23, wherein said driver allows user switching among operating modes, wherein said operating modes include at least one of first and second selections, wherein said first selection allows winding of a section of said snare electrode about said spool for closing said loop to engage said resection portion, wherein said second selection allows unwinding of a section of said snare electrode from said spool for at least one of placing said loop over said resection portion and relocating said loop.

25. The instrument of claim 23, wherein said proximal part at least one of includes and is removably engaged with said driver.

26. The instrument of claim 23, wherein said driver is adapted to be coupled with a power source, and wherein said power source includes at least one of an electrical source, a battery, and physical input.

27. The instrument of claim 23, wherein said driver includes at least one of a electromechanical driver and a manual winding mechanism, wherein said manual winding mechanism comprises said proximal part.

28. The instrument of claim 23, further comprising a casing for said driver, wherein said casing includes at least one of an outward surface electrically insulated from said snare electrode and a handle.

29. The instrument of claim 23, wherein said spool includes at least one of a socket and a slot for receiving a shaft of said driver.

30. The instrument of claim 21, wherein at least one of said proximal and distal parts includes an autoclavable portion.

31. The instrument of claim 21, wherein at least one of said proximal and distal parts includes a disposable portion.

33. The instrument of claim 21 in combination with said electrical source, wherein said electrical source allows a selection of at least one electrical frequency for at least one of a cauterization of said resection portion and a coagulation of blood vessels of said patient.

34. The instrument of claim 21 in combination with a companion electrode selectively coupled to said electrical source and to said patient.

35. The instrument of claim 21, wherein said companion electrode is removably attachable to at least one of a shield and a cap.

36. The instrument of claim 21, wherein a portion of said spool is at least one of slidably engaged with and frictionally engaged with a sidewall of said proximal part.

37. The instrument of claim 21, wherein said distal part includes a tube, wherein said tube forms said passageway, and wherein said distal part is formed with non-conductive material.

38. The instrument of claim 37, wherein said tube includes an opening for at least one of accessing, adjusting, and severing said snare electrode.

39. A method of effecting electrosurgical resection, said method comprising:

selecting a snare electrode having first and second portions;

selecting a body having proximal and distal parts, said distal part including a passageway extending axially therethrough, said passageway having first and second ports;

telescoping said snare electrode in said passageway and extending said second portion of said snare electrode from said second port in order to form a loop, said first portion of said snare electrode being wound about a spool rotatably supported in said proximal part;

sizing said loop for placement around a resection portion of an organ, wherein said resection portion is to be removed from a patient;

rotating said spool in a winding direction to retract said first portion of said snare electrode away from said first port, to close said loop and engage said resection portion of said organ; and

passing an electrical current from an electrical source to said loop to cauterize said resection portion of said organ.

40. The method of claim 39, further comprising:

inserting first and second blades into an incision of said patient; and

spreading said first and second blades to form an operating window at said incision, wherein said spreading allows said distal part to be disposed in said operating window.

41. The method of claim 39, wherein at least one of said rotating and said passing serves to coagulate blood vessels of said patient.

42. The method of claim 39, wherein said rotating allows user switching among operating modes, wherein said operating modes include at least one of first and second selections, wherein said first selection allows winding of a section of said snare electrode about said spool for closing said loop to engage said organ, wherein said second selection allows unwinding of a section of said snare electrode from said spool for at least one of placing said loop around said organ and relocating said loop.

43. The method of claim 39, wherein said organ comprises at least one of a uterus, gallbladder, liver and blood vessel growth and tonsil.