ELECTROSURGICAL INSTRUMENT WITH SUCTION, IRRIGATION AND MEANS TO COLLECT BLOOD

Electrosurgical Instrument with Suction. Irrigation and

Means to collect blood-

Background of the invention:

Electrosurgical instruments with suction and irrigation properties has been described;

However, means to enable bending of the suction tube alongside with the electrode

without kinking of the suction tube has not. Bending of the electrode (usually blade-

electrode) is needed when operating on hidden areas, where direct straight approach

with the electrode is impossible. Such is the case, when the internal mammary

arteries are being developed to be used for coronary bypass operation. The surgeon

then bends the electrode to facilitate the approach to the developed arteries.

One purpose of the following invention is to provide the surgeon with an instrument

with means to enable bending of the electrode and its surrounding suction tube

(without kinking of the tube), thus enabling efficient suction-evacuation of the

smoke, blood and debris along the way of the developed structure, and consequently

enabling appropriate visualization of the "hidden" (covert) surgical field.

Existing electrosurgical instruments with suction lack the property of versatility in

determining the distance between the tip of the electrode and the orifice of the

surrounding suction tube. The distance is too large to enable the efficient and

simultaneous suction of the blood and coagulation of the cut-open blood vessel (small and medium sizes). A prominent example is, when the implant-pouch for

Augmentation Mammoplasty (also known as breast augmentation) is being prepared;

Various-size bleeders deep in the pouch have to be coagulated in order to "dry" the

pouch before the breast implant could be inserted. To enable the speedy coagulation

of these bleeders, the distance between the active tip (portion) of the electrode and the

surrounding orifice of the suction tube has to be sufficiently small, or else no

simultaneous coagulation and suction could take place. Therefore, other purpose of

this invention is to provide an electro-surgical-suction instrument with the

characteristics of having means (two in the following description) of changing the

size of the distance between the tip of the electrode and the surrounding orifice of the

tube at the will of the surgeon.

Disclosure:

Brief description of the drawings of the invention:

Fig. 1: General view of the electrosurgical-suction-irrigation instrument with isotonic

fluid (with anticoagulant) supply, a chamber for separation of fluid from gas (air), a

vacuum source, the electrosurgical hand-piece, and the two disengaged members of

the suction tube surrounding the electrode .

Fig.2: Screwed (engaged) members of the suction tube surrounding the fixed

electrode of the electrosurgical instrument. Fig.3: One embodiment of the electrode with wings for fixating the electrode within

the distal member of the suction tube.

Fig.4: Cross-section of the electrode disposed within the suction tube in an eccentric

positioning, in relation to the surrounding distal member of the suction tube. The

eccentric positioning of the electrode is achieved by means of the asymmetric wings.

Fig. 5: Cross-section of the electrode disposed within the suction tube in a centric

positioning, in relation to the surrounding distal member of the suction tube. The

central positioning is achieved by means of symmetrical wings extending peripherally

from the isolated part of the electrode.

Fig.5a: Wings extending centrally toward the electrode from the wall of the distal

member of the suction tube, close to the orifice of said tube, and said wings unite and

merge into a ring around the electrode, whereas the electrode becomes disposed

loosely within said ring.

Please refer to the above figures.

Fig 1 includes the electrosurgical instrument having a conventional plastic handle 1,

electric compartment 2, coagulation knob 3, cutting knob 4, suction tube 5 and irrigation - with isotonic fluid (with anticoagulant) - tube 6. The suction tube 5 is

connected to a closed chamber 7 under a fluid level 8. The closed chamber traps

blood and debris in its fluid lower part 9, and connects to a vacuum source through its

upper (air-filled) part by means of tube 11. This Configuration allows the separation

of blood and debris from air, which come mixed in suction tube 5. The non-gaseous

portion of the mixture sinks to the bottom of the chamber 9, thus protecting the

vacuum machine 10 from fluid and keeps it dry.

The blood and the anticoagulant can then be re-infiised to the patient (in case of

significant amount of bleeding!).

The irrigation tube 6 is connected to the bag of isotonic fluid 12 (isotonic-to preserve

the blood cells). Both the suction tube 5 and the irrigation tube 6 have means to

control the rate of flow- 13 and 14 respectively in Fig.1. The irrigation tube 6 is

attached to the suction tube 5 and to the handle 1 at several points.

The distal part of the suction tube 5 has two members: proximal 15 and distal 16. The

distal 16 screws into and engages the proximal part 15 by means of wide spiral screw.

The entering distal part is described as the "spiral representation" 17 and the

receiving internal screw in the proximal member is represented by the tiny small lines

t8 (as it would show if the proximal tube was cut longitudinally- note the relatively

large intervals between the small lines representing the receiving wide spiral).

The distal tube 16 has a segment 19, which is made of a plastic "accordion"

arrangement of the tube (like the bendable portion of a drinking straw). This "accordion" 19 enables to elongate or shorten the distal tube in relation to the

electrode 20, thus determining the distance between the tip of the electrode 21 and the

orifice 22 of the distal part of the suction tube 16.

The accordion segment 19 could also enable (plastic) to bend the distal part 16

simultaneously with the bending of the electrode 20 without kinking of the suction

tube.

The wide spiral screw (17 into 18) also enables to determine the distance between tip

21 of the electrode and orifice 22 of the suction tube. Fig. 1 shows the two members

of the suction tube disengaged; they could be screwed partially (small interval or

portion only!), thus resulting in a small distance between tip 21 and orifice 22 (as

shown in Fig. 1). In Fig. 2 the two members are fully engaged (screwed), resulting in

large distance between tip 21 and orifice 22.

The "accordion" structure could also serve to determine the distance between tip 21

and orifice 22 by simply pulling (widening or elongating) or "squeezing" (shortening)

of the "accordion" segment 19 of the distal part section 16 of the suction tube.

Fig. 3 describes the electrode 20 (the distal part of the suction tube was removed in

this figure for clarity). The electrode has wings 23 attached to it, either

asymmetrically as in Fig.4, or symmetrically as in Fig. 5. The wings in this

embodiment are not attached to the suction tube 16, but rather the edge of the wings

spans centrifugally close to the wall of the suction tube 16. The wings enable to fixate

the electrode in a fixed position within and in relation to the surrounding suction tube. Another embodiment of this feature is wings attached to the walls of the suction tube

and extending from those walls towards the center of the hollow part of the tube, and

ending in a ring formation around the electrode- Fig 5a; thus the electrode is disposed

loosely within that ring (Fig 2 hints this embodiment). These arrangements allow

both: sliding of the tube in relation to the electrode, and fixation of the electrode

(from moving sideways) within the hollow part (lumen) of the tube.

Mode of operation:

The instrument is used to cut tissue and coagulate bleeding blood vessels. The suction

is utilized to evacuate smoke, blood and debris. The bag 12 has isotonic fluid with

anticoagulant and the rate of flow is controlled by means 14 (in the form of metal clip

in this case). By pressing (with the clip) on tube 6 at various degrees of pressure, one

gets various degrees (rates) of flow. The fluid with the anticoagulant mixes with the

blood near orifice 22, thus preventing the blood from coagulating (clotting) and

consequently preserves it for reuse in the patient- (coagulated blood cannot be used

for infusion!!).

The suction tube 5 conveys the mixture of anticoagulant fluid, blood, smoke and air

to the closed separation-chamber 7. The mixture enters the lower part, which is filled

of isotonic fluid, at point 24. The blood and the fluid remain in the bottom, while the

gaseous components are sucked through entrance 25, which is disposed in the air part of the chamber (upper part), and are evacuated by the vacuum machine 10 through

tube 11. This chamber serves both as a blood collector and gas/fluid separator, and

protects the vacuum machine from getting wet by blood or fluid, which are kept in

the bottom of the chamber by gravitation.

The mode of activation of the distal parts of the suction tube 15 and 16 is as follows:

when the surgeon prefers to have a long part of the electrode 20 exposed out of the

suction tube he simply screws part 16 into part 15, and/or squeezes the accordion

segment 19 of the distal suction tube 16 (this configuration-position is described in

Fig.2). If the surgeon wants to coagulate cut-open blood vessels and simultaneously

suck the blood and debris, then he could "open" the accordion- meaning, having the

accordion segment 19 longer, and/or unscrew part 16 from part 15 in the out-direction

(without separating completely part 16 from part 15! !); consequently the suction tube

would be longer, and the length of the electrode 20, that is exposed (or bulging) out

of the tube, would be Shorter (like the case represented in Fig. 1). The surgeon can

play with these two characteristics to achieve the optimal positioning for him. The

"accordion"-segment-structure also enables bending without kinking of that segment

of tube 16 (Idnking would block the suction tube! ! !- namely no blood or smoke

Would be evacuated).

The wings of the electrode in Fig. 3, 4, 5 or the wings of the suction tube in Fig.2 and

5a, enables the fixation of the electrode in relation to the walls of the suction tube, thus preventing the free movement to the sideways, while allowing the longitudinal

movement of the distal, suction tube relative to the electrode.

Various sizes of distal-tube-part 16 could be used together with various sizes of

fitting electrodes for the various needs of various operations (surgical procedures).