JP7599673B2

JP7599673B2 - Laparoscopic electrosurgical device

Info

Publication number: JP7599673B2
Application number: JP2019211046A
Authority: JP
Inventors: コスメスクイアン
Original assignee: アイ．シー．メディカル，インコーポレイテッド
Priority date: 2019-11-22
Filing date: 2019-11-22
Publication date: 2024-12-16
Anticipated expiration: 2039-11-22
Also published as: JP2025024233A; JP2021078982A

Description

本発明は一般に、腹腔鏡検査中の電気外科的切断および凝固用の腹腔鏡超極性電気外科用装置を対象とする。腹腔鏡超極性電気外科用装置は、ハンドピース部材と、導電性中空筒状部材であって、第１および第２の端部ならびに第１の導電性端部を越えて延びる導電性付加物を備える導電性中空筒状部材を有する、リターン電極と、ハンドピース部材内に収容され、リターン電極の導電性中空筒状部材の内部内に吊設されたアクティブ電極であって、アクティブ電極の一部がリターン電極の導電性中空筒状部材の第１の端部を越えて延びて、リターン電極の導電性付加物とリターン電極の導電性中空筒状部材の第１の端部を越えて延びるアクティブ電極の一部との間にオープンスペースを作成する、アクティブ電極と、ハンドピース部材内に収容され、アクティブ電極と連通して、装置が切断および／または凝固のために作動されるとアクティブ電極をリターン電極の導電性付加物に向かって動かすアクチュエータとを含む。 The present invention is generally directed to a laparoscopic hyperpolar electrosurgical device for electrosurgical cutting and coagulation during laparoscopy. The laparoscopic hyperpolar electrosurgical device includes a handpiece member, a conductive hollow tubular member having a first and second end and a conductive appendage extending beyond the first conductive end, an active electrode housed within the handpiece member and suspended within the interior of the conductive hollow tubular member of the return electrode, a portion of the active electrode extending beyond the first end of the conductive hollow tubular member of the return electrode to create an open space between the conductive appendage of the return electrode and the portion of the active electrode extending beyond the first end of the conductive hollow tubular member of the return electrode, and an actuator housed within the handpiece member and in communication with the active electrode to move the active electrode toward the conductive appendage of the return electrode when the device is actuated for cutting and/or coagulation.

腹腔鏡手術は、ビデオカメラの助けを借りて小さな切開を通して外科的処置が行われる低侵襲手術である。トロカールまたはカニューレが小さな切開に設置され、次いで、患者の内部にアクセスするためにカメラおよび他の器具がトロカールまたはカニューレ内に導入される。胃腸手術、婦人科手術などの多くの種類の手術、および泌尿器科が腹腔鏡検査を利用する。腹腔鏡手術は、術後痛を最小限にし、回復時間を早め（したがって入院を短くし）、その結果、傷跡がより小さくなる。 Laparoscopic surgery is a minimally invasive procedure in which surgical procedures are performed through small incisions with the aid of a video camera. A trocar or cannula is placed into the small incision, and then a camera and other instruments are introduced into the trocar or cannula to access the patient's interior. Many types of surgery, such as gastrointestinal surgery, gynecological surgery, and urology, utilize laparoscopy. Laparoscopic surgery minimizes postoperative pain, speeds recovery time (thus shortening hospital stays), and results in smaller scars.

多くの腹腔鏡処置は、組織を切開および凝固するために電気外科技術を利用する。電気外科手術は、ＲＦ電気外科発生器（電気手術器またはＥＳＵとしても知られる）、および電極を備えるハンドピースを使用して、生体組織を切断または凝固するために様々な電圧で高周波交流無線周波（ＲＦ）電流の入力を与える。ハンドピースは、１つの電極を備える単極の器具または２つの電極を備える双極の器具であり得る。単極の器具を使用する際には、リターン電極板が患者に取り付けられ、高周波電流が発生器から単極の器具へ、患者を通って患者のリターン電極板へ流れて、発生器に戻る。その汎用性および有効性のために、単極電気外科手術が一般に用いられている。しかし、患者の背中に配置されたリターン電極が高電圧および高ＲＦエネルギを患者に通すため、単極電気外科手術で発生する過剰な熱が、過剰な組織損傷およびその組織の壊死を引き起こす恐れがある。 Many laparoscopic procedures utilize electrosurgical techniques to cut and coagulate tissue. Electrosurgery uses an RF electrosurgical generator (also known as an electrosurgical unit or ESU) and a handpiece with an electrode to provide an input of high frequency alternating radio frequency (RF) current at various voltages to cut or coagulate living tissue. The handpiece can be a monopolar instrument with one electrode or a bipolar instrument with two electrodes. When using a monopolar instrument, a return electrode plate is attached to the patient and high frequency current flows from the generator to the monopolar instrument, through the patient to the patient's return electrode plate and back to the generator. Due to its versatility and effectiveness, monopolar electrosurgery is commonly used. However, because the return electrode placed on the patient's back passes high voltage and high RF energy to the patient, excessive heat generated in monopolar electrosurgery can cause excessive tissue damage and necrosis of that tissue.

腹腔鏡単極電気外科手術は、電流が意図しない経路に沿って導通し、非標的組織を焼くかまたは蒸発させると、間接的な熱傷を引き起こすことがある。これらの間接的な熱傷は、直接結合または容量結合の結果として生じることがある。直接結合は、アクティブ電極の先端が手術野内の別の金属器具と直接接触する場合に生じることがある。たとえば、アクティブ電極が腹腔鏡に誤って触れるかまたはアークを発し、腹腔鏡が非導電性カニューレに設置されていた場合、腹腔鏡全体が帯電状態になり、腹腔鏡にかかる電流が腹腔鏡に触れている患者の腸または他の内部組織に伝達されることがあり、それによって熱傷につながる。容量結合は、エネルギが無傷の絶縁体を通って導電性材料に伝達されるときに生じる。たとえば、電流は、アクティブ電極を囲む絶縁体を通して金属トロカールなどの別の導体に漏れることがあり、それが手術部位から離れた所にある代わりの部位における火傷につながることがある。経験豊かな外科医でさえ、腹腔鏡処置中に、術野の制限された視界のせいで容量結合に起因する熱傷を見逃すことは簡単である。 Laparoscopic monopolar electrosurgery can cause indirect burns when current is conducted along unintended paths and burns or vaporizes non-target tissue. These indirect burns can occur as a result of direct or capacitive coupling. Direct coupling can occur when the tip of the active electrode comes into direct contact with another metal instrument in the surgical field. For example, if the active electrode accidentally touches or arcs to the laparoscope and the laparoscope is placed in a non-conductive cannula, the entire laparoscope can become charged and the current on the laparoscope can be transferred to the patient's intestines or other internal tissues that are touching the laparoscope, thereby leading to burns. Capacitive coupling occurs when energy is transferred through intact insulators to a conductive material. For example, current can leak through the insulator surrounding the active electrode to another conductor, such as a metal trocar, which can lead to burns at an alternative site away from the surgical site. Even experienced surgeons can easily miss burns due to capacitive coupling during laparoscopic procedures due to the limited visibility of the surgical field.

したがって、手術中に電流が患者の身体を通過しないように患者の背中のリターン電極の必要性を取り除くことによって組織損傷および組織壊死をなくす腹腔鏡超極性電気外科
用装置が必要である。容量結合をなくすことによって患者への熱傷の可能性を低くし、切断および凝固を実現するのに腹腔鏡単極電気外科用装置よりも少ない電力しか必要としない腹腔鏡超極性電気外科用装置も必要である。アクティブ電極とリターン電極の両方を同じ装置内に含む本発明の腹腔鏡超極性電気外科用装置が、これらの必要性を満たす。 Thus, there is a need for a laparoscopic hyperpolar electrosurgical device that eliminates tissue damage and tissue necrosis by eliminating the need for a return electrode on the patient's back so that current does not pass through the patient's body during surgery. There is also a need for a laparoscopic hyperpolar electrosurgical device that reduces the possibility of burns to the patient by eliminating capacitive coupling and requires less power to achieve cutting and coagulation than laparoscopic monopolar electrosurgical devices. The laparoscopic hyperpolar electrosurgical device of the present invention, which includes both active and return electrodes within the same device, meets these needs.

本発明は、組織を切断および／または凝固するための電気外科用ハンドピース装置を使用するときの容量結合をなくすことによって腹腔鏡手術中に患者への潜在的損傷を減少させる、アクティブ電極とリターン電極の両方を有する腹腔鏡超極性電気外科用装置を対象とする。 The present invention is directed to a laparoscopic hyperpolar electrosurgical device having both active and return electrodes that reduces potential injury to a patient during laparoscopic surgery by eliminating capacitive coupling when using an electrosurgical handpiece device to cut and/or coagulate tissue.

例示的な一実施形態では、本発明の腹腔鏡超極性電気外科用装置は、第１の端部、第２の端部、ならびに切断および／または凝固用の少なくとも１つの作動要素を有するハンドピース部材と、導電性中空筒状部材であって、第１の端部、ハンドピース部材の第１の端部内に収容された第２の端部、および導電性中空筒状部材の第１の端部から延びる導電性付加物を備える導電性中空筒状部材を有する、リターン電極と、ハンドピース部材および導電性中空筒状部材内に収容されたアクティブ電極であって、アクティブ電極の少なくとも一部が導電性中空筒状部材の第１の端部を越えて延びるアクティブ電極と、ハンドピース部材内に収容され、アクティブ電極と連通して、切断および／または凝固を作動させるとアクティブ電極をリターン電極の導電性付加物に向かって動かすアクチュエータとを含む。ハンドピース部材は、その中に含まれる中空領域であって、導電性中空筒状部材の内部およびハンドピース部材内に含まれる中空領域の少なくとも一部が共に煙排出チャネルを形成する中空領域をさらに含んでもよい。 In one exemplary embodiment, a laparoscopic hyperpolar electrosurgical device of the present invention includes a handpiece member having a first end, a second end, and at least one actuating element for cutting and/or coagulation, a conductive hollow tubular member having a first end, a second end housed within the first end of the handpiece member, and a return electrode having a conductive hollow tubular member with a conductive appendage extending from the first end of the conductive hollow tubular member, an active electrode housed within the handpiece member and the conductive hollow tubular member, at least a portion of the active electrode extending beyond the first end of the conductive hollow tubular member, and an actuator housed within the handpiece member and in communication with the active electrode to move the active electrode toward the conductive appendage of the return electrode upon actuation of cutting and/or coagulation. The handpiece member may further include a hollow region contained therein, wherein an interior of the conductive hollow tubular member and at least a portion of the hollow region contained within the handpiece member together form a smoke evacuation channel.

本発明の腹腔鏡超極性電気外科用装置は、リターン電極の導電性中空筒状部材の少なくとも一部内に収容された非導電性ガイド部材であって、アクティブ電極の少なくとも一部が非導電性ガイド部材中を移動または横断することが可能である非導電性ガイド部材をさらに含んでもよい。非導電性ガイド部材は、導電性中空筒状部材の第１の端部の近傍で導電性中空筒状部材の内径にわたって延びて、導電性中空筒状部材内に収容されたアクティブ電極を囲む導電性中空筒状部材の内部に隣接する非導電性ガイド部材の対向する側部に沿って２つのチャネルを生成してもよい。 The laparoscopic hyperpolar electrosurgical device of the present invention may further include a non-conductive guide member housed within at least a portion of the conductive hollow tubular member of the return electrode, through which at least a portion of the active electrode may travel or traverse. The non-conductive guide member may extend across an inner diameter of the conductive hollow tubular member near a first end of the conductive hollow tubular member to create two channels along opposing sides of the non-conductive guide member adjacent the interior of the conductive hollow tubular member surrounding the active electrode housed within the conductive hollow tubular member.

例示的な一実施形態では、本発明の腹腔鏡超極性電気外科用装置中のアクティブ電極は、導電性ロッド部材に接続された曲線状導電性部材を備えてもよい。曲線状導電性部材は「Ｕ」または「Ｖ」字形状を備えてもよく、曲線状導電性部材は、「Ｕ」または「Ｖ」字形状の内側が導電性ロッド部材と反対側を向いた状態で、導電性ロッド部材に垂直な関係で接続されていてもよい。本発明の腹腔鏡超極性電気外科用装置の別の例示的な実施形態では、絶縁材がリターン電極の導電性付加物とリターン電極の導電性中空筒状部材を越えて延びるアクティブ電極の一部との間に配置されていてもよい。本発明の腹腔鏡超極性電気外科用装置のさらに別の例示的な実施形態では、リターン電極の導電性付加物は、それを通る開口を有する導電性ループを備えてもよく、リターン電極の導電性中空筒状部材を越えて延びるアクティブ電極の一部は、鋭利な縁部を有する平面導電性部材を備えてもよい。 In one exemplary embodiment, the active electrode in the laparoscopic hyperpolar electrosurgical device of the present invention may comprise a curved conductive member connected to the conductive rod member. The curved conductive member may comprise a "U" or "V" shape and the curved conductive member may be connected in a perpendicular relationship to the conductive rod member with the inside of the "U" or "V" shape facing away from the conductive rod member. In another exemplary embodiment of the laparoscopic hyperpolar electrosurgical device of the present invention, an insulating material may be disposed between the conductive appendage of the return electrode and the portion of the active electrode that extends beyond the conductive hollow tubular member of the return electrode. In yet another exemplary embodiment of the laparoscopic hyperpolar electrosurgical device of the present invention, the conductive appendage of the return electrode may comprise a conductive loop having an opening therethrough and the portion of the active electrode that extends beyond the conductive hollow tubular member of the return electrode may comprise a planar conductive member having a sharp edge.

本発明の腹腔鏡超極性電気外科用装置は、リターン電極の導電性中空筒状部材も煙排出チャネルとして機能し得るようにリターン電極の導電性中空筒状部材に接続された排気口をさらに含んでもよい。腹腔鏡超極性電気外科用装置はまた、切断および／または凝固が作動されると煙排出を同時に作動させるためにアクチュエータを煙排出装置に接続する接続部材をも含んでもよい。 The laparoscopic hyperpolar electrosurgical device of the present invention may further include an exhaust port connected to the conductive hollow tubular member of the return electrode such that the conductive hollow tubular member of the return electrode may also function as a smoke exhaust channel. The laparoscopic hyperpolar electrosurgical device may also include a connecting member connecting the actuator to the smoke exhaust device for simultaneously activating smoke exhaust when cutting and/or coagulation are activated.

本発明の腹腔鏡超極性電気外科用装置の別の例示的な実施形態では、装置は、第１の端部および第２の端部を有するハンドピース部材と、導電性中空筒状部材であって、第１の端部、ハンドピース部材の第１の端部内に収容された第２の端部、および導電性中空筒状部材の第１の端部から延びる導電性付加物を備える導電性中空筒状部材を有する、リターン電極と、ハンドピース部材内に収容され、導電性中空筒状部材の内部内に吊設されたアクティブ電極であって、アクティブ電極の少なくとも一部が導電性中空筒状部材の第１の端部を越えて延びて、リターン電極の導電性付加物と導電性中空筒状部材の第１の端部を越えて延びるアクティブ電極の一部との間に含まれるオープンスペースを作成する、アク
ティブ電極と、ハンドピース部材内に収容され、アクティブ電極と連通して、切断および／または凝固を作動させるとアクティブ電極をリターン電極の導電性付加物に向かって動かすアクチュエータとを含む。腹腔鏡超極性電気外科用装置は、装置と連通して装置を切断および／または凝固を行うために作動させるフットスイッチをさらに含んでもよい。 In another exemplary embodiment of a laparoscopic hyperpolar electrosurgical device of the present invention, the device includes a handpiece member having a first end and a second end, a conductive hollow tubular member having a first end, a second end housed within the first end of the handpiece member, and a conductive appendage extending from the first end of the conductive hollow tubular member, an active electrode housed within the handpiece member and suspended within an interior of the conductive hollow tubular member, at least a portion of the active electrode extending beyond the first end of the conductive hollow tubular member to create an open space contained between the conductive appendage of the return electrode and the portion of the active electrode extending beyond the first end of the conductive hollow tubular member, and an actuator housed within the handpiece member and in communication with the active electrode for moving the active electrode toward the conductive appendage of the return electrode upon actuation of cutting and/or coagulation. The laparoscopic hyperpolar electrosurgical device may further include a foot switch in communication with the device for actuating the device to perform cutting and/or coagulation.

腹腔鏡超極性電気外科用装置のハンドピース部材はまた、中空領域であって、導電性中空筒状部材の内部およびハンドピース部材内に含まれる中空領域の少なくとも一部が共に煙排出チャネルを形成する中空領域をも含んでもよい。腹腔鏡超極性電気外科用装置は、切断および／または凝固が作動されると煙排出を同時に作動させるためにアクチュエータを煙排出装置に接続する接続部材をさらに含んでもよい。加えて、腹腔鏡超極性電気外科用装置は、導電性中空筒状部材の少なくとも一部内に収容された非導電性ガイド部材であって、アクティブ電極の少なくとも一部が非導電性ガイド部材中を移動することが可能である非導電性ガイド部材を含んでもよい。 The handpiece member of the laparoscopic hyperpolar electrosurgical device may also include a hollow region, where the interior of the conductive hollow tubular member and at least a portion of the hollow region contained within the handpiece member together form a smoke evacuation channel. The laparoscopic hyperpolar electrosurgical device may further include a connection member connecting the actuator to the smoke evacuation device for simultaneously activating the smoke evacuation upon activation of the cutting and/or coagulation. Additionally, the laparoscopic hyperpolar electrosurgical device may include a non-conductive guide member housed within at least a portion of the conductive hollow tubular member, where at least a portion of the active electrode is movable through the non-conductive guide member.

図１は、装置の内部構成要素を示す、本発明の腹腔鏡超極性電気外科用装置の例示的な実施形態の側面透視図である。FIG. 1 is a side perspective view of an exemplary embodiment of a laparoscopic hyperpolar electrosurgical device of the present invention showing the internal components of the device. 図２は、図１に示す腹腔鏡超極性電気外科用装置の例示的な実施形態の切断および凝固端部の部分拡大図である。2 is a partial enlarged view of the cutting and coagulating end of the exemplary embodiment of the laparoscopic hyperpolar electrosurgical device shown in FIG. 図３は、図２に示す腹腔鏡超極性電気外科用装置の例示的な実施形態の切断および凝固端部の部分拡大図の上面図である。3 is a top view of a partial enlargement of the cutting and coagulating end of the exemplary embodiment of the laparoscopic hyperpolar electrosurgical device shown in FIG. 2. FIG. 図４は、装置の内部構成要素を示す、本発明の腹腔鏡超極性電気外科用装置の別の例示的な実施形態の側面透視図である。FIG. 4 is a side perspective view of another exemplary embodiment of a laparoscopic hyperpolar electrosurgical device of the present invention showing the internal components of the device. 図５は、装置の内部構成要素を示す、本発明の腹腔鏡超極性電気外科用装置のさらに別の例示的な実施形態の切断および凝固端部の部分側面透視図である。FIG. 5 is a partial side perspective view of the cutting and coagulating end of yet another exemplary embodiment of a laparoscopic hyperpolar electrosurgical device of the present invention showing the internal components of the device. 図６は、装置の内部構成要素を示す、本発明の腹腔鏡超極性電気外科用装置のさらに別の例示的な実施形態の切断および凝固端部の部分側面透視図である。FIG. 6 is a partial side perspective view of the cutting and coagulating end of yet another exemplary embodiment of a laparoscopic hyperpolar electrosurgical device of the present invention showing the internal components of the device. 図７は、図６に示す腹腔鏡超極性電気外科用装置の例示的な実施形態の切断および凝固端部の部分図の上面図である。7 is a top view of a partial view of the cutting and coagulating end of the exemplary embodiment of the laparoscopic hyperpolar electrosurgical device shown in FIG. 6. FIG. 図８は、装置の内部構成要素を示す、本発明の腹腔鏡超極性電気外科用装置のさらに別の例示的な実施形態の側面透視図である。FIG. 8 is a side perspective view of yet another exemplary embodiment of a laparoscopic hyperpolar electrosurgical device of the present invention showing the internal components of the device.

本発明は、ハンドピース部材と、導電性中空筒状部材であって、一方の端部がハンドピース部材に接続され、他方の端部がそれから延びる導電性付加物を有する導電性中空筒状部材を有する、リターン電極と、ハンドピース部材内に収容され、リターン電極の導電性中空筒状部材の内部内に吊設されたアクティブ電極であって、アクティブ電極の少なくとも一部が導電性付加物を有するリターン電極の中空筒状部材の端部を越えて延びるアクティブ電極とを含む腹腔鏡超極性電気外科用装置を対象とする。本発明の腹腔鏡超極性電気外科用装置は、リターン電極が患者の身体の別の部分に設置される必要性をなくすように設計されており、さらに容量結合をなくすことによって熱傷の可能性を低くする。 The present invention is directed to a laparoscopic hyperpolar electrosurgical device that includes a handpiece member, a return electrode having a conductive hollow tubular member connected at one end to the handpiece member and having a conductive appendage extending therefrom at the other end, and an active electrode housed within the handpiece member and suspended within the interior of the conductive hollow tubular member of the return electrode, at least a portion of the active electrode extending beyond the end of the hollow tubular member of the return electrode having the conductive appendage. The laparoscopic hyperpolar electrosurgical device of the present invention is designed to eliminate the need for the return electrode to be placed on another part of the patient's body, and further reduces the possibility of burns by eliminating capacitive coupling.

例示的な一実施形態では、図１～図３に示すように、本発明の腹腔鏡超極性電気外科用装置１０は、第１の端部１４、第２の端部１６、ならびに切断および／または凝固用の少なくとも１つの作動要素１８，２０を備えるハンドピース部材１２と、導電性中空筒状部材２４であって、第１の端部２６、ハンドピース部材１２の第１の端部１４内に収容されたまたはそれに接続された第２の端部２８、および導電性中空筒状部材２４の第１の端部２６から延びる導電性付加物３０を有する導電性中空筒状部材２４を含む、リターン電極２２と、ハンドピース部材１２およびリターン電極２２の導電性中空筒状部材２４内に収容されたアクティブ電極３２であって、アクティブ電極３２の少なくとも一部３４がリターン電極２２の導電性中空筒状部材２４の第１の端部２６を越えて延びるアクティブ電極３２と、ハンドピース部材１２内に収容され、アクティブ電極３２と連通して、切断および／または凝固が作動されるとアクティブ電極３２をリターン電極２２の導電性付加物３０に向かって動かすアクチュエータ３６とを有する手動装置である。ハンドピース部材１２およびリターン電極２２の導電性中空筒状部材２４内に収容されたアクティブ電極３２は、中実導電性円筒部材３３の形をとってもよく、一方、リターン電極２２の導電性中空筒状部材２４の第１の端部２６を越えて延びるアクティブ電極３２の一部３４は、中実導電性円筒部材３３に垂直な関係で中実導電性円筒部材３３の端部に接続された「Ｕ」または「Ｖ」字形導電素子３５の形をとってもよい。 In one exemplary embodiment, as shown in FIGS. 1-3, the laparoscopic hyperpolar electrosurgical device 10 of the present invention includes a handpiece member 12 having a first end 14, a second end 16, and at least one actuating element 18, 20 for cutting and/or coagulation, and a conductive hollow tubular member 24 having a first end 26, a second end 28 housed within or connected to the first end 14 of the handpiece member 12, and a conductive appendage 30 extending from the first end 26 of the conductive hollow tubular member 24. A handheld device having a ring electrode 22, an active electrode 32 housed within the conductive hollow tubular member 24 of the handpiece member 12 and the return electrode 22, at least a portion 34 of the active electrode 32 extending beyond the first end 26 of the conductive hollow tubular member 24 of the return electrode 22, and an actuator 36 housed within the handpiece member 12 and in communication with the active electrode 32 to move the active electrode 32 toward the conductive appendage 30 of the return electrode 22 when cutting and/or coagulation is activated. The active electrode 32 housed within the conductive hollow tubular member 24 of the handpiece member 12 and the return electrode 22 may take the form of a solid conductive cylindrical member 33, while the portion 34 of the active electrode 32 extending beyond the first end 26 of the conductive hollow tubular member 24 of the return electrode 22 may take the form of a "U" or "V" shaped conductive element 35 connected to the end of the solid conductive cylindrical member 33 in a perpendicular relationship to the solid conductive cylindrical member 33.

ハンドピース部材１２は、その中に含まれる中空領域３８であって、リターン電極２２の導電性中空筒状部材２４の内部４０がハンドピース部材１２内の中空領域３８の少なくとも一部と共に煙排出チャネルを形成する中空領域３８をさらに含んでもよい。腹腔鏡超極性電気外科用装置１０は、切断および／または凝固が作動されると煙排出を同時に作動させるためにアクチュエータ３６を煙排出装置（図示せず）に接続する接続部材４４をさらに含んでもよい。ハンドピース部材１２は、ハンドピース部材１２内の煙排出チャネルと連通する排気口４２をさらに含んでもよい。その場合に真空管４３が排気口４２に接続されていてもよく、一方、真空管４３の他方の端部は煙排出装置（図示せず）に接続されている。（ハンドピース部材１２内のアクチュエータ３６に接続された）接続部材４４と真空管４３の両方は、同じ煙排出装置（図示せず）に接続されている。 The handpiece member 12 may further include a hollow region 38 contained therein, in which the interior 40 of the conductive hollow tubular member 24 of the return electrode 22 forms a smoke exhaust channel with at least a portion of the hollow region 38 in the handpiece member 12. The laparoscopic hyperpolar electrosurgical device 10 may further include a connection member 44 connecting the actuator 36 to a smoke exhaust device (not shown) for simultaneously activating smoke exhaust when cutting and/or coagulation are activated. The handpiece member 12 may further include an exhaust port 42 in communication with the smoke exhaust channel in the handpiece member 12. In that case, a vacuum tube 43 may be connected to the exhaust port 42, while the other end of the vacuum tube 43 is connected to the smoke exhaust device (not shown). Both the connection member 44 (connected to the actuator 36 in the handpiece member 12) and the vacuum tube 43 are connected to the same smoke exhaust device (not shown).

腹腔鏡超極性電気外科用装置１０は、回路基板４８と、リターン電極２２を回路基板４８に接続する第１の導電性連通手段５０（電線または任意の他の導電性コネクタなど）と、アクティブ電極３２を回路基板４８に接続する第２の導電性連通手段５２（電線または任意の他の導電性コネクタなど）と、腹腔鏡超極性電気外科用装置１０を使用した切断および／または凝固を可能にするために腹腔鏡超極性電気外科用装置１０を電気外科発生器に接続する第２の接続部材４６（１つまたは複数の絶縁電線を含むコードなど）とをさらに含む。切断および／または凝固用の作動要素（ボタンなど）１８，２０は、回路基板４８の上方に配置されており、それにより、装置１０の利用時にボタンを押すと回路基板と係合して切断および／または凝固をもたらす。 The laparoscopic hyperpolar electrosurgical device 10 further includes a circuit board 48, a first conductive communication means 50 (such as a wire or any other conductive connector) connecting the return electrode 22 to the circuit board 48, a second conductive communication means 52 (such as a wire or any other conductive connector) connecting the active electrode 32 to the circuit board 48, and a second connection member 46 (such as a cord including one or more insulated wires) connecting the laparoscopic hyperpolar electrosurgical device 10 to an electrosurgical generator to enable cutting and/or coagulation using the laparoscopic hyperpolar electrosurgical device 10. Cutting and/or coagulation actuation elements (such as buttons) 18, 20 are disposed above the circuit board 48 such that, during use of the device 10, pressing the buttons engages the circuit board to effect cutting and/or coagulation.

腹腔鏡超極性電気外科用装置１０は、リターン電極２２の導電性中空筒状部材２４内に収容された非導電性ガイド部材６０であって、アクティブ電極３２の少なくとも一部が非導電性ガイド部材６０中を移動または横断することが可能である非導電性ガイド部材６０をさらに含んでもよい。非導電性ガイド部材６０は、導電性中空筒状部材２４の第１の端部２６の近傍でリターン電極２２の導電性中空筒状部材２４の内径にわたって延びて、導電性中空筒状部材２４内に収容されたアクティブ電極３２を囲む導電性中空筒状部材２４の内部に隣接する非導電性ガイド部材６０の対向する側部に沿って２つのチャネルを生成してもよい。先に上述したように、アクティブ電極３２は、導電性ロッド部材３３に接続された曲線状導電性部材３５を含んでもよく、曲線状導電性部材３５はＵまたはＶ字形状を有してもよい。非導電性ガイド部材６０は、アクチュエータ３６が作動されてアクティブ電極３２の導電性円筒ロッド部材３３をリターン電極２２の導電性付加物３０に向かっ
て押し出したときに、リターン電極２２の導電性中空筒状部材２４の第１の端部２６を越えて延びるアクティブ電極３２の一部３４（曲線状導電性部材３５など）がリターン電極２２の導電性付加物３０に向かって着実かつ確実に動くことができることを確実にする。 The laparoscopic hyperpolar electrosurgical device 10 may further include a non-conductive guide member 60 housed within the conductive hollow tubular member 24 of the return electrode 22, through which at least a portion of the active electrode 32 may travel or traverse. The non-conductive guide member 60 may extend across an inner diameter of the conductive hollow tubular member 24 of the return electrode 22 near the first end 26 of the conductive hollow tubular member 24 to create two channels along opposing sides of the non-conductive guide member 60 adjacent the interior of the conductive hollow tubular member 24 surrounding the active electrode 32 housed within the conductive hollow tubular member 24. As previously discussed above, the active electrode 32 may include a curvilinear conductive member 35 connected to the conductive rod member 33, and the curvilinear conductive member 35 may have a U- or V-shape. The non-conductive guide member 60 ensures that when the actuator 36 is actuated to push the conductive cylindrical rod member 33 of the active electrode 32 toward the conductive appendage 30 of the return electrode 22, the portion 34 of the active electrode 32 (such as the curved conductive member 35) that extends beyond the first end 26 of the conductive hollow tubular member 24 of the return electrode 22 can move steadily and reliably toward the conductive appendage 30 of the return electrode 22.

装置１０が切断および／または凝固を行うために作動されると、アクチュエータ３６（ソレノイドを備えてもよい）も作動される。アクチュエータ３６はアクティブ電極３２の導電性円筒ロッド部材３３を前に押し出すように機能し、ひいてはリターン電極２２の導電性中空筒状部材２４を越えて延びるアクティブ電極３２の一部３４（たとえば、曲線状導電性部材３５）をリターン電極２２の導電性付加物３０に向かって動かす。その場合に、リターン電極２２の導電性中空筒状部材２４を越えて延びるアクティブ電極３２の一部３４（たとえば、曲線状導電性部材３５）、切断の必要がある患者の組織、およびリターン電極２２によって閉回路が作成される。組織を通して接点（したがって完全な回路）が作られる。電流は患者の身体を通過せず、装置１０を使用して切断および／または凝固を行うのにはるかに少ない電力しか必要ではない。加えて、腹腔鏡装置１０のアクティブ電極３２が腹腔鏡装置１０のリターン電極２２内に収容されているので、患者と腹腔鏡装置１０との間に容量結合が生じることがない。 When the device 10 is actuated to perform cutting and/or coagulation, the actuator 36 (which may comprise a solenoid) is also actuated. The actuator 36 functions to push the conductive cylindrical rod member 33 of the active electrode 32 forward, which in turn moves the portion 34 (e.g., the curved conductive member 35) of the active electrode 32 that extends beyond the conductive hollow tubular member 24 of the return electrode 22 toward the conductive appendage 30 of the return electrode 22. In that case, a closed circuit is created by the portion 34 (e.g., the curved conductive member 35) of the active electrode 32 that extends beyond the conductive hollow tubular member 24 of the return electrode 22, the patient's tissue that needs to be cut, and the return electrode 22. A contact (and thus a complete circuit) is made through the tissue. No current passes through the patient's body, and much less power is required to perform cutting and/or coagulation using the device 10. In addition, since the active electrode 32 of the laparoscopic device 10 is contained within the return electrode 22 of the laparoscopic device 10, no capacitive coupling occurs between the patient and the laparoscopic device 10.

別の例示的な実施形態では、図４に示すように、本発明の腹腔鏡超極性電気外科用装置１００は、第１の端部１０４および第２の端部１０６を備えるハンドピース部材１０２と、導電性中空筒状部材１２４であって、第１の端部１２６、ハンドピース部材１０２の第１の端部１０４内に収容されたまたはそれに接続された第２の端部１２８、および導電性中空筒状部材１２４の第１の端部１２６から延びる導電性付加物１３０を有する導電性中空筒状部材１２４を含む、リターン電極１２２と、ハンドピース部材１０２内に収容され、導電性中空筒状部材１２４の内部１４０内に吊設されたアクティブ電極１３２であって、アクティブ電極１３２の少なくとも一部１３４が導電性中空筒状部材１２４の第１の端部１２６を越えて延びて、リターン電極１２２の導電性付加物１３０と導電性中空筒状部材１２４の第１の端部１２６を越えて延びるアクティブ電極１３２の一部１３４との間に含まれるオープンスペースを作成する、アクティブ電極１３２と、ハンドピース部材１０２内に収容され、アクティブ電極１３２と連通して、装置１００が切断および／または凝固のために作動されるとアクティブ電極１３２をリターン電極１２２の導電性付加物１３０に向かって動かすアクチュエータ１３６とを有するフットスイッチ式装置である。装置１００は、装置１００と連通して装置１００を切断および／または凝固を行うために作動させるフットスイッチ１０７をさらに含んでもよい。フットスイッチ１０７は、装置による切断／凝固に動力を供給するために接続部材１０９によって電気外科発生器ユニット（ＥＳＵ）（図示せず）に接続されていてもよい。 In another exemplary embodiment, as shown in FIG. 4 , a laparoscopic hyperpolar electrosurgical device 100 of the present invention comprises a handpiece member 102 having a first end 104 and a second end 106, a conductive hollow tubular member 124 having a first end 126, a second end 128 housed within or connected to the first end 104 of the handpiece member 102, and a return electrode 122 having a conductive appendage 130 extending from the first end 126 of the conductive hollow tubular member 124, and an active electrode 132 housed within the handpiece member 102 and suspended within an interior 140 of the conductive hollow tubular member 124. 1, the foot switch device has an active electrode 132, at least a portion 134 of the active electrode 132 extending beyond the first end 126 of the conductive hollow tubular member 124 to create an open space contained between the conductive appendage 130 of the return electrode 122 and the portion 134 of the active electrode 132 that extends beyond the first end 126 of the conductive hollow tubular member 124, and an actuator 136 housed within the hand piece member 102 and in communication with the active electrode 132 to move the active electrode 132 toward the conductive appendage 130 of the return electrode 122 when the device 100 is activated for cutting and/or coagulation. The device 100 may further include a foot switch 107 in communication with the device 100 to activate the device 100 to perform cutting and/or coagulation. The foot switch 107 may be connected to an electrosurgical generator unit (ESU) (not shown) by a connecting member 109 to power cutting/coagulation by the device.

図１～図３に示す実施形態のように、ハンドピース部材１０２は、その中に含まれる中空領域１３８であって、導電性中空筒状部材の内部がハンドピース部材内の中空領域の少なくとも一部と共に煙排出チャネルを形成する中空領域１３８をさらに含んでもよい。腹腔鏡超極性電気外科用装置１００は、切断および／または凝固が作動されると煙排出を同時に作動させるためにアクチュエータ１３６を煙排出装置（図示せず）に接続する接続部材１４４をさらに含んでもよい。ハンドピース部材１０２は、ハンドピース部材１０２内の煙排出チャネルと連通する排気口１４２をさらに含んでもよい。その場合に真空管１４３が排気口１４２に接続されていてもよく、一方、真空管１４３の他方の端部は煙排出装置（図示せず）に接続されている。（ハンドピース部材１０２内のアクチュエータ１３６に接続された）接続部材１４４と真空管１４３の両方は、同じ煙排出装置（図示せず）に接続されている。腹腔鏡超極性電気外科用装置１００はまた、腹腔鏡超極性電気外科用装置１００を使用した切断および／または凝固を可能にするために腹腔鏡超極性電気外科用装置１００を電気外科発生器（ＥＳＵ）に接続する第２の接続部材１４６（１つまたは複数の絶縁電線を含むコードなど）をも含んでもよい。（ハンドピース部材１０２内のアクチュエータ１３６に接続された）接続部材１４６とフットスイッチ１０７の両方は、同じ電気手術器（ＥＳＵ）発生器（図示せず）に接続されている。 As in the embodiment shown in Figures 1-3, the handpiece member 102 may further include a hollow region 138 contained therein , the interior of the conductive hollow tubular member forming a smoke evacuation channel with at least a portion of the hollow region within the handpiece member. The laparoscopic hyperpolar electrosurgical device 100 may further include a connecting member 144 connecting the actuator 136 to a smoke evacuation device (not shown) for simultaneously activating smoke evacuation when cutting and/or coagulation are activated. The handpiece member 102 may further include an exhaust port 142 in communication with the smoke evacuation channel within the handpiece member 102. A vacuum tube 143 may then be connected to the exhaust port 142, while the other end of the vacuum tube 143 is connected to the smoke evacuation device (not shown). Both the connecting member 144 (connected to the actuator 136 within the handpiece member 102) and the vacuum tube 143 are connected to the same smoke evacuation device (not shown). Laparoscopic hyperpolar electrosurgical device 100 may also include a second connecting member 146 (such as a cord including one or more insulated wires) that connects laparoscopic hyperpolar electrosurgical device 100 to an electrosurgical generator (ESU) to enable cutting and/or coagulation using laparoscopic hyperpolar electrosurgical device 100. Both connecting member 146 (connected to actuator 136 in handpiece member 102) and foot switch 107 are connected to the same electrosurgical unit (ESU) generator (not shown).

腹腔鏡超極性電気外科用装置は、導電性中空筒状部材１２４内に収容された非導電性ガイド部材１６０であって、アクティブ電極１３２の少なくとも一部が非導電性ガイド部材１６０中を移動／横断することが可能である非導電性ガイド部材１６０をさらに含んでもよい。非導電性ガイド部材１６０は、図１～図３を参照して上述した非導電性ガイド部材６０と同じ機能を果たし、それと同じように動作する。 The laparoscopic hyperpolar electrosurgical device may further include a non-conductive guide member 160 housed within the conductive hollow tubular member 124, through which at least a portion of the active electrode 132 may travel/traverse. The non-conductive guide member 160 performs the same functions and operates in the same manner as the non-conductive guide member 60 described above with reference to Figures 1-3.

図５は、本発明の腹腔鏡超極性電気外科用装置２００のさらに別の例示的な実施形態の切断および凝固端部の部分側面透視図である。図５に示すように、セラミックなどの絶縁材２３５が、リターン電極２２２の導電性付加物２３０とリターン電極２２２の導電性中空筒状部材２２４の第１の端部２２６を越えて延びるアクティブ電極２３２の一部２３４との間に含まれている。非導電性ガイド部材２６０がリターン電極２２２の導電性中空筒状部材２２４内に収容されて、リターン電極２２２の導電性中空筒状部材２２４の第１の端部２２６を越えて延びるアクティブ電極２３２の一部２３４を支持する。リターン電極２２２の導電性中空筒状部材２２４を越えて延びるリターン電極の一部２３０およびアクティブ電極の一部２３４は、その間に含まれる絶縁材２３５を含めて、静止し移動不能であってもよい。あるいは、リターン電極２２２の導電性中空筒状部材２２４を越えて延びるリターン電極２２２の一部２３０は、リターン電極２２２の導電性中空筒状部材２２４を越えて延びるアクティブ電極２３２の可動部分２３４から絶縁されるようにその上に含まれる絶縁材２３５の層を有してもよい。 Figure 5 is a partial side perspective view of the cutting and coagulating end of yet another exemplary embodiment of the laparoscopic hyperpolar electrosurgical device 200 of the present invention. As shown in Figure 5, an insulating material 235, such as a ceramic, is included between the conductive appendage 230 of the return electrode 222 and the portion 234 of the active electrode 232 that extends beyond the first end 226 of the conductive hollow tubular member 224 of the return electrode 222. A non-conductive guide member 260 is housed within the conductive hollow tubular member 224 of the return electrode 222 to support the portion 234 of the active electrode 232 that extends beyond the first end 226 of the conductive hollow tubular member 224 of the return electrode 222. The portion 230 of the return electrode and the portion 234 of the active electrode that extends beyond the conductive hollow tubular member 224 of the return electrode 222 may be stationary and non-movable, including the insulating material 235 included therebetween. Alternatively, the portion 230 of the return electrode 222 that extends beyond the conductive hollow tubular member 224 of the return electrode 222 may have a layer of insulating material 235 included thereon such that it is insulated from the moving portion 234 of the active electrode 232 that extends beyond the conductive hollow tubular member 224 of the return electrode 222.

図６および図７は、本発明の腹腔鏡超極性電気外科用装置３００のさらに別の例示的な実施形態の切断および凝固端部を示す。図６および図７に示すように、リターン電極３２２の導電性付加物３３０は、それを通る開口３３３を有する導電性ループ３３１であり、導電性中空筒状部材３２４の第１の端部３２６を越えて延びるアクティブ電極３３２の一部３３４は、鋭利な縁部３３６を有する平面導電性部材３３５である。腹腔鏡超極性電気外科用装置３００は、導電性中空筒状部材３２４内に収容された非導電性ガイド部材３６０であって、アクティブ電極３３２の少なくとも一部が非導電性ガイド部材３６０中を移動／横断することが可能である非導電性ガイド部材３６０をさらに含んでもよい。非導電性ガイド部材３６０は、図１～図３を参照して上述した非導電性ガイド部材６０と同じ機能を果たし、それと同じように動作する。 6 and 7 show the cutting and coagulating end of yet another exemplary embodiment of the laparoscopic hyperpolar electrosurgical device 300 of the present invention. As shown in FIGS. 6 and 7, the conductive appendage 330 of the return electrode 322 is a conductive loop 331 having an opening 333 therethrough, and the portion 334 of the active electrode 332 that extends beyond the first end 326 of the conductive hollow tubular member 324 is a planar conductive member 335 having a sharp edge 336. The laparoscopic hyperpolar electrosurgical device 300 may further include a non-conductive guide member 360 housed within the conductive hollow tubular member 324, through which at least a portion of the active electrode 332 may travel/traverse. The non-conductive guide member 360 serves the same function and operates in the same manner as the non-conductive guide member 60 described above with reference to FIGS. 1-3.

さらに別の例示的な実施形態では、図８に示すように、本発明の腹腔鏡超極性電気外科用装置４００は、第１の端部４１４、第２の端部４１６、ならびに切断および／または凝固用の少なくとも１つの作動要素４１８，４２０を備えるハンドピース部材４１２と、導電性中空筒状部材４２４であって、第１の端部４２６、ハンドピース部材４１２の第１の端部４１４内に収容されたまたはそれに接続された第２の端部４２８、および導電性中空筒状部材４２４の第１の端部４２６から延びる導電性付加物４３０を有する導電性中空筒状部材４２４を含む、リターン電極４２２と、ハンドピース部材４１２および導電性中空筒状部材４２４内に収容されたアクティブ電極４３２であって、アクティブ電極４３２の少なくとも一部４３４がリターン電極４２２の導電性中空筒状部材４２４の第１の端部４２６を越えて延びるアクティブ電極４３２と、ハンドピース部材４１２内に収容され、アクティブ電極４３２と連通して、切断および／または凝固が作動されるとアクティブ電極４３２をリターン電極４２２の導電性付加物４３０に向かって動かすアクチュエータ４３６とを有する手動装置である。アクチュエータ４３６は押し部材４３７を有してもよく、アクチュエータ４３６の近傍に位置するアクティブ電極４３２の一部はばね部材４３９内に収容されていてもよく、ばね部材４３９は、アクチュエータ４３６の押し部材４３７がハンドピース部材４１２内に収容されたアクティブ電極４３２の端部から後退または係脱
された後にアクティブ電極４３２をその作動前の状態に戻すのを助ける。 In yet another exemplary embodiment, as shown in FIG. 8 , a laparoscopic hyperpolar electrosurgical device 400 of the present invention comprises a handpiece member 412 having a first end 414, a second end 416, and at least one operative element 418, 420 for cutting and/or coagulation, and an electrically conductive hollow tubular member 424 having a first end 426, a second end 428 housed within or connected to the first end 414 of the handpiece member 412, and an electrically conductive appendage 430 extending from the first end 426 of the electrically conductive hollow tubular member 424. a return electrode 422 including a first end 426 of the return electrode 422, an active electrode 432 housed within the hand piece member 412 and the conductive hollow tubular member 424, at least a portion 434 of the active electrode 432 extending beyond a first end 426 of the conductive hollow tubular member 424 of the return electrode 422, and an actuator 436 housed within the hand piece member 412 and in communication with the active electrode 432 to move the active electrode 432 toward the conductive appendage 430 of the return electrode 422 upon actuation of cutting and/or coagulation. The actuator 436 may have a pusher member 437, and a portion of the active electrode 432 located near the actuator 436 may be housed within a spring member 439 that assists in returning the active electrode 432 to its pre-actuation state after the pusher member 437 of the actuator 436 is retracted or disengaged from the end of the active electrode 432 housed within the hand piece member 412.

排気口４４２が、導電性中空筒状部材４２４の内部４４０と連通するように導電性中空筒状部材４２４に接続されていてもよい。その場合に導電性中空筒状部材４２４の内部４４０は、真空管が排気口４４２に取り付けられると煙およびデブリを手術部位から除去することができる煙排出チャネルとして機能することができる。腹腔鏡超極性電気外科用装置４００は、切断および／または凝固が作動されると煙排出を同時に作動させるためにアクチュエータ４３６を煙排出装置（図示せず）に接続する接続部材４４４をさらに含んでもよい。 An exhaust port 442 may be connected to the conductive hollow tubular member 424 such that it is in communication with the interior 440 of the conductive hollow tubular member 424, which may then function as a smoke evacuation channel through which smoke and debris may be removed from the surgical site when a vacuum tube is attached to the exhaust port 442. The laparoscopic hyperpolar electrosurgical device 400 may further include a connecting member 444 connecting the actuator 436 to a smoke evacuation device (not shown) for simultaneously activating smoke evacuation when cutting and/or coagulation are activated.

腹腔鏡超極性電気外科用装置４００は、導電性中空筒状部材４２４内に収容された１つまたは複数の非導電性ガイド部材４６０であって、アクティブ電極４３２の少なくとも一部が（１つまたは複数の）非導電性ガイド部材４６０中を移動することが可能である１つまたは複数の非導電性ガイド部材４６０をさらに含んでもよい。（１つまたは複数の）非導電性ガイド部材４６０は、導電性中空筒状部材４２４の内径にわたって延びて、導電性中空筒状部材４２４内に収容されたアクティブ電極４３２を囲む導電性中空筒状部材４２４の内部４４０に隣接する（１つまたは複数の）非導電性ガイド部材４６０の対向する側部に沿って２つのチャネルを生成してもよい。アクティブ電極４３２は、導電性ロッド部材４３３に接続されたブレード型部材４３５を含む。 The laparoscopic hyperpolar electrosurgical device 400 may further include one or more non-conductive guide members 460 housed within the conductive hollow tubular member 424, through which at least a portion of the active electrode 432 may travel. The non-conductive guide member(s) 460 may extend across the inner diameter of the conductive hollow tubular member 424 to create two channels along opposing sides of the non-conductive guide member(s) 460 adjacent the interior 440 of the conductive hollow tubular member 424 surrounding the active electrode 432 housed within the conductive hollow tubular member 424. The active electrode 432 includes a blade-shaped member 435 connected to a conductive rod member 433.

装置が切断および／または凝固を行うために作動されると、アクチュエータ４３６（ソレノイドを備えてもよい）も作動される。アクチュエータ４３６の押し部材４３７は、アクティブ電極４３２のロッド部材４３３を前に押し出すように機能し、ひいてはリターン電極４２２の導電性中空筒状部材４２４を越えて延びるアクティブ電極４３２の一部４３４をリターン電極４２２の導電性付加物４３０に向かって動かす。その場合に、リターン電極４２２の導電性中空筒状部材４２４を越えて延びるアクティブ電極４３２の一部４３４、切断の必要がある患者の組織、およびリターン電極４２２によって閉回路が作成される。組織を通して接点（したがって完全な回路）が作られる。電流は患者の身体を通過せず、装置４００を使用して切断および／または凝固を行うのにはるかに少ない電力しか必要ではない。また、腹腔鏡装置４００のアクティブ電極４３２が腹腔鏡装置４００のリターン電極４２２内に収容されているので、患者と腹腔鏡装置４００との間に容量結合が生じることがない。ばね部材４３９は、アクチュエータ４３６の押し部材４３７がハンドピース部材４１２内に収容されたアクティブ電極４３２の端部から後退または係脱された後にアクティブ電極４３２をその作動前の状態に戻すのを助ける。 When the device is actuated to perform cutting and/or coagulation, the actuator 436 (which may comprise a solenoid) is also actuated. The pusher member 437 of the actuator 436 functions to push the rod member 433 of the active electrode 432 forward, which in turn moves the portion 434 of the active electrode 432 that extends beyond the conductive hollow tubular member 424 of the return electrode 422 toward the conductive appendage 430 of the return electrode 422. In that case, a closed circuit is created by the portion 434 of the active electrode 432 that extends beyond the conductive hollow tubular member 424 of the return electrode 422, the patient's tissue that needs to be cut, and the return electrode 422. A contact (and therefore a complete circuit) is made through the tissue. No current passes through the patient's body, and much less power is required to perform cutting and/or coagulation using the device 400. Also, because the active electrode 432 of the laparoscopic device 400 is contained within the return electrode 422 of the laparoscopic device 400, there is no capacitive coupling between the patient and the laparoscopic device 400. The spring member 439 helps return the active electrode 432 to its pre-actuation state after the push member 437 of the actuator 436 is retracted or disengaged from the end of the active electrode 432 contained within the handpiece member 412.

図に示す符号に関する要素／特徴の識別情報は以下のとおりである。
１０腹腔鏡超極性電気外科用装置
１２ハンドピース部材
１４（ハンドピース部材の）第１の端部
１６（ハンドピース部材の）第２の端部
１８切断用作動要素
２０凝固用作動要素
２２リターン電極
２４導電性中空筒状部材
２６（導電性中空筒状部材の）第１の端部
２８（導電性中空筒状部材の）第２の端部
３０導電性付加物
３２アクティブ電極
３３導電性円筒ロッド部材
３４（導電性中空筒状部材の第１の端部を越えて延びる）アクティブ電極の一部
３５曲線状導電性部材
３６アクチュエータ（たとえば、ソレノイド）
３８（ハンドピース内の）中空領域
４０導電性中空筒状部材の内部
４２（ハンドピースの）排気口
４３真空管
４４（煙排出器への／用の）接続部材
４６（装置による切断／凝固のためのＥＳＵ発生器への）第２の接続部材
４８回路基板
５０（リターン電極を回路基板に接続する）第１の導電性連通手段
５２（アクティブ電極を回路基板に接続する）第２の導電性連通手段
６０非導電性ガイド部材
１００フットスイッチ制御を用いる腹腔鏡超極性電気外科用装置
１０２ハンドピース部材
１０４（ハンドピース部材の）第１の端部
１０６（ハンドピース部材の）第２の端部
１０７フットスイッチ
１０９（装置による切断／凝固のためのＥＳＵ発生器への）接続部材
１２２リターン電極
１２４導電性中空筒状部材
１２６（導電性中空筒状部材の）第１の端部
１２８（導電性中空筒状部材の）第２の端部
１３０導電性付加物
１３２アクティブ電極
１３４（導電性中空筒状部材の第１の端部を越えて延びる）アクティブ電極の一部
１３６アクチュエータ（たとえば、ソレノイド）
１３８（ハンドピース内の）中空領域
１４０（導電性中空筒状部材の）内部
１４２（ハンドピースの）排気口
１４３真空管
１４４（煙排出器への／用の）接続部材
１４６（装置による切断／凝固のためのＥＳＵ発生器への）接続部材
１６０非導電性ガイド部材
２００腹腔鏡超極性電気外科用装置
２２２リターン電極
２２４導電性中空筒状部材
２２６（導電性中空筒状部材の）第１の端部
２３０導電性付加物
２３２アクティブ電極
２３４（導電性中空筒状部材の第１の端部を越えて延びる）アクティブ電極の一部
２３５絶縁材（たとえば、セラミック）
２６０非導電性ガイド部材
３００腹腔鏡超極性電気外科用装置
３２２リターン電極
３２４導電性中空筒状部材
３２６（導電性中空筒状部材の）第１の端部
３３０導電性付加物
３３１導電性ループ
３３２アクティブ電極
３３３開口
３３４（導電性中空筒状部材の第１の端部を越えて延びる）アクティブ電極の一部
３３５平面導電性部材
３３６鋭利な縁部
３６０非導電性ガイド部材
４００腹腔鏡超極性電気外科用装置
４１２ハンドピース部材
４１４（ハンドピース部材の）第１の端部
４１６（ハンドピース部材の）第２の端部
４１８切断用作動要素
４２０凝固用作動要素
４２２リターン電極
４２４導電性中空筒状部材
４２６（導電性中空筒状部材の）第１の端部
４２８（導電性中空筒状部材の）第２の端部
４３０導電性付加物
４３２アクティブ電極
４３３導電性ロッド部材
４３４（導電性中空筒状部材の第１の端部を越えて延びる）アクティブ電極の一部
４３５ブレード型部材
４３６アクチュエータ（たとえば、ソレノイド）
４３７（アクチュエータの）押し部材
４３９ばね部材
４４０（導電性中空筒状部材の）内部
４４２（煙およびデブリを排出するための導電性中空筒状部材の）排気口
４４４（煙排出器への／用の）接続部材
４４６（装置による切断／凝固のためのＥＳＵ発生器への）接続部材
４４８回路基板
４５０（リターン電極をＥＳＵ発生器への接続部材に接続する）導電性連通手段
４５２（アクティブ電極を回路基板に接続する）導電性連通手段
４６０非導電性ガイド部材 Element/feature identification information for the numbers shown in the figures is as follows:
10 Laparoscopic hyperpolar electrosurgical device 12 Handpiece member 14 First end (of handpiece member) 16 Second end (of handpiece member) 18 Cutting active element 20 Coagulation active element 22 Return electrode 24 Conductive hollow tubular member 26 First end (of conductive hollow tubular member) 28 Second end (of conductive hollow tubular member) 30 Conductive appendage 32 Active electrode 33 Conductive cylindrical rod member 34 Portion of active electrode (extending beyond first end of conductive hollow tubular member) 35 Curved conductive member 36 Actuator (e.g., solenoid)
38 hollow area (in hand piece) 40 interior of conductive hollow tubular member 42 exhaust port (of hand piece) 43 vacuum tube 44 connection member (to/for smoke evacuation device) 46 second connection member (to ESU generator for cutting/coagulation by device) 48 circuit board 50 first conductive communication means (connecting return electrode to circuit board) 52 second conductive communication means (connecting active electrode to circuit board) 60 non-conductive guide member 100 laparoscopic hyperpolar electrosurgical device with foot switch control 102 hand piece member 104 first end (of hand piece member) 106 second end (of hand piece member) 107 foot switch 109 connection member (to ESU generator for cutting/coagulation by device) 122 return electrode 124 conductive hollow tubular member 126 first end (of conductive hollow tubular member) 128 Second end 130 (of the conductive hollow tubular member) Conductive appendage 132 Active electrode 134 Portion of active electrode 136 ( extending beyond the first end of the conductive hollow tubular member) Actuator (e.g., a solenoid)
138 hollow area 140 (within hand piece) interior 142 (of conductive hollow tubular member) exhaust port 143 (of hand piece) vacuum tube 144 connection member (to/for smoke evacuation device) 146 connection member (to ESU generator for cutting/coagulation by device) non-conductive guide member 200 laparoscopic hyperpolar electrosurgical device 222 return electrode 224 conductive hollow tubular member 226 first end 230 (of conductive hollow tubular member) conductive appendage 232 active electrode 234 portion of active electrode 235 (extending beyond first end of conductive hollow tubular member) insulating material (e.g., ceramic)
260 Non-conductive guide member 300 Laparoscopic hyperpolar electrosurgical device 322 Return electrode 324 Conductive hollow tubular member 326 First end (of conductive hollow tubular member) 330 Conductive appendage 331 Conductive loop 332 Active electrode 333 Opening 334 Portion of active electrode (extending beyond first end of conductive hollow tubular member) 335 Planar conductive member 336 Sharp edge 360 Non-conductive guide member 400 Laparoscopic hyperpolar electrosurgical device 412 Handpiece member 414 First end (of handpiece member) 416 Second end (of handpiece member) 418 Cutting working element 420 Coagulation working element 422 Return electrode 424 Conductive hollow tubular member 426 First end (of conductive hollow tubular member) 428 Second end (of conductive hollow tubular member) 430 Conductive appendage 432; active electrode 433; conductive rod member 434; portion of active electrode 435 (extending beyond the first end of the conductive hollow tubular member); blade-shaped member 436; actuator (e.g., a solenoid).
437 (actuator) pressing member 439 Spring member
440 Interior (of conductive hollow tubular member) 442 Exhaust port (of conductive hollow tubular member for exhausting smoke and debris) 444 Connection member (to/for smoke exhauster) 446 Connection member (to ESU generator for cutting/coagulation by device) 448 Circuit board 450 Conductive communication means 452 (connecting return electrode to ESU generator connection member) Conductive communication means 460 (connecting active electrode to circuit board) Non-conductive guide member

本発明の例示的な実施形態についての上記の説明は、本発明の様々な例示的な実施形態を示す。これらの例示的な実施形態およびモードは、当業者が本発明を実施することを可能とするために十分詳細に説明および図示されており、本発明の範囲、適用性、または構成をいかなる形でも限定することを意図するものではない。むしろ、本開示は、例示的な実施形態およびモードの実施と、当業者に知られているかまたは明らかな任意の同等のモードまたは実施形態の両方を教示することを意図するものである。さらに、含まれる全ての例は、例示的な実施形態およびモードの非限定的な例示であり、同様に、当業者に知られているかまたは明らかな任意の同等のモードまたは実施形態に役立つものである。 The above description of exemplary embodiments of the present invention illustrates various exemplary embodiments of the present invention. These exemplary embodiments and modes are described and illustrated in sufficient detail to enable one skilled in the art to practice the present invention, and are not intended to limit the scope, applicability, or configuration of the present invention in any manner. Rather, the present disclosure is intended to teach both the implementation of the exemplary embodiments and modes, and any equivalent modes or embodiments known or apparent to those skilled in the art. Moreover, all examples included are non-limiting examples of the exemplary embodiments and modes, and are likewise intended to serve as examples of any equivalent modes or embodiments known or apparent to those skilled in the art.

具体的に記載されていないものに加えて、本発明の実施において用いられる構造、配置、用途、割合、要素、材料、または構成部品の他の組合せおよび／または修正は、本発明の範囲から逸脱することなく、変更するか、そうでない場合には、特定の環境、製造仕様、設計パラメータ、または他の動作要件に特に適合させることができ、また本開示に包含されることを意図するものである。 In addition to those not specifically described, other combinations and/or modifications of the structure, arrangement, application, proportions, elements, materials, or components used in the practice of the invention may be varied or otherwise specifically adapted to a particular environment, manufacturing specifications, design parameters, or other operating requirements without departing from the scope of the invention and are intended to be encompassed by this disclosure.

特に断りのない限り、明細書および特許請求の範囲における単語および語句が、一般に認められている一般的な意味、または当業者によって用いられる通常の慣習的な意味を与えられることを本出願人は意図している。これらの意味が異なる場合、明細書および特許
請求の範囲における単語および語句は可能な限り広い一般的な意味を与えられるべきである。任意の他の特別な意味が任意の単語または語句について意図される場合、本明細書はその特別な意味を明確に記述および定義することにする。 Unless otherwise noted, it is the applicant's intention that the words and phrases in the specification and claims be given their generally accepted ordinary meaning or their ordinary and customary meaning used by those of ordinary skill in the art. Where these meanings differ, the words and phrases in the specification and claims should be given the broadest possible ordinary meaning. If any other special meaning is intended for any word or phrase, this specification shall expressly state and define that special meaning.

Claims

a handpiece member having a first end, a second end, and at least one of a cutting element and a coagulating element;
a return electrode comprising a conductive hollow tubular member having a first end and a second end received within the first end of the handpiece member, and a conductive appendage extending upwardly from the first end of the conductive hollow tubular member in a perpendicular relationship to a length of the conductive hollow tubular member;
an active electrode contained within the handpiece member and the conductive hollow tubular member, at least a portion of the active electrode extending beyond the first end of the conductive hollow tubular member;
a non-conductive guide member received within at least a portion of the conductive hollow tubular member so as to extend across an inner diameter of the conductive hollow tubular member;
an actuator housed within the handpiece member and in communication with the active electrode to move the active electrode toward the conductive appendage of the return electrode when at least one of cutting and coagulation is activated.

The laparoscopic electrosurgical device of claim 1, wherein the handpiece member further comprises a hollow region contained therein, the interior of the conductive hollow tubular member and at least a portion of the hollow region contained within the handpiece member together forming a smoke exhaust channel.

The laparoscopic electrosurgical device of claim 2, further comprising a connection member connecting the actuator to a smoke exhaust device for simultaneously activating smoke exhaust when at least one of cutting and coagulation is activated.

2. The laparoscopic electrosurgical device of claim 1, wherein the non-conductive guide member extending across an inner diameter of the conductive hollow tubular member near the first end of the conductive hollow tubular member creates two channels along opposing sides of the non-conductive guide member adjacent an interior of the conductive hollow tubular member surrounding the active electrode contained within the conductive hollow tubular member.

The laparoscopic electrosurgical device of claim 1, wherein the active electrode comprises a curved conductive member connected to a conductive rod member.

The laparoscopic electrosurgical device of claim 5 , wherein the curved conductive members comprise U-shaped or V-shaped conductive members.

The laparoscopic electrosurgical apparatus of claim 5 , wherein at least a portion of the conductive rod member is movable through the non-conductive guide member.

The laparoscopic electrosurgical device of claim 1, wherein the actuator comprises a solenoid.

The laparoscopic electrosurgical device of claim 1, further comprising an exhaust port connected to the conductive hollow tubular member such that the conductive hollow tubular member can also function as a smoke exhaust channel.

1. A laparoscopic electrosurgical device, comprising:
a handpiece member having a first end and a second end;
a return electrode comprising a conductive hollow tubular member having a first end and a second end received within the first end of the handpiece member, and a conductive appendage extending upwardly from the first end of the conductive hollow tubular member in a perpendicular relationship to a length of the conductive hollow tubular member ;
an active electrode contained within the handpiece member and suspended within an interior of the conductive hollow tubular member, at least a portion of the active electrode extending beyond the first end of the conductive hollow tubular member to create an open space contained between the conductive appendage of the return electrode and the portion of the active electrode that extends beyond the first end of the conductive hollow tubular member;
a non-conductive guide member received within at least a portion of the conductive hollow tubular member of the return electrode so as to extend across an inner diameter of the conductive hollow tubular member of the return electrode, wherein at least a portion of the active electrode is movable within the non-conductive guide member;
an actuator housed within the handpiece member and in communication with the active electrode to move the active electrode toward the conductive appendage of the return electrode when the laparoscopic electrosurgical device is activated for at least one of cutting and coagulation.

The laparoscopic electrosurgical device of claim 10 , further comprising a foot switch in communication with the laparoscopic electrosurgical device to activate the laparoscopic electrosurgical device to perform at least one of cutting and coagulation.

The laparoscopic electrosurgical device of claim 11 , further comprising a connecting member connecting the actuator to a smoke evacuation device for simultaneously activating smoke evacuation upon activation of at least one of cutting and coagulation.

11. The laparoscopic electrosurgical device of claim 10, wherein the handpiece member further comprises a hollow region contained therein, the interior of the conductive hollow tubular member and at least a portion of the hollow region contained within the handpiece member together forming a smoke exhaust channel.

11. The laparoscopic electrosurgical device of claim 10, wherein the non-conductive guide member extends across the inner diameter of the conductive hollow tubular member near the first end of the conductive hollow tubular member to create two channels along opposing sides of the non-conductive guide member adjacent an interior of the conductive hollow tubular member surrounding the active electrode contained within the conductive hollow tubular member .