The monopolar electrode with internal insulation


(57) Abstract:

The invention relates to medicine, namely to surgery. Electrode for monopolar coagulation comprises coagulating a work item, which is connected with a current-carrying wire. The wire has a heat resistant dielectric coating. The casing is a metal tube, resistant to mechanical and chemical influences. Inside the enclosure passes the current-carrying wire. In the dielectric handle posted by electrocontact associated with current-carrying wire. The electrode can prevent electroerosive complications. 1 Il.

The invention relates to medicine, namely to electrosurgical instruments used in laparo and thoracoscopic surgery.

In endosurgery for the purpose of coagulation and cutting of fabrics are widely used tools for monopolar coagulation, giving the chance to make as electrosurgical and mechanical manipulation of a single instrument. Existing prototypes - endosurgical instruments foreign and domestic firms allow you to use manoharlal in different modes. Working branches through the metal body and handles covered with insulation di is roscopically operations in emergency surgery. M., 1997, S. 9-12). Application of known instruments connected to the existence of specific complications - electrobiology damage, causing serious consequences (Balalykin A. S. Endoscopic abdominal surgery. M , 1996; Davydov, A. A. et al. Electrothermal injuries during laparoscopic cholecystectomy. The materials of the Russian Symposium "Complications of endoscopic surgery". M, NCH RAMS, 1996).

The prototype of the invention is L-shaped monopolar electrode produced by the domestic firm Andmedium. It consists of a body and handles are covered with insulation, the working part, which is supplied with alternating current of high frequency electrosurgical generator through electrocontact located on the handle of the tool (Balalykin A. S. Endoscopic abdominal surgery. M., 1996, S. 13-15). Electrosurgical complications such as burns perforations of the intestine, burn injuries of the bile ducts, the development of late burn strictures, burns wounds of the abdominal wall usually involve a violation of the principles and rules of surgery, use of a defective endosurgical tools with damaged insulation. This raises the effects of a direct or capacitive insulation faults. The exclusion of any electrosurgical electrode, disposable or reusable, can potentially be damaged due to operation or manufacturing defects, it is very sensitive to frequent mechanical stress during operation (rubbing her about the metal valve trocar) and during sterilization. These insulation are a point, almost imperceptible, but at the same time can cause shedding 100% electric flow on tissue defects can be significant. The foregoing has prompted the development of a new design monopolar electrode, devoid of the shortcomings of existing analogues electrode with internal insulation and the metal is not current-carrying case.

The aim of the invention is the prevention electrobiology complications in endosurgery when performing monopolar coagulation.

Significant difference between the proposed electrode with internal insulation is that: 1) the body of the electrode is not in electrical conductivity and therefore not covered by electrical insulation; 2) the body has a protective function and is a case in which the current-carrying wire in a heat resistant dielectric coating. The electrode ASTM wire (3), having the heat-resistant dielectric coating (4), housing (5), which is a metal tube, resistant to mechanical and chemical influences, inside of which passes a current-carrying wire. In the dielectric handle (6) posted by electrocontact (7) associated with current-carrying wire.

The device is used as follows. To the electric socket of the electrode (7) is connected to the cord from the electrosurgical apparatus. Cutting and coagulation of tissue is the working end of the electrode (1).

This design allows us to dramatically increase the service life of the electrode. Additionally, the electrode safe as excluded electraprobe and minor condenser capacity accumulating on the body dissipates after contacting metal trocar.

Clinical example 1. Patient S. 61 year history N160054 operated on for chronic calculous cholecystitis. Surgery laparoscopic cholecystectomy. Earlier, the patient underwent laparotomy about penetrating injuries of the abdomen and had extensive adhesions in the upper floor of the abdominal cavity. The selection of the gallbladder from the bed and coagulation Lodge for the purpose of hemostasis spend docnoj intestine during the operation, the body of the electrode when performing coagulation repeatedly contacted with the wall of the intestine. When viewed in this section of the intestine at the end of operation of any changes from the wall, indicating the presence possible in this case (due to the direct or capacitor breakdown) electroooooo damage was not detected. The postoperative period is smooth. Recovery.

Clinical example 2. Patient A. 48 years, history N18261 operated 18.05.96, chronic calculous cholecystitis. Performed laparoscopic cholecystectomy. For the selection of the gallbladder from the Lodge used the L-shaped electrode for monopolar coagulation company KARL STORZ. In the postoperative period on the 4th day the patient was operated again in connection with the development complication - cholangitis and mechanical jaundice. Operations identified electrothermal burns wall of the common bile duct. The reason for its development was electraprobe through the insulation of the instrument in its working end. This is a small insulation damage was found during the detailed inspection of the instrument used in laparoscopic surgery, and arose from the friction of the valve of the trocar when conducting instrument into the abdominal cavity during repeated use.

Pictomio in 120 cases. Damage to the shell and insulation of the electrode of this design, electrobiology complications in patients was not.

The monopolar electrode containing metal case, the work item and the handle, characterized in that the working element is connected with held in case of current-carrying wire, which is enclosed in a heat resistant dielectric coating, the body is made from a material resistant to mechanical and chemical attack.


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