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Claims  |
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I claim:
1. In a hand-operated electrosurgical cautery instrument constructed
particularly for single occasion use as a disposable combination
cauterizer electrode and sucker tube, adapted for use with remotely
located vacuum source means and electrical high frequency current source
and control means, the improvement wherein said cautery instrument
comprises:
a. sucker tube means including an elongated metallic tube of small diameter
adaptable for entry into surgical cavities, said tube constituting an
electrode and at least a partial sucker tube combination having distal,
intermediate and proximal portions; said proximal portion adapted to be
connected with a flexible tubing for connection with said vacuum source
means;
b. handle means embracing and in sealed relationship with at least an
intermediate portion of said sucker tube;
c. a flexible electrical conductor wire of predetermined length having one
end electrically connected to a portion of said electrode tube which is
embraced by said handle means; said wire extending from and being
insulated exteriorly of said handle means, and having the other wire end
free and adapted to be electrically connected with said source of high
frequency power;
d. said handle means including a specially contoured handle having
substantial cross-sectional thickness and good thermal and electrical
insulating characteristics, and unitarily surrounding a substantial
portion of said electrode tube length, including complete fail-proof
enclosure of said conductor wire connection with said electrode tube, said
handle terminating short of and freely exposing a substantial distal
portion of said electrode tube, and having a generally elongated
intermediate portion, and said handle further having a proximal end
portion, and having a generally distal end portion embodying plural
compound curvatures defining plural digital grippping portions to provide
for positive deft manipulation of said instrument in use; and
e. said handle means and sucker tube collectively having selectively
establishable suction control cavity means including:
1. an internal, recessed suction control cavity in said handle means
surrounding said intermediate portion of said sucker tube;
2. an aperture in said sucker tube generally adjacent said recessed suction
control cavity; and
3. an externally accessible frangible membrane in said handle means
initially integrally covering said suction control cavity and adapted to
be selectively manually breachable as preference may dictate.
2. An instrument as defined in claim 1, wherein said distal portion of said
electrode tube which is not enclosed by said handle is enveloped by a
sleeve of an electrically insulative material.
3. An instrument as defined in claim 1, wherein said distal portion of said
electrode tube which is not enclosed by said handle is enveloped by a
sleeve of an electrically insulative material having a generally uniform
and substantially less cross-sectional thickness than that of said handle.
4. An instrument as defined in claim 1 wherein said handle means includes
composite complementally abuttable handle members having distal portions
of reduced cross-sectional size from the rest of said handle members and
collectively tapering to a free end portion distally of said instrument,
and further including sucker-tube-sleeve insulating means surrounding both
essentially all of the distal end of the sucker/electrode tube which
projects distally from said handle, and said reduced cross-sectional size
distal tapering portions of said handle.
5. An instrument as defined in claim 1, wherein said contoured handle is
provided with a laterally widened portion to fixedly and unitarily encase
therein said interconnected wire and proximal portion of said electrode
tube, in a fail-safe permanent manner.
6. An instrument as defined in claim 1, wherein said handle-formed, plural
digital gripping portions include at least a pair of oppositely disposed
finger-and-thumb gripping portions symmetrically formed in laterally
opposed sides of said handle toward a distal portion, to provide for
ambidextrous use of said instrument.
7. An instrument as defined in claim 6, further including a second pair of
digital receiving contoured areas formed in opposed top and bottom
surfaces of said handle adjacent said first-mentioned gripping portions,
said second pair of recesses being longitudinally offset from one another
in the distal portion of said handle, to particularly receive forefinger
and index finger gripping thereof along with simultaneous thumb gripping
in one of said laterally opposed recesses.
8. An instrument as defined in claim 1, wherein said electrical conductor
wire of paragraph (b) is permanently electrically connected to a generally
proximal portion of said electrode tube.
9. An instrument as defined in claim 1, wherein said distal portion of said
electrode tube which is not enclosed by said handle is of manually
bendable form and adapted to be of slightly curved form.
10. An instrument as defined in claim 9 wherein said curved tube portion is
in a vertical plane so as to tend to point downwardly when held in one
operative use position.
11. An instrument as defined in claim 10, wherein said electrode tube is
also curved slightly downwardly along a proximal portion and generally
co-planar with the distal end curvature, said proximal curvature being
such as to be embodied and generally concealed within said handle.
12. An instrument as defined in claim 1 wherein said handle at its distal
portion further includes a substantially reduced and generally circular
cross-sectional handle portion integrally formed therewith and projecting
longitudinally distally therefrom, said reduced cross-sectional portion
being of a size to facilitate insertion into surgically drilled holes in a
patient's skull during the performance of craniotomies.
13. An instrument as defined in claim 12 wherein said reduced
cross-sectional distal handle portion and said distal portion of said
electrode tube are both of gently arcuate form.
14. An instrument as defined in claim 12, wherein said distal portion of
said electrode tube which is not enclosed by said handle is enveloped by a
sleeve of electrically insulative material having a generally uniform
cross-sectional thickness which is substantially less than that of said
handle portions.
15. An instrument as defined in claim 1 wherein said handle comprises two
basic longitudinally split half portions which are integrally joined
together in a permanent manner about portions of the sucker tube and
conductor wire components of paragraphs (a) and (c).
16. An instrument as defined in claim 15, wherein said handle portions are
divided generally horizontally into complementally adjoining upper and
lower half members.
17. An instrument as defined in claim 16 wherein said handle portions are
provided with complementally opposed recessed areas throughout at least a
substantial length of each handle portion, said recessed areas adapted to
receive at least portions of both said combined electrode and sucker tube
means and also attached portion of said electrical conductor wire.
18. An instrument as defined in claim 1, wherein said metal electrode tube
has its proximal portion terminating within said handle, and said sucker
tube means further includes a predetermined length of said flexible tubing
as an integral part thereof, one end of which is affixed in operative
connection with said proximal portion of said electrode tube, and said
flexible tubing having a portion integrally enclosed within said handle,
and said tubing further including a length extending from a generally
proximal portion of said handle.
19. An instrument as defined in claim 18, wherein said flexible sucker
tubing is basically of non-metallic material but includes integrally
formed means enabling it to have electrically conductive characteristics
which when grounded precludes build-up of electrostatic charges.
20. An instrument as defined in claim 18, wherein said flexible sucker
tubing includes a basic fluid conduit, and a second longitudinally split
conduit integrally formed coestensively therewith for at least a partial
predetermined extent thereof exteriorly of said handle; said split conduit
adapted to removably receive therein in an integrated manner the said
electrical conductor wire for at least part of said predetermined length
adjacent to said handle.
21. An instrument as defined in claim 18, wherein said flexible sucker
tubing includes a basic fluid conduit, and integrally
conductor-wire-fastener means formed with said sucker tubing.
22. An instrument as defined in claim 1, wherein said composite handle
includes a pair of longitudinally divided complementary handle members
each having complementally mating opposed recessed channels throughout a
substantial length thereof to receive said sucker tube means and an
adjoining portion of said electrical conductor wire.
23. An instrument as defined in claim 1, wherein said suction control
cavity is formed nearly completely through a wall of said handle and is in
general alignment with said suction control hole provided in said
electrode/sucker tube; said handle wall exteriorly adjacent said suction
control cavity constituting said integral frangible membrane covering for
said cavity, and said membrane being of pheripherally weakened form to
facilitate a manual breachable selective removal when preferred to have a
suction control feature with said cautery instrument.
24. An instrument as defined in claim 23, wherein said suction cavity is of
size progressively increasing in cross-sectional area inwardly away from
said weakened membrane cover.
25. An instrument as defined in claim 1, wherein said suction control hole
means in said sucker tube include anhole through a side wall portion
thereof; and further including sealing means adjacent said suction hole in
said sucker tube to preclude potentially undesired air flow from other
portions of said instrument.
26. An instrument as defined in claim 25, wherein said handle is provided
with an internal enlargement radially and axially adjacent to and
communicating with said suction control cavity means, and said suction
control hole in said sucker tube, thereby facilitating assembly of the
instrument sucker tube and handle components without particular need to
carefully align said suction control hole and said suction control cavity.
27. In a hand-operated electrosurgical cautery instrument embodying a
combination cauterizer electrode and sucker tube, the instrument being
adapted for use with remotely located vacuum source means and electrical
high frequency current source and control means, handle means having
electrical and thermal insulating characteristics fully embracing and in
sealed relationship with at least an intermediate portion of said
combination electrode and sucker tube and terminating short of and freely
exposing a substantial distal portion of said electrode/sucker tube, a
flexible electrical conductor wire of predetermined length having one end
electrically connected to a portion of said electrode tube which is
embraced by the handle means, the wire extending from a generally proximal
portion and being insulated exteriorly of said handle means for connection
with said electrical power source; the improvement comprising in
combination therewith:
a. a suction control hole provided in said electrode/sucker tube in an area
within the sealed portion of said handle means;
b. suction control cavity means formed internally in said handle means
generally adjacent said suction control hole in said electrode/sucker
tube; and
c. said handle means including a frangible layer overlying its said suction
control cavity means and constituting a unitarily formed membrane cover
thereof which is adapted to be selectively removed to establish a suction
control feature with said instrument or may be left undisturbed and in
place as desired by the user.
28. An instrument as defined in claim 27 wherein said handle is provided
with an internal enlargement radially and axially adjacent to and
communicating with said suction control cavity means, and said suction
control hole in said sucker tube, thereby facilitating assembly of the
instrument sucker tube and handle components without particular need to
carefully align said suction control hole and said suction control cavity.
29. An instrument as defined in claim 27, wherein said distal portion of
said electrode tube which is not enclosed by said handle is enveloped by a
sleeve of an electrically insulative material having a generally uniform
and substantially less cross-sectional thickness than that of said handle.
30. An instrument as defined in claim 27, wherein said handle means
includes composite complementally abuttable handle members having distal
portions of reduced cross-sectional size from the rest of said handle
members and collectively tapering to a free end portion distally of said
instrument, and further including sucker-tube-sleeve insulating means
surrounding both essentially all of the distal end of the sucker/electrode
tube which projects distally from said handle, and said reduced
cross-sectional size distal tapering portions of said handle.
31. An instrument as defined in claim 27, wherein said electrical conductor
wire is permanently electrically connected to the generally proximal
portion of said electrode tube.
32. An instrument as defined in claim 27, wherein said distal portion of
said electrode tube not enclosed by said handle is of manually bendable
form and adaptable to be of slightly curved form.
33. An instrument as defined in claim 27, wherein said handle comprises two
basic longitudinally split half portions which are integrally joined
together in a permanent manner about portions of the sucker tube and
conductor wire components.
34. An instrument as defined in claim 27, wherein said suction cavity means
includes a cavity of a size progressively increasing in cross-sectional
area inwardly away from said frangible membrane cover.
35. An instrument as defined in claim 27, further including sealing means
adjacent said suction control hole in said sucker tube to preclude
potentially undesired air flow from other portions of said instrument.
36. An instrument as defined in claim 27, wherein said handle at its distal
portion further includes a substantially reduced and generally circular
cross-sectional handle portion integrally formed therewith and projecting
longitudinally distally therefrom, said reduced cross-section portion
being of a size to facilitate insertion into surgically drilled holes in a
patient's skull during the performance of craniotomies.
37. An instrument as defined in claim 27, wherein said metal electrode tube
has its proximal portion terminating within said handle, and said sucker
tube means further includes a predetermined length of said flexible tubing
as in an integral part thereof, one end of which is affixed in operative
connection with said proximal portion of said electrode tube, and said
flexible tubing having a portion integrally enclosed within said handle,
and said tubing further including a length extending from a generally
proximal portion of said handle.
38. An instrument as defined in claim 27, wherein said flexible sucker
tubing is basically of non-metallic material but is comprised of a
composition enabling it to have electrically conductive characteristics
which when grounded precludes build-up of electrostatic charges. |
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Claims |
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Description |
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BACKGROUND OF THE INVENTION
This invention relates to an improved self-contained electrosurgical
cautery of the disposable type which preferably is adatped to be
prepackaged in sterilized ready-to-use condition.
More specifically the invention relates to disposable electrical cauteries
used in a dual capacity to effect the coagulation and/or closing off the
terminal portions of severed blood vessels and to simultaneously draw off
excess blood from the surgical opening or wound.
The prior art is known to encompass various electrosurgical instruments
including some electrical cauteries embodying hand-held electrosurgical
electrodes connected through an electrical conductor wire to an
electrosurgical unit, some of which utilize an inactive electrode in plate
form or the like beneath the patient, and further connect the latter
electrode to the electrosurgical unit which is properly grounded.
While some of these prior art devices have provided innovative and improved
surgical procedures and results, much of the currently available equipment
still suffers from certain of the following disadvantages. 1. Inadequate
thermal insulation provided by only thin plastic coatings around
relatively thin pencil-like electrodes. These electrodes get unbearably
hot, particularly during heavy usage, and must be cooled before the
operation can be completed. Such delays endanger the patient and are
otherwise costly. 2. Unsafe electrical insulation which evolves from
repeated cycles of usage and resterilization, which tend to crack and chip
the insulation on known prior art devices. These usually cause short
circuits often resulting in electrical burns or shock to the user severe
enough to burn holes in rubber operating gloves. Further, this tends to
contaminate the operating field, and the surgeon often must continue to
operate with painful burns.
3. Unreliable electrical connectors, evolving from the electrical
connectors and interconnecting wire being subjected to repeated
resterilization whereby they become unreliable after a few uses.
Operations are frequently delayed when one of the connectors shorts out
and requires repair.
4. Resterilization takes costly time, and they are difficult to sterilize
as a result of the time delay between completion of operations and
cleansing of the instruments, during which delay blood and other tissue
remaining in the sucker tube or barrel of the electrode tends to dry and
cling to the inside wall thereof in spite of regular washing. This residue
breeds bacteria which is frequently not killed in sterilization because
steam and disinfectant gases do not adequately vent through the thin
tubing of the barrel. In normal surgical procedure, the barrel often
becomes clogged with tissue and must be cleared by inserting a thin wire.
Withdrawing this wire brings with it the bacteria lodged there and
contaminates the sterile operating field.
5. Poor human engineering has provided present electrodes which are
unwieldly and difficult to use with precision. The very thin barrel of the
electrode is too small to grip securely, especially with moist surgical
gloves; and the heavy rubber tubing and wire connector at the rear of such
prior art electrodes make them extremely unbalanced. Furthermore, the
separately extended or hanging vacuum tubing and electrical conductor
wiring of the prior art cauterizers tend to interfere with and impede
efficient surgical and operating room procedures. Also because a cautery's
electrical resistance changes after each use, the associated electrical
power source must be re-adjusted almost each time.
6. The discomfort and possibility of infection associated with currently
available electrodes forces many surgeons to use slower more difficult
means of controlling bleeding in spite of the decided advantages offered
by cauterization afforded by prior art electrosurgical units such as the
CSV BOVIE manufactured by the Ritter Equipment Company, a division of
Sybron Corporation.
In order to alleviate the foregoing problems and disadvantages, the present
improved inventions were developed and have been successfully used.
SUMMARY OF THE INVENTION
The improved disposable cauterizer of this invention overcomes all of the
above problems, and basically consists of an insulated-handle-enclosed
metal tube with a conductor wire permanently attached, thus eliminating
the bulky connector and avoiding the possibility of a short circuit. A
specially contoured plastic handle of generous proportions may be molded
over the tube in some embodiments, or otherwise made to permanently cover
the junction of the conductor wire. The thick handle provides more than
adequate thermal and electrical protection, and its anatomical contour
thereby makes the electrode very easy to manipulate.
Prior to use, a flexible hose or sucker tube, connectible with vacuum
source, is attached to the proximal portion of the tubular electrode
which, in one form, projects from the corresponding proximal end of the
handle, and the wire, which is suitably insulated, is connected to a high
frequency power source. In another more preferred form, a preferably clear
flexible plastic sucker tube is firmly connected to an electrode, and the
handle is initially made in two parts having complemental recessed areas
and channels therein to receive the assembly of the sucker tube and
preattached electrical conductor wire. In this latter form, the hollow
stainless steel electrode tube does not project from the rearward or
proximal portion of the handle, but terminates approximately midway within
the handle, and one end of the preferably clear electrically conductive
flexible plastic sucker tube is firmly attached over the end of the
handle-enclosed portion of the electrode tube. Both the sucker tubing and
electrical conductor wire are of predetermined lengths to reach the
respective associated equipment. Provision also is made on the sucker
tubing to integrate therewith the electrical conductor wire, at least for
preferably several feet in the immediate area of the operating table, to
reduce the likelihood of interference by separate tubing and electrical
conductor wires otherwise stretched out individually among the patient and
operating staff members.
Yet another preferred embodiment contemplates my improved cautery which
includes the provision of a selectively establishable suction control hole
in the handle and tube, of the type disclosed in the mid-to-latter part of
the Abstract of the Disclosure.
In operation, blood from a surgical incision is drawn by a vacuum through
the barrel of the electrode and clear of severed vessels, and a high
frequency current passing through the electrode cauterizes the ends of the
vessels preventing further bleeding. The device of this type is most aptly
described as a cauterizer, however, surgeons frequently refer to it as a
desiccator or just BOVIE after the power supply with which it is often
used. When the control hole is desired, the weakened membrane usually is
initially punched out, and which hole can be covered selectively by the
finger or thumb to obtain full or partial suction at the tip of the
suction tube.
This improved electrode is designed to be disposable after one use and will
be shipped from the factory prepackaged in sterile containers. This
guarantees the sterility of the instrument and insures that the connecting
wire will not fail due to wear.
Accordingly, it is the principal object of this invention to provide an
improved disposable type cautery which will overcome all of the
aforementioned disadvantages, and, by embodying the foregoing improved
features, may be used in conjunction with existing electrosurgical units.
This and other objects and advantages of the present invention will become
apparent from a consideration of the following detailed description taken
together with the illustrative drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view of one embodiment of the improved suction-type
cauterizer having a slightly curved electrode probe;
FIG. 2 is a front elevational view taken on line 2--2 of FIG. 1;
FIG. 3 is a rear elevational view of the instrument of FIG. 1;
FIG. 4 is a top plan view of the instrument of FIG. 1;
FIG. 5 is a side elevational view of the instrument of FIGS. 1 and 4, the
forward half of which is substantially symmetrical about a longitudinal
center line;
FIG. 6 is a bottom plan view of the instrument shown in FIGS. 1, 4 and 5;
FIGS. 7, 8 and 9 are cross-sectional views as taken substantially on lines
7--7, 8--8, and 9--9 of FIG. 5;
FIG. 10 is a cross-sectional view taken on line 10--10 of FIG. 6;
FIG. 11 is a fragmentary side elevational view of the proximal position of
the instrument as viewed on line 11--11 of FIG. 4;
FIG. 12 is a fragmentary side elevational view similar to FIG. 5, but only
of the distal probe portion of a modified embodiment having a straight
electrode probe, and having a portion of the body broken away;
FIG. 13 is a fragmentary side elevational view of the proximal end portion
of a modified hose connection portion of the body;
FIG. 14 is a perspective view similar to FIG. 1, but depicting a modified
form having a foreshortened handle and reduced size elongated electrode
probe adapted more particularly for neurological use;
FIG. 15 is a bottom plan view of the modified form of FIG. 14;
FIG. 16 is a side elevational view of the FIG. 14 form as taken on line
16--16;
FIG. 17 is a perspective view, similar to FIGS. 1 and 14, of a further,
preferred embodiment fabricated of two body half members fused together to
integrally unite the components therein, and depicting a straight
electrode probe therewith;
FIG. 18 is an exploded perspective view of the embodiment of FIG. 17,
better showing body recess details and the relative relationship of the
component members thereof;
FIG. 19 is a side elevational view of the embodiment of FIGS. 17 and 18
showing folded predetermined lengths of the flexible sucker tubing and
electrical conductor wiring associated therewith, and depicted within a
broken outlined sterilized package schematically representative of the
intended disposable character in which the representative is preferably
merchandised;
FIG. 20 is an end view of novel form of flexible sucker tubing preferably
having integrally molded or otherwise suitably formed therewith means for
integrating the electrical conductor wire in association therewith, as
better shown in FIG. 18;
FIG. 21 is a longitudinal fragmentary cross-sectional view representative
of a further preferred embodiment, showing provisional for a suction
control hole means in the cautery;
FIG. 22 is a view of the upper half of the cautery of FIG. 22, taken
substantially on line 22--22 of FIG. 21, and omitting the suction/cautery
tubing;
FIG. 23 is a view similar to FIG. 21 showing a still further modification
of the form of FIG. 21; and
FIG. 24 is an enlarged transverse cross-sectional view taken substantially
on line 24--24 of FIG. 23.
DETAILED DESCRIPTION OF EMBODIMENTS
In the preceding and following description, the term distal is understood
to refer to the forward-most end most remote from the user, whereas the
term proximal refers to the rearward-most end of the cautery closest to
the user.
Referring to the form of FIGS. 1-11, the suction cautery is generally
designated at 10 and comprises an elongated, electrically conductive metal
electrode/sucker tube 12 terminating in a distal end 14 and a proximal end
16, and having one end of a length of insulated electrical conductor wire
18 permanently attached at 20 (FIG. 4) to a proximal portion of the tube
12. The permanent connection thereof eliminates the necessity of a
separate connector fixture, which is often bulky, and avoids the
possibility of a short circuit, particularly when the major part of the
tube 12 and the end portion of wire 18 are permanently encased in the
uniquely anatomically shaped or contour-molded plastic handle 22. The
projecting portion of tube 12 of this form is preferably of slightly
acruate form in the vertical plane thereof.
Handle 22 is of generous proportions and includes opposed distally disposed
identical recessed thumb and finger gripping portions 22, 24 and an
arcuately raised projection 26 on the top side which smoothly forms a
first concave finger rest 28 with the distal extremity of the handle. The
handle 22 further includes a generally inverted pyramidal shaped
projection 30 on the distally bottom side which blends smoothly with the
main body of the handle to form a second concave finger rest 32
therebeneath. The specially contoured handle permits ambidextrous deft and
positive gripping of the instrument in the various manners as depicted in
FIGS. 1 and 5. While the instrument preferably will be handled primarily
in the manners mentioned, the slightly trapezoidal shaped cross-section of
the main body, as depicted in FIG. 9, further facilitates a comfortable
and positive manipulative grip of the instrument when held at an
intermediate portion of the handle.
Preferably, the proximal portion of handle 22 includes a pronounced
laterally offset portion 34 which rigidly encases the conductor wire 18.
The proximal main body portion further preferably includes an intergrally
molded convoluted or annularly ribbed hose-connection nipple 36 to
facilitate a good friction fit therewith of a flexible vacuum hose 38
shown in broken outline in FIGS. 1 and 4. The body handle is seen to have
substantial thickness, and is fabricated of a plastic or other suitable
rigid material having appropriate electrical and thermal insulating
qualities. Therefore, it is very comfortable and easy to manipulate.
The distally projecting end of the suction/electrode tube 12 is usually
covered with an insulation sleeve 40 beyond the handle 22 to within about
1/8 inch of the end. If desired, the insulation sleeve 40 may extend the
full length of the tube and be molded or gripped partially or fully within
the handle 22, although this is not necessary in view of the insulative
qualities of handle 22. Sleeve 40 may be of tapering or otherwise
non-uniform cross-section in an area exposed forwardly of the handle 22
and the coutoured finger gripping area.
The improved disposable cautery electrode is to be factory packaged in
sterile containers or envelopes, ready for use upon opening by the doctor.
Prior to surgical use, the flexible vacuum hose 38 from a suitable vacuum
source is connected to the hose nipple 36, and the conductor wire 18, of
predetermined length is connected to a high frequency source of electrical
power, such as mentioned in the preamble hereof. During operative use, the
accumulating blood from a surgical incision is drawn through the hollow
barrel of the tubular electrode 12, clear of the severed blood vessels,
and a high frequency electrical current is passed through the electrode to
cauterize the vessels and prevent further bleeding.
Referring to the modified form of FIGS. 12 and 13, the instrument 10' is
essentially identical to the aforedescribed embodiment, except that the
distally protruding electrode or point is of straight form, and the
proximally extending hose-connecting nipple 36' is of slightly different
form from that of the previously described form. Because of the near
identical construction of these various forms, the same but primed and
double primed reference numbers are being used to designate corresponding
parts therein. While separate forms may be provided for different lengths
of protruding probes, depending upon preferences of different surgeons, it
is contemplated that the tubular electrode is of a sufficiently deformable
material whereby the forward probe end can be manually bent or curved to
adapt it to different use circumstances.
Further referring to the modified embodiment of FIGS. 14-16, this cautery
handpiece, designated generally at 10", is very much the same as the
previous forms except for embodying a foreshortened handle 22" having an
integrally formed, slightly arcuate tubular distal portion 23. The
generally cylindrical form of said forward portion 23 lends this
embodiment more particularly to neurological use such as in craniotomies,
whereby the reduced diameter of the probe end will readily pass through
holes surgically drilled in the patient's skull.
Referring next to the further preferred embodiments depicted in FIG. 17-20,
they are representative of improved features now to be described in more
detail.
The cautery assembly of this embodiment is quite similar in most respects
to the first described embodiments, and is generally denoted by the
numeral 50 having an initially two-part handle 52. Said handle 52 includes
an upper half member 54 and a lower half member 56. Said members are
suitably internally recessed and channeled to receive, and are
subsequently fused together around the preferably stainless steel
electrode tube 58 and adjoining flexible plastic sucker tubing 60 and
electrical conductor wiring 62. It is noted that the electrode tube 58 is
very similar in construction and identical in function to the counterpart
tubes 12 and 12' of the other embodiments. The main difference is that
tube 58 has a proximal terminal end portion 64 which terminates within a
generally medial portion of the composite handle 52. The presterilized
sucker tubing 60 is preferably simply slip fitted over the end 64 of tube
58, as shown, and the adjacent portion of the flexible plastic tubing is
received within preferably snug-fitting complementary recessed channels
54a and 56a in the body members.
Distally of the connection of the flexible tubing 60 upon the electrode
tube end 64, is the preferably permanent connection of the insulated
electrical conductor wire 62 to the metal electrode tube 58. The conductor
wire is stripped of its insulation for a short area and wrapped and
suitably soldered or brazed to said tube 58, as shown at 66 in FIG. 18.
Recessed provision, preferably in the form of opposed complemental
recesses 54b and 56b, is made to readily accommodate the aforedescribed
connections. Furthermore, the proximal portions of the handle members 54
and 56 also include preferably complemental recessed channels 54c and 56c
respectively, to receive and firmly grip therein the lead end portion of
the electrical conductor wire 62.
Additionally, the distal portions of said handle members are provided with
preferably complemental recesses 54d and 56d to receive therebetween both
a major portion of the electrode tube 58, and also preferably a portion of
the overlying insulating sleeve 68 provided around the distally exposed
portion of the electrode tube or probe 58. The distal most tip end 58' is
left bare, as mentioned in the first-described embodiments.
The general overall configuration and handle contours, particularly in the
distal finger-gripping areas, remain essentially like those of the
first-described embodiments, after the handle members are fused together.
It is contemplated that the handle members may be initially fabricated in
vertically divided half members rather than in the illustrated
horizontally divided manner, in which case any offset tail portion would
be generally vertically disposed, if used, rather than horizontally as
shown.
While the handle members may be joined together in any suitable manner,
either mechanically or adhesively, a preferred form is by the fusing
together by the application or ultrasonic vibrations to the assembled
handle components.
Straight or curved probe ends of the electrode tube may be provided as
desired, as well as a similar distally projecting reduced cross section of
the body handle corresponding to that of member 23 in the embodiment of
FIG. 14.
In each of the foregoing embodiments, the flexible plastic tubing 60 is to
be of an electrically conductive nature so that when in use it will ground
and dissipate any tendency to build up static electricity which is known
to be capable of exploding ether or other ambient gases having a
propensity to ignite or explode.
FIGS. 18 and 20 more particularly illustrate the novel form of the flexible
tubing 60 which I prefer to use in conjunction with all embodiments.
Tubing 60 comprises the usual basic full tubing conduit 61, and a second
integrally formed longitudinally split conduit portion 61a within which
conduit portion the insulated electrical conductor wire 62 is adapted to
be substantially fully and removably disposed. In the illustrated FIG. 18
embodiment, due to the use of separate channel-like recesses for the
tubing 60 and wiring 62, the second split conduit portion 61a is either
removed from or not originally fabricated with the basic tubing conduit 61
for the extent of which is housed within the handle 52. Preferably the
second, split conduit portion commences closely behind the proximalmost
end of the handle, and may be co-extensive with the full length or any
lesser predetermined portion of the flexible tubing 60, dependent upon the
particular circumstances relating to the type and relative disposition of
the vacuum and power source equipment with which they are attachable.
Primarily the flexible tubing and electrical conductor wire are
co-extensively joined for a sufficient common length so as to greatly
reduce the degree of potential interference by otherwise using two lines
separately in the immediate area of the operating table and attending
staff members. While the second split conduit 61a is shown as a complete
conduit which is longitudinally split, it also may be in the form of a
discontinuous conduit, or spaced split conductor-wire-fastener rings or
bands. Furthermore, in some other preferred forms, the split, designated
70, which may be oriented in different peripheral portions, is made to
have a positive longitudinal spacing to better facilitate insertion and
removal of the cable 62.
In merchandising the pre-sterilized cautery assembly of this invention in
individual envelope or container form, designated schematically at 72 in
FIG. 19, it is to be understood that the conductor wire 62 preferably
would be integrated within the split conduit 61a, although not shown as
such in said FIG. 19. The conductor wire 62 is preferably provided with an
electrical jack 74 of a suitable form to fit complementally into a power
source with which it is adapted to be used. While a preferred size of the
flexible vacuum tubing 60 may be of 1/8 inch I.D., it also may be made of
other various sizes or, may be provided with a suitable adaptor means 76
(FIG. 19) to facilitate joining with other size tubing or tubing
connections on the associated equipment.
The handles 22 and 52 are preferably made of an opaque plastic material and
may be provided in various colors, if desired, although an opaque white
has been found very acceptable and maintains a very antiseptic appearance
of the presterilized instruments. Due to the nature of the surgical use to
which these instruments are subjected, and the problems encountered among
various of the unsatisfactory prior art devices, it was necessary to
evolve any expendable electrode cautery to completely avoid any possible
contamination which otherwise might arise from a previous use.
Accordingly, the improved cauteries of this application were simply and
economically designed to be exceptionally dependable as well as disposable
while embodying the improved functional features lending themselves to be
economically, functionally, dependably and aesthetically attractive.
Reference next will be made to the suction control hole embodiments
depicted representatively in FIGS. 21-24, forming the main basis of this
continuation-in-part application.
Some surgeons prefer to use an electrosurgical cautery having the suction
control hole feature to enable them to have control over the suction or
vacuum in a suction-integrated cautery of this type. Control of the vacuum
or suction feature permits the surgeon to interrupt the formed vacuum and
thereby preclude potential increase of wound trauma when applying the
electrode to the tissue and severed vessels for coagulation. This control
thereby precludes the electrode from tending to "kiss" onto or otherwise
become unduly attached to the tissue in contact therewith, which
attachment may cause the tissue to stretch and tear during removal of the
electrode.
Suction control means for other electrosurgical cauteries has been known
heretofore. The simplest means of obtaining suction control in the
improved cauteries of this and my preceding applications, appears to be by
placement of a vent hole in the barrel of the cautery/suction tube, and
adjacent insulative handle.
In FIGS. 21 and 22, the cautery per se is designated generally as 50', with
similar parts designated by the same but primed reference numerals as
those used relative to FIGS. 17-20, where applicable. The upper portion
54' of the handle 52' is preferably provided with an integrally formed or
molded holelike potential suction-control cavity 80 covered by a thin,
peripherally weakened membrane 82 which can be readily punched out when
desired, as by a small hemostat, probe | | |
