Surgical cutting tool

Abstract: Various surgical tools are disclosed. One is a pair of surgical scissors, one of the blades of which has a distal blade portion electrically insulated from the remainder of the blade, a first electrical conductor electrically connected to the distal blade portion, and a second electrical conductor electrically connected elsewhere on the scissors, thereby enabling the scissors to act as a cautery. Other tools are also disclosed which have means for enabling suction to be applied to the site of operation of the tool and/or electrical connections to enable the tool to act as a cautery.

Description: This invention relates to a surgical cutting tool in the form of a pair of surgical scissors. Such surgical scissors are known from US-A-3 651 811 for example. When using such a tool, for example surgical scissors, or a surgical scalpel, the surgeon normally needs to have at least one assistant who can carry out suctioning at the site where the surgical tool is being used, so as to remove blood and other body fluids which are released by the use of the tool and which would otherwise obscure the surgeon's field of view. Such an assistant may also carry out ancillary tasks, for example cauterization. However, the need to involve an assistant has a number of disadvantages. One of these is that the carrying out of activities by the assistant at the same site as that where the surgeon is working may impede the surgeon's activities, and thus render them more difficult, or at least make the operation more lengthy. Furthermore, if it were not necessary for the assistant to carry suctioning and cauterization, the assistant might be more usefully employed in other tasks to assist the surgeon, and under some circumstances no assistant might be required at all. According to the invention claimed in the patent (EP-B-760629) granted on the patent application from which the present application is divided, there is provided a surgical cutting tool which is provided with means enabling suction to be applied to the site of operation of the tool. According to the present invention there is provided a pair of surgical scissors comprising first and second blades each having a cutting surface and an exterior surface, the cutting surfaces facing one another, the blades being pivotally connected to one another for relative pivotal movement about a pivotal axis, one of the blades having the tip portion electrically insulated from the remainder of the said one blade, a first electrical conductor electrically connected to the said distal blade portion, and a second electrical conductor electrically connected elsewhere on the scissors, thereby enabling the scissors to act as a cautery. The invention will now be further described with reference to the accompanying drawings, in which: Figure 1 shows a pair of surgical scissors according to the invention claimed in EP-B-760629; Figure 2 shows a view on an enlarged scale of the tip of one type of blade which may be used in the scissors of Figure 1; Figure 3 shows an alternative type of tip for use in the scissors of Figure 1; Figure 4 shows a second embodiment of surgical scissors according to the invention claimed in EP-B-760629; Figures 5a to 5d show a first combination of scissor tip configurations which can be used in the scissors of Figure 4; Figures 6a to 6d show a second combination of tip configurations which can be used in the scissors of Figure 4; Figures 7a to 7d show the incorporation of a clamp in a pair of surgical scissors, and are respectively a plan view with the scissors closed, a plan view with the scissors open, a side view with the scissors closed, and a side view with the blades separated for the sake of clarity, to show their construction; Figure 8 shows a pair of scissors according to the present invention. Referring to Figures 1 to 3, this shows a pair of surgical scissors 10 having members 12 and 14 which are connected by a pivot 16 and which have finger openings 18 and 20 respectively and blades 22 and 24 respectively. The blade 24 can be conventional in construction, but the blade 22 has a tip portion 26 which is modified. One form of modified tip is shown on an enlarged scale in Figure 2, and an alternative form of tip is shown on a similar scale in Figure 3. The scissors are curved, as are the other embodiments of scissors described herein, and where any of the scissors are shown in plan view they are shown with the concave side facing the viewer. Alternatively, however, the ideas described herein, can be applied to scissors which are straight. A suction tube 28, which is preferably of metal, though it could be of some other material, runs up one edge of the member 12. The tube may be an entity distinct from the member 12 and merely attached thereto, but it is preferably a tube which is implanted in the member 12. Such implantation could be achieved, for example, by forming a bore in the member 12 and inserting the tube lengthwise in it, or forming a recess in the back edge of the member 12 and inserting the tube into that. In the latter case the exposed portion of the tube might be covered, for example by solder material. A further possibility would be not to have a separate tube 28 as such and rely on a bore in the member 12 to achieve the same effect. For simplicity of description, such a bore is regarded in the ensuing description as itself constituting a tube. One end of the tube is attached to a flexible tube 30 which in turn is connected to a source of suction (not shown). The other end of the tube terminates in the tip 26, as is described below. The tube 28 has a short branch 32 which communicates with atmosphere via an orifice 34 located in the finger opening 18. The orifice 34 allows a small amount of air to enter the tube 28, and thus, when it is open, reduces the suction effect applied at the tip 26. The surgeon can thus control the amount of applied suction by closing the orifice 34, or opening it wholly or partially, using that one of his fingers which is in the finger hole 18 (this being, under normal circumstances, the surgeon's thumb). In the embodiment of tip shown in Figure 2, at least one aperture 36 (three such apertures are shown, though there could be a greater or lesser number) extends through the blade from one face to the other. The upstream end 38 of the suction tube 28 is positioned adjacent one edge of the largest of the three apertures. The tip shown in Figure 2 provides a significant suction effect only when the scissors are at least partially closed, and control of the suction effect can therefore be achieved by opening and closing the scissors. Additional control, when the scissors are at least partially opened, can be achieved by opening and closing the orifice 34. In the embodiment of tip shown in Figure 3, a part-conical depression is formed in that surface of the tip which faces towards the viewer as seen in Figures 1 and 3, i.e. the surface which faces away from the blade 24. Suction is here controlled solely by means of the orifice 34. Two further forms of scissors with suction will now be described with reference to Figures 4, 5 and 6. In Figure 4, a pair of surgical scissors is denoted as having a blade 101 and a blade 102, with the cutting surfaces of the blades being denoted below using a suffix C (1C is the cutting surface of blade 101 and 2C is the cutting surface of blade 102), and exterior surfaces of the blades (i.e those which face away from one another) being denoted by the suffix E (with 1E denoting the exterior surface of blade 101 and 2E denoting the exterior surface of blade 102). Figures 5a to 5d show one possible combination of these four surfaces. Surface 2C shown in Figure 5a has a part-conical recess 50, the larger end of which communicates with the upstream end 38 of the suction tube 28. From this it will be understood that in this embodiment the suction tube is provided in the blade 102. This can be seen more clearly in Figure 5c, which shows surface 2E. The surface 1C of blade 101 has a part-conical recess 52 which matches the recess 50 in surface 2C, except at the distal end, where a triangular aperture 54 extends through the blade and is thus visible also on surface 1E (see Figure 5b). Suction is applied by the scissors to the operating site via the aperture 54 when the scissors are at least substantially closed. When they are open it is applied via the grooves 50 and 52. Figures 6a to 6d show an alternative set of surfaces which can be used. Here the suction tube 28 is provided on blade 101, with its upstream end 38 opening into surface 1C shown in Figure 6d. This has the consequence that surface 2E is a regular blade surface, without any additional features resulting from the use of suction. Figures 7a to 7d show how a pair of surgical scissors may be provided with means for clamping the patient's tissue. For simplicity, Figures 7a to 7d do not show any means for providing the scissors with suction. It is to be understood, however, that such suction means could be provided in the structure shown in Figures 7a to 7d, though suction means need not provided. The scissors of Figures 7a to 7d are shown as having a pair of blades 201 and 202, with the tip of blade 202 having a clamp member 204 which, as considered in the view of Figures 7c and 7d, overlaps the tip of the blade 201. The blade 201 has, at its tip, a portion which is cut away to define a recess with which the clamp portion 204 can mate, so that when the scissors are closed the face 206 which is thus formed on the blade 201, and which is visible in Figure 7d, bears against that face of clamp portion 204 which, as viewed in Figure 7d, is remote from the viewer. Figure 8 shows the provision of a pair of surgical scissors with a cautery, according to the present invention, for effecting cauterization. One terminal (it is illustrated as being the positive terminal, but it could alternatively be the negative terminal) of an electrical supply is connected to a wire 304 which runs along one of the members 301 constituting the scissors (the other of the members is denoted by reference numeral 302) and terminates in a tip portion 306 which is electrically isolated from the remainder of the member 301. It will be understood that the wire 304 is insulated from the member 301 except where it is in electrical contact with the tip 306. The other wire 308 is electrically connected directly to the member 301, and indirectly to the member 302 through the pivot 16. A bipolar cautery is thus formed. If a unipolar cautery were desired, one of the wires 304 and 308 would be omitted, and the other connection would be made to the patient's body. For ease of illustration Figure 8 does not show any means for providing suction to the scissors. It is to be understood, however, that such suction means might be provided, though they need not be. It is also to be understood that the cautery arrangement of Figure 8 could be combined with the clamp arrangement of Figures 7a to 7d, with or without a suction arrangement.

Claims: A pair of surgical scissors comprising first and second blades each having a cutting surface and an exterior surface, the cutting surfaces facing one another, the blades being pivotally connected to one another for relative pivotal movement about a pivotal axis, characterised in that one of the blades has the tip portion (306) electrically insulated from the remainder of the said one blade, a first electrical conductor (304) electrically connected to the said distal blade portion (306), and a second electrical conductor (308) electrically connected elsewhere on the scissors, thereby enabling the scissors to act as a cautery. A pair of surgical scissors according to claim 1, wherein the blades are electrically connected to one another through their pivotal connection, whereby the said second electrical conductor (308) is electrically connected both to the remainder of the said one blade and to the other of the blades. A pair of surgical scissors according to claim 1 or 2, further comprising means for enabling suction to be applied to the site of operation of the scissors.

Inventors: MANUSHAKIAN HAGOP SAMUEL, MANUSHAKIAN, HAGOP SAMUEL
Applicants: MANUSHAKIAN HAGOP SAMUEL, WEISSELBERG MARTIN CHRISTOPHER, MANUSHAKIAN, HAGOP SAMUEL, WEISSELBERG, MARTIN CHRISTOPHER
Application year: 1995
Main classification: A61B18
IPC codes: A61B17, A61B18, A61M1