Surgical instrument

Abstract

A device for morcellating tissue within a body cavity of a patient comprises a stationary tube having a distal end portion, and a bipolar electrosurgical electrode assembly located at the distal end of the tube. The electrosurgical electrode assembly comprises first and second electrodes separated by an insulation member, the bipolar electrosurgical electrode assembly extending around the circumference of the distal edge of the tube. When an electrosurgical cutting voltage is applied to the electrode assembly, and relative movement is initiated between the tube and the tissue, a core of severed tissue is formed within the tube such that it can be removed from the body cavity of the patient. A tissue-pulling device such as a jaw assembly can be employed to pull tissue against the distal end of the tube.

1 . In combination, a device for morcellating tissue within a body cavity of a patient and a tissue-pulling device, the morcellating device comprising a stationary tube having a distal end portion, the tissue-pulling device being locatable within the tube, the combination including a bipolar electrosurgical electrode assembly including first and second electrodes, the first electrode being located at the distal end of the tube, such that, when an electrosurgical cutting voltage is applied to the electrode assembly the tissue-pulling device can be moved to pull tissue against the distal end of the tube to form a core of severed tissue within the tube, and further moved in order to remove the severed tissue from the body cavity of the patient.  
     
     
         2 . A combination according to  claim 1 , wherein the first electrode extends around the circumference of the distal edge of the tube.  
     
     
         3 . A combination according to  claim 2 , wherein the first electrode extends completely around the circumference of the stationary tube.  
     
     
         4 . A combination according to  claim 1 , wherein the second electrode is located at the distal end of the tube, and is separated from the first electrode by an insulation member.  
     
     
         5 . A combination according to  claim 4 , wherein the tube constitutes the second electrode.  
     
     
         6 . A combination according to  claim 4 , wherein the first electrode comprises a conductive track present on the insulation member.  
     
     
         7 . A combination according to  claim 6 , wherein the conductive track is printed on to the insulating member.  
     
     
         8 . A combination according to  claim 1 , wherein the second electrode is located on, or constituted by, the tissue-pulling device.  
     
     
         9 . A combination according to  claim 1 , wherein the tissue-pulling device is longitudinally movable with respect to the tube.  
     
     
         10 . A combination according to  claim 9 , wherein the tissue-pulling device comprises a pair of jaw members movable between open and closed positions.  
     
     
         11 . A combination according to  claim 10 , wherein the jaw members are mounted on a rod extending though the tube.  
     
     
         12 . A combination according to  claim 1 , wherein the tissue-pulling device comprises a screw member rotatable with respect to the tube.  
     
     
         13 . A combination according to  claim 1 , wherein the stationary tube has an end face which is angled with respect to the longitudinal axis of the tube.  
     
     
         14 . A combination according to  claim 13 , wherein the end face of the tube is at an angle of between 30 and 60 degrees to the longitudinal axis of the tube.  
     
     
         15 . A combination according to  claim 14 , wherein the end face of the tube is at an angle of 45 degrees to the longitudinal axis of the tube.  
     
     
         16 . A method of laparoscopically removing a uterus, the method comprising the steps of: 
 a) dissecting the body of the uterus from the stump of the uterus,    b) laparoscopically inserting a morcellating device comprising a stationary tube having a distal end portion, and a tissue-pulling device located within the tube, the morcellating device and/or the tissue-pulling device including a bipolar electrosurgical electrode assembly, the electrosurgical assembly comprising first and second electrodes, at least one of the electrodes being located at the distal end of the tube,    c) grasping tissue with the tissue-pulling device and pulling it against the distal end of the tube,    d) energising the bipolar electrode assembly with an electrosurgical cutting voltage,    e) continuing to pull the tissue with the tissue-pulling device so that a core of tissue is formed within the tube, and    f) withdrawing the core of tissue from the tube.    
     
     
         17 . A device for morcellating tissue within a body cavity of a patient, the device comprising a stationary tube having a distal end portion, and a bipolar electrosurgical electrode assembly located at the distal end of the tube, the electrosurgical assembly comprising first and second electrodes separated by an insulating member, the bipolar electrosurgical electrode assembly extending around the circumference of the distal edge of the tube, such that, when an electrosurgical cutting voltage is applied to the electrode assembly and relative movement is initiated between the tube and the tissue, a core of severed tissue is formed within the tube such that it can be removed from the body cavity of the patient.