Mou v. City of San Jose et al

Filing 1347

Mou v. City of San Jose et al

Doc. 1347 Att. 3

Case5:07-cv-05740-JF Document25-4
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Filed06/24/08 Page1 of 8

Okada et -a].

United' States Patent

t191

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C451

Oct. 7 1975 ,

3,910,279

FOREIGNPATENTS OR APPLICATIONS
321.112

511902

Fraipnee--

_.____ 1261303.14

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Pdmarj Examiner-Richard A. Gaudct AsrLloni l3mirter-k S. Cobcn

ABSTRACT. tS71 In the foward end portion oz the nexib~e inilating tube of an ekctrosurw instrument there i formod s an opening o fcnesea at the side surface thereof, and r when an ekcbode wire k forad into the insulating tube. the working s;ctfba lhercof is outwardly loopsd ad through s i opening, so that said loopcd woriring s e ~ tion k broujEhti t contact 4th &e tissue of the body no cavity to nact thc.sanie.~ i s ' i m t m m w t s in&* i duced into a predetermined &tion of the body cavity using an ~ldoscopc while ai operator is obsuving
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U.S. Patent oct. i.1.975

Sheet 1 of 2

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U.S. Patent

OCL 7.1975

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mudon of the inventionenabler the narrowing ofthe opening-forallowing the WJrking seqion o the irmktf ingwimto.klooped. that cntry'ofbody%!lid into 90 thembe i pmcntcdto a n+Gmum extent and simultas . mentfor rescctingthe.timreofbodycavityofahuman'5 thcrr i no f w o damagingthe inner d all of s f the body cavity during thi rrsedion' opearion Furbeing. An example of.* prior art clectrc6urgicaIhmuther, -6 . the working Scaion is outwardly w d ment of this t$pc is diilored.inthe ram= spec%- .: frpn, Ihe opting dong the direaion of the w k . cations of. for example. US. Pat Nos. 2018,335 and it is cffecbivdy contacted with the inlet or oullet por-42,865. .Inthe electrosurgical instrument sha% in IO t o o the b d y =vi%. &by in f enabling a suficiurt recheoc .US. p a t e n t ' s p c c i f i c a h m clect;odc shaped section operation at said portion to be pafonncd. Furh loop'at -*tip end portion is exteriorly extended a ther. sinq the tube .and WiFe have h i i flexibility. the tube + brplght & a given pasitionw the body i m from the fencsba fonned in the d i d end of the endoe p i c tube. Said loopuJ working scction of the eleco m or cavity Wtii& i to%c resectcd s . (rodt is m g c d in a substantial~y &amverse ciiiection 15 -11 the p r c r c r r ~ embodiment ofthe invention. c h ind ~ to che axial line.of the tube. and by caun'ngsaid s c i n eto sulatingtube i insutedthrough &e s and in. to mntflCttlw tirnre o the body cavity the clectrixurgif saicd togcthuwith .the cndascopc into the b ~ a o m y d rrscctioD operation of. cutting or foagulating the or cayity while said.is bcmg o k l v u l by a body tissue K carried out Said ekctrode is so con- viewer o an operator. Accordingly. it is w i l e to r sr e as to dide the looped working scction longitu- 2 quiddy id exacUy.bring the instnunent to a desked tud 0 din* o f the tubc. .. position to k s u b k t c d t the resection opention. so o In the efcctrormrgifal instrument having qch a cont a the operation range has been utrcmcly cn1;lrgUt ht FctiOn', h o m e r , the fuKstra formed in the.diidal Frhr s ute. + the insulating tube is i n t e g d y formed end of the tube should be large enough to enable the of, for i.xamptC. pblytctranuorocthylcnc resin knovin looped working section. to slide therchough. But 25 uihjcr the ~ a m d c l n" the electrode wire is c T f o , and hrtegrally fonned of s t a b l e s steel, the instrument is . wliere thc fenestra is rrnducd large, the peripheral pbrtion chercof and the.ntructural portion within the . made sMplc inconstructionand the inrPument trouble tube unpreferably contact the inner wall of the body has b&n.rrduccdin number. Provided for the base porcavity during the rcstction opention.todamage often . tion o the insulating tube is a grip member for bcing f thebqdy.tizsuc- _. 30 man-y operatadby a vicwer or an operator. ~ i d t a Further. where the fenestr;l is r e n d d . k r g c . a largc nmusly mounted on the b a s section of Ihc electrode .mhount of body liquid is entered intothe tube from said wire is a kn+ member. For tbis reason. ifthe opcntor fenestraduringthe -ation to break the tr- . manUany operata grip m b c r knob memsulating budition. k c f o r q mcasurcs for preventing . .k . the working &-&on ofthe wire win be able to be r the b r e g e of the insulating mndit+n shodd previ- . 5 outwardly loopad w t case and the looping d e e 3 ih d y bttak&,whichrcsultsin a m p k a t c d structure will.& able @ b +nuhanmudy sdjustcd. .e of instrument. The Jm descnbcd anbcrdients inuzhate the Illana Whcrc it is d c s i d to + t tbe tube particularly into u ner in &ch the.dcctnxurgical instrumurc acCo;ding a relative@ fine'or narrow body cavity and spread the to thc invention isktroduced into the body organ or inlet or outlet portion of the M y cavity by operation 40 cavity using the e d nbut it is also poaible t ino ofthei. the looped working seaion ir made t troducc sajd instrument &ne direalj. into & body U e t against said trlet or wuct portion to be unpref, :orpanorcavity.In the instrument havhig a construction ernbly bent or in&pted hwnadficiently contacting pciinitting such d introduction. mcans for observi m the same b u s e t i looped w a i g section i arlc s mg ihe interior o the f organ or cavik. such a a s ranged wansvuscly to the artial line of the @bc. 45 fiba blmdfmmdc image guide is p m ~ d c d a manner in Furthermore. iince, intbe inrtrumCnthavtrgtheconurtcnding +m the fonvard. end or distal cnd of the ventional Construchon the d o s c o p i c tube'isform+ , tube into the pbc Ac m t .a fun object o the imention'is to proco g y f therefore & no high flexibility. of rigid mate+ the ptaccs in'thc body organ or cavitj where the resee . vide an c k t r c m r g i d instrument c p e ofresecting aw , tiop operation can be perfonnad ari: h i t a d . faiiig t o the tissue o tho inner wall of the body ca~ty high f with suftkicngy br oia tho q u l r e i i icsection operation ry efficiency. . U&gth_..~ent. : A object o thc invention is t provide an f o .ii inztrUm9t capable of performing the SUMMAkY THE lNW3hlON tinrUr.-tion in a given place w t i the body cavity ihn . ~~invcntioniieharactcmadin.thatforthepurpost ~ h e r r r r s a c t i o n i r d o A third object o the invention t pmvide an elccf of sbl%g various p r o b l m arismg from the elcctrosurgj&d !+rupknt having +e c&vcntiona! tmutruction Impurgic;? insmmnat which can be made shnple in . . thi.~i&gscc&mofthedcctrodiwirehavingabody conmuchon and &refore manuhcmcd at b w cost &tipn dG+ lengthwise the +sting tube. 6o and which h a high securabiiity&ith rrrpcd to the livs+&&Pmg s c c h +g desi@ i i + ' d i r d y coning b ~ a during y ust. .. . iicted'&Jt'the b d y ti"% is made t k j d o u t in the q BRJEFDESQUPnON' 0 DRAwMGs %i v i t h ' w to &a$'lipe ofthe t b u .OF .$ep h c im$udi~gng'Jaiai&lbe~via the openRG. 1 ha.!ongibldinat stcti& View of the fd % f o p u j at:lhi'+c end or forcnd bectbn of an dectmsurgiczd insiNmcnt accoiding cnd of hte and,.%! ' u d t i n g tube.& to an embodtncnt.pf ~nvcnti?ri; . . e I ~ e . W i r&-m*f*ofma+a! e bvRG;2isaplanyinv;partlyin~.ofthcfonvard udscafonofthe~tnuncntshowDmFLO.1: iw hi. flu.ity. nie'&o&&d charac&g con-

ELECTROSURClCALINSrrtUMENT BACKGROUND OF% -ON lhis invention d a t e s to an .&surgifal insuU-

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operation by an opuator of the wire 3 i carried out s tionofthehntrumentshovninFIG.1 : dong the axial l i iofthe tube 1 As seen f o thc 0x1. rm FIG. 4 illustratu the m e r m which the instrument ditioa?rof the WwkingscCtiOm6 indicated by solid lines of FIG. 1 is introduced into thc body cavity using the and two l i . the kngth of the arorkine endoscope to permit the reseaion of the tbsue of the 5 soxion 6 ofthe wire 3 b rnadakrgcrundcr thc roopcd conditionin&catod by the twodou-and-dash lincqso aody aviw. FIG. 5 i a longitudinald n a l view of the forward s that thelength o the body saction 4 is madc analter by f a d section ofan clearosurgical imtrumcnt acmrding that uctcnt. h can be d e r a d that the boundary Line. to a second anbcdiment d rhe invention: ktwcen the working section 6 4 the bbdyscction4 FIG. 6is aplan view ofthe forward endsectionofthe IO is d e d m @tion with the pushing-into o drawbgr inrtnrment shown m FIG. 5: out operatianofthe wirc 3. si*. thet!oundary liic FIG. 7 is a longitudinal sedional view o the forward f ktwrcn thc working sonion 6 and the end section 5 end saction o an electrmurgical inslrwnn, according f t will be somewhat varied in psition. though crtrrmefy to a third embodiment ol the invention; slightly. FIG. 8 is a am sectional view on line 8 8 of FlG. IS In the basc seukin of the clectrosurgicalimbument shownin FlC.3.the base end portion l b o f thctuk 1 7; F G 9 is alongitudinal stctioaalview of& forward I. i s slightly enlarged in d i i r . and agripmunb.39 is end scction ofan electmwgical instrument according fitted at one ad i t said enlargtd base end portion 1 no b to a fourth embodiment o tht invention: and f in alignment with the au'al line of thc tube 1 . h grip FIG. loisalongitudinalsationalviewofthefonvard 20 munber 9 has a wim imertion hole 10 in alignmi end K a i o n ofan eltctrmurgicalinarwnent according w t the axial line of t k t u b e 1.Theothcrendportion ih to a fifth embodiment of the invention-

FIG. 3 k a

hpartly brdtch oftliebase see .

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wire insertion Me 10 of the grip member 9. and is as t n u n a t shown in FIGS. 1and 2, an insulating tube I b formed ofmaterial having high f l u u i i t y N& % a tended frwn said other end portion of the grip manber polytctra-fluoroethy~ne resin known under thc name 9. Mormtbd onto the atended base end portion 7 of o "Teflom"The f o w d a d pwtion lo ofthe tube 1 30 the wire is a knob munber 11. The base end portion 7 f is formed at its side surface with two through Ma 2u of thewirc3within thelcnobmember 11is ekctridly and 2b spaced from each 0th a a prescribed intervat t connectedtoaaoutputtodeUby mtamofa 00 alongtheaxiallincofchtatbel.SaidborhbolcrZoand tor 12.%outputcodeUisconncctcdioapropcr 2b constitute opening or fencstrac 2 for pum-ttingthe current suppty source not shown A high frcguaKy papage of the working Scaion of an elaaode wire 3 35 m . t kflowcd in thebase a d 7 o thewire 3 via the f Said dcctrodc wire 3 a single flcxiik wirr prepred. output code 13and the connector 12 from said source. for example. by twisting a large number oftine stainless Said high frequency t i s supplied from tbe base stell dementstogether. Said Wire 3 i divided mto three s Cnd portion 7 to the I c q d workiig section 6 through sections namely. a body sccti0n 4, end section 5 and the wire 3. and thc looped working section 6 suppried working section 6 though they arc not mutually dis- 40 with said current is brought into contact with the tinue criminated in the illum-atiom by dear bormaaty lines. o the body cavity. k e b y t cut or coagulate the f o
T b e b o d y x a i o n 4 h a s a b a r t e n d 7 a s k t a d c ~ a - i i same. and is dirpoKd lengthwise of the tube 1 within the As shown in FIG. 3, the opeaator can take hdd of -The end'section5of thewirc3ffbcedwithin the said knob mcmbcr 11 with his fingur as in the case of tip end o the f o d end pationl o ofthetu& by fix- 45 the grip member 9. f ingmcans,for example. t h e s i i s o l d u i n ~ ~ w 0 ~ - It is to bc notad thatrhe knob member 1 and p i p 1 h g cedm 6 between said ead section 5 and body s e e member9 an both formed of a propa trsulatingmatcrial suchas asyntbetic resin. tion 4 i s a section for perFmhgthetucuion operation by d i i m n t a c t w t the tLmK ofthebody c w ih a, Rcfcrringt RG 4 the endosaope 14 i s ip a state ino and succeeds the body &4 at O n e tnd via said satcd into the ctuodenum 15 comtituting the body through hole ZP and nrccccds the end section 5 a the t organofahumM~lnsaidstatc,the ' d e n d 140 d

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otberendviassd throughhde2b.Thc~gMktrgsection 6bwhony u p d to the uteriorofthe tube 1,Whm. as latcrdaaibed.thc wire 3 b pusbed toward the for- 55 ward end podon la along axial l n ofthe tube 1 ie as indicated by an arrow of FIG. 1 , i t h made to mund out in the form of a !arge loop tranrversely to the axial h e of the tube 1as h t e d by hvodottand-dnsh l i o RG. 1 Tbe roundingout operation OFthe working f . section 6 bpcrfodonthesamcplane W d g dK ui n axial line of the tube 1 In othcr words. upon pahing. into operation of rhe & 3 the uvrkingsbction 6 k ourwardly looped in a manner going away hwn the outer circumfo the tube 1along the axial line f

oftheendcscoptl4justreacksthcvicinityofthepan-tic duct 1 opened to the dwdhlum. This endo6

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wopc 14 xofagcnkralconstruclion.andintroduction ofthc endoscope 14 into the duodenum I S k carried out while UIG operator o vir i ohserving the in@ s rior ofthe body cavity via a pmper observatiar mcaru provided within the cndoxopc 14. F r this reason, said o introduction of the endoscope is -thly pafd. so that it b - k i toqukkly bring the distal end to adi.lcaredpartwithin the body cavitywhichb tobc observed SaidbbsaMtl on mcam indudq for el;ample.
a n ~ ~ c c c ~ w i t h i n t h e p m x i n mportion end l dtht cnhcope r4'4notsho~animage&uidcoonsisl-

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thucoF.and.up~ldmwingoutopcrabjonofthewire3. conversely is shrunk m a manna approaching said outer circumference The pudrhrg-mto o hwing-out r

mgofaflcxibk~.bZuwnedispmadwithintheendoscopeandkngthwisethcnof.andanob~kmdisposd within tho distal end 1Q 'Ihcst constbent dc-

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menu. however. are of a general construction. and ihe wire insertion hok 10 provided.for the.grip member 9, ilI&r&ons thereofare omitted. . and 50 acts as to maintain the wim 3 straight in cooperProvided for thc side surface o the distal end 1Q are f ation with said M e . 10. The guide pipe 22 functions to an image guide window 17, i l l u r n i n a h light guidc prcvcnt Ihc wire 3 from buckling at the aboveWind?w- ISanrJ fluid mctbon pwt 19. whkh however 5 mentioncd.forcing-intoo drawing-dut operation ti-. r are also knawh For this rn -. such operation can smo~thly perbe Also provided for the side surface of thc d s a end itl fonncd with safety. 14a isa %do* opening 20 for allowingthe ekch.osurIn FIGS. 5 Bnd 6, the forward end section of an elco gical iistru-t to be projected therethrough. W i trc-surgicalinrtrumen t acmiding-toa sccond embodiwindow opening 20 communkatcs with an-btrument I O & n t of the invention i only illustrated. Since. hows i k r t i o n chand 21 formed in a mantier extending e m , the base end seaion MS the same construction as f p m the distal end 1Q into *e C I + S C X ~ 14~Z that i l l m t t d i F G 3 the illustration thereof is n I. . Into said insertionchannel 21 is insertdl the e c lm c oniitted. I thi fd n cnd section o the instrument f surgical instrument according to thC invention. the forshown here in FlGs. 5 and 6, the -.parts end secward end portion l o of which is prdjcctcd into thebody I5 tions as those o FIGS. 1 and 2 arc denoted by the same f cavity through the Window opmingJ0. &.the projtctn f e m c e n u m a a k Thc difference between the coning t m .the Wrkiig section 6 of thc wr 3 is shnmlc ie ie struction shown in FIGS. 5.and 6 and that show. in to a siatc.contacting the odter circumference of the FIGS. 1 and3 ruidu in e t theopening2 in the latter tu& 1 ofthe instrumcnL When. t h e r e . the ope& .c0tlStri)ction b cbnrtitutcdby the two through h o b ZO tor or viewer has found. while obsuving the'oclllq por- 20 and Zb i & c d the o p i n g 2 in thc former is copstidon 16d of the pancr.&tic duct 16 opcned to the duourced by an elohgate slot having a prrscnbed length. denurn-15. *at A d outlet Nortion i u c t k n d y nars This elongate dot 2 is formed lengthwise of the flexible rowed. and has to r&& p a n i d y the h u e of outinsulating tube I in the side surface of the forward end le( poftion 160 by meanr of the instrument for the purpWtion lo thereof. The working section 6 o the wire f pow of enlarging said narrowed outlet p o d o n 16u. the 25 3within the tubc 1 is outwardly projectively looped rtSCCtiOn operation is c me out a follows W e the a 'd s from the shrunk position indicated by solid lines of f o n u a r d c n d p d o n lo o the tube 1 o the instmmmt f f FIG. 5 to the @tion indicated by two dots-and-dash i being inserted into &e outlet portion 16h ofthe pans lines' through the dongate slot 2 Said projectively -tic duct 16, the working &on 6 is butwardly ~Oopea Wortdng wcti0rr6 is made to contact Ihe tissue loopedas shown m FIG. 4. while the outwardly'looped of the body cavity for rrsoctingthe same. In F G 5, in I. workiig section 6 is pressing the tisue o tht riarrow+d f the shrunk position. the working section 6 is in a state outlet. pod- 16u i a manner t Clarge the outlet n o -yholIy tiid& within the tube 1 Also in such shrunk . portion ,160.ihe scction 6 resects the p d tissue by positi+a: however. tht.worlting section 6 m a y be ex.the high frequency current flo&ng through tbi section . jmcd somevmat cxtcriorlyofrhetube 1from the elon6.Since theworkiig section 6 pdoiming the -cion 35 gate slot 2 . operation a such is in a state e n r a r d l y looped inthe s 'It is to be notcdthat the body section 4 and end +ccsame pkne induding t h e axial'line of the tube 1 as prction 5 of the wire 3have thesame constructirjn as thosc vb$y described. the working section 6 even &en the . illustrated inTICS. 1 and 2 . tube 1 is brought into contact wt thc body k u e ih In FlGS. 7 and 4 thc forwand end scction of an electronrrgical imtnimen t according to a third cmbodiwhile 6cinginrrcried deeply iritti tht panucaticduct 16. maint?ins its suffrcienr rigidity without bcing bent by ment of the invention is only i l s r t d Since. howlutae. mid bcdy k u c In ti manner. the hoped working hs ever. me base end section thereof has the same construction as h t illustrated in F G 3 the illustration I. , a t i o n 6 cuts or.co;lgu$tc for resetion & tissue of the.nprowcd outlet portion l@of the panaeatk duct . therwl is omitted. Thc difference between the con16. enabling the outlet portion to be enlargid t a suffi 4s struction shown m, F G . 7 and 8 and that shown in o IS F G . 1 and 2 resides.m that in the latter construction IS dently targe s k . A the rcsulf dommunication of the s a single wire 3 and a pair o through hoks 2u and 2 b f pancreatic d " 16 with the duodenum 3 d k i c n r l y therefor are provided Weas in the former cons~hllcatt+cd. chus executing the desired m e d i d tmitment. The operation for looping the working kction 6 i 5o tion an addiiional wire 30 and an additional pair o s f through holes 2c and 2d for allowing raid wire 30 to be carried out by manually operating the grip inanba 9 'passed therethroughare provided. That i to say. in the s and the knob member 11shown m FIG. J.Namcly. the knob mcmbcr 1 in a d i d o n in 1 instrumentshorn in FIGS. 7 and 4 tht additional Wire operator m v r s which it approaches thc grip member 9 with the grip . 30 is a smgk elcctiode wire prcparcd by twisting a member 9 hcJd by the. fingers of one hand and the knob 55 numberof fine s a n e s stccl d a n e n k together and has tils by the fingers of gothcr. Then. the high flexibility, L in the case o the wire 3 The body f . member 11 Kction 40 o the wire 30 is d i i lengthwise o the f f wire 3 b f o d into the tube 1 to permit thc working sation 6 to .be outwardly loopbd as indicated by t w u Nbc 1Withm the same bi a state gathered together with the section 4 of the wire 3 Said both body sec. dots-and& t i n s of FIG. 1 On thc other hand. if the . operator moves thc knob mcmbcr 1 ina direction in 1 t o s 4 and 40are coveredby a cover tube 2 . The end in 3 which it gocs away from % grip member 9,the wire &on 50 ofthe wire 30 is fixed within the tube 1 by 3.wiU be drawn out from the tube 1 so that the working . thc fixing means S for cxunple. by & silver soldering . s t i o n 6 i returned to the shrunk statc mfk~tcdby s jointly With the end S e U h 5 of ihe wire 3 The work. solid lima from the looped state indicated by:twodouing section 60bctwccn the end section SO and the body _ - .. . section 40 is projcctivdy loopodoutwardly of the tube anddash lines wire 3 is covered w t a rigid guidcpipe 22 by ih 1 via the through hoks 2 and Win a diametrical direc. the extent o .a p r c d c t e m i h Icngth.extcndimgfrom i t s f tion and yet in SI direction oppmite to that in which the baK end 7. Said guide p& 22 is inscrtcd through the i. working Xaion 6 K loo& As clexrly seen from FIG.

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8. the loopingp h e of the working section 60 is flwh tuted by o singl&re. In Mher words. it is &Me that with a flat plane -nduding the axial line o the tube 1. f the working &n almc is constituted by a plurality and said flat plane i the same as rhe looping plane o s f o &tiVcly thii electrode wkcs whereas the remaining f . wctians by n single common w r . ie the wor)ringsccLbn 6 Aocordmgly.said a d d i t i d pair A n dcctrosurgiul instrument according to a fihh of through h o b 2 and 2d nre formed. along the au'al 5 c line k e o f at a prcscriicd intcNal i a state spaccd n c m b o d i i t shown in FIG- 10 has almmt Ihc same from each ather. in those ponions ofthe tube 1 which rnnstndon as that shown in F G 7. The difference I. dimetrically oppose said pair of through h o l a 20 and chcrebetweenonly resides in that in the construction of. 2b. F G IO one eknrode wire 30 has no body scctbn and I. In F G 7, the condition in which the wires 3 and 30 IU the body seaion 4 of thc other elcctrodewire 3 is cok I. a n forccd into the tube I to permit both working s x ccumntly uscd for both wires 3 and 3 . One cnd of the 0 t i o n s 6 a n d 6 0 t o b e L a r g e l y l o o p a d e x ~ y o f t h c workingsedion60ofthcwire30issecuredtooneend tube I is shown. Under thii condition. a high frequency o the working W * o n 6 o the wire 3, for example. by f f ament is llowcd in both lcopcd working sections6 and the welding process. Accordingly. when the body scc60, wfiich arc brought into contact with the rimre of I5 tion 4 is w e d in an arrow-indicated direction, the the body cavity. *by performing the CQCCtiOn of bothworlrhrgscftions and LO arc respectively projcc6 said tbsur t i d y looped extcrioriy o the tube I. On the othcr f IC a above described. two or more cl~rrrodc i r u s w hand. when the body sation 4 is pullcd in the opposite arc &@xed withii the tube 1 thmby to permit a plu, direction, the both loopod wrtdngsections , shrunk d i i of working sections t be projanivcly looped 20 at thesame time. It is t be noted that construction can o o of u be made such that the both a d s ofthe working scction from the o u t c r ~ r c u m f e r u m thc t b 1 in different dicctions. the operation for rrsaaing the body tisue 60 o the wirt 30 arc secured t the both ends of the f o d l more quickly be cam& out. Furthermore. accordworking seaion 6 of the wire 3 If arrangement is made . ing to the inventkm. a plurality o wiresare all H e r e d f a such. the end &n s 50 of the wire 30 win not be or collected into a single bundle within the boay scc- 25 r c q u i d and thc end &*on 5 will concurrently function. s that the operatiom by the operator arc the o tionastheSedion50. same a in the case o a single wirc. s f whatwectaimk In the c s shown in FIGS. 7 and 8. the working sccae 1 An dcczzcarpicalin+trumcntfor rrsccting the tis. Cion 60 of tbe wire 30 may not nQltssaTily 50 conbe sue of a body c v t canprkin~ aiy s h c t c d a to d i a m e h i d l y oppose thc w o f i g wrtion s a f l c x i i indating~ b including a forward end porc t o substantiany straight dong the axial line ofthe in 6 of thc wire 3 Accordingly. the looping plane of che . working section 60 may not bemade flush with that o f tube and havinga fixed lip end and a pair o ax-dly f the worlrhrgsection 6 Accordingly. the pair of though . alignad hda formed m a side of the fotward end holes 2c and 2d may not d i i d l y oppose the portion ofthe tube: 35 a flcxiie dectrode wirr affucd t said tip end and through holcs 2 and 26. o The through h o b 2 and 2d constitute the opcning c capable of W n m u a l l y forccd into and w t rg ih 2 of the tube I together wt the through holes 20 and ih . drawn h t b along its axis. said clccbodc the u 3- will be undtrstood from the previously de-As wire indudingr body d o n having a basc end dii m i d embodiments. the opcning 2 may be f a d posed within said tube lengthwise thereof, an end s a tecanse it has only to have a size pcnnitting the 4 m saction f d within the tip end o the forward cnd f passage of a fine electrode wire 3 Furthcr. during the . portion o the t u b and a working s a t i o n outzidc f rrrection operation the working sation is m a state o the tube having both ofits ends rcrpativdy conf parsed through the opcning 2.50 that entry of body l i p n d tothebcdy section and the end m i o n and uid into the tube 1 b u h r m c l y avoided projectively tooped in an axial plane through said ~n c~cctronrrg.icalinstmmcnt according t a fourth 45 o pair o hola and radially adjustable in response to f embodiment shown in FIG. 9 has almost tbc same cont e force aertod on said elcctrode wire.; and h Srmction =that shown in FIG. 7. The difkthcmmeans for connecting said base cnd of the body sccbchvccnodyrrsides in that m the amsvuction of FlG. tion to a source ofelcceicc u m n t including means 9 the body d o n 400 comsponding to thosc of the to radially adjust thc worlcing section whereby said wir-3 and 30 o FIG. 7 is a m d t u t e d by a single relaf looped wnricing section may be brought ioto tivcly t h i i conductive wire having a large m e s s contact with the h e of thc body cavity rbereby to -t said tisue. than t a o the working scdon The forward end of ht f Uu bodv r&n 400 is rinidlv CMneCtcd at 4001r to the 2 An elcctraartgical instrument according to &m rcawarb cnds of the wo&nisections 6 and 60. for ex- 55 1. whacin said (kxibk clccuode winz is a single wire. 3 An clearooUrgical imtNmcnt according to claim . ample. by the welding proccsr When the body section s 1 which further comprirCr a second pair of axially . 400 i pushcd in an arrow-tdicatcd diredon by the manual opcration of the opuator, the both working atigncd holes f d m a side o said forward end porf s c i n 6 and 60 a r e projcctivdy loopcd exteriorly o etos f tion of the tubsa scctmd tlcxible electrode wire capaIhc tube 1 On the other hand. when the body s t i o n bo ble ofbeing nunudly forccd into and withdrawn from . 400 is pulled i the opposite d i d o n . the hvo looped n the tube dongits axis ilml hming:t secondbody zection working sections 6 and 60 arc shrunk at the same time. disposed within thc tuhc lmgthwisc thereof and scIf Ihe body scction 400 b constituted by a n'ngk relaa r e d to the M y section o the fint aforesaid clccf tivdy thick wire larger in thickness than that o the f vode w r . and a semd end saction fixed withh the ie working Section as in ti cmbodimmt. the f a r Will be hs tip end o the forward end portion together with the f more rcduccd that the body saction k buckled when end d o n o the f i t afoorruid electrode wire and a f pushed into or drawn out from the tube 1. It is to be Sccond working section outside of the tube dspowd notcd that the end sections5 and 50 mn atso be cordbctwan said sccond M y s vi n and wid second end c to

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Case5:07-cv-05740-JF Document25-4

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1. M i furthcx comprta a second dectrode wire 10 section and pmjcaivcly looped i another axial pkne n through said wtond pak o h o l a and &ly f d - having a second wlorking section outsidc of the tube m able i respMIsc t the force ucrted on bolh eln o and having OM end thereofconnected to the body stxwiru.saidsecondbodysaQianbeingconMctodtosaid tion ofsaid fuffaforesaid ekctrode arircand the othcr end f x d Within the tip end o said fonvsrd end porie f connecting mcan* 4. An e l c c m s u r g i d ingmmmt according to claim tion: 1 which further mmpriwj a grip member securrd to . a~pairofaxiallyalignadholaprovidedfordifi base end of the insulating tube and having an inserl fawt portio= ofthe side o t z forward end porfb tion hole for altowingsaid clcctrode wire t~ bc imuted tion of the tube, said tecond worlringscction bdng n thcrerhmugh i the axiat direction of the tube, a gn'p I oxm=tcdtOthebodySctionandtipendand surface at in ouw circumfcrcnc4 and a rigid guide aa . being p m ~ ~ y l o o p in another plane in relapipe coveringfhcelectrode Wire at the bze end of tbc tion tothe axial line of the tube through saidseo body section and didably utmding thrwgh the -merond pair of M a t r a n s v a t y with respect to taid tion hok ofthe grip member. therrby to. prCVint che axial line. electrode wire f o buekliig d h g w o n and withrm 6. An elcctrasurgical hKtnrmcnt aaprdiig to daim drawal ofsaid wire. said connecting mcars -duding e 5. whercin the body section of the dearode wire is mmcted of a single wire largu in thickness than manually opeaMc knob membcr secured t said guide o that of each respectiveworking section. Pipc **e+, 5. An electrmrgml inswmcnt according to ciaLn
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