| 摘要 |
An electrosurgical scalpel device, method of making the device, and method for using the device for tissue dissection. In one aspect of the invention, an electrosurgical scalpel has a conductive blade electrode formed as a generally flat, substantially rectangular sheet lying in a plane with a longitudinal axis. The blade has a longitudinal portion extending along the axis and a hook lying in the plane of the blade projects outwardly of the axis at a distal end portion, defining a notch oriented at a rake angle to catch tissue as the blade is retracted along a generally straight cutting line. Because of the higher contact force and small contact area in the notch, electrical energy is preferentially applied to dissect tissue along the cutting line while leaving tissue and/or structure distal or adjacent to the cutting line substantially unharmed. The blade cuts smoothly, and is readily controlled with essentially axial movements to excavate around and along an embedded vessel within endosurgical cavity. The blade also has a short edge portion extending transverse to the axis in the plane for blunt dissection. The blunt distal end may be pushed into fatty or muscle tissue without damage, then activated for retracting dissection, so that deep cuts may be effected with little risk of vessel damage. The blade lies at the end of a long narrow shaft, which can access the interior chest wall through a lateral incision, and may be levered against the ribs in a novel procedure to safely and effectively harvest the internal mammary artery.
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