Stretchable cryosurgical probe sheath

The Invention relates to the field of cryosurgical probes for Freezing and thus to destroy use of biological tissue. In particular, the invention in the field of cryosurgical probes which through a Joule-Thomson cooling system cooled with closed loop are available.

On Joule-Thomson cooling system works in that a High pressure gas by means of an expansion element that a certain Type of flow restriction is has expanded. The flow restriction could be a small aperture, a narrow capillary tube, or other specific type be of limited passage. Normally, the cooling system a high pressure gas source, a heat exchanger, an expansion element, a heat transfer element and various tubes and lines on which of one component to another, the gas to guide. The high pressure gas flows through the heat exchanger, in order to reduce the gas temperature somewhat, then the gas temperature is further decreases in the expansion element, as isenthalpic expansion takes place. The expanded cooled Gas is a heat transfer element exposed where the gas heat absorbed, which has been withdrawn from the area. The operation a Joule-Thomson cooling system can by contaminants in the gas, eg., water, oil or particles, greatly affected will. Any such contaminants can flow restriction block in the expansion element readily because the flow restriction normally is very small.

water and oil are particularly harmful contaminants, as these at the flow restriction, where most of cooling done selectively collect. When the gas expands and cools, sinks the temperature of the entrained Water and oil also what and for freezing or solidification of the water Oil leads. These Solidification occurs exactly at the flow restriction, because right there cooling actually takes place. Water and oil, at least in trace amounts, are often found in the ambient air, and they can therefore in the cooling system be initiated when the system connections are defective or exchanged system parts will.

The most Joule-Thomson systems are open systems, which means that this Gas after expansion and heat absorption to the atmosphere is discharged. The high-pressure gas source in such a system is usually a high pressure gas cylinder. For ongoing use exhausted the amount of gas in the cylinder. An open system such as this a certain amount of impurity substance tolerate since the contaminants from the system together with the gas during use are released into the environment. If an impurity in system during carried out the replacement of parts or if system connections from other reasons open are, the impurity is purged by and large, when the gas then is discharged.

It however possible, operating a Joule-Thomson system with a closed circuit, that is, the gas is pressurized and after the expansion in Circulation added. After expansion in the expansion element, the contact with the heat transfer element and the heat absorption the low pressure gas is returned to the compressor, which can be used to the gas again to put pressure on. The renewed pressure set gas is then the heat exchanger and the expansion member is returned to the circuit. There is no gas delivered from the system. Therefore, all contaminants, that enter the system are collected in the system, where they have a Period accumulate. The degree of contamination can affect finally increase one level, where solidification of the water and oil clog the expansion member. On Method and apparatus have been developed for operating a micro-miniature mixed-gas Joule-Thomson refrigeration system, as disclosed in US Patent 6,151,901 and US Patent 5,787,715. If such a mixed gas is used, especially in a miniature or micro-miniature refrigeration system, changed the introduction of air into the system, the gas mixture proportions, and the cooling power the gas mixture can be significantly reduced.

Out these reasons closed Joule-Thomson systems are often permanently sealed, to prevent the introduction of contaminants. Of the Replacement of parts or other open system connections It is not possible in a permanently sealed system. Certain Systems use self sealing couplings, the system automatically seal when they are separated. This automatic sealing limits the amount of air leakage and contamination, but a certain contamination occurs nevertheless. Usually the Couplings used in a closed system, Threaded couplings that are not for Repeated separating designed.

the Contamination problem is in a closed mixed gas Joule-Thomson refrigeration system, the in a surgical device, eg. as a cryosurgical Probe is used, more complicated. Such a device has normally a compressor connected to the probe <?page 3?>is, wherein the probe consists essentially of a handle, of a cannula and of a cold surface consists. The heat exchanger typically located in the handle, and the expansion element is typically located in the cold tip. The probe cannula or cold tip must with different Forms, for. Example, with flat, cylindrical or sharp, replaceable be to fulfill different functions. Further, the cold tip must be in the be able to use in a surgical application sterilized to be, to a repeated use of the system at various to enable patients.

Known cryosurgical probes are therefore open systems. In an open system, the cannula or cold tip removed and sterilized or disposed of. The introduction of contaminants in the cooling system while the removal or replacement of the cannula or cold tip is no particular problem in an open system, since the contaminants during the can be flushed out of the gas discharging from the system. Open systems are in Operation due to the necessary continuous exchange of gas lossy and expensive. also is the discharge of the gas in the environment is not always environmentally friendly. Closed systems are more economical and environmentally friendly. If a known closed system in a surgical application would be used would be the removal and Replacing the needle or cold surface for sterilization purposes contaminants in the system introduce, ultimately resulting in blockage of the expansion element. A closed surgical system could theoretically be provided with self-sealing couplings, but contamination would yet over a certain period incurred. Furthermore, have self-sealing Couplings O-rings and precision parts on. Sterilization of the cannula or cold surface would the O-rings and precision parts inevitably high temperatures and aggressive chemicals expose, which ultimately leads to degradation of the sealing ability of the couplings.

The Use of disposable cannulas or -Kaltflächen would this solve dilemma. Firstly, even if disposed of interchangeable parts and new sterile parts are replaced, repeated interruptions required which ultimately leads to an accumulation of contaminants would lead. Secondly are the most disposable parts for economic reasons from Plastic. Plastic usually contains traces of Water. If a plastic part exposed in a cooling system of the gas is, water may eventually the plastic leach and contaminate the gas in the system. thirdly increase self-sealing fittings typically the size, Weight and the substantial cost of a device, making it amenable to use in a disposable device undesirable power. Fourthly, each time a disposable element, such. B. a cannula or a cold surface, is disposed, cooling gas, contained in the disposable element is lost. This requires a further addition of gas to prevent the deterioration of the cooling capacity to avoid the system.

A Evacuation of gas from the disposable component, or the use of spare components that are pre-loaded with gas, would the complexity and increase the cost of the system considerably.

Further has a typical cryosurgical probe one or more auxiliary instruments near the cold surface, for use in conjunction with the cold tip, for. example, temperature sensors, Heaters, ultrasound transducers, optical elements, and fluid ports for flush and ventilation. If a reusable probe is employed, repetitive Sterilization of these auxiliary instruments deteriorate their performance. The ideal practice would, if this auxiliary means would be included in a disposable element.

Finally, it is desired to to insulate the shaft of a cryosurgical probe, a freezing of the tissue at undesired to avoid locations along the probe when the probe is in a body cavity introduced or organ is. An effective means to isolate it would be a provide vacuum space along the probe shaft. The stage the vacuum, which is held in such a space, can be with time, however, because of the outgassing of metals, plastics and brazed deteriorate. This outgassing increases during sterilization procedures, in where the probe heat supplied is. would therefore it is desired to incorporate the vacuum insulation space into a disposable element. This disposable element would once to be sterilized, and the disposable element can then be economically discarded are, thus minimizing the amount of vacuum degradation.

WHERE 98/29029 relates to a disposable sheath for use as a removable sterile cover for a cryosurgical probe. The case comprises: a hollow handle, the one on a handle shaft portion cryosurgical probe releasably can be attached, a connector body attached to said hollow grip is attached, a tubular passage through the container body for Receiving a cannula portion the cryosurgical probe into this, a thermally resistant catheter the connector body is attached, wherein the catheter's on a portion of a cannula kryochirurgi probe releasably can be attached, and a <?page 4?>thermally conductive segment is attached to the catheter, said conductive segment on a heat transfer portion a cryosurgical probe and placed in contact with this detachable is.

The present invention is defined in the claims.

The Invention relates to a shell for use with a Joule-Thomson cryosurgical probe with closed circuit and the combination of shell and Probe with a closed circuit. The shell is so flexible that they a Probe can be slid, whereby the probe from the environment separated and the use of the probe in a surgical application is possible. The case has a handle on the handle shaft of the cryosurgical probe is attached, and a stretchable wrapping, of the proximal end Handle is attached. The enclosure can longitudinally be stretched around the cooling tubes and Instrumentation Cable abzudekken that attached to the handle shaft are, whereby a sterile barrier for these components prepared is.

The case has a hollow catheter assembly with multiple lumen of a Catheter and a connector body consists. The catheter is through the connector body to the distal portion the handle attached, wherein at least one lumen being shaped and is dimensioned such that it close attention to the needle of cryosurgical probe fits. The catheter is not thermally conductive, so that it contributes to a heat transfer To prevent from the environment to the gas mixture and freezing tissue of undesirable Ask preventing along the catheter. A thermally conductive Segment is at the distal end of the catheter in the form of a metal cap or metal tip attached. The metal tip can be round, flat, be sharp or arbitrarily shaped differently so that they for a cryosurgical operation suitable is. The thermally conductive cap or tip sits on the cold surface on the probe. A biasing member biases in the catheter assembly the conductive end of the sheath proximally against the cold surface at the front of the probe. This causes the conductive segment on the catheter heat from Zielge tissue to cold surface transfers that then turn heat the expanded gas mixture efficiently transmits.

The novel features of the present invention and the invention themselves are best understood from the accompanying drawings of the following Description understood in which like reference numerals denote like parts, and the following show:

<figref idrefs="S24">1</figref> is a side view of a cryosurgical probe of the type used in the invention could be;

<figref idrefs="S24">2A</figref> is a side view of a casing of the invention;

<figref idrefs="S24">2 B</figref> is a side view of an alternative embodiment of the invention the shell;

<figref idrefs="S24">2C</figref> is a distal end of the in <figref idrefs="S24">2 B</figref> shown alternative embodiment the shell;

<figref idrefs="S25">3</figref> is a sectional view of a sheath according to the invention in place on a cryosurgical probe;

<figref idrefs="S25">4</figref> is a schematic view of an in <figref idrefs="S24">1</figref> shown cryosurgical probe;

<figref idrefs="S26">5</figref> is a sectional view of a proximal portion of the sheath, such as in <figref idrefs="S24">2A</figref> shown;

<figref idrefs="S26">6</figref> is a distal end view of the cryosurgical probe as shown in <figref idrefs="S24">1</figref> shown;

<figref idrefs="S27">7</figref> is a side view of the proximal portion of the sheath <figref idrefs="S24">1</figref> With the rolled wrapping;

<figref idrefs="S27">8</figref> is a sectional view of the proximal portion of the sheath of <figref idrefs="S27">7</figref> With the rolled wrapping;

<figref idrefs="S28">9</figref> is a longitudinal sectional view of the proximal portion of the connector body of the sheath;

<figref idrefs="S29">10</figref> is a longitudinal sectional view of the distal portion of the connector body of the sheath;

<figref idrefs="S30">11</figref> is a cross-sectional view of the distal portion of the connector body of the Cover;

<figref idrefs="S30">12A</figref> is a cross-sectional view of the catheter of the sheath, on the needle the cryosurgical probe is installed;

<figref idrefs="S30">12B</figref> is a cross-sectional view of an alternative embodiment the catheter of the sheath, with a vacuum jacket on the cannula of the cryosurgical probe is installed;

<figref idrefs="S31">13</figref> is a side view of the distal end of the catheter of the sheath;

<figref idrefs="S31">14</figref> is a longitudinal sectional view of the distal end of the catheter of the sheath;

<figref idrefs="S32">15</figref> is a longitudinal sectional view the casing of the invention; and

&lt;?page 5?&gt;

<figref idrefs="S32">16</figref> is a partial longitudinal sectional view a portion of the in <figref idrefs="S32">15</figref> Case shown.

Detailed Description of the Invention

The Invention relates to the use of a sheath on a cryosurgical Probe with a mixed gas Joule-Thomson system with a closed circuit is working. Such cryosurgical probe<figref>10</figref> is in <figref idrefs="S24">1</figref> shown. The probe <figref>10</figref> consists mainly of a handle shaft <figref>12</figref>, a tubular hollow cannula <figref>14</figref> and a cold surface <figref>16</figref>, The handle shaft <figref>12</figref> may be metallic to an effective to enable sealing. The handle shaft may have end caps with the handle shaft cylinder kaltverlötet are to the interior of the handle shaft <figref>12</figref> to obtain a vacuum whereby the insulation allows is. could Alternatively the handle shaft <figref>12</figref> with insulating material, eg. as airgel, be filled. Various components of the cooling system, z. B. a heat exchanger, can along with various auxiliary instruments in the handle shank <figref>12</figref> housed be to individual elements, eg., temperature sensors, heaters, illumination optics, Viewing optics, laser optics and ultrasound transducer support. On power cable <figref>18</figref>Extending from the proximal portion the handle shaft <figref>12</figref> extends, pipes for the refrigeration system, power cables may for electrical contain components, or fiber optic cables to the lighting, to support viewing and laser components.

More Cooling System Components, z. B. a high pressure line, for transporting a high pressure gas mixture of the probe handle <figref>12</figref> the cold surface <figref>16</figref>, And a low-pressure line to the Returning the expanded gas mixture from the cold face <figref>16</figref> the probe handle <figref>12</figref> can in the hollow cannula <figref>14</figref> housed be. Still other components of the cooling system, eg. As a Joule-Thomson expansion element, can in the cold surface <figref>16</figref> housed be. The hollow cannula<figref>14</figref> is normally carried out so that they heat transfer minimized from the surrounding tissues to the cryogenic gas mixture. you may consist of a thermally resistant material, eg. B. rigid Plastic, consist, or it may consist of a metal, wherein the inside or outside an insulator is applied, in order to prevent heat transfer. The cannula <figref>14</figref> can a rigid tube be, as shown, or it can be flexible depending on the application and otherwise be formed. The cold surface<figref>16</figref> is a heat transfer element, the adapted is that a heat transfer is maximized by the target tissues to the expanded gas mixture. It may consist of a thermally conductive material, such. As metal, preferably Silver. The cold surface<figref>16</figref> can a cap-shaped Element at the distal end of the cannula <figref>14</figref> be, as shown, or it may have a different shape depending on the application elsewhere on the cannula <figref>14</figref> arranged be. A plurality of grooves<figref>17</figref> are in the cold surface <figref>16</figref> educated, to the flow a thermal grease to allow, if the cold surface <figref>16</figref> in the disposable sheath fitted is. Since the cryosurgical probe<figref>10</figref> with a closed cooling system is used, it must necessarily be sealed to prevent contamination. You may have separable compounds which provides an exchange of parts enable, but any such connection must necessarily have sealing components for normal sterilization procedures are not suitable.

<figref idrefs="S24">2A</figref> shows the case <figref>20</figref> to Assembly on the probe <figref>10</figref>To the use of the probe <figref>10</figref> in a protected Environment without impairing the effectiveness of the probe <figref>10</figref> to enable. As choice , the sheath <figref>20</figref> out Materials that can be sterilized easily, and they can be used as disposable sheath be manufactured inexpensively. The case<figref>20</figref> has a grip <figref>22</figref> to which on the probe handle <figref>12</figref> arranged is, preferably with corrugations or other surface features to the surgeon a secure grip to offer. A stretchy wrap<figref>23</figref> is at the proximal portion of the handle <figref>22</figref> attached or this formed. The enclosure<figref>23</figref> is in <figref idrefs="S24">2A</figref> shown in the deployed or expanded state, wherein the supply cable <figref>18</figref> and the proximal portion the probe handle shaft <figref>12</figref> are covered. The handle<figref>22</figref> and wrapping <figref>23</figref> consist of thermally insulating material, eg. as plastic. You should a certain flexibility have to make them on the probe handle <figref>12</figref> and the supply cable <figref>18</figref> arranged can be. The case <figref>20</figref> has also a hollow tubular catheter <figref>24</figref> on, extending distally. The hollow catheter<figref>24</figref> it's so shaped and sized to the cannula section <figref>14</figref> the cryosurgical probe <figref>10</figref> covers, it preferably close fitting to the probe cannula <figref>14</figref> sitting, a hindrance to the use of the probe <figref>10</figref> in to avoid a surgical environment. The hollow catheter<figref>24</figref> consists of thermally resistant Material, eg. As plastic to a surrounding heat transfer from the Tissues to the probe cannula <figref>14</figref> continue to prevent.

At the distal end of the hollow catheter <figref>24</figref> attached is a thermally conductive segment, z. B. a cap-shaped tip <figref>26</figref>, The sheath tip <figref>26</figref> it's so shaped and sized to exactly on the probe cold tip <figref>16</figref> fits to the heat transfer through the sheath tip <figref>26</figref> to Probe cold tip <figref>16</figref> to maximize. The sheath tip<figref>26</figref> can a cap-shaped Element at the distal end of the catheter <figref>24</figref> be, as shown, or it can be a thermally conductive segment, which is also different is shaped or arranged to the configuration &lt;?page 6?&gt;and location of Probe cold tip <figref>16</figref> to fit. The thermally conductive segment of the envelope, for. Example, the sheath tip<figref>26</figref>. has made a material that heat good transfers, z. B. Metal. All components of the shell<figref>20</figref> are attached to each other in a sealing, so that when the envelope <figref>20</figref> sterile , the probe <figref>10</figref> cover with a protective sleeve that probe the <figref>10</figref> for use useful in a surgical environment makes. Various auxiliary instruments for use, in conjunction with cryosurgery can in hollow catheter <figref>24</figref> or in the sheath tip <figref>26</figref> arranged be, as described below. These instruments may be temperature sensors, Heaters, viewing optics, illumination optics, laser optics and ultrasound transducer be. Controls for operating these instruments or devices for Displaying values ​​of these instruments can in the probe handle <figref>12</figref> or elsewhere to facilitate the observation and use be placed by the surgeon. Connections between the instrumentation near the sheath tip <figref>26</figref> and the operating devices in the probe handle <figref>12</figref> or proximal the handle shaft <figref>12</figref> can the hollow catheter <figref>24</figref> be included as below will be described.

The shell <figref>20</figref> can also a connector body <figref>28</figref> exhibit, fulfills the various functions. The connector body <figref>28</figref> provides means for connecting the hollow catheter <figref>24</figref> With the handle <figref>22</figref> . It may also include means for locking the represents shell <figref>20</figref> on the probe <figref>10</figref> represent. Further, the connector body<figref>28</figref> a Attachment site for Connector, for. Example, electrical contacts or optical elements, offer, to auxiliary instrumentation near the sheath tip <figref>26</figref> With the probe handle <figref>12</figref> connect to.

Finally, of connector body <figref>28</figref> a fastening point for one connection or a connecting piece <figref>30</figref> provide, z. B. a luer fitting that can be used to allow fluid flow to or from the area near the sheath tip <figref>26</figref> to enable. Fluid flow to the area can, in certain applications, where a fluid, eg. as a salt solution, into a body cavity with a small opening must be injected, to be required. An example of such an application is the insertion a probe cannula <figref>14</figref> in the uterus for endometrial ablation. Fluid flow to the area to the top <figref>26</figref> around, z. B. a saline or another fluid for rinsing is the area suitable, by a syringe to the fitting <figref>30</figref> appropriate is to be provided. As an alternative, as shown in<figref idrefs="S24">2 B</figref> and <figref idrefs="S24">2C</figref> shown, a compliant brine reservoir <figref>25</figref> the handle <figref>22</figref> arranged be and the connecting piece <figref>30</figref> over a tube <figref>27</figref> connected be. A squeezing or pressing the brine reservoir <figref>25</figref> can cause the saline solution in the connecting piece <figref>30</figref> flows. the has flowed Fluid (not shown) by pushing a plug on the cannula <figref>14</figref> and the catheter <figref>24</figref>Who exactly between the catheter <figref>24</figref> and the opening the body cavity fits, in the body cavity be detained. Similarly, a balloon (not shown) around the catheter <figref>24</figref> around are inflated against the cavity opening seal. Fluid flow from the area around the tip<figref>26</figref> around can be achieved by applying a vacuum source to the fitting <figref>30</figref> connected is. Fluid flow may be between the tip portion and the connecting piece<figref>30</figref> on the hollow catheter <figref>24</figref> lead, as is described below.

<figref idrefs="S24">2A</figref> shows even a finger stop <figref>32</figref>That at the distal portion the shell handle <figref>22</figref> educated , and a finger slide <figref>34</figref>, Of the proximal portion of connector body <figref>28</figref> educated is. As shown below, the finger slide can<figref>34</figref> in Direction of the finger stop <figref>32</figref> are drawn to the connector body <figref>28</figref> the probe handle <figref>12</figref> to Unlock.

<figref idrefs="S25">3</figref> shows a combined inventive cryosurgical instrument <figref>40</figref>Selected from the shell <figref>20</figref> is that on the probe <figref>10</figref> is arranged as a protective coating, with a thermally conductive segment for effectively transferring heat the target tissue to the cold tip <figref>16</figref> the probe <figref>10</figref>, Note that the envelope<figref>23</figref> the envelope <figref>20</figref> so flexible is that they over the proximal end of the probe handle shaft <figref>12</figref> and the supply cable <figref>18</figref> expands.

<figref idrefs="S25">4</figref> is a schematic illustration of a cryosurgical probe <figref>10</figref> as Longitudinal section, the components and functions of the typical probe <figref>10</figref> to show which included his invention can. A high-pressure gas pipe <figref>36</figref> provides a warm high pressure gas mixture for the cooling components in the probe <figref>10</figref> ready and a low-pressure gas pipe <figref>38</figref> receives the cool low pressure gas mixture, that of the probe <figref>10</figref> is returned. The high pressure and the low pressure gas tube <figref>36</figref>. <figref>38</figref> are with the outlet or intake of gas compressor <figref>42</figref> connected. The high-pressure tube<figref>36</figref> is even with a high-pressure passage through a pre-cooling heat exchanger <figref>44</figref> connected, and the low-pressure tube <figref>38</figref> is with a low pressure passageway through the heat exchanger <figref>44</figref> connected. The heat exchanger <figref>44</figref> cools the expanded warm high pressure gas mixture by heat exchange with the cool Low pressure gas mixture before, before the high pressure gas mixture to the cold surface <figref>16</figref> is expanded.

Of the high pressure outlet <figref>46</figref> of heat exchanger <figref>44</figref> is with a high-pressure line <figref>48</figref> connected, by the hollow cannula <figref>14</figref> to cold surface <figref>16</figref>&lt;?page 7?&gt;leads. At the distal end of the high-pressure line <figref>48</figref> is a Joule-Thomson expansion element <figref>50</figref>. in that the cold surface <figref>16</figref> or close is arranged on this. The cryogenic high-pressure gas mixture through the high-pressure line <figref>48</figref> flows, is the expansion element <figref>50</figref> isenthalpically expanded to substantially reduce the temperature of the gas mixture. The colder Low pressure gas mixture is then cold face <figref>16</figref> exposed, to the tissue via the thermally conductive sheath tip <figref>26</figref> to cool. A separator plate <figref>52</figref> separates the low-pressure region of cold surface <figref>16</figref> from the probe cannula <figref>14</figref>, The low-pressure gas mixture flows back through openings in the separator <figref>52</figref>To discuss the probe cannula <figref>14</figref> to the Low pressure inlet <figref>54</figref> of heat exchanger <figref>44</figref> to return. The reflux of the low pressure gas mixture through the cannula <figref>14</figref> can actually a Low pressure line done that in <figref idrefs="S25">4</figref> not is shown.

On Mother connector fitting <figref>56</figref> is in the distal portion of the probe handle shaft <figref>12</figref> provided to a point of engagement between the probe <figref>10</figref> and the shell <figref>20</figref> provide. An inwardly protruding locking flange <figref>58</figref> can around the outer periphery the female connector <figref>56</figref> to be available. One or more connector elements <figref>60</figref> can in female connector <figref>56</figref> be provided with the auxiliary instrumentation of the envelope <figref>20</figref> carried is to engage. The connector element<figref>60</figref> can an electrical contact for use with auxiliary instrumentation, z. B. a temperature sensor, heater, or ultrasonic transducer be. As well , the connector element <figref>60</figref> an optical element for be used with an auxiliary instrumentation such. as a viewing optics, Illumination optics or laser optics. The connector element<figref>60</figref> is a Instrumentation Head <figref>62</figref> with a display or control device <figref>64</figref> connected. The instrumentation conductor <figref>62</figref> can, as required, an electrical its director or an optical fiber bundle. Only a group of connector elements <figref>60</figref>, ladders <figref>62</figref> and View or control devices <figref>64</figref> is the simplicity shown sake, but it is understood that a plurality of such systems in a given cryosurgical instrument <figref>40</figref> used could be. Furthermore, it should be understood that the display or controller <figref>64</figref> from the instrument <figref>40</figref> are could, as described for a video viewing system would be useful. An alignment rib<figref>66</figref> can the periphery of the probe handle shaft <figref>12</figref> be designed to an orientation of the probe handle shaft <figref>12</figref> with a sheath grip <figref>22</figref> to support.

<figref idrefs="S26">5</figref> shows, that the connector body <figref>28</figref> a through longitudinal bore <figref>68</figref> having, to the passage of the probe cannula <figref>14</figref> to enable. The connector <figref>30</figref> is in fluid communication with the bore <figref>68</figref>To a fluid stream to the outside the hollow catheter <figref>24</figref> to allow extending into the bore <figref>68</figref> extends. A male connector fitting <figref>70</figref> is at the proximal portion of the connector body <figref>28</figref> provided to the female connector fitting <figref>56</figref> in the distal Section of the probe handle shaft <figref>12</figref> to engage. A releasable lock <figref>72</figref> is the male connector terminal <figref>70</figref> provided to the locking flange <figref>58</figref> to engage. One or more connector elements <figref>74</figref> are the male connector fitting <figref>70</figref> provided to the connector elements <figref>60</figref> in female connector fitting <figref>56</figref> in the Probe handle <figref>12</figref> to engage. The connection of the connector member <figref>74</figref> with the auxiliary instrumentation and the connection of the fluid flow path from the fitting <figref>30</figref> to the hollow catheter <figref>24</figref> are better in another figure shown. <figref idrefs="S26">6</figref> is an end view of a Probe handle shaft <figref>12</figref>That the interior of the female connector-fitting <figref>56</figref> shows. A plurality of connector elements, <figref>60</figref> is the female connector fitting <figref>56</figref> arranged in a circle shown.

<figref idrefs="S27">7</figref> shows the case <figref>20</figref> With an enclosure <figref>23</figref> in the folded or contracted state. The shell would normally be transported or stored in this state until they on a cryosurgical probe <figref>10</figref> is applied. At the proximal End of the sheath <figref>23</figref> are approaches <figref>78</figref> provided to the raising of the envelope <figref>23</figref> on the probe handle <figref>12</figref> and the supply cable <figref>18</figref> to facilitate. <figref idrefs="S27">8</figref> is a sectional view, the an embodiment the envelope <figref>20</figref> in more detail shows. An alignment groove<figref>76</figref> is in the inner bore the shell handle <figref>22</figref> shown, to the alignment rib <figref>66</figref> on the outside the probe handle shaft <figref>12</figref> to engage. You can see, that the connector body <figref>28</figref> as a multi-piece running arrangement can be.

<figref idrefs="S28">9</figref> shows in more detail an embodiment of connector body <figref>28</figref> and its connection to the sheath grip <figref>22</figref>, The connector body <figref>28</figref> has in essentially a distal portion <figref>80</figref>, A middle portion <figref>82</figref> and a proximal portion <figref>84</figref> on. The distal portion<figref>80</figref> has a finger slide <figref>34</figref> on, and the distal portion of the distal portion <figref>80</figref> is at the hollow catheter <figref>24</figref> attached. The middle part <figref>82</figref> is in the proximal portion of the distal Part <figref>80</figref> disposed, and it provides a means for Connecting the distal portion <figref>80</figref> with the instrumentation connectors <figref>74</figref> and the releasable lock <figref>72</figref> . The middle part <figref>82</figref> can, as shown, of a cylinder <figref>92</figref> exist, which on the locking <figref>72</figref> screwed is. A collet<figref>86</figref> becomes between the cylinder <figref>92</figref> and the locking <figref>72</figref> detected. The collet <figref>86</figref> is on a sleeve <figref>90</figref> fixed, in turn, to a connector fixing <figref>96</figref> is attached. Instrumentation Head <figref>94</figref> are with instrumentation connectors <figref>74</figref> connected. The instrumentation conductor <figref>94</figref> through the longitudinal&lt;?page 8?&gt;drilling <figref>68</figref> or along the same to the catheter <figref>24</figref>,

<figref idrefs="S29">10</figref> shows in more detail an embodiment of the distal portion <figref>80</figref> of connector body <figref>28</figref>, The distal End of the longitudinal bore <figref>68</figref> ends in a fluid bore <figref>100</figref>In fluid communication with an inner bore <figref>98</figref> of the connector <figref>30</figref> is. The proximal Portion of the hollow catheter <figref>24</figref> extends into fluid bore <figref>100</figref>Wherein the diameter of the fluid bore <figref>100</figref> is greater than the outside diameter the catheter <figref>24</figref>, This leaves a fluid flow space, of the catheter <figref>24</figref> in the fluid bore <figref>100</figref> surrounds. The proximal end <figref>102</figref> the fluid bore <figref>100</figref> can by a shoulder in the, longitudinal bore <figref>68</figref> completed will. By contrast, the proximal end<figref>102</figref> the fluid bore <figref>100</figref> by an epoxy resin seal to close. The probe cannula<figref>14</figref> can snugly into the longitudinal bore <figref>68</figref> be inserted. The distal end of the connector body <figref>28</figref> can with a Zugentlastungsmanschette <figref>106</figref> be provided to the catheter <figref>24</figref> the connector body <figref>28</figref> to fix. On clearance <figref>108</figref> between the cuff <figref>106</figref> can filled with epoxy resin be to the distal end of the fluid bore <figref>100</figref> complete.

<figref idrefs="S30">11</figref> shows a sectional view of the distal portion of the connector body <figref>28</figref> and of the proximal portion of the hollow catheter <figref>24</figref>, In this view, one can see that the catheter <figref>24</figref> a multiple lumen catheter is. A variety lumen <figref>110</figref> leads longitudinal through the wall of the catheter <figref>24</figref>, Some of the lumen<figref>110</figref> will used to guide a fluid stream, as in <figref>112</figref> shown, and other lumens are used to auxiliary instrumentation signals to conduct, as in <figref>114</figref> shown. As the fluid bore<figref>100</figref> are the fluid lumen <figref>112</figref> to the outside of the catheter <figref>24</figref> open while the fluid lumen <figref>112</figref> along the remainder of the length of the catheter <figref>24</figref> to outside are not open. The instrumentation lumens<figref>114</figref> are to Outside on the whole length the catheter <figref>24</figref> closed. Since the fluid lumens<figref>112</figref> to Outside in the fluid bore <figref>100</figref> are open, a fluid from the fitting <figref>30</figref> in the wall of the catheter <figref>24</figref> or from the wall of the catheter <figref>24</figref> in the connecting piece <figref>30</figref> stream. The central bore <figref>116</figref> performs the catheter <figref>24</figref>To the probe cannula <figref>14</figref> take.

<figref idrefs="S30">12A</figref> shows a cross-sectional view of the catheter <figref>24</figref> and the probe cannula <figref>14</figref> before the connector body <figref>28</figref>, The cannula <figref>14</figref> includes a group three stainless steel coaxial tubes <figref>48</figref>. <figref>55</figref>. <figref>57</figref> on, wherein said outer tube <figref>57</figref> themselves substantially snugly into the catheter <figref>24</figref> inserts. one can be seen that a Vacuum or an insulating gap <figref>118</figref> between the outer tube <figref>57</figref> and the low-pressure line <figref>55</figref> is trained. The low-pressure line<figref>55</figref> leads to Low pressure inlet <figref>54</figref> of heat exchanger <figref>44</figref>, The high pressure line <figref>48</figref> lies within the low pressure conduit <figref>55</figref>,

<figref idrefs="S30">12B</figref> shows a cross-sectional view of a alternative embodiment the catheter <figref>24</figref> and the probe cannula <figref>14</figref> before the connector body <figref>28</figref>, The cannula <figref>14</figref> contains a Set of two coaxial stainless steel tubes <figref>48</figref>. <figref>55</figref>, in which the outer tube <figref>55</figref> themselves substantially snugly in an inner tube <figref>117</figref> in the catheter <figref>24</figref> inserts. one can be seen that a Vacuum jacket or insulation gap <figref>118</figref> in the catheter <figref>24</figref> in between the inner tube <figref>117</figref> and the catheter <figref>24</figref> is trained. Here, as stated above, the Low pressure line <figref>55</figref> the high pressure inlet <figref>54</figref> of heat exchanger <figref>44</figref>, The high pressure line <figref>48</figref> lies within the low pressure conduit <figref>55</figref>,

<figref idrefs="S31">13</figref> shows a side view of the distal end of the hollow catheter <figref>24</figref> and the sheath tip <figref>26</figref>, A plurality of terminals <figref>120</figref> in the lumen <figref>110</figref> is in the distal end of the catheter <figref>24</figref> educated. Some of the connections <figref>120</figref> is for the Fluid flow to or from the area near the sheath tip <figref>26</figref> certainly. Other connections <figref>120</figref> are for optical elements determines a viewing, lighting and laser systems support. Still other ports <figref>120</figref> might as connecting terminals for electrical Conjunction with a temperature sensor, heater, or ultrasonic transducer in the sheath tip <figref>26</figref> used will.

<figref idrefs="S31">14</figref> shows a longitudinal section of the distal portion of the catheter <figref>24</figref> and the sheath tip <figref>26</figref>, Of the Auxiliary instrumentation conductor <figref>94</figref> through a lumen <figref>114</figref> to the distal end of the catheter <figref>24</figref>Where he met with an optical Element in the terminal <figref>120</figref> or with an auxiliary instrument <figref>126</figref> in the sheath tip <figref>26</figref> connected is. The auxiliary instrument<figref>126</figref> could be a temperature sensor, a heater, a Gewebewiderstandsmeßkomponente or an integrated component to perform two or more temperature sensing, or Impedanzmeß- be heating functions. For example, the instrument<figref>126</figref> on combined heater and resistance detector (RTD) be composed of a film is that between very thin (0.003 inch) Polyimidfilmbahnen is arranged. It could also the auxiliary instrument be an ultrasonic transducer. These auxiliary instruments<figref>126</figref>. in the sheath tip <figref>26</figref> are, can sandwiched between an inner thermally conductive layer <figref>122</figref> and an outer thermally conductive layer <figref>124</figref> be arranged. The inner conductive layer <figref>122</figref> may be made of copper, and the outer conductive layer <figref>124</figref> may be made of stainless steel. at Demand can epoxy between the instrument <figref>126</figref> and the conductive layers <figref>122</figref>. <figref>124</figref> be cast. An epoxy-vent <figref>128</figref> in the outer layer <figref>124</figref> is For this Purpose intended. If Isolierschich&lt;?page 9?&gt;th between the instrument <figref>126</figref> and the inner and outer layers <figref>122</figref>. <figref>124</figref> arranged are, must the insulating layers as thin be that heat transport possible through this is. A thermally conductive grease<figref>130</figref> can in the shell layer <figref>26</figref> scheduled be to the thermal contact between the probe cold tip <figref>16</figref> and the sheath tip <figref>26</figref> to maximize.

<figref idrefs="S32">15</figref> shows an embodiment according to the invention the envelope <figref>220</figref>. in which one or more biasing elements in the catheter assembly <figref>223</figref> the conducting tip <figref>226</figref> the catheter <figref>224</figref> against the cold surface <figref>16</figref> the probe cannula <figref>14</figref> Pretension. The case <figref>220</figref> has a hollow handle <figref>222</figref> , in which the catheter assembly <figref>223</figref> attachable is. The catheter assembly<figref>223</figref> includes a catheter <figref>224</figref> and a connector body <figref>228</figref> on. The case <figref>220</figref> can on a cryosurgical probe handle represented by dashed Lines is shown, by means of one or more interlocks <figref>225</figref> secured be. catheter<figref>224</figref> may be made of a flexible material, z. B. elastomer made, which can be stretched and toward its unstretched length may be biased. Similarly, the connector body<figref>228</figref> out a flexible material, for. example, an elastomer composed, and may be deformed and the non-deformed toward its may be biased state.

<figref idrefs="S32">16</figref> shows a longitudinal section of the distal portion of the handle <figref>222</figref> and proximal Portion of the catheter assembly <figref>223</figref> in a larger scale. In addition, a Side view of the proximal portion of the cannula <figref>14</figref> the cryosurgical probe <figref>10</figref> shown. The connector body<figref>228</figref> has a substantially tubular distal section <figref>231</figref>Which exactly fit into a longitudinal bore the distal end of the hollow handle <figref>222</figref> inserts. Of the distal portion <figref>231</figref> of connector body <figref>228</figref> can in a desired longitudinal position of one or more circular O-rings <figref>227</figref> being held. The connector body<figref>228</figref> can a conical apron <figref>233</figref> at have its proximal end, which at the distal wall of the cavity in hollow handle <figref>222</figref> bears. The proximal end of the catheter<figref>224</figref> is in a longitudinal bore in the distal portion <figref>231</figref> of connector body <figref>228</figref> by Glueing or otherwise secured connection. The seal between the catheter <figref>224</figref> and the connector body <figref>228</figref> and of the O-rings <figref>227</figref> Seal produced form a sterile barrier at the distal end of the hollow handle <figref>222</figref>,

The catheter assembly <figref>223</figref>, Including its conductive tip <figref>226</figref>. is formed with an undeformed length which is slightly smaller than the necessary length to accommodate the length the cannula <figref>14</figref>. including its cold surface <figref>16</figref>, If cryoprobe <figref>10</figref> in the shell <figref>220</figref> is inserted, around the sleeve <figref>220</figref> With the handle shaft of the cryoprobe <figref>10</figref> to lock, it is therefore namely necessary, one or more components of the catheter assembly <figref>223</figref> slightly stretch or otherwise deform. The stretching or deforming in the embodiment shown can the connector body <figref>228</figref> or in the catheter <figref>224</figref> or occur in both. When the catheter assembly<figref>223</figref> so has been deformed to the length of cannula <figref>14</figref> recorded may be, causes the elastic property of the catheter assembly <figref>223</figref>. that the conductive tip <figref>226</figref> proximally against the cold surface <figref>16</figref> the cryoprobe <figref>10</figref> is biased. thereby, a fixed contact between the conductive tip <figref>226</figref> and the catheter assembly <figref>223</figref> and the cold surface <figref>16</figref> the cryoprobe <figref>10</figref> ensured whereby the heat transfer from around the cryoprobe <figref>10</figref> is maximized.

Instead of to use elastic materials, a similar effect by using other types of biasing elements, such. as one or more springs (Not shown), can be achieved to the catheter assembly proximally bias. Further, a conductive tip<figref>226</figref> or the cold surface <figref>16</figref> or both slightly conical be to the positive contact surface to increase between the two peaks or surfaces.

Although the particular invention as illustrated in detail herein and disclosed is complete is able to solve the tasks and established here to offer advantages, it should be understood that this disclosure is performing character with respect to the presently preferred embodiments has the invention and that no limitations except in the accompanying claims are defined beabsichtig.