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WO1996016604A1 - Instrument chirurgical a tige tubulaire - Google Patents

Instrument chirurgical a tige tubulaire Download PDF

Info

Publication number
WO1996016604A1
WO1996016604A1 PCT/EP1995/004643 EP9504643W WO9616604A1 WO 1996016604 A1 WO1996016604 A1 WO 1996016604A1 EP 9504643 W EP9504643 W EP 9504643W WO 9616604 A1 WO9616604 A1 WO 9616604A1
Authority
WO
WIPO (PCT)
Prior art keywords
carrier
shaft
jaws
handle part
surgical instrument
Prior art date
Application number
PCT/EP1995/004643
Other languages
German (de)
English (en)
Inventor
Nicola Giordano
Theodor Lutze
Dieter Weisshaupt
Paul Wieneke
Original Assignee
Aesculap Ag
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Aesculap Ag filed Critical Aesculap Ag
Publication of WO1996016604A1 publication Critical patent/WO1996016604A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/30—Surgical pincettes, i.e. surgical tweezers without pivotal connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2905—Details of shaft flexible
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2933—Transmission of forces to jaw members camming or guiding means
    • A61B2017/2937—Transmission of forces to jaw members camming or guiding means with flexible part

Definitions

  • the invention relates to a surgical tubular shaft instrument with a rigid tubular shaft, with a tool having two mutually pivotable jaws at one end of the shaft and with a handle part at the other end of the shaft, with an actuating element on the handle part and with one actuated by the same Transfer member for opening and closing the jaws of the tool.
  • Tubular shaft instruments of this type are used in the surgical field above all where operations are to be carried out through very narrow body openings. For this purpose, these instruments are passed through trocar sleeves, the outer diameter of which is generally a maximum of 8 mm.
  • the shaft diameters of such surgical instruments have to be less than 2 mm in many applications, and it is therefore extremely difficult to transfer the desired opening and closing movement to the tool.
  • push and pull rods in the interior of the shaft are used for this purpose but additionally the use of gear mechanisms and joints, by means of which the sliding movement of the push and pull rod can be transmitted to the jaws of the tool.
  • a surgical tubular shaft instrument of the type described in the introduction in that the two jaws of the tool are located at the free end of a rod made of elastically bendable material and arranged in the interior of the shaft and axially immovably connected to the handle part in that the carrier is surrounded by a flexible tube which can be displaced from the handle part along the carrier between an advanced closed position in which the tube is partially pushed over the jaws and thereby swings them elastically against one another, and one retracted opening position in which the tube releases the jaws which pivoting apart elastically that the support in its section adjoining the jaws is laterally angled in the elastically undeformed state, so that the jaws project laterally from the shaft of the instrument, and that the shaft surrounding the support and the flexible tube starts from the handle part is displaceable along the carrier between a retracted release position, in which the laterally angled section of the carrier protrudes from the shaft, and a stretching position, in which the laterally angled section of the carrier is at least partially immer
  • Such a construction of a surgical instrument makes it possible to set the angle of the tool from the handle part and still additionally open and close the jaws of the tool in all possible angular positions of the tool. No complicated gear elements are necessary in the area of the tool, so that the construction can also be used with a shank that has a very small outer diameter, for example 2 mm.
  • the jaws are opened and closed exclusively by axially displacing the flexible tube on the carrier, the tube pivoting the jaws towards one another when the tube is pushed over the jaws.
  • a change in the angulation of the carrier is achieved in that the shaft is pushed more or less over the bent region of the carrier and this thereby stretches more or less.
  • the flexible tube arranged on the carrier is also stretched and does not in any way prevent the change in the angular position.
  • the jaws can be opened and closed at any angular position, since the flexible tube can be moved along the support at any angular position.
  • the carrier is an elastic metal wire.
  • the carrier consists of a pseudo-elastic shape memory alloy with stress-induced martensite formation at body and ambient temperature.
  • a pseudo-elastic shape memory alloy with stress-induced martensite formation at body and ambient temperature.
  • Such alloys are known per se (EP 145 166 B1), they are distinguished by the fact that they are in an austenitic state in a certain temperature range when they are not braced. If, on the other hand, they are braced, there is a phase transition with martensite formation, which is reversible. The phase transition takes place isothermally and leads to the fact that this material allows extraordinarily high elastic deformations which are greater than the elastic deformations within an unchanged phase. Due to the phase transition, a stronger, reversible deformation is possible with this material, one speaks therefore of a pseudoelastic effect.
  • Such a material can be, for example, a nickel-titanium alloy. This should be selected so that the described pseudo-elastic effect at temperatures is observed, which corresponds to the body temperature and the operating temperature of the surgical instrument, which is, for example, between 15 ° C. and 45 ° C.
  • the jaws are formed in one piece with the carrier.
  • the carrier can be divided at its free end by a longitudinal section into two halves which are permanently bent away from one another and which form the jaws of the tool. In the undeformed state, the jaws protrude from one another, so the tool is open; When the flexible tube is pushed over the jaws, it elastically forces the two halves of the carrier against one another, so the jaws are closed.
  • the flexible tube can be a plastic tube that closely surrounds the carrier; for example, this can consist of polytetrafluoroethylene (PTFE).
  • PTFE polytetrafluoroethylene
  • Such a material also has the advantage that it has a very low coefficient of friction, so that the flexible tube slides well on the carrier and in the shaft.
  • the carrier can be clamped on the handle part. It is advantageous if a clamping screw which can be screwed in transversely to the longitudinal direction of the carrier is mounted on the handle part for clamping the carrier. This makes it possible to disassemble the instrument simply by loosening this clamping screw, for example for cleaning purposes or to replace the carrier with the tool arranged thereon.
  • an electrical connection is provided on the handle part, which enables an electrical connection to the carrier, the carrier being electrically insulated from the handle part. If the carrier is guided in a plastic tube, this results in complete insulation over the entire length of the instrument, and so it is possible to connect the tool to a voltage source via the electrical connection, so that the instrument is used, for example, for electrical coagulation can be.
  • a driver is slidably mounted on the handle part in the direction of the longitudinal axis of the shaft, which can be slid by the actuating element and which is firmly connected to the flexible tube.
  • the driver can have the clamping tube surrounding the flexible tube, which can be clamped onto it. This enables the connection between the driver and the flexible tube to be released, so that after the carrier has been removed, this flexible tube can also be removed from the handle part, cleaned and replaced.
  • a further actuating element can be arranged on the handle part, which displaces the shaft which is mounted in a guide on the handle part and which can be displaced parallel to its longitudinal axis. This can also be removable from the handle if necessary.
  • the grip part and all parts connected to it are arranged on one side of a plane that runs through the shaft. This makes it possible to have two similar instruments to be introduced through a trocar sleeve without these instruments interfering with one another. All parts connected to the shaft protrude to one side of the instruments, preferably even within a limited angular range, so that the instruments can still rotate freely about their longitudinal axis.
  • FIG. 1 a schematic side view of a surgical tubular shaft instrument partially shown in longitudinal section;
  • Figure 2 is an enlarged partial view of area A in Figure 1 with the tool open and angled support;
  • FIG. 3 a view similar to FIG. 2 with a closed tool
  • FIG. 4 a view similar to FIG. 2 with the tool open and the carrier stretched and
  • Figure 5 is a view similar to Figure 4 with a closed tool.
  • the surgical instrument shown in the drawing comprises a rigid, tubular shaft 1 which is displaceable on a handle part 2 parallel to its longitudinal axis is stored.
  • the handle hurry 2 has a frame 3 with a handle 4 projecting vertically therefrom.
  • An actuating element 5 is mounted on the frame 3 about a horizontal pivot axis and can be pivoted against the handle 4 against the action of a leaf spring 6 held on the handle 4.
  • the free end 7 of the actuating element 5 encompasses fork-shaped lateral pins 8 of a connecting piece 9 which is fixedly arranged on the shaft 1.
  • the connecting piece 9 is displaceable on a guide rod 10 which runs parallel to the longitudinal axis 1 of the shaft and is held in the frame 3.
  • the guide rod 10 is surrounded by a helical spring 11, which is supported on the one hand on the frame 3 and on the other hand on the connecting piece 9 and shifts the shaft 1 into a retracted position; thus the helical spring 11 acts in the same direction as the leaf spring 6, which also contributes by pivoting the actuating element 5 to the fact that the shaft 1 is pulled into the retracted position when the actuating element 5 is not actuated.
  • the shaft 1 is preferably formed as a metal tube and is so stable that a lateral deformation is practically impossible.
  • the outside of the shaft 1 is covered with a layer 28, which can be an insulating coating or a coating with a material that is particularly compatible with the body.
  • a carrier 12 in the form of a metal wire onto which a flexible plastic tube 13 is pushed.
  • the carrier 12 At its front end protruding from the shaft 1, the carrier 12 is on the side bent, for example at an angle of 40 °, so that the free end of the carrier 12 is inclined to the longitudinal axis of the shaft 1.
  • the carrier 1 At this free end, the carrier 1 is divided by a longitudinal section into two halves 14, 15, which are permanently bent outwards and thus, in the undeformed state, enclose an angle of, for example, 30 ° between them.
  • the carrier 12 consists of a highly elastic metal alloy, in particular a pseudo-elastic shape memory alloy with stress-induced martensite formation in a temperature range in which the instrument is used, that is to say for example in a temperature range between 15 ° C. and 45 ° C. It can be a NiTi alloy, for example.
  • the plastic tube 13 is advantageously made of polytetrafluoroethylene, this material can be sterilized and has the advantage of a very low coefficient of friction.
  • the carrier 12 surrounded by the plastic tube 13 protrudes from the rear of the shaft 1 and, after a short free section 16, enters an angled rigid tube 17 mounted on the handle part 2, which ends in a holder 18, which in turn has an arm 20 is held on the handle part 2.
  • a clamping screw 19 is screwed into the holder 18, with which the free end of the carrier 12 protruding from the plastic tube 13 is clamped in the holder 18, so that the carrier is secured in the axial direction and against rotation.
  • the holder 18 is completely electrically insulated from the handle part 2 in a manner which is not fully apparent from the drawing and carries a connection pin 21, on which a socket of an electrical line can be plugged. In this way, an electrical connection can be made to the carrier, which is electrically insulated from the rest of the instrument by the insulation of the holder 18 in relation to the handle part 2 and by the plastic tube 13 surrounding it.
  • two clamping jaws 22 of a driver 23 engage on the plastic tube 13 from the outside, which is slidably mounted on the frame 3 parallel to the longitudinal direction of the shaft 1.
  • the driver 23 runs on two guide rods 24 which are held in the frame 3 and which are surrounded by helical springs 25. These are supported on the one hand on the frame 3 and on the other hand on the driver 23 and move the driver 23 into a position in which the plastic tube 13 is retracted to the maximum.
  • a pull rod 26 also acts on the catch 23, which is connected in an articulated manner to a further actuation lever 27 which is pivotably mounted on the frame about a horizontal axis of rotation, when it is actuated in the direction of arrow B in FIG. 1, the catch 23 is displaced against the action of the helical spring 25 becomes.
  • the driver 23 takes the plastic tube 13 with it and moves it on the carrier 12.
  • the plastic tube 13 is pushed forward, it lies over the two spread halves 14 and 15 of the carrier 12 and bends them elastically against one another, as can be seen in FIGS Representations of Figures 3 and 5 can be seen.
  • the two halves 14 and 15 are thereby elastically forced against each other, they form the jaws of a gripping tool, which by the Pushing the plastic hose 13 is closed.
  • these jaws could also be cutting elements or the like.
  • the displacement of the shaft 1, on the one hand, and the displacement of the plastic tube 13, on the other hand, are carried out completely independently of one another, so that in every closed state of the tool an angle can occur in the desired manner and, conversely, opening and closing in every angular position of the carrier of the tool.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un instrument chirurgical à tige tubulaire rigide, pourvu, à une extrémité de cette tige, d'un outil possédant deux mâchoires qui peuvent pivoter l'une par rapport à l'autre et d'une partie formant poignée à l'autre extrémité de la tige, avec un élément d'actionnement sur la poignée et un organe de transmission actionné par ce dernier, et servant à ouvrir et fermer les mâchoires de l'outil. Pour permettre, même pour un très petit diamètre extérieur de la tige, d'une part l'ouverture et la fermeture des mâchoires et, d'autre part, la formation d'un angle par l'outil, il est proposé, selon l'invention, qu'il y ait dans l'instrument un support et un petit tube souple qui l'entoure et que la tige et le petit tube puissent être déplacés axialement indépendamment l'un de l'autre et commandent ainsi la formation d'un angle par l'outil et son mouvement d'ouverture.
PCT/EP1995/004643 1994-11-29 1995-11-25 Instrument chirurgical a tige tubulaire WO1996016604A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DEP4442439.6 1994-11-29
DE19944442439 DE4442439C2 (de) 1994-11-29 1994-11-29 Chirurgisches Rohrschaftinstrument

Publications (1)

Publication Number Publication Date
WO1996016604A1 true WO1996016604A1 (fr) 1996-06-06

Family

ID=6534433

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1995/004643 WO1996016604A1 (fr) 1994-11-29 1995-11-25 Instrument chirurgical a tige tubulaire

Country Status (2)

Country Link
DE (1) DE4442439C2 (fr)
WO (1) WO1996016604A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5891017A (en) * 1997-01-31 1999-04-06 Baxter Research Medical, Inc. Surgical stabilizer and method for isolating and immobilizing cardiac tissue

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE29705871U1 (de) * 1997-04-04 1997-06-26 Bartels Mikrotechnik GmbH, 44227 Dortmund Mikrogreifvorrichtung
GB0013279D0 (en) * 2000-06-01 2000-07-26 Genzyme Sa Laparoscopic application
US8052694B2 (en) 2003-03-19 2011-11-08 Boston Scientific Scimed, Inc. Device for manipulating material in a tissue

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3404677A (en) * 1965-07-08 1968-10-08 Henry A. Springer Biopsy and tissue removing device
DE8535164U1 (de) * 1985-12-13 1986-02-27 Maslanka, Harald, 7200 Tuttlingen Chirurgisches Greifinstrument
US4945920A (en) * 1988-03-28 1990-08-07 Cordis Corporation Torqueable and formable biopsy forceps
WO1992005828A1 (fr) * 1990-10-09 1992-04-16 Raychem Corporation Dispositif ou appareil de manipulation de matieres
EP0555105A1 (fr) * 1992-02-07 1993-08-11 Symbiosis Corporation Instrument de chirurgie endoscopique ayant des effecteurs terminaux pivotables
WO1994020025A1 (fr) * 1993-03-04 1994-09-15 Microsurge, Inc. Instrument chirurgical

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5147378A (en) * 1991-03-05 1992-09-15 Harold Markham Grapsing forceps
DE4136861C2 (de) * 1991-11-11 1994-12-15 Kernforschungsz Karlsruhe Steuerbares chirurgisches Instrument
US5318589A (en) * 1992-04-15 1994-06-07 Microsurge, Inc. Surgical instrument for endoscopic surgery
WO1995009566A1 (fr) * 1993-09-29 1995-04-13 Hingeless Tool Company ('hit') Outil exempt de charniere utile en chirurgie

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3404677A (en) * 1965-07-08 1968-10-08 Henry A. Springer Biopsy and tissue removing device
DE8535164U1 (de) * 1985-12-13 1986-02-27 Maslanka, Harald, 7200 Tuttlingen Chirurgisches Greifinstrument
US4945920A (en) * 1988-03-28 1990-08-07 Cordis Corporation Torqueable and formable biopsy forceps
WO1992005828A1 (fr) * 1990-10-09 1992-04-16 Raychem Corporation Dispositif ou appareil de manipulation de matieres
EP0555105A1 (fr) * 1992-02-07 1993-08-11 Symbiosis Corporation Instrument de chirurgie endoscopique ayant des effecteurs terminaux pivotables
WO1994020025A1 (fr) * 1993-03-04 1994-09-15 Microsurge, Inc. Instrument chirurgical

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5891017A (en) * 1997-01-31 1999-04-06 Baxter Research Medical, Inc. Surgical stabilizer and method for isolating and immobilizing cardiac tissue

Also Published As

Publication number Publication date
DE4442439C2 (de) 1997-09-04
DE4442439A1 (de) 1996-06-05

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