RU2846794C2 - Knife cartridge for surgical instrument - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment, namely to a knife cartridge for a surgical instrument. Knife cartridge for a surgical instrument comprises a cartridge body, a blade body, a blade, a first control for moving the blade body and a second control for moving the blade in the blade body. Cartridge body is configured to be connected to a tool. Blade body is movable in the cartridge body. Blade is installed so that it can be moved in the blade body.

EFFECT: using the invention enables providing patient’s safety when cutting the biological tissue.

16 cl, 11 dwg

Description

The invention relates to a knife or blade cartridge for a surgical instrument.

Surgical instruments, particularly those intended for use in open surgery, are often designed as pincers or scissors. For example, publication US 2011/0004208 A1 discloses such an instrument for sealing and separating vessels. Both jaws of this pincer-like instrument, movable relative to each other, are equipped with coagulation electrodes. Furthermore, this instrument is equipped with a mount for a knife cartridge containing a blade designed to separate sealed blood vessels. The knife cartridge is replaceable, allowing the instrument to be equipped with a new, sharp blade when the blade becomes dull. This also opens the possibility of using disposable knives on sterilizable instruments or reusable instruments.

Sterilizable instruments contain a blade channel in the replaceable cartridge to guide the knife blade. This channel can become contaminated during use and is difficult to access during cleaning. However, it is essential to prevent any potential harm to the patient due to infectious material remaining in the instrument.

The objective of the invention is to develop a design measure that would improve safety for the patient and/or staff when using the appropriate instruments.

This problem is solved in a knife cartridge connected to a surgical instrument, as described in paragraph 1 of the invention formula.

The knife cartridge proposed in the invention can be used on a pincer-shaped surgical instrument designed to cut biological tissue grasped between two jaws using a blade. The blade is movably mounted within a blade housing; the blade housing, in turn, is movably mounted within the cartridge housing. This solution allows the blade housing, with the blade positioned within this housing while protecting the blade from external influences, to first extend until it contacts the tissue grasped between the jaws, and only then is the blade withdrawn from the blade housing to cut the tissue. When the blade is retracted into the blade housing after the cut, it may draw adhering tissue residue with it, resulting in the blade housing becoming contaminated internally. However, the channel provided in the instrument, through which the blade housing extends from the cartridge housing until it reaches the jaws that have grasped the tissue, remains clean. Any part that comes into contact with tissue is contained within the blade housing, which, if necessary, is also contained within the cartridge housing and is disposed of along with the cartridge housing after use. Any part in contact with the instrument's blade channel, namely the blade housing, does not come into contact with tissue. Thus, the blade cartridge proposed in the invention facilitates the cleaning and sterilization of surgical instruments. Furthermore, potential instrument wear is reduced, as the sharp blade does not slide within the corresponding blade groove of the instrument, but rather moves in a controlled manner within the blade housing. The proposed solution improves patient safety.

The blade body can be made of metal, plastic, or a combination of these materials. The blade body can be a rectangular tube surrounding the blade or a guide, and can be elastically deformable. Thus, the blade body can also move, elastically deforming, through an arcuate groove in the tool.

The knife cartridge proposed in the invention guides the blade, housed within the blade body, to its intended use—that is, to the tissue grasped between the jaws. The blade body can slide within a groove provided in the instrument, extending, for example, through the instrument's hinge area. The blade, particularly its cutting edge, is protected (shielded by the blade body). This prevents the blade's cutting edge from sliding across instrument components, leading to dulling, and prevents the blade's cutting edge from leaving scratches or other marks on such instrument components, which could subsequently trap contaminants. This increases patient safety.

The blade cartridge is preferably equipped with a lock that secures the cartridge body to the tool. The lock can be switched from the locked to the unlocked position using a separate control. Alternatively, the lock can be operated using the first control, which is also used to move the blade body. This makes handling the tool simple and intuitive.

The blade housing preferably has a first fixed position, in which the blade housing is positioned entirely within the cartridge housing. The cartridge housing may be provided with a mounted position sensor designed to block actuation of the first control and/or removal of the blade housing from the first fixed position. The mounted position sensor serves to block movement of the blade housing when the blade cartridge is not installed on the tool. The mounted position sensor also serves to unblock movement of the blade housing when the blade cartridge is installed on the tool.

The installed position sensor is preferably a movably mounted locking device with a spring support, movable between a locking position and an unlocking position. In the locking position, it prevents the blade housing from being released from its first fixed position (home position). The installed position sensor is preferably positioned so that, when the blade cartridge is attached to the tool, it moves from its locking position to the unlocking position due to interaction with the tool's contact surface against the force of its spring. Only then is the blade housing unlocked. This holds the blade and the blade housing in the cartridge immobile until the blade cartridge is installed on the tool. This prevents them from being unintentionally released from the cartridge housing due to improper handling of the blade cartridge. This significantly eliminates the risk of injury to personnel working with the blade cartridge, infection transmission, and other adverse effects.

When the cartridge body is attached to the tool and the installed state sensor accordingly unlocks the extension of the blade body, the blade body can be moved by acting on the first control element to the second fixed position (active position), in which the blade body protrudes from the cartridge body.

The instrument typically has a channel extending from the cartridge mounting location, located proximal to the hinge connecting the handles of the scissor-shaped instrument, to a knife groove formed in the jaws of the instrument. In the second fixed position, the blade body is extended to the knife groove. When the blade body moves from the first fixed position to the second fixed position and back, the blade is immobilely connected to the blade body (without the possibility of moving relative to it). This connection between the blade and the blade body can be eliminated in the second fixed position by a corresponding unlocking movement of the first control element, as a result of which the blade gains freedom of axial movement relative to the blade body. Such unlocking of the blade is accomplished by means of a transmission device (mechanism), which, upon separation of the (first) control element from the blade, simultaneously creates a force connection between the blade and the second control element, i.e., a connection that allows the blade to be set in motion by acting on the second control element. Now the second control can be used to extend the blade from the blade housing, thereby, for example, cutting biological tissue. The transfer device can also be described as a "switch," designed to create a power connection alternately between the first and second control elements and the blade. This switch connects the first control element to both the blade housing and the blade. When the switch is switched, it connects the second control element exclusively to the blade.

An actuation lock may be provided between the first control element and the second control element. This lock allows the second control element to be actuated to move the blade only when the transfer device (switch) has been activated by a corresponding movement of the first control element. This results in the blade being separated from the blade housing and simultaneously connecting the second control element to the blade. This solution may also be used in embodiments of a knife cartridge without a blade housing or with a short blade housing that remains entirely within the knife cartridge, or from which the blade protrudes or emerges during the distal movement of the blade housing.

A movement blocker may be functionally connected to the first control element, which blocks the movement, and therefore the rearrangement, of the blade body in the cartridge body, while the transmission device allows a power connection between the second control element and the blade, and there is no power connection between the first control element and the blade.

Furthermore, the first control element can be used to release the locking connection between the blade cartridge and the tool. For this purpose, the lock provided on the cartridge body may have a cam capable of pushing the latch in the unlocking direction against spring force. Furthermore, the first control element may also be equipped with a cam that, when appropriate force is applied to the first control element, can move, acting on the latch cam.

The mechanism described above ensures that the blade can only extend from the cartridge housing and blade housing when the blade cartridge is properly connected to the instrument and the blade housing is in the active position. In the active position, the blade housing is positioned with its end at the blade application point. The distance between the cartridge housing and the blade application point is bridged by the blade housing. The blade application point is located distal to the hinge connecting the instrument handles, while the blade cartridge is positioned proximal to this hinge. Thanks to the proposed design, the channel intended for the blade housing in the instrument is rarely, if ever, susceptible to contamination.

The cartridge housing can only be removed from the tool when both the blade and the blade housing are retracted into the cartridge housing. Disengaging the lock securing the cartridge housing to the tool, i.e., separating the cartridge housing from the tool, is only possible when the blade housing is fully retracted into the cartridge housing. Once the cartridge housing is removed from the tool, neither the blade housing nor the blade can be pulled out of the cartridge housing. The blade housing and blade are fixed in the cartridge housing. In any case, the cutting edge of the blade is enclosed in the blade cartridge and cannot be accessed.

Other preferred embodiments of the invention are disclosed in the claims and in the following description, taken in conjunction with the drawings, which show:

Fig. 1 is a side view in a schematic representation of a tool equipped with a knife cartridge proposed in the invention,

Fig. 2 is a schematic side view of the knife cartridge shown in Fig. 1,

in Fig. 3 - the knife cartridge shown in Fig. 2 with the blade body in its active position and the blade extending from it (the extended position of which is shown by the dashed line),

Fig. 4 - the knife cartridge shown in Fig. 3, in cross-section along plane IV-IV,

Fig. 5 is a schematic perspective view of a fragment of the tool shown in Fig. 1 without a knife cartridge on a greatly enlarged scale,

Fig. 6 is a perspective view of a fragment of the knife cartridge shown in Fig. 3, with cross-sections,

Fig. 7-11 are schematic representations of the knife cartridge shown in Fig. 2 and 3, made in various positions and states to illustrate the kinematic connections of its parts.

Fig. 1 shows a surgical instrument 12 with two handles 13, 14, connected to each other by a hinge 15 with the possibility of their mutual rotation like the handles of pliers or scissors. At their proximal ends, the handles 13, 14 have ears 16, 17. At their distal ends, the handles 13, 14 form jaws 18, 19, capable of grasping biological tissue between themselves and compressing it. For example, such tissue can be blood vessels, other hollow organs, tendons, skin, muscles, etc. The jaws 18, 19 can be made smooth or slightly profiled. In addition, they can be made of an electrically conductive or non-conductive material. If the surfaces 20, 21 of the jaws 18, 19 facing each other are electrically conductive, they may also be, for example, designed as electrodes, allowing for the application of current to the tissue grasped between the jaws 18, 19, thereby coagulating and/or welding it. In this case, the surfaces 20, 21 facing each other form electrodes supplied with current via a cable (not shown in the drawing) or a voltage source provided on the instrument 12. Furthermore, other elements, such as switches and the like, may be provided, allowing for the control of the current, in particular, its switching on and off.

Instrument 12 is preferably a coagulation-dissection instrument in which a blade is used for tissue dissection (Figs. 3, 4, 6). Blade 22 is contained in a knife cartridge 23, which is removably attached to instrument 12. For example, for this purpose, handle 14 has a seat, designed, for example, in the form of a socket, into which knife cartridge 23 is inserted. Knife cartridge 23 is preferably intended for single use, whereas instrument 12 is designed as a sterilizable, reusable instrument 12. If knife cartridge 23 is separated from instrument 12 after use and disposed of, then instrument 12 is sent for cleaning and sterilization.

The knife cartridge 23 comprises a cartridge body 24, which may be formed, for example, as a part manufactured by injection molding of plastics. At its distal end during use, the cartridge body is provided with a docking structure 25, which mates with the mating connecting structure of the handle 14. For example, the docking structure may be a projection formed like a boss, which fits into a transverse groove 26 of the instrument 12, having a corresponding shape. At its opposite proximal end, the cartridge body 24 may comprise a lock 27, which may include a retainer 28, located in the cartridge body 24 and mounted, for example, so as to be rotatable. The lock 28 can interact with the locking projection 28a of the tool 12, which jumps into the lock 28 when the cartridge housing 24 is brought to the handle 14 of the tool by rotating the cartridge housing about the transverse axis defined by the transverse groove 26. In this case, the mating structure 25 and the transverse groove 26 form a rotary hinge. In addition, the lock 27 can include a spring 29, made, for example, in the form of a compression spring, a bending spring, a leaf spring, etc. The spring means 29 can be a component of the lock 28, made integral with it, can be an elastic tongue formed on the inner wall of the cartridge housing 24, or can be a separate spring element. The lock 28 is movably mounted in the cartridge housing 24 by means of a rotary support 30, for example, mounted with the possibility of movement or rotation.

The cartridge housing 24 also houses a blade housing 31, which may be in the form of a flattened tube of rectangular cross-section or in the form of a flat guide, preferably made of metal or plastic. The drawings, in particular Figs. 4 and 6, show that the blade housing 31, at least in its front portion extending from the cartridge housing, surrounds the flat blade 22 with both its wide sides and its upper and lower narrow sides. At the same time, the blade housing 31, at least along a portion of its length, in particular in its proximal portion, which always remains within the cartridge housing 24, may also be open, in particular on its upper narrow side. At this point, the ridge 22a of the blade 22 may protrude from the blade housing 31.

In certain sections, the blade body 31 may be open on one of its wide sides. For example, the blade body 31 may be open, for example, on the side opposite the cutting edge 32 of the blade 22. As shown in Fig. 6, the cutting edge 32 may be positioned offset from the center of the blade 22 and may directly border the flat side surface of the blade 22. In this case, the other side surface 33 transitions into a beveled surface 33a, which extends to the cutting edge 32. The blade body 31 is preferably made of such a length that, in the retracted position, the blade 22 is completely hidden in the blade body 31. In this case, the cutting edge 32 is located inside the blade body 31. However, the blade body can also be shortened so that blade 22 always protrudes slightly from the blade body, and cutting edge 32 is positioned before the distal end of blade body 31. Embodiments of the invention without a blade body also exist.

The blade body 31 is located in the cartridge body 24 with the possibility of directed movement in the direction V (Fig. 7, 8). In this case, the blade body 31 can be moved from its first fixed position, shown in Fig. 7, to the second fixed position, shown in Fig. 9. In the first fixed position, the blade body 31 is completely recessed into the cartridge body 24. In the second fixed position, shown in Fig. 8 and 9 (active position), the blade body 31 protrudes from the distal end of the cartridge body 24.

To move the blade body 31 from the first fixed position to the second fixed position shown in Figs. 8 and 9, a first control element 34 is used, which includes a rotary locking rocker 35. This rotary locking rocker 35 has a rotary pin 36 mounted with the possibility of directional movement in a groove 37 extending in the direction V of movement, and simultaneously mounted with the possibility of rotation. The rotary locking rocker 35 forms a double-arm lever, the first arm 38 of which is connected to the blade body 31 for transmitting movement to the blade body 31 in the direction V of its movement. For this purpose, the arm 38 can be provided with a coupling element 39 in the form of a protrusion entering into a recess in the blade body 31.

The rotary-stop rocker arm 35 has a second arm 40 on which the first control element 34 can be located. In a preferred embodiment of the invention, the control element 34 is fixedly connected to the rotary-stop rocker arm 35. In addition, one of the arms 38, 40, preferably arm 40, is provided with a pivotally movable stopper 41, which is made, for example, in the form of a cam or a projection. When the rotary-stop rocker arm 35 is moved in the direction V of movement, the pivotally movable stopper slides along the stop surface 42, which is located so that it blocks the rotation of the rotary-stop rocker arm 35. However, in the stop surface 42 there is a recess 43, which is opposite the pivotally movable stopper 41, when the rotary-stop rocker arm 35 is in its second fixed position, i.e. in the position with maximum extension in the distal direction (active position), as shown in Fig. 8 and 9.

On the first arm 38 of the rotary-stopping rocker arm, a coupling element 44 is also located, which, through a (through) recess in the blade housing 31, creates a fixed connection in the direction of movement V between the first arm 38 and the blade 22. For this, the blade 22 has, in a place facing the coupling element 44, a recess into which a projection of the arm 38 enters, forming the coupling element 44. Thus, the blade 22, by means of the projection 39 and the coupling element 44, is fixedly coupled with the blade housing 31 in the direction of movement V until the rotary-stopping rocker arm 35 remains in the non-rotated position, i.e. until the rotary-movable stopper 41 enters the recess 43 (Fig. 7, 8 and 11).

For activating the blade 22, i.e. for extending it from the blade housing 31, a second control element 45 is provided, preferably formed by a double-arm lever mounted on the cartridge housing 24 in a rotatable manner. The axis of rotation of the second control element 45 is preferably oriented transversely to the direction V. In this case, the second control element 45 projects from the cartridge housing 24, as shown, in particular, in Figs. 1-3. When the knife cartridge 23 is connected to the handle 14 of the tool 12, the control element 45 projects in the direction of the other handle 13 and, when the handles of the tool 12 are closed, passes by this other handle, since it is located with a lateral offset relative to it.

The arm 46 of the lever, located in the cartridge housing 24 and forming the second control element 45, can be connected to the blade 22 via a connecting rod 47. For this purpose, the blade 22 has a ridge 22a protruding from the blade housing 31 at its proximal end, which has an inclined edge at its distal end. A crossbar 48 interacts with this ridge 22a, which can be formed by an elastic lever secured to the cartridge housing 24 and having a forked end. A connecting pin 49, located at the end of the connecting rod 47, is located inside the forked end of the crossbar 48.

The rotary locking rocker 35 is provided at the distal end of its arm 38 with a transmission mechanism 50. This mechanism includes a projection 51 (see Fig. 8-11) extending from the arm 38, passing past the blade body 31 and ending near the connecting recess 52 formed in the ridge 22a. The ridge does not allow the connecting pin 49 to enter the connecting recess 52 until the rotary locking rocker 35 is in the rotated position, i.e. until the rotary-sliding stopper 41 gets into the recess 43. When the arm 38 of the rotary-stopping rocker 35 is turned upward (Fig. 8), the coupling element 44 enters the blade housing, and the projection 51 displaces the connecting pin 49 from the recess 52. When the arm 38 of the double-arm lever is turned downward (Fig. 9), the connecting pin 49 jumps into the recess 52. In this way, the transmission mechanism 50 ensures that the blade 22 can be connected either to the first control element 34 and the blade housing 31, or to the second control element 45.

In addition, between the rotary-stopping rocker 35 and the second control element 45, an actuation lock 53 is provided (see Fig. 8), which temporarily blocks the actuation of the second control element 45. This lock is effective when the blade housing 31 is in the extended, i.e. active, position. Thus, the lock is effective as long as the rotary-stopping rocker 35 is still engaged with the blade 22. The corresponding projection 54 of the rotary-stopping rocker 35 allows the projection 55 of the second control element 45 to move only when the rocker 35 is turned so that the rotary-movable stopper 41 enters the recess 43, the coupling element 44 is disengaged, and the blade 22 is unlocked. This state is illustrated in Fig. 9. In it, the connecting rod 47 creates a power connection (ensuring the transmission of drive forces) between the second control element 45 and the blade 22, which can now be extended from the blade housing 31 by acting on the second control element 45.

In addition, the second arm 40 of the rotary-stop rocker arm is connected to a wedge or cam 56, which is connected to a wedge or cam 57 of the lock 28. The cams 56 and 57 are arranged so that they interact when the rotary-stop rocker arm 35 is in its extreme proximal position.

The cartridge housing 24 may also comprise a mounted state sensor 58, which may be formed by an elastic tongue formed on the cartridge housing 24 and protruding slightly beyond the outer contour of the latter. This elastic tongue has a lower end movable transversely to the direction V of movement. This lower end may be embodied in the form of a locking pad 59, with which a stop surface formed on the arm 40 of the rotary locking rocker interacts. The stop surface may be positioned so as to prevent significant movement of the rotary locking rocker 35 from its proximal position until the mounted state sensor 58 is displaced from its initial position.

The above-described knife cartridge 23 operates as follows: In Fig. 7, the knife cartridge 23 is shown in its delivery state, in which it can be handled safely. The blade 22 is completely retracted into the blade housing 31 and is fixed therein. The blade housing 31 is located completely within the cartridge housing 24 and is fixed therein. The first control element 34 is in a proximal position. Acting on the second control element 45 does not change this state. It is impossible to extend either the blade 22 from the blade housing 31 or the blade housing 31 from the cartridge housing 24.

The knife cartridge 23 can be attached to the instrument 12, as a result of which the lock 28 will engage with the corresponding locking projection 28a, which can be formed on the instrument 12. At the same time, an element of the instrument 12, for example a surface provided on the handle 14, slightly pushes the installed state sensor 58 against the action of its spring in the direction of the inner cavity of the cartridge housing 24. Since the installed state sensor 58 protrudes beyond the contour of the cartridge housing 24, it is pressed, for example, inside the contour of the cartridge housing 24. Due to this, the locking biscuit 59 unlocks the first control element 34, allowing it to move in the distal direction (in Fig. 7 to the right). Now the operator can move the first control element 34 in the distal direction. In this case, the blade body 31 and the blade 22 fixed in it are extended from the cartridge body 24 in the distal direction, namely in the direction V, as shown in Fig. 8. In this case, the blade body 31, moving in the channel 61 provided for it (Fig. 5), advances to the branch 18.

The channel 61 can pass through the area of the hinge 15 connecting the handles. It ends at the branch 18, adjoining the knife groove 62, and with its end surface surrounding it, it preferably adjoins the entrance of the knife groove 62. When the blade body 31 is extended in the channel 61, the cutting edge 32 of the blade 22 is enclosed in the blade body 31 and protected by it.

During the movement of the control element 34 in the distal direction, the rotary-locking rocker 35 continues to fix the blade 22 in the blade housing 31. During this movement, the separation of the blade housing 31 and the blade 22 is impossible, since the rotary-movable stopper 41 slides along the locking surface 42 and prevents the rotation of the rotary-locking rocker 35. And only when the blade housing reaches the maximum distal position, i.e., when the blade housing 31 is in the second fixed position, the rotary-movable stopper 41 is opposite the recess 43, as shown in Fig. 8. Now the rotary-locking rocker 35 is unlocked and is able to rotate. The operator can now press the first control element 34 against the housing 24 of the cartridge and thereby slightly rotate the rotary locking rocker 35. In this case, as shown in Fig. 9, the coupling element 44 leaves the housing 31 of the blade and is also disconnected from the blade 22. At the same time, the transmission mechanism 50 releases the connecting recess 52, as a result of which the connecting pin 49 can enter the connecting recess 52 of the blade 22. In addition, the projection 54 releases the projection 55, which now makes it possible to actuate the second control element 45, i.e. to rotate it, as shown in Fig. 10.

When the second control element 45 is acted upon (when it is rotated clockwise in the drawings), it pushes the blade 22 in the direction of movement V with its connecting rod 47, i.e., it moves it distally from the blade housing 31. The blade 22 enters the knife groove 62, and the cutting edge 32 moves along the knife groove 62 (Fig. 5). The blade 22 can cut, for example, tissue captured between the jaws 18, 19. In this case, the knife groove can be straight or can be curved if the blade 22 is sufficiently flexible. In the second case, the blade 22 is preferably designed in such a way that the cutting edge 32 is located on the side of the convex side wall of the knife groove 62.

If the second control element 45 is unlocked, the corresponding return spring 63 pulls the control element 45 back to its original position. At the same time, the blade 22 is retracted into the blade housing 31 by means of the connecting rod 47. In this way, a return from the state shown in Fig. 10 back to the state shown in Fig. 9 occurs. However, the tool 12 and the knife cartridge 23 remain ready for operation. The control element 45 can be actuated again, as a result of which the blade 22 will again extend and retract.

If the blade cartridge 23 is to be removed from the tool 12, the second control element 45 is first unlocked to obtain the state shown in Fig. 9. After this, the first control element 34 is rotated downwards from the cartridge housing 24 so that the coupling element 44 enters the blade housing 31. In this way, the blade 22 is fixed immovably in the still extended blade housing 31. It is no longer possible to operate the second control element, since the projection 54 provided on the rotary locking rocker 35 blocks the projection 55 provided on the second control element 45. In this case, the transmission mechanism 50 lifts the connecting pin 49 of the connecting rod 47, removing it from the connecting recess 52. As a result, the second control element 45 is now disconnected from the blade 22.

Then the first control element 34 is moved in the proximal direction, i.e. in Fig. 8 to the left, as a result of which it takes the position shown in Fig. 7. The connecting pin 49 of the connecting rod 47 comes off the ridge 22a of the blade 22. In this case, due to the rotary-movable stopper 41 sliding along the stop surface 42, it is impossible to turn the rotary-stop rocker 35, which means that it is impossible to remove the rigid connection between the blade 22 and the blade body 31.

If it is now necessary to completely remove the knife cartridge 23 from the instrument 12, the first control element 34 must be moved with force in the proximal direction and moved beyond its extreme proximal position shown in Fig. 7, as shown in Fig. 11. In this case, the cam 56 acts on the cam 57, as a result of which the lock 28 rotates against the force of the spring 29. Due to this, the lock 27 is opened, and the knife cartridge 23 can be removed from the instrument 12.

The above description accordingly applies to any embodiments of the knife cartridge 23 without the blade housing 31, but on the condition that the blade housing 31, and possibly the projection 39, are absent.

The knife cartridge 23 proposed in the invention is intended for use on a surgical instrument 12. The knife cartridge 23 contains a blade that is driven by a second control element 45. The blade 22 is retained in a blade housing 31 that can be moved by a first control element 34 from a first fixed position (passive position) to a second fixed position (active position). In the passive position, the blade housing 31 is located entirely in the cartridge housing 24, and the blade 22 is fixed in the blade housing 31. In the active position, the blade housing 31 protrudes from the cartridge housing. The lock between the blade housing 31 and the blade 22 is released only in the active position of the blade housing, and only then is a power connection, i.e. one that ensures the transmission of the drive force, created between the second control element and the blade 22.

Because blade 22 is enclosed within blade housing 31, tissue debris carried by the blade as it is withdrawn from the fabric is contained within the blade housing and does not escape. This makes cleaning and subsequent use of tool 12 easier and more reliable.

Reference designations:

12 tool

13, 14 tool handles

15 hinge

16, 17 handle ears

18, 19 branches

20, 21 facing each other surfaces of the branches 18, 19

22 blade

22a blade comb

23 knife cartridge

24 cartridge body

25 docking structure

26 transverse groove

27th castle

28 retainer

28a locking lug

29 spring means

30 support

31 blade body

32 cutting edge blade

33 side surface of the blade

33a beveled blade surface V direction of movement

34 first governing body

35 rotary and locking rocker

36 steering knuckle

37 groove

38 first shoulder of the rotary-stop rocker arm 35

39 coupling element, protrusion

40 second arm of the rotary-stop rocker arm 35

41 rotary-sliding stopper

42 locking surface

43 notch

44 coupling element

45 second governing body

46 lever arm

47 connecting rod

48 crossbar

49 connecting finger

50 transmission mechanism

51 projection of shoulder 38 of lever

52 connecting notch

53 actuation blocker

54 projection of the rotary-stop rocker arm 35

55 projection of the second control body 45

56 cam of rotary-stop rocker arm

57 locking cam 28

58 installed state sensor

59 locking cracker

60 thrust surface

Channel 61

62 knife groove

63 return spring

Claims (21)

1. A knife cartridge (23) for a surgical instrument (12), containing: - a cartridge body (24) designed with the possibility of connection with a tool (12), - a blade body (31) mounted with the possibility of movement in the cartridge body (24), - a blade (22) mounted with the possibility of movement in the blade housing (31), - the first control element (34) for moving the blade housing (31) and - a second control element (45) for moving the blade (22) in the blade housing (31). 2. A knife cartridge according to claim 1, characterized in that the cartridge body (24) contains a lock (27) for detachably connecting the cartridge body (24) with the tool (12). 3. A knife cartridge according to claim 2, characterized in that the lock (27) is designed with the possibility of being activated by means of the first control element (34). 4. A knife cartridge according to one of the previous paragraphs, characterized in that the blade body (31) is designed to be in a first fixed position, in which the blade body (31) is located entirely inside the cartridge body (24). 5. A knife cartridge according to one of the previous paragraphs, characterized in that the blade body (31) is designed to be in a second fixed position, in which the blade body (31) is held partially protruding from the cartridge body (24). 6. A knife cartridge according to one of the previous paragraphs, characterized in that the blade (22) is designed with the possibility of being in a retracted position, in which the blade (22) is located entirely inside the blade housing (31) and is fixed in the blade housing (31). 7. A knife cartridge according to one of the previous paragraphs, characterized in that the blade (22) has a ridge (22a) protruding from the body (31) of the blade. 8. A knife cartridge according to one of the previous paragraphs, characterized in that the first control element (34) is mounted with the possibility of movement on the body (24) of the cartridge. 9. A knife cartridge according to one of the previous paragraphs, characterized in that the first control element (34) is mounted on the body (24) of the cartridge movably along the path of movement. 10. A knife cartridge according to claim 9, characterized in that the path of movement of the first control element (34) is defined by a groove (37). 11. A knife cartridge according to claim 9 or 10, characterized in that it contains a rotation lock (41) designed to act between the first control element (34) and the cartridge body (24) in such a way as to allow rotation of the first control element (34) only in the extreme position along the travel path. 12. A knife cartridge according to one of the previous paragraphs, characterized in that the first control element (34) contains a coupling element (39) for connection with the blade body (31). 13. A knife cartridge according to one of the previous paragraphs, characterized in that it contains a transmission mechanism (50) designed in such a way as to alternately connect the first control element (34) and the second control element (45) to the blade (22). 14. A knife cartridge according to one of the previous paragraphs, characterized in that the first control element (34) is designed with the possibility of rotation for kinematic connection of the second control element (45) with the blade (22). 15. A knife cartridge according to one of the preceding paragraphs, characterized in that it contains an actuation lock (54, 55) configured to act between the first control element (34) and the second control element (45). 16. A knife cartridge according to one of the previous paragraphs, characterized in that a sensor (58) of the set state is operatively connected to the first control element (34), configured to block the actuation of the first control element (34) when the knife cartridge is separated from the tool (12).