[go: up one dir, main page]

WO1992020292A1 - Appareil chirurgical - Google Patents

Appareil chirurgical Download PDF

Info

Publication number
WO1992020292A1
WO1992020292A1 PCT/EP1992/001099 EP9201099W WO9220292A1 WO 1992020292 A1 WO1992020292 A1 WO 1992020292A1 EP 9201099 W EP9201099 W EP 9201099W WO 9220292 A1 WO9220292 A1 WO 9220292A1
Authority
WO
WIPO (PCT)
Prior art keywords
instrument
handle
indicates
inserts
insert
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/EP1992/001099
Other languages
German (de)
English (en)
Inventor
Harald Heidmüller
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Publication of WO1992020292A1 publication Critical patent/WO1992020292A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00353—Surgical instruments, devices or methods for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
    • A61B17/3421—Cannulas
    • A61B2017/3445—Cannulas used as instrument channel for multiple instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00184—Moving parts
    • A61B2018/00196—Moving parts reciprocating lengthwise

Definitions

  • the invention relates to a surgical device with a handle and an instrument arrangement, which is mounted to move a front functional part out of the handle and can be actuated by means of an external handle.
  • Electrosurgical devices (US 3,494,364) are used in microsurgery.
  • an instrument insert that can be moved in a tube is supplied with high-frequency voltage and an electrical arc is generated directly between the instrument insert designed as an electrode and the tissue to be cut or removed.
  • the predominant parts of the instrument insert are provided with insulation. Burning of the cutting electrode is prevented by using non-oxidizing material.
  • DE 34 12 756 C2 discloses a device in the form of an arthroscopy knife, which is used in particular for removing minisks in arthroscopic surgery. Devices of the type mentioned are also used in laparoscopic surgery, where the movement possibilities of the instruments are limited by the guidance in a trocar.
  • a device according to the preamble of claim 1 is described in US 4,418,692.
  • the instrument arrangement comprises a gripping member with two pliers electrodes which can either be retracted or extended into a tube simultaneously by means of a pressure member protruding axially from a grip part, or only one of which can be displaced longitudinally.
  • the instrument arrangement consists of at least two independently displaceable parallel instrument inserts, each of which is provided with a radially projecting pin which is guided in an associated longitudinal slot of the handle piece and since the longitudinal slots on one Are closed at the end by a detachable head piece of the handle.
  • the functional parts of the axially displaceable instrument inserts can be an electrosurgical knife or any other elements that can be pulled out of the handle and exchanged after the head piece has been removed. Without changing the surgical device, which could result in loss of time and malfunctions, at least two instrument inserts with different or the same functional parts are optionally available, for example a pure manipulation instrument, such as a hook or button, and an electrosurgical instrument, such as a cutting knife .
  • the instrument inserts can each be multi-unit, for example designed as so-called pipe scissors with two tubes or rods guided into one another, in the mutual displacement of which a pair of scissors, pliers or clip applicators are actuated.
  • it makes sense to provide a locking arrangement which only allows the multi-unit instrument insert to be actuated in an extremely advanced working position.
  • the instrument inserts are extremely miniaturized and sensitive to damage, it makes sense and is beaten in each case to insert a protective and guide tube in the front handle, which protects the instrument inserts in the area of the trocar from damage and which guides them cleanly in the trocar tube.
  • a protective and guide tube can be detachably arranged in the handle.
  • the longitudinal guidance of the axially displaceable instrument inserts within the handle is preferably carried out by means of guide rods and sleeves which are telescopically connected to the other part of the handle or the instrument insert. These can be electrically conductive and can be provided with an electrical feedthrough and plug connection on the releasable rear end piece of the handle piece.
  • the end piece can be replaced by a end piece which is designed as a pipe socket with channels.
  • FIG. 1 shows a first embodiment of the instrument with two instrument inserts in top view
  • FIG. 1A is a longitudinal section through the instrument of FIG. 1,
  • FIG. 2 shows a second embodiment of the instrument with a coagulation ball and a hook-shaped knife on two instrument inserts in longitudinal section
  • FIG. 2A shows a cross section through the instrument of FIG. 2, 3 shows a third embodiment of the instrument with a button and a hook-shaped knife on two instrument inserts in longitudinal section,
  • FIG. 3A shows a cross section through the instrument of FIG. 3,
  • FIG. 4A shows a longitudinal section through the complete instrument of FIG. 4,
  • FIGS. 4.4A shows a cross section through the instrument according to FIGS. 4.4A
  • FIG. 5 shows a fifth embodiment of the instrument with three instrument inserts in a partial top view
  • FIG. 5A shows a longitudinal section through the instrument of FIG. 5,
  • FIG. 6 shows a sixth embodiment of the instrument with two instrument inserts in a partial top view
  • FIG. 6A shows a longitudinal section through the instrument of FIG. 6,
  • FIGS. 8th shows a seventh embodiment of the instrument with two instrument inserts in longitudinal section, FIGS. 8th,
  • 9A shows a modified guide arrangement in partial longitudinal section and in cross section
  • 1.1A shows a device which consists of a multi-part, octagonal cross-section handle 1, a protective tube 2 and two instrument inserts 19, 20 and a screwed-on end piece 4 in the form of a plug connector 8.
  • the protective tube 2 is inserted with a base piece 14 into an inner recess 15 in a detachable head piece 17 of the handle piece 1 and secured therein by means of a radial grub screw 16.
  • the two instrument inserts 19, 20 are held axially displaceably in the handle 1, a radially movable and spring-supported adjustment pin 21 with a slide button 22 on the instrument insert 19 and a fixed adjustment pin 45 with a slide button 46 on the instrument insert 20 being provided are each guided in longitudinal slots 23, 24 of the handle piece 1.
  • a radially movable and spring-supported adjustment pin 21 with a slide button 22 on the instrument insert 19 and a fixed adjustment pin 45 with a slide button 46 on the instrument insert 20 being provided are each guided in longitudinal slots 23, 24 of the handle piece 1.
  • the instrument inserts 19, 20 can also be guided in one another in such a way that their relative displacement to one another is possible completely independently of one another. In the embodiment shown, this is not possible due to the connecting means 26, 27 between the instrument inserts 20.
  • FIG. 3.3A shows a device which largely corresponds to the illustration in FIG. 2, the same details being denoted by the same numbers.
  • one of the instrument inserts 35 is designed here as a simple button 47 rounded in the front, in particular made of non-conductive material.
  • FIGS. 4,4A, 4B show a device which essentially corresponds to those according to FIGS. 2 and 3, the same details being designated with the same reference numerals.
  • one of the instrument inserts 35 is designed in several parts and has two jaws 49, 50 which are movable relative to one another and which can be pivoted relative to one another about an axis of rotation 51 at the front end.
  • the actuation takes place in the manner of a tube shear known per se, in which two rod or sleeve parts lying one inside the other are axially displaced relative to one another. This is done by a radially movable pin 52, which has a slide button 53 and is supported by a compression spring 54.
  • Connecting means 55, 56 are fastened to the pin 52.
  • the link 55 is connected to the inner sleeve through a slot in the outer sleeve and the link 56 is connected to the outer sleeve.
  • the pin 52 has an annular groove 57.
  • a guide edge 32 is provided in the longitudinal slot 23, while an extension is provided at the front end of the longitudinal slot 33 through which the pin 52 fits. In the working position advanced up to this extension 33, the pin 52 is radially freely movable, so that the pliers or scissors can be actuated by springing out and pressing in the pin 52.
  • FIG. 5.5A shows a device which essentially corresponds to that according to FIG. 2, parts which correspond to one another being assigned the same numbers.
  • a further instrument insert 58 with a front oblique cutting edge 59 is provided, which can be axially displaced via a further pin, not shown in detail, with a sliding button 60, the pin, which cannot be recognized, being guided in a longitudinal groove 61.
  • FIG. 6,6A shows a device which essentially corresponds to that in FIG. 5, but the details are in some cases not completely carried out. It comprises two instrument inserts 35, 36, the former of which is made up of multiple members with two jaws 49, 50 that can be pivoted about an axis of rotation 51, and the second comprises a hook knife 38.
  • a radial bore 74 is provided, into which a locking pin 75 is inserted. Its length is such that it only projects into one of the bores for the shafts of the instrument inserts 35, 36 in the protective tube. In the extremely retracted position, the shafts have inner recesses 76, 77 directed toward the locking pin 75.
  • FIG. 8.8A it can be seen that two shafts 62, 63 of two parallel instrument inserts, which are located within a protective tube 2, are guided relative to one another via a sleeve 64 which is drilled twice, this sleeve preferably at the rear end opposite the octagonal handle 1 or the protective and guide tube 2 is fixed axially.
  • FIG. 9.9A It can be seen in FIG. 9.9A that two shafts 66, 67 of two instrument inserts can be supported against one another via a composite guide bridge 65.
  • the bridges can in turn be fixed axially in the protective tube 2, not shown here.
  • FIG. 10A-F two hook-shaped knives 68, 69 with angled rearward-facing cutting edge are shown in side view and in cross section, furthermore two knives 70, 71 with a differently curved cutting edge on the side, and ultimately two further knives 72, 73 with in each case the front-side cutting edge, which in any case, when used on electrosurgical instrument inserts, is metallically bare only in the area of the cutting edges and is otherwise not conductively insulated.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (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

Un appareil chirurgical comprend une poignée (1) et au moins deux instruments (19, 20) insérables dans celle-ci pouvant être poussés en avant sur la poignée indépendamment l'un de l'autre. Les instruments (19, 20) sont axialement réglables au moyen de curseurs (21; 45) radialement saillants. Les extrémités antérieures des instruments (19, 20) portent des parties fonctionnelles (29, 30) qui coopèrent les unes avec les autres et forment un dispositif de coupe.
PCT/EP1992/001099 1991-05-24 1992-05-19 Appareil chirurgical Ceased WO1992020292A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19914116970 DE4116970A1 (de) 1991-05-24 1991-05-24 Chirurgisches instrument mit wechselgriff
DEP4116970.0 1991-05-24

Publications (1)

Publication Number Publication Date
WO1992020292A1 true WO1992020292A1 (fr) 1992-11-26

Family

ID=6432334

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1992/001099 Ceased WO1992020292A1 (fr) 1991-05-24 1992-05-19 Appareil chirurgical

Country Status (3)

Country Link
EP (1) EP0540721A1 (fr)
DE (1) DE4116970A1 (fr)
WO (1) WO1992020292A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0614648A1 (fr) * 1993-03-08 1994-09-14 Dobrivoje Dr. Tomic Parties actives pour instruments chirurgicaux de coupe et de raisie
US5355871A (en) * 1992-09-11 1994-10-18 Dexide, Inc. Elastomeric controller for endoscopic surgical instruments
WO1995029640A1 (fr) * 1994-05-02 1995-11-09 Aesculap Ag Instrument chirurgical a corps tubulaire
US5474057A (en) * 1993-02-22 1995-12-12 Valleylab Inc. Laparoscopic dissection tension retractor device and method
US5597640A (en) * 1992-10-09 1997-01-28 Signode Corporation Oriented plastic strap
WO1997006738A1 (fr) * 1995-08-18 1997-02-27 Somnus Medical Technologies, Inc. Appareil d'ablation et systeme de retrait des tissus mous du palais
WO2000059392A1 (fr) * 1999-04-01 2000-10-12 Erbe Elektromedizin Instrument chirurgical

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19602759C2 (de) * 1996-01-26 2001-12-13 Wolf Gmbh Richard Instrument für die Hochfrequenzchirurgie
US6162209A (en) 1998-11-17 2000-12-19 Scimed Life Systems, Inc. Multi-function surgical instrument tool actuator assembly
DE10149421A1 (de) * 2001-10-06 2003-04-24 Fraunhofer Ges Forschung Instrument für die minimal-invasive Chirurgie
DE50201512D1 (de) * 2002-01-21 2004-12-16 Storz Karl Gmbh & Co Kg Medizinisches Instrument für die manuell-unterstützte minimal invasive Chirurgie
US7549988B2 (en) * 2004-08-30 2009-06-23 Boston Scientific Scimed, Inc. Hybrid lesion formation apparatus, systems and methods
US7892228B2 (en) 2005-02-25 2011-02-22 Boston Scientific Scimed, Inc. Dual mode lesion formation apparatus, systems and methods

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3651811A (en) * 1969-10-10 1972-03-28 Aesculap Werke Ag Surgical cutting instrument
DE3220940A1 (de) * 1982-06-03 1983-12-08 Harald 7200 Tuttlingen Maslanka Diathermie-instrument
DE8711635U1 (de) * 1987-08-27 1988-01-21 GIP Gastrointestinale Produkte Vertriebs GmbH, 8221 Grabenstätt Bipolares Diathermieschlingen-Instrument
EP0364420B1 (fr) * 1988-09-28 1992-11-11 Ams Medinvent S.A. Dispositif d'implantation ou d'extraction transluminale

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR95160E (fr) * 1965-11-30 1970-07-31 Lamidey Marcel Commande par dépression d'appareillages électriques et spécialement de générateurs électrochirurgicaux.
US3494364A (en) * 1967-11-09 1970-02-10 Weck & Co Inc Edward Handle component for electro-surgical instrument
US4418692A (en) * 1978-11-17 1983-12-06 Guay Jean Louis Device for treating living tissue with an electric current
US4919129A (en) * 1987-11-30 1990-04-24 Celebration Medical Products, Inc. Extendable electrocautery surgery apparatus and method

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3651811A (en) * 1969-10-10 1972-03-28 Aesculap Werke Ag Surgical cutting instrument
DE3220940A1 (de) * 1982-06-03 1983-12-08 Harald 7200 Tuttlingen Maslanka Diathermie-instrument
DE8711635U1 (de) * 1987-08-27 1988-01-21 GIP Gastrointestinale Produkte Vertriebs GmbH, 8221 Grabenstätt Bipolares Diathermieschlingen-Instrument
EP0364420B1 (fr) * 1988-09-28 1992-11-11 Ams Medinvent S.A. Dispositif d'implantation ou d'extraction transluminale

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5355871A (en) * 1992-09-11 1994-10-18 Dexide, Inc. Elastomeric controller for endoscopic surgical instruments
US5597640A (en) * 1992-10-09 1997-01-28 Signode Corporation Oriented plastic strap
US5474057A (en) * 1993-02-22 1995-12-12 Valleylab Inc. Laparoscopic dissection tension retractor device and method
EP0614648A1 (fr) * 1993-03-08 1994-09-14 Dobrivoje Dr. Tomic Parties actives pour instruments chirurgicaux de coupe et de raisie
WO1995029640A1 (fr) * 1994-05-02 1995-11-09 Aesculap Ag Instrument chirurgical a corps tubulaire
WO1997006738A1 (fr) * 1995-08-18 1997-02-27 Somnus Medical Technologies, Inc. Appareil d'ablation et systeme de retrait des tissus mous du palais
NL1003812C2 (nl) * 1995-08-18 1997-07-02 Somnus Medical Technologies Ablatie-apparaat en systeem voor het verwijderen van zacht gehemelteweefsel.
WO2000059392A1 (fr) * 1999-04-01 2000-10-12 Erbe Elektromedizin Instrument chirurgical

Also Published As

Publication number Publication date
EP0540721A1 (fr) 1993-05-12
DE4116970A1 (de) 1992-11-26

Similar Documents

Publication Publication Date Title
DE19946527C1 (de) Medizinisches bipolares Instrument zum Fassen, Koagulieren und Schneiden von Gewebe
DE69834350T2 (de) Rongeur
DE10003020C2 (de) Bipolares Faßinstrument
DE69919343T2 (de) Führungshülse für verschobene wirbelkörper
EP1211995B1 (fr) Instrument medical bipolaire
EP1221903B1 (fr) Resectoscope urologique avec une electrode monopolaire ou bipolaire
EP1107703B1 (fr) Instrument medical bipolaire servant a couper des tissus
EP1056409B1 (fr) Instrument bipolaire a usage medical
DE4138116A1 (de) Medizinisches hochfrequenz-koagulations-schneidinstrument
EP1014879A1 (fr) Tournevis medical
EP1043957A1 (fr) Instrument medical pour preparer des tissus
WO1992020292A1 (fr) Appareil chirurgical
DE3733194A1 (de) Instrument zum halten chirurgischer nadeln
EP2769682B1 (fr) Instrument endoscopique et tige pour un instrument endoscopique
EP1306064A1 (fr) Instrument destiné à implanter une prothèse intervertébrale
DE102010036713A1 (de) Chirurgisches Instrument zum Entfernen chirurgischer Clips
DE10126541B4 (de) Urologisches Resektoskop für Kinder
DE10156917B4 (de) Instrument für die endoskopische Chirurgie
EP4046583A1 (fr) Appareil électrochirurgical portatif et corps de contact pour appareils electrochirurgicaux portatifs
EP1699368B1 (fr) Instrument medical de coupe et/ou de retenue
DE202007005510U1 (de) Chirurgisches Instrument
DE20001204U1 (de) Bipolares Faßinstrument
DE19731884C1 (de) Medizinisches Instrument
DE102011081344B4 (de) Koagulationsinstrument
DE3408243A1 (de) Urethrotom fuer die harnroehrenerweiterung

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): CA US

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH DE DK ES FR GB GR IT LU MC NL SE

WWE Wipo information: entry into national phase

Ref document number: 1992911531

Country of ref document: EP

WWP Wipo information: published in national office

Ref document number: 1992911531

Country of ref document: EP

NENP Non-entry into the national phase

Ref country code: CA

WWW Wipo information: withdrawn in national office

Ref document number: 1992911531

Country of ref document: EP