[go: up one dir, main page]

WO1995009566A1 - Outil exempt de charniere utile en chirurgie - Google Patents

Outil exempt de charniere utile en chirurgie Download PDF

Info

Publication number
WO1995009566A1
WO1995009566A1 PCT/US1994/011033 US9411033W WO9509566A1 WO 1995009566 A1 WO1995009566 A1 WO 1995009566A1 US 9411033 W US9411033 W US 9411033W WO 9509566 A1 WO9509566 A1 WO 9509566A1
Authority
WO
WIPO (PCT)
Prior art keywords
jaws
tool
hingeless
intermediate member
inner member
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/US1994/011033
Other languages
English (en)
Inventor
Andreas Melzer
Franz Jakoubek
Klaus Roth
Gerhard Buess
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.)
Hingeless Tool Co ('hit')
Original Assignee
Hingeless Tool Co ('hit')
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 Hingeless Tool Co ('hit') filed Critical Hingeless Tool Co ('hit')
Priority to AU79608/94A priority Critical patent/AU7960894A/en
Publication of WO1995009566A1 publication Critical patent/WO1995009566A1/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
    • 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
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • 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
    • A61B17/295—Forceps for use in minimally invasive surgery combined with cutting implements
    • 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
    • A61B17/32—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
    • A61B17/32—Surgical cutting instruments
    • A61B17/3201—Scissors
    • 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
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2919—Handles transmission of forces to actuating rod or piston details of linkages or pivot points
    • A61B2017/292—Handles transmission of forces to actuating rod or piston details of linkages or pivot points connection of actuating rod to handle, e.g. ball end in recess
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30092—Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
    • A61F2210/0019—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation

Definitions

  • the invention relates to a hingeless tool having a pair of jaws which are movable towards each other. More particularly, the tool includes an inner member which can be used as a grasper, scissors, manipulator, needle driver, or other tool having general utility or especially adapted for use during a surgical operation.
  • the invention provides a hingeless tool comprising an inner member, an intermediate member and an optional outer member.
  • the inner member can comprise a rod which includes a pair of spaced-apart jaws extending axially at a distal end of the inner member. At least one of the jaws is elastically deformable towards the other jaw and both jaws form a unitary piece.
  • the intermediate member can comprise a tube which surrounds the inner member and is slidable axially with respect to the inner member. A distal end of the intermediate member is engageable with the jaws such that at least one of the jaws is elastically deformed towards the other jaw as the intermediate member is moved over the jaws.
  • the intermediate member causes the jaws to apply a grasping pressure not exceeding a threshold value to an object located between the jaws.
  • the outer member can comprise a sheath which surrounds the intermediate member and supports the intermediate member such that the intermediate member can slide axially towards and away from the jaws.
  • the inner member can be formed from a unitary piece of a shape memory alloy which provides the jaws in an austenitic state in an unstressed condition but transforms to a stress induced martensitic state in a stressed condition. That is, the jaws are in the unstressed condition when the jaws are not elastically deformed toward each other and are in a stress induced martensitic state when the jaws are elastically deformed towards each other.
  • the intermediate member can be formed from a shape memory alloy which is in an austenitic state in an unstressed condition but transforms to a stress induced martensitic state in a stressed condition thus allowing highly elastic bending of the intermediate member.
  • the inner member can comprise first and second parts wherein the first part includes the jaws and the second part is detachably connected to the first part. Further, the first and second parts can be of the same or different materials.
  • the tool can include a handle and the outer member can be fixedly or removably attached to the handle.
  • the handle can include a stationary grip and a movable grip.
  • the movable grip and stationary grip are of a single piece of material and are connected together in a hingeless manner, e.g. by a flexible section of the handle.
  • a portion of the stationary grip can be fixed to a proximal end of the inner member and a portion of the movable grip can be fixed to a proximal end of the intermediate member.
  • the intermediate member can be moved with respect to the inner member by moving the movable grip.
  • the handle can be removably attached to the inner member and the intermediate member for cleaning thereof.
  • the jaws can include at least one step thereon and the intermediate member can include at least one constriction engageable (e.g. by snap fit) with the steps of the jaws by moving the intermediate member axially with respect to the inner member.
  • the inner member and intermediate member can include means for limiting axial movement of the inner member with respect to the intermediate member so that the intermediate member can engage no more than one-half of the axial length of the jaws.
  • the opposing surfaces of the jaws can be separated by a clearance when the jaws are elastically deformed towards each other to a maximum extent by the intermediate member.
  • the jaws can have surfaces capable of gripping tissue when the jaws are elastically deformed towards each other.
  • the jaws can be designed such that only one of the jaws is elastically deformed by the intermediate member.
  • both jaws are elastically deformed by engagement with the intermediate member.
  • the inner member can include various features.
  • a protection spring can be provided between the jaws at a location intermediate distal and proximal ends of the jaws.
  • the inner member can comprise a cutter or scissors wherein at least one of the jaws can include a cutting edge.
  • both jaws can include cutting edges which slide past each other when the jaws are elastically deformed by the intermediate member.
  • the cutting edges can have any desired shape such as rectilinear or curved cutting edges.
  • the inner member can comprise a needle driver wherein one of the jaws optionally includes a cutting blade which is slidably received in a corresponding slot in the other jaw.
  • the cutting blade can have a cutting edge facing the mating surface of the other jaw and both jaws can have a layer of a soft martensitic shape memory alloy to provide improved gripping of a needle.
  • the various parts of the tool can comprise various materials.
  • the inner member, the intermediate member and the outer member can be of a material selected from the group consisting of a shape memory alloy such as Ni-Ti or a Ni-Ti based alloy, a copper alloy such as Be-Cu, a nickel alloy such as Be-Ni, titanium or a titanium alloy such as ⁇ -titanium, spring steel, a polymer, polymer alloy, polymer composite or a polymer/metal composite.
  • the intermediate member and outer member are each of a nickel-titanium based shape memory alloy and the outer member includes a coating of an electrically insulating material such as a polymer coating on an outer periphery thereof.
  • Figure 1 shows a tool in accordance with the invention wherein the hingeless jaws are in the open condition
  • Figure 2 shows the tool of Figure 1 wherein the jaws are in the closed position
  • Figure 3 shows a handle which can be used to manipulate the tool shown in Figure 1;
  • Figures 4 and 5 show various embodiments of jaw designs for a replaceable element of the tool shown in Figure 1;
  • Figure 6 shows an embodiment of the tool of Figure 1 wherein the jaws include a locking mechanism;
  • Figure 7 shows an embodiment of the tool of Figure 1 wherein a protection spring is provided between the jaws;
  • Figures 8 and 9 show embodiments wherein the jaws of the tool according to the invention can include cutting edges; and Figures 10-12 show an embodiment of a tool in accordance with the invention wherein the jaws are used as a needle driver.
  • the invention provides a tool having hingeless and elastically activated jaws.
  • the tool can be especially adapted for use in endoscopic surgical operations.
  • Such a tool can overcome the design restrictions of conventional endoscopic instruments.
  • tissue can be grasped with definite and limited grasping pressure.
  • the invention also provides a handle wherein the movable grip opens and closes at 90° to the longitudinal axis so that no resulting longitudinal movement of the hand is transmitted leading to change of the position of the jaws or blades of the instrument.
  • An outer member in the form of a sheath is supported by the handle and keeps the instrument stable when the jaws are activated.
  • An inner member which is actually a part of the jaws has to be the passive component of the action while an intermediate member in the form of a tube is moved forward and backward to close and open the jaws.
  • hingeless instruments leads to a standardized modular principle that has further advantages.
  • Fourth, a functional check of all parts is easy and is automatically achieved on each application, which leads to reduced events of intraoperative instrument failures. Fifth, the manufacturer is able to use a minimal number of parts which reduces cost.
  • Sixth, the simple design of the jaw action allows an expanding selection and updating of the jaw designs for new applications.
  • the manufacturer can provide the surgeon with all parts so that in case of wear or breakage only the defective component needs to be exchanged.
  • the simple design reduces wear and breakage because the number of hinges and pivots of the standard tools are reduced or eliminated.
  • the elasticity of the jaws action mechanism and the jaws themselves allow a precise, physiologic grasping pressure, which minimizes the risk of organ perforation or tissue damage caused by the grasper.
  • the handle function can be described by coaxial and transaxial actions.
  • the grips have finger rings positioned 90° to the longitudinal axis to provide transaxial movement.
  • the action of fingers relative to the hand are transmitted in longitudinal movements.
  • the complete instrument moves.
  • This unintended action requires manual dexterity to compensate.
  • the grip according to the invention such movement can be minimized since the jaws move in a direction 90° to the longitudinal axis, hence, the force vector in longitudinal direction is zero.
  • the resulting movement along the longitudinal axis is reduced due to the fixation of the outer member and the inner member to a stationary part of the grip.
  • the grips and handles can be provided with or without closed finger rings but open finger rings are preferable because they allow easier manipulation.
  • the tool and handle of the invention provide reduced play (close to zero), reduced wear and tear, reduced number of parts and hysteresis.
  • drives such as pneumatic cylinders or servo motors can also be incorporated in the tool of the invention.
  • the inner member and/or intermediate member can include a certain ramp or hump design in the elastic part of the jaws to facilitate incremental closing and retaining of position of the jaws and thus obviate the need for a ratchet attachment mechanism in the grip.
  • the inner member can be individually shaped according to the surgeon's wishes or the anatomical situation.
  • the jaws can be individually shaped and curved according to the surgeon's desire or the anatomical situation.
  • the jaws can be designed as one piece with the elastic action element. Regular stainless steel jaws can be mounted, welded, or glued at the action element.
  • the jaws can be shaped as different types of scissors (hook, serrated, curved, etc.). Although it is preferred that the jaws be closed by sliding the intermediate member over the proximal end of the jaws, the jaws can also be closed by moving the inner member and pulling the jaws into the intermediate member.
  • the jaws can be shaped as one piece with a longitudinally extending rod or the jaws and rod can be separate pieces which are removably or fixedly held together in any suitable manner (e.g., welded, crimped, glued, etc.).
  • the outer member can be of any biocompatible material such as polymer, metal, shape memory alloy, polymer/metal composite or polymer coated metal.
  • the outer member can be removably connected to the grip by using a spring loaded attachment, screw, bayonet, etc.
  • the jaws can be made by injection molding plastic in a suitably shaped die or by wire electrostatic discharge machining of a stock wire, rod or other shaped material. Polymer jaws and other parts of the instrument (grip) can be improved by inserting elastic metal parts in the polymer.
  • the tool comprises a modular surgical instrument with improved cleanability and reliability through a reduced number of parts and improved handling through reduced "play", and which is self-locking by design (without ratcheting means).
  • the instrument preferably includes at least three concentric members including an inner rod, an intermediate tube and an outer sheath. However, the outer sheath can be omitted, if desired.
  • the rod has a distal end and a proximal end, the distal end being configured as a hingeless tool (grasper, needle holder, scissors, retractor, dissector, surgical forceps, etc.) with jaw movement substantially perpendicular to the axis of the instrument, and the proximal end is configured to allow easy engaging and disengaging with a handle through a quick-release mechanism.
  • the tube is movable relative to the fixed center rod and the proximal end of the tube is configured to allow easy engaging and disengaging with a handle through a quick- release mechanism.
  • the outer sleeve is fixed and not movable with the proximal end of the sleeve being configured to allow easy engaging and disengaging with a handle through a quick-release mechanism.
  • the distal end of the center rod is composed of at least one member made from an elastic material.
  • the opening and closing of the distal end jaws is accomplished by the relative movement of the concentric movable tube.
  • the distal end of the jaws can be configured to allow self-locking of the tool without ratcheting means when the movable tube is moved forward.
  • the jaws can be integral with the fixed center rod, or the jaws can be removably attached to the fixed center rod by crimping or other releasable joint means.
  • the jaws are preferably made from a Ni- Ti based shape memory alloy.
  • the present invention is intended to solve problems associated with conventional endoscopic devices by providing an instrument without complex parts and small hidden cavities that could entrap biological debris, and that can be very easily disassembled and reassembled. This is accomplished by using a closing tube which moves forward to actuate the distal end of a tool.
  • the tube can be driven forward by any of a variety of grips or handles. Note that since the tube is driven forward instead of the tube being withdrawn, the distal end of the working tool will not move axially to any significant extent. This feature is important to the surgeon as it allows accurate and predictable positioning of the distal end of the tool.
  • the overall length of the tool can range from 12 to 16 inches and the diameter of the outer sheath can range from 1.5 mm to 1/4 inch, for example.
  • a "quick release” feature which allows separation of the tool from a distal end of a support rod.
  • This also leads to a "modular” instrument concept, wherein the various components can be individually replaced, allowing for a selection of more customized tools, disposable or single-use components, replacement for wear or breakage, or design updates and modifications.
  • Due to the nature of the tool it is highly advantageous to make the distal end of the tool from a material with a large elastic range. Towards these ends, one might use a titanium alloy (especially the ⁇ -titanium alloys), or shape memory alloys (especially Ni-Ti based alloys).
  • Shape memory alloys in the pseudoelastic, superelastic or optimized elastic state have the additional advantage of producing a substantially constant closing force due to the formation of a stress induced martensitic microstructure - this is a result of their characteristic of exhibiting a nearly constant stress over a wide strain range. This attribute is able to provide tools with a more physiological, or compliant feel. This is a particularly valuable feature of these tools in that the gripping force is controlled by design, and not by the pressure the surgeon is applying at the grip end of the tool.
  • An additional advantage of this type of tool is that it has very little, if any, "play”, or backlash: tools with many moving parts, and hinges and pivots invariably have some annoying "play”, preventing the desired one-to-one positional correspondence between handle and distal end movement. It has also been observed that complex instruments with many small moving parts are susceptible to breakage. The current invention should significantly reduce the risk of failure during operation as well as cleaning.
  • the instrument By forming flat sections, or detents, along the length of the distal end, the instrument can be designed to have tactile "stops" to aid the surgeon. This could take the form of tactile clicks to provide positional feedback, or a position in which the tool would lock, instead of springing back to its open position.
  • FIG. 1 shows one embodiment of a tool 1 in accordance with the invention.
  • the tool 1 includes an inner member 2 having a pair of spaced-apart jaws 3, 4 at one end thereof, an intermediate member 5 and an outer member 6.
  • the jaws 3, 4 can be placed around an object to be engaged with the tool and the intermediate member 5 can be slid axially to close the jaws and clamp the object.
  • the jaws 3, 4 can be accurately positioned and closed without axial movement of the inner member 2. That is, the jaws 3, 4 move in a lateral direction which is perpendicular to the axial movement of the intermediate member 5 and an even grasping pressure not exceeding a threshold value can be applied to the object along the length of the jaws 3, 4.
  • part of the jaws (such as at least one half of the jaws) extend outwardly beyond the distal end of the intermediate member and opposing surfaces of the jaws are slightly separated by a clearance sized to accommodate the object to be gripped.
  • the exposed parts of the jaws (beyond the distal end of the intermediate member) are free to flex away from each other.
  • overgripping is avoided due to the clearance and resilient nature of the exposed ends of the jaws.
  • hinged devices wherein jaws are pivoted together provide a greater grasping pressure at positions located closer to the pivot and it is not possible to limit the grasping pressure to a particular value.
  • the jaws of the inner member apply a grasping force which does not exceed a threshold value to an object therebetween when the intermediate member is slid axially partially over and presses the jaws towards each other.
  • the threshold value can be varied by appropriate selection of the material of the inner member (e.g. metal such as Ti, Ti alloy such as a ⁇ -Ti alloy, spring steel, a copper alloy such as BeCu, a nickel alloy such as BeNi, shape memory alloy such as NiTi, polymer, polymer alloy, polymer/metal composite), the shape of the jaws, the relative dimensions of the inner and intermediate members and combinations thereof.
  • spring steel has a relatively high modulus but lower elasticity than BeCu or BeNi alloys whereas a polymer material has a much lower modulus but high strain limits and lower yield strength.
  • a superelastic, pseudoelastic or optimized elastic shape memory alloy has both wide strain limits and a substantially higher modulus than polymers.
  • the grasping force can be determined by the elastic strain limits of the jaw material.
  • the intermediate member can be dimensioned to partially close the jaws to a predetermined degree or gradually close the jaws incrementally as the intermediate member is advanced towards the jaws.
  • the inner member, the intermediate member and/or the outer member can be of a shape memory alloy which undergoes a stress induced martensitic transformation.
  • a shape memory alloy can provide better steerability and/or bendability of the tool which allows it to be steered to difficult-to-reach sites, particularly during endoscopic surgery.
  • the tool shown in Figure 1 includes several optional features.
  • the outer member 6 can include a step 8 separating a distal portion of the outer member from an enlarged proximal portion of the outer member 6.
  • the intermediate member 5 can include a flange 7 at a proximal end thereof for engagement with the step 8.
  • the intermediate member 5 in order to manipulate the intermediate member 5, the intermediate member 5 could include a projection which extends radially outwardly through a longitudinal slot in the outer member 6.
  • the jaws 3, 4 can be closed, as shown in Figure 2, by sliding the intermediate member 5 until the flange 7 engages the step 8.
  • the inner member 2 can include a quick release mechanism at a proximal end thereof.
  • the inner member 2 can include a fitting 9 defined by a groove 10.
  • a support member having a socket or constriction at the distal end thereof can be used to snap fit over the fitting 9 whereby a variety of inner members having different jaw designs can be used with the tool 1.
  • the inner member 2 can include a gap 11 separating the jaws 3, 4 at proximal ends thereof. As shown in Figure 2, the gap 11 separates the jaws 3, 4 even when the jaws are closed by the intermediate member 5. However, the gap 11 can be omitted, if desired.
  • FIG. 3 shows a handle usable with the tool 1.
  • the handle 12 includes a stationary grip 13 and a movable grip 14 connected by a flexible part of the handle.
  • the movable grip 14 includes a portion 15 which engages the intermediate member 5 whereby intermediate member 5 can be moved axially by pressing movable grip 14 towards stationary grip 13.
  • the portion 15 can include a slot or axially extending hole therethrough for receiving a proximal end of the intermediate member 5.
  • the intermediate member 5 can include a projection 16 which engages a distal side of the portion 15 and a projection 17 which engages a proximal side of the portion 15.
  • the projections 16, 17 can be integral with the tube 5 or can comprise removable parts such as snap rings, etc. whereby the intermediate member 5 can be separated from the handle 12.
  • the stationary grip 13 includes a portion 18 for engaging a proximal end of the inner member 2.
  • the inner member 2 can include a pin 19 which is received in a hole in the portion 18 whereby the inner member 2 can be separated from the handle 12.
  • the handle 12 can be used to direct the jaws 3, 4 of the inner member 2 to a desired location and the jaws 3, 4 can be closed by squeezing the movable grip 14 towards the stationary grip 13, i.e., the movable grip 14 moves the intermediate member 5 axially such that the distal end of the intermediate member 5 engages and slides over the jaws 3, 4.
  • the handle 12 can also include finger grips 20, 21 in addition to the handle grip 13, 14.
  • Figure 4 shows an embodiment of an inner member 2a wherein the jaws 3a, 4a have surfaces 22 capable of gripping tissue.
  • the jaws 3a, 4a include a series of projections and recesses which interengage each other when the jaws are closed.
  • the jaws 3a, 4a are separated by a gap 11a located at a proximal end of the jaws.
  • the inner member 2a includes a groove 10a and a fitting 9a which can be snap fitted in a distal end of a support rod 23 which forms an extension of the inner member 2a. In use, the proximal end of the rod 23 can be fixed to the portion 18 of the handle 12.
  • Figure 5 shows an embodiment of the inner member 2b wherein the jaw surfaces are flat and one jaw 3b includes a thick jaw portion 24 and the other jaw 4b includes a thin jaw portion 25.
  • the jaw 4b having the thin jaw portion 25 can be treated such that only jaw 4b moves when engaged by the intermediate member 5.
  • the jaw 4b can be processed to be the only movable jaw of the inner member 2b by deforming jaw 4b away from jaw 3b and subjecting the inner member 2b to a heat treatment wherein the deformed condition of jaw 4b is memorized.
  • inner member 2b can be formed from a nickel titanium shape memory alloy and jaw 4b can be bent outwardly from jaw 3b, heated to a temperature such as 450°C, and cooled while preventing jaw 4b from moving towards jaw 3b.
  • Figure 6 shows an embodiment wherein the intermediate member 5b can be locked with respect to the inner member 2c.
  • intermediate member 5b includes a constriction 26 at a distal end thereof for engaging a series of steps 27, 28 on an outer periphery of jaws 3c, 4c.
  • intermediate member 5b can be advanced axially along inner member 2c and the constriction 26 will snap fit in one of the steps 27, 28.
  • Figure 7 shows an embodiment wherein the inner member 2d includes a protection spring 29 extending between the jaws 3d, 4d.
  • the projection spring 29 prevents material from moving into gap 11.
  • Figure 8 shows an embodiment wherein the tool comprises scissors and the inner member 2e includes jaws 3e, 4e which include cutting edges 30, 31, respectively.
  • intermediate member 5 slides axially toward the jaws 3e, 4e to move the jaws toward each other and cut material located between cutting edges 30, 31.
  • Figure 9 shows a top view of an embodiment wherein the inner member 2f includes jaws 3f, 4f having cutting edges 31a, 31b having the shape of a hook 32.
  • the jaws 3f, 4f move in a direction perpendicular to the plane of the Figure.
  • Figures 10-12 show an embodiment wherein the tool comprises a needle driver.
  • one of the jaws 4g includes a cutting blade 33 having a cutting edge 34.
  • the other jaw 3g includes a slot therein for receiving the cutting blade 33 when the jaws 3g, 4g are closed by sliding the intermediate member 5 axially towards a distal end of the jaws 3g, 4g.
  • Figure 11 shows a top view of jaw 4g.
  • Figure 12 shows a side view of the jaws 3g, 4g in the open position wherein the cutting edge 34 is separated from the jaw 3g and the cutting blade 33 is partially received in a corresponding slot in the jaw 3g.
  • the mating surfaces of the jaw 3g, 4g can be plated with a soft layer of material for gripping a needle.
  • the mating jaw surfaces can be smooth or patterned with ridges, etc.
  • the soft material is preferably a martensitic nickel titanium shaped memory alloy.
  • the thickness should be sufficient to grip a needle and the thickness can be on the order of 0.2mm.
  • the soft martensitic layer will be deformed by a needle gripped by the jaws 3g, 4g.
  • An advantage of the soft martensitic layer is that it can be returned to its original shape by a sterilizing treatment such as by heating the inner member 2g to a temperature such as 130°C.

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

Outil (1) exempt de charnière qui comporte un élément interne, un élément intermédiaire (5) entourant l'élément interne (2) et un élément externe (6) optionnel entourant l'élément intermédiaire (5). L'élément externe (6) peut être un fourreau relié à demeure ou amovible à une poignée et l'élément intermédiaire (5) coulisse axialement dans le fourreau (6). L'élément interne comporte une paire de mâchoires espacées (3, 4) exemptes de charnières qui forment une pièce d'un seul tenant à une extrémité distale dudit élément et une extrémité proximale de l'élément interne est attaché à une partie fixe de la poignée. L'élément intermédiaire (5) est un tube coulissant axialement et l'extrémité proximale du tube est reliée à une partie mobile de la poignée. Les parties fixe et mobile de la poignée sont reliées sans charnière par une partie souple de la poignée. L'extrémité distale du tube coulisse sur une partie des mâchoires pour déformer élastiquement lesdites mâchoires l'une vers l'autre. En conséquence, en déplaçant la partie mobile de la poignée, on peut déplacer l'élément intermédiaire axialement pour pousser les mâchoires l'une vers l'autre sans mouvement axial desdites mâchoires. L'élément interne peut être constitué de deux parties reliées entre elles de manière détachable. L'extrémité de travail de l'élément interne possédant diverses configurations de mâchoires peut dont être utilisé de manière interchangeable avec ledit outil. Par exemple, les mâchoires peuvent être conçues pour être utilisées comme pinces, ciseaux ou guide d'aiguille utile en chirurgie endoscopique.
PCT/US1994/011033 1993-09-29 1994-09-29 Outil exempt de charniere utile en chirurgie Ceased WO1995009566A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU79608/94A AU7960894A (en) 1993-09-29 1994-09-29 Hingeless tool useful in surgery

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US12802893A 1993-09-29 1993-09-29
US08/128,028 1993-09-29

Publications (1)

Publication Number Publication Date
WO1995009566A1 true WO1995009566A1 (fr) 1995-04-13

Family

ID=22433243

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1994/011033 Ceased WO1995009566A1 (fr) 1993-09-29 1994-09-29 Outil exempt de charniere utile en chirurgie

Country Status (2)

Country Link
AU (1) AU7960894A (fr)
WO (1) WO1995009566A1 (fr)

Cited By (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4442439A1 (de) * 1994-11-29 1996-06-05 Aesculap Ag Chirurgisches Rohrschaftinstrument
DE29705871U1 (de) * 1997-04-04 1997-06-26 Bartels Mikrotechnik GmbH, 44227 Dortmund Mikrogreifvorrichtung
FR2766084A1 (fr) * 1997-07-21 1999-01-22 Duche Mathieu J B Dispositif pour endoscopie souple ou rigide et chirurgie coelioscopique
EP0900049A4 (fr) * 1995-05-12 1999-03-10
WO1999045853A1 (fr) * 1998-03-12 1999-09-16 Forschungszentrum Karlsruhe Gmbh Instrument de prehension et de lithotritie
WO2001091644A1 (fr) * 2000-06-01 2001-12-06 Genzyme S.A. Applicateur laparoscopique
NL1019041C2 (nl) * 2001-09-26 2003-03-27 Sentitic Tangmechanisme.
US6605036B1 (en) 1996-05-10 2003-08-12 Andrew Michael Wild Surgical instrument assembly for use in endoscopic surgery
EP1342451A1 (fr) * 1997-09-25 2003-09-10 Allegiance Corporation Instrument chirurgical avec bras malléable
EP1416865A4 (fr) * 2001-07-25 2004-10-27 Rkl Technologies Inc Poignee de commande pour instrument chirurgical
DE102007001752A1 (de) * 2007-01-08 2008-07-17 Aesculap Ag & Co. Kg Chirurgischer Handgriff und chirurgisches Instrument
EP2147643A3 (fr) * 2008-07-22 2010-08-18 Vance Products Incorporated D/B/A Cook Urological Incorporated Extracteur avec poignée
DE102013005874A1 (de) * 2013-04-08 2014-10-09 Markus Baur Griffstück für ein chirurgisches lnstrument
WO2014172589A1 (fr) 2013-04-17 2014-10-23 Sp Surgical Inc. Procédé et appareil permettant de passer une suture
WO2016056909A2 (fr) 2014-10-08 2016-04-14 Technische Universiteit Delft Dispositif de préhension
NL2013592B1 (en) * 2014-10-08 2016-10-03 Univ Delft Tech Mechanical end effector.
WO2017191583A1 (fr) * 2016-05-06 2017-11-09 Mor Research Applications Ltd. Dispositif de préhension présentant une surface de préhension accrue
CN109177319A (zh) * 2018-11-14 2019-01-11 温州临界科技有限公司 一种手提袋穿绳机用移袋装置
US11883051B2 (en) 2020-08-24 2024-01-30 Covidien Lp Hollow graspers

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3844291A (en) * 1973-04-26 1974-10-29 G Moen Grip device
WO1991002493A1 (fr) * 1989-08-16 1991-03-07 Raychem Corporation Dispositif pour saisir ou pour couper un objet
US5147378A (en) * 1991-03-05 1992-09-15 Harold Markham Grapsing forceps

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3844291A (en) * 1973-04-26 1974-10-29 G Moen Grip device
WO1991002493A1 (fr) * 1989-08-16 1991-03-07 Raychem Corporation Dispositif pour saisir ou pour couper un objet
US5147378A (en) * 1991-03-05 1992-09-15 Harold Markham Grapsing forceps

Cited By (29)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4442439A1 (de) * 1994-11-29 1996-06-05 Aesculap Ag Chirurgisches Rohrschaftinstrument
EP0900049A4 (fr) * 1995-05-12 1999-03-10
US6605036B1 (en) 1996-05-10 2003-08-12 Andrew Michael Wild Surgical instrument assembly for use in endoscopic surgery
DE29705871U1 (de) * 1997-04-04 1997-06-26 Bartels Mikrotechnik GmbH, 44227 Dortmund Mikrogreifvorrichtung
FR2766084A1 (fr) * 1997-07-21 1999-01-22 Duche Mathieu J B Dispositif pour endoscopie souple ou rigide et chirurgie coelioscopique
EP1342451A1 (fr) * 1997-09-25 2003-09-10 Allegiance Corporation Instrument chirurgical avec bras malléable
WO1999045853A1 (fr) * 1998-03-12 1999-09-16 Forschungszentrum Karlsruhe Gmbh Instrument de prehension et de lithotritie
WO2001091644A1 (fr) * 2000-06-01 2001-12-06 Genzyme S.A. Applicateur laparoscopique
EP1416865A4 (fr) * 2001-07-25 2004-10-27 Rkl Technologies Inc Poignee de commande pour instrument chirurgical
NL1019041C2 (nl) * 2001-09-26 2003-03-27 Sentitic Tangmechanisme.
WO2003026519A1 (fr) * 2001-09-26 2003-04-03 Sentitic Forceps
US8043303B2 (en) 2002-10-04 2011-10-25 Cook Medical Technologies Llc Handle for interchangeable medical device
DE102007001752B4 (de) * 2007-01-08 2008-11-20 Aesculap Ag Chirurgischer Handgriff und chirurgisches Instrument
DE102007001752A1 (de) * 2007-01-08 2008-07-17 Aesculap Ag & Co. Kg Chirurgischer Handgriff und chirurgisches Instrument
EP2147643A3 (fr) * 2008-07-22 2010-08-18 Vance Products Incorporated D/B/A Cook Urological Incorporated Extracteur avec poignée
DE102013005874A1 (de) * 2013-04-08 2014-10-09 Markus Baur Griffstück für ein chirurgisches lnstrument
US10258322B2 (en) 2013-04-17 2019-04-16 Maruho Medical, Inc. Method and apparatus for passing suture
EP2986234A4 (fr) * 2013-04-17 2017-01-11 SP Surgical Inc. Procédé et appareil permettant de passer une suture
WO2014172589A1 (fr) 2013-04-17 2014-10-23 Sp Surgical Inc. Procédé et appareil permettant de passer une suture
AU2019200690B2 (en) * 2013-04-17 2021-02-25 Clauson Creative Engineering, Inc. Method and apparatus for passing suture
US11523816B2 (en) 2013-04-17 2022-12-13 Maruho Medical, Inc. Method and apparatus for passing suture
WO2016056909A2 (fr) 2014-10-08 2016-04-14 Technische Universiteit Delft Dispositif de préhension
WO2016056909A3 (fr) * 2014-10-08 2016-06-02 Technische Universiteit Delft Dispositif de préhension
NL2013592B1 (en) * 2014-10-08 2016-10-03 Univ Delft Tech Mechanical end effector.
NL2013593B1 (en) * 2014-10-08 2016-10-03 Univ Delft Tech Grasper.
WO2017191583A1 (fr) * 2016-05-06 2017-11-09 Mor Research Applications Ltd. Dispositif de préhension présentant une surface de préhension accrue
CN109177319A (zh) * 2018-11-14 2019-01-11 温州临界科技有限公司 一种手提袋穿绳机用移袋装置
CN109177319B (zh) * 2018-11-14 2023-11-21 温州临界科技有限公司 一种手提袋穿绳机用移袋装置
US11883051B2 (en) 2020-08-24 2024-01-30 Covidien Lp Hollow graspers

Also Published As

Publication number Publication date
AU7960894A (en) 1995-05-01

Similar Documents

Publication Publication Date Title
WO1995009566A1 (fr) Outil exempt de charniere utile en chirurgie
JP3677469B2 (ja) 対象物体を操作するためのデバイス
US11690692B2 (en) Virtual reality surgical tools system
US5752972A (en) Modular endoscopic surgical instrument
US8945174B2 (en) Medical instrument with flexible jaw mechanism
US6231601B1 (en) Method of surgery including adjusting the shape of an implement handle
KR101926743B1 (ko) 복강경에서 사용하기 위한 조합형 가위-그래스퍼 도구
EP2034910B1 (fr) Instrument chirurgical présentant un ensemble d'outil détachable
US5562699A (en) Forceps
US6004329A (en) Shape-adjustable surgical implement handle
EP1948026B1 (fr) Dispositif de découpe et de coagulation à ultrasons
EP0507621B1 (fr) Actuateur pour un instrument chirurgical endoscopique, actionné par le pouce
US6190399B1 (en) Super-elastic flexible jaw assembly
US5449374A (en) Tissue spreading forceps
US20160113732A1 (en) Surgical tool
JP2017196433A (ja) 可撓性ジョーおよび／または可撓性手首機構を有する医療機器
EP1601294A1 (fr) Dispositif medical reformable
US6096059A (en) Microsurgical tool
JP6013507B2 (ja) 医療用器具
EP1463455B1 (fr) Outil chirurgical
EP2394591B1 (fr) Ressort de poignée sélectionnable
CN114469318A (zh) 电外科器械
US6863679B1 (en) Paired forceps
WO1995015718A1 (fr) Porte-aiguille de microchirurgie
EP1857060B1 (fr) Fil flexible pour actionner un dispositif médical

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AM AT AU BB BG BR BY CA CH CN CZ DE DK ES FI GB GE HU JP KE KG KP KR KZ LK LT LU LV MD MG MN MW NL NO NZ PL PT RO RU SD SE SI SK TJ TT UA UZ VN

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): KE MW SD SZ AT BE CH DE DK ES FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN ML MR NE SN TD TG

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
121 Ep: the epo has been informed by wipo that ep was designated in this application
REG Reference to national code

Ref country code: DE

Ref legal event code: 8642

NENP Non-entry into the national phase

Ref country code: CA

122 Ep: pct application non-entry in european phase