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WO2009153015A1 - Pince chirurgicale avec couteau et ressort de rappel - Google Patents

Pince chirurgicale avec couteau et ressort de rappel Download PDF

Info

Publication number
WO2009153015A1
WO2009153015A1 PCT/EP2009/004310 EP2009004310W WO2009153015A1 WO 2009153015 A1 WO2009153015 A1 WO 2009153015A1 EP 2009004310 W EP2009004310 W EP 2009004310W WO 2009153015 A1 WO2009153015 A1 WO 2009153015A1
Authority
WO
WIPO (PCT)
Prior art keywords
handle
return spring
knife
shaft tube
mouth
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/EP2009/004310
Other languages
German (de)
English (en)
Inventor
Thomas Aue
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.)
Olympus Winter and Ibe GmbH
Original Assignee
Olympus Winter and Ibe GmbH
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 Olympus Winter and Ibe GmbH filed Critical Olympus Winter and Ibe GmbH
Publication of WO2009153015A1 publication Critical patent/WO2009153015A1/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
    • 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
    • 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
    • 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
    • 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
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0046—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • 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
    • A61B2017/2931—Details of heads or jaws with releasable head
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • 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
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00404—Blood vessels other than those in or around the heart
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00619—Welding
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/0063—Sealing
    • 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
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1412—Blade
    • 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
    • A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
    • A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws
    • 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
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0813—Accessories designed for easy sterilising, i.e. re-usable

Definitions

  • the invention relates to a surgical forceps referred to in the preamble of claim 1 Art.
  • tissue can be captured by the mouth, crushed and coagulated by heat and cut with a knife.
  • forceps are used for welding and severing blood vessels. It is important that the two ends of the blood vessels, which are separated by a cut, are securely welded together by coagulation.
  • Tissue coagulation requires heat input into the tissue. This can be done in different ways, eg. B. by the introduction of ultrasonic energy in the area between the jaw parts. In conventional technology can also be heated with high frequency current, the z. B. between arranged on the jaws electrodes flows, as the extensive literature on this subject is removable, including the cited below font.
  • the knife is loaded with a return spring to always return it automatically to the starting position.
  • the US 2006/0189981 Al shows a generic construction.
  • a finger-operated lever is provided which advances the knife in the axial direction of the shaft tube via a rod.
  • the finger lever is loaded with the return spring. Upon return of the finger lever by the spring, he pulls back the rod and the knife. To do this, the finger lever, rod and knife not only have to be designed to transmit pressure but also to transmit by train. A simple decomposition of this pliers is therefore not possible.
  • demountable pliers known that can be better cleaned and sterilized in disassembled state.
  • the mouth of the shaft tube must be separable.
  • the longitudinal member controlling the closing movement of the mouth in the form of a rod arranged in the shaft tube can be pulled off with the mouth.
  • the disassembled parts are then easily accessible and can be rinsed for cleaning and disinfection purposes. This dismantling and the subsequent reassembling must be easy by hand, so that even a nurse without consulting a technician can do this work quickly.
  • bayonet connections between the jaw and the shaft tube known and simple snap connections between the distal end of the longitudinal member and the handle.
  • the object of the present invention is to make the generic pliers disassembled for cleaning purposes. This object is achieved with the features of the characterizing part of claim 1.
  • the mouth is releasably attached to the shaft tube and also the longitudinal member is releasably attached to the handle.
  • the return spring is moved distally from the known proximal arrangement and acts on the knife, which is formed separately from the thrust member and can be acted upon by this only in the printing direction by contact.
  • the knife can thus be operated in a widely familiar manner, where it can be acted upon by the thrust member in the thrust direction and pushed back by the spring.
  • the advantage of this design is that at the separation point, the knife is separable from the pusher member. When loosening and removing the mouth, the knife remains on the mouth and the push member remains on the shaft tube. The knife may sometimes protrude very far in the proximal direction, u. U. over the entire length of the shaft tube to further improve the cleanability.
  • the return spring which acts on one end of the knife, must be mounted stationary at the other end.
  • This storage can z. B. on the shaft tube, but advantageously according to claim 2 to a jaw carrier, which carries the jaws and the entire joint mechanism and the longitudinal member, so that all these parts are jointly handled as a unit.
  • the invention is shown in a single figure 1, for example, and schematically in a longitudinal section through a pliers according to the invention.
  • 1 shows a surgical forceps 1 with an elongate shaft tube 2 at the distal end of a mouth 3 and at the proximal end of a handle 4 are arranged.
  • the mouth 3 has two jaw parts 5 and 6, which are pivotally mounted on a common axis 7 in the embodiment.
  • the axis 7 is held in a substantially tubular support 8 of the mouth.
  • the tubular carrier 8 fits snugly in the distal end of the shaft tube 2 and carries on the outside a pin 9 which removably engages in a known manner in an internal bayonet groove 10 on the inside of the shaft tube 2.
  • a rod-shaped longitudinal member 11 which is the shaft tube 2 arranged continuously and runs at the distal end with a transverse pin 12 in an oblique groove 13 in the jaw part 5.
  • the drawing simplistic only partially illustrated other jaw part 6 has a mirror-symmetrically arranged, not shown groove, which is also engaged with the pin.
  • the jaws 5 and 6 are opened or closed in a conventional manner.
  • a ball 14 At the proximal end of the longitudinal member 11 is releasably held with a ball 14 in a ball receiving a movable handle portion 15 of the handle 4, which is articulated via a hinge 16 with a fixed handle 17, which is fixed to the proximal end of the shaft tube 2.
  • the illustrated forceps 1 should be tissue, z. B. pinch a blood vessel between the jaws 5, 6 and coagulate by heat.
  • devices not shown are provided for the sake of drawing simplification, which can generate heat in the area between the jaws 5, 6. This can z. B. electrodes on the jaws 5, 6, between which current flows, as such. B. describes the cited prior art.
  • a knife 18 is provided, with a cutting edge 19.
  • the knife 18 has a longitudinal slot 20, with which it surrounds the axis 7.
  • the knife 18 is formed very flat over its entire length and arranged in the region of the axis 7 between the two jaws 5, 6. In the distal end region of the jaw parts, when they are closed, it runs in central longitudinal slots 21, which are arranged in both jaw parts 5, 6. In FIG. 1, the slot 21 can be seen in the lower jaw part 6, which is cut in the sectional plane of FIG. 1 for this purpose.
  • the knife 18 is longitudinally displaceable with its slot 20 on the axis 7 over a larger area. It can thus be retracted in the proximal direction until it rests directly against the axis 7 with the cutting edge 19, or can be advanced until the cutting edge 19 is in the region of the distal tips of the two jaw parts 5, 6.
  • the carrier 8 At the proximal end of the blade 18, this is flared laterally with flanges 22 which are longitudinally guided in the inner surface of the tubular support 8.
  • the carrier 8 At its proximal end, the carrier 8 has an inner flange 23, to which the flanges 22 of the knife 18 can come into abutment. As a result, the movement of the blade 18 in the proximal direction is limited.
  • the carrier 8 also has a distal inner flange 24 in the distal end region. Between this distal inner flange 24 of the carrier 8 and the outer flanges 22 of the knife 18, a return spring 25 designed as a helical spring is arranged, which presses the knife 18 in the proximal direction.
  • a tubular thrust member 26 is arranged, which rests with its distal end face against the flanges 22, so the proximal end face of the blade 18.
  • the knife 18 is advanced against the restoring force of the return spring 25 in the distal direction. If the pusher member 26 is force-free set or withdrawn, the knife 18 is pressed by the return spring 25 again in the proximal direction to the stop on the inner flange 23 of the support 8.
  • the thrust member 26 extends beyond the proximal end of the shaft tube 2 with its proximal end and is actuated there by a lever 27, which is mounted at 28. At its free end, the lever 27 on a curved handle on which can be attacked with a finger to push the pusher member 26 in the distal direction.
  • the illustrated pliers 1 can be disassembled for cleaning purposes.
  • the mouth 3 is touched and this is rotated relative to the shaft tube 2, so that the bayonet engagement between the pin 9 and the bayonet groove 10 is released.
  • the jaw 3 with its carrier 8 can be pulled out of the shaft tube 2 in the distal direction.
  • the ball 14 at the proximal end of the longitudinal member 11 is separated from the handle part 15.
  • the mouth 3 can now be pulled out of the shaft tube 2 in the distal direction together with the longitudinal member 11.
  • the thrust member 26 remains in the shaft tube. 2
  • the pliers 1 can be formed even further separable, for example, the handle 4 from the shaft tube 2 can be solved. Further precautions can be taken to improve cleanability and sterilizability.
  • the carrier 8 of the mouth 3 shown as a tube part can be designed to be largely open in order to allow rinsing and cleaning agents to enter.

Landscapes

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

Abstract

L'invention porte sur une pince chirurgicale (1) sur laquelle sont disposées une tige creuse longitudinale (2), une mâchoire (3) à l'extrémité distale de celle-ci, et une poignée (4) à l'extrémité proximale de celle-ci, la mâchoire (3) comportant deux éléments de mâchoire (5, 6) pour lesquels au moins l'un est orientable par rapport à l'autre par action d'un élément longitudinal (11) actionné par la poignée (4), munie d'un dispositif de chauffage électrique du tissu tenu par la mâchoire et d'un couteau (18), qui est mobile à l'aide d'un élément de poussée (26) actionnable par la poignée (4) dans la zone de la mâchoire (3) dans la direction longitudinale de la tige creuse (2) en opposition avec la force d'un ressort de rappel (25), caractérisé en ce que la mâchoire (3) est fixée de façon amovible sur la tige creuse (2) et que l'élément longitudinal (11) est fixé de façon amovible sur la poignée (4) et en ce que l'élément de poussée (26) est séparé du couteau (18) et est disposé longitudinalement de manière à buter contre celui-ci, le couteau (18) étant soumis à l'action du ressort de rappel (25).
PCT/EP2009/004310 2008-06-20 2009-06-16 Pince chirurgicale avec couteau et ressort de rappel Ceased WO2009153015A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102008028992.2 2008-06-20
DE102008028992A DE102008028992B3 (de) 2008-06-20 2008-06-20 Chirurgische Zange mit Messer und Rückstellfeder

Publications (1)

Publication Number Publication Date
WO2009153015A1 true WO2009153015A1 (fr) 2009-12-23

Family

ID=40936595

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2009/004310 Ceased WO2009153015A1 (fr) 2008-06-20 2009-06-16 Pince chirurgicale avec couteau et ressort de rappel

Country Status (2)

Country Link
DE (1) DE102008028992B3 (fr)
WO (1) WO2009153015A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110192909A (zh) * 2019-06-13 2019-09-03 常州市第一人民医院 一种万向蓝钳
CN110882047A (zh) * 2019-10-31 2020-03-17 深圳市微语信息技术开发有限公司 一种骨科导向复位固定钳
CN114159129A (zh) * 2021-12-03 2022-03-11 北京安和加利尔科技有限公司 一种可更换刀杆的剪式超声刀
US11304743B2 (en) 2019-01-30 2022-04-19 Covidien Lp Electrosurgical forceps
US11419665B2 (en) 2018-10-26 2022-08-23 Covidien Lp Electrosurgical forceps
US11497545B2 (en) 2019-02-14 2022-11-15 Covidien Lp Electrosurgical forceps
US11510725B2 (en) 2019-01-30 2022-11-29 Covidien Lp Electrosurgical forceps

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102016112479A1 (de) 2016-07-07 2018-01-11 Olympus Winter & Ibe Gmbh Elektrochirurgisches Instrument mit Dünnschichtsensor
DE102017119310A1 (de) 2017-08-23 2019-02-28 Olympus Winter & Ibe Gmbh Elektrochirurgisches Maulinstrument mit unterschiedlichen Schneidefunktionen
DE102018100688A1 (de) 2018-01-12 2019-07-18 Olympus Winter & Ibe Gmbh Chirurgisches Maulinstrument mit zentralem Aktivierungselement

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5611808A (en) * 1995-09-12 1997-03-18 Cabot Technology Corporation Blade assembly receptacle and method
US5913874A (en) * 1997-09-25 1999-06-22 Cabot Technology Corporation Cartridge for a surgical instrument
US20070106297A1 (en) * 2005-09-30 2007-05-10 Dumbauld Patrick L In-line vessel sealer and divider

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4323093A1 (de) * 1993-07-10 1995-01-19 Wolf Gmbh Richard Chirurgische Zange
US7083618B2 (en) * 2001-04-06 2006-08-01 Sherwood Services Ag Vessel sealer and divider

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5611808A (en) * 1995-09-12 1997-03-18 Cabot Technology Corporation Blade assembly receptacle and method
US5913874A (en) * 1997-09-25 1999-06-22 Cabot Technology Corporation Cartridge for a surgical instrument
US20070106297A1 (en) * 2005-09-30 2007-05-10 Dumbauld Patrick L In-line vessel sealer and divider

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11419665B2 (en) 2018-10-26 2022-08-23 Covidien Lp Electrosurgical forceps
US11304743B2 (en) 2019-01-30 2022-04-19 Covidien Lp Electrosurgical forceps
US11510725B2 (en) 2019-01-30 2022-11-29 Covidien Lp Electrosurgical forceps
US11497545B2 (en) 2019-02-14 2022-11-15 Covidien Lp Electrosurgical forceps
US12310647B2 (en) 2019-02-14 2025-05-27 Covidien Lp Electrosurgical forceps
CN110192909A (zh) * 2019-06-13 2019-09-03 常州市第一人民医院 一种万向蓝钳
CN110882047A (zh) * 2019-10-31 2020-03-17 深圳市微语信息技术开发有限公司 一种骨科导向复位固定钳
CN114159129A (zh) * 2021-12-03 2022-03-11 北京安和加利尔科技有限公司 一种可更换刀杆的剪式超声刀
CN114159129B (zh) * 2021-12-03 2023-12-22 北京安和加利尔科技有限公司 一种可更换刀杆的剪式超声刀

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