WO2010081641A1 - Surgical jaw instrument having actuating rod - Google Patents

Abstract

A surgical instrument (1) comprising a shaft (2), having a manual actuating device (7, 11) at the proximal end and a jaw device (4, 5) at the distal end, wherein both jaw parts (4, 5) can be moved relative to each other by an actuating rod (13) that extends over the length of the shaft (2) and that, at the proximal end, is in actuating engagement with a moveable handle piece (11) of the manual actuating device (7, 11) which can be moved manually relative to a stationary handle piece (7), characterized in that an adjustment device (10, 9, 16, 17; 10, 20, 22) is provided, with which the ratio of the movement direction of the jaw parts (4, 5) to the movement direction of the handle pieces (7, 11) can be changed.

Description

 Surgical jaw instrument with operating rod

The invention relates to a surgical instrument referred to in the preamble of claim 1 Art.

Depending on the type of jaws used in such instruments, the mouth is designed as a pair of pliers or scissors. In this case, both jaws can be designed to be pivotable or only one that is moved against a stationary jaw part.

The operation of the mouth is carried out by the manual over a control rod. Shaft and actuating rod can be made relatively long, which can make shaft forceps or shank scissors suitable for laparoscopy.

With pliers or scissors, it usually depends on the closing movement, which should be done with high force in order to apply high holding forces or squeezing forces or cutting forces can. Since the fingers of the hand can generate greater forces during a closing movement, generic instruments are usually designed so that the jaw parts are closed when the gripping pieces move toward each other. Such a generic design shows z. No. 5,607,449, which also shows further expedient embodiments of such an instrument, such as, for example, the laying for cleaning purposes, the rotatability of the mouth with respect to the manual override device and the like.

Depending on the surgical field of use, it may also be necessary to apply force during spreading of the jaw parts with a generic instrument, in order, for example, to press apart adjacent body parts in the surgical field. In some operations such work may be required very frequently and over a long period of time. It then shows very quickly that the hand of the surgeon, although slightly high clamping forces, but reluctant high spreading forces. Working becomes very uncomfortable.

More practical would then be an instrument in which the jaw parts are spread when closing movement of the grips. Something is known from the remote technical field of snap ring pliers according to DE 296 09 423 Ul per se. However, the use of such pliers for surgical purposes would have the disadvantage that usually higher closing forces are required, which would be very uncomfortable with the closing of the handle, the pliers opening construction.

The object of the present invention is to enable a generic instrument easier spreading of the jaws without complicating the closing with high power.

This object is achieved with the features of the characterizing part of claim 1.

According to the invention, the surgical instrument has a changeover device with which the ratio of the directions of movement on the mouth and on the grip pieces can be reversed. Such a pair of pliers or scissors can thus normally close the jaw parts when closing the grips, but can be changed to then open the mouth part when closing the grips. By switching the instrument so this can be either to close or to open the mouth with closing grips, so with high power, be formed. An instrument according to the invention can therefore be used optimally for both types of actuation.

The changeover device can be designed in different ways with more or less complicated kinematics. Claim 2 relates to an advantageous embodiment of the invention in which the changeover is very simple gestaltbar. The movable handle is formed like a lever and may be mounted at one or the other of two bearings, which are opposite to each other with respect to the actuating rod. Upon movement of the actuating ends of the grips towards each other, the actuating rod is thus pushed in the distal direction during storage at the one bearing point and, when stored at the other bearing point, in the proximal direction. Upon actuation of the handle pieces in the same direction so the mouth can be operated in one direction or the other depending on the choice of the bearing point.

Advantageously, the features of claim 3 are provided. This results in a kinematics, which avoids the lateral deflection in the intended longitudinal adjustment of the actuating rod.

Advantageously, the features of claim 4 are provided. This is a very simple and cost-effective design option, in which bearing bores are provided on both bearing pieces at the bearing points and an axle pin is selectively inserted at one or the other bearing point.

Alternatively, according to claim 5, a bearing device may be provided, with which the two gripping pieces are mounted on each other, wherein these La- Device is slidably formed on both grips between the bearings.

In the drawing, the invention is shown for example and schematically. Show it:

Fig. 1 is a side view of an instrument according to the invention in the first embodiment and

Fig. 2 is a side view of an instrument according to the invention in a second embodiment.

Fig. 1 shows a surgical instrument 1 with an elongated tube formed as a tube 2, at its distal end on an axis 3, two jaws forming a mouth 4, 5 are pivotally mounted.

The jaw parts 4, 5 may be formed as scissor blades or as jaws, so that the instrument can be used as a pair of scissors or pliers.

The shaft 2 is relatively long and carries at its proximal end a main body 6, of which the shaft 2 z. B. may be designed to be removable or rotatable with respect to this.

On the main body 6, a fixed handle 7 is attached, that carries the usual finger ring 8 at its operating end. On the fixed handle 7, a bearing bore 9 is provided, in which an axle pin 10 is inserted, which also passes through a bearing bore 9 aligned hole in a movable handle piece 11. If the surgeon z. B. with index finger and thumb in the handle ring 8 and another handle ring 12 summarizes the operating end of the movable handle 11, it can by relative movement of these two fingers, the lever-like movable handle piece 11 pivot about the axle pin 10 relative to the fixed handle 7.

The mouth 4, 5 is driven by an actuating rod 13, which extends over the length of the shaft 2 and in the embodiment of the tubular shank in the interior of which lies. The B etätigungs rod 13 engages with its distal end, not shown, on an actuating kinematics, which pivots the jaws 4, 5 relative to each other. This kinematics may, for example, according to US 5,607,449, Fig. 4, be formed, or in any other known manner.

The proximal end of the actuating rod 13 is formed in the usual manner as a ball head 14. The ball head 14 is pivotally mounted in a ball seat 15 in the movable handle piece 11. The ball head 14 and the ball seat 15 together form an actuating bearing 18th

In conventional training of actuation kinematics for the jaws 4, 5, these are closed in the arrow direction when the actuating rod 13 is pulled in the direction of arrow, ie in the proximal direction. This corresponds to a closing movement in the direction of the arrow between the finger rings 8 and 12.

In a closing movement between z. B. index finger and thumb of a hand relatively high forces are applied effortlessly. If, however, the jaw parts 4, 5 have to be opened in the opposite direction to the direction of the arrow shown in FIG. 1, the finger rings 8, 12 must be moved apart from the direction of the arrow, which is cumbersome for the hand. Such spreading movements of the jaws 4, 5 are both in the use of pliers As well as the use of scissors in some operations required to operate at the surgical site z. B. to push something apart. Then, the configuration discussed so far with reference to FIG. 1 is impractical.

However, the construction shown in FIG. 1 has a second configuration option. In addition to the bearing 9, 10 used for storage according to the representation of FIG. 1, the instrument 1 has a second bearing point which can be used alternatively for supporting the movable handle piece 11 on the stationary grip piece 6.

This second bearing consists of two bearing bores 16, 17, which are formed on the movable handle 11 and the stationary handle 7 ,. The axle pin 10 can be removed at the bearing point 9 and used at the bearing point 16, 17.

It then reverses the kinematics. The movable handle 11 is now pivotally mounted about the bearing 16, 17, which is the bearing 9 with respect to the actuating rod 13 opposite. If the finger rings 8, 12 are moved towards one another in the direction of the arrow, then the actuating rod 13 is moved in the distal direction against the direction of the arrow and the jaw parts 4, 5 are spread in the opposite direction of the arrow.

By simply repositioning the axle pin 10 in one or the other bearing point so the ratio of the directions of movement of the jaw parts 4, 5 to the directions of movement of the handle pieces 7, 11 are reversed.

The problem of the axle pin 10 which is lost during relocation can be solved in a suitable way. It can z. B. also two axle pins, in each case at one and at the other bearing point, movably arranged such net, that when one axle pin is engaged, the other is disengaged and vice versa.

Fig. 2 shows a second embodiment of the instrument 1, wherein for like or similar parts, the reference numerals of Fig. 1 are used.

In this construction, the movable handle is in turn pivotally mounted about the pivot pin 10, which is not fixedly mounted on the fixed handle 7, as in the embodiment of FIG. 1, but sitting at the free end of a lever 20, which about a bearing point 25th pivotally mounted on the main body 6 at a distance from the movable handle piece 11. The axle pin 10 engages in a slot, or a groove 22 in the movable handle piece 11, which extends between two formed as Endabwinkelung 23, 24 bearings. In this Endabwinkelungen 23. 24, the axle pin 10 can engage.

In the thereby predetermined end positions of the pivoting of the lever 20 about the bearing point 25 end stops 26, 27 are provided for the lever 20. If the lever 20 is located on the end stop 26, then the axle pin 10 is located in the lower end angling 23 of the groove 22. The instrument 1 can now be operated in the same configuration as shown in FIG. When closing movement between the finger rings 8, 12, the actuating rod 13 is pulled in the proximal direction.

If the lever 20 is brought into the other end stop at 27, the axle pin 10 is in the upper Endabwinkelung 24. The kinematics is now reversed. During closing movement on the finger rings 8, 12, the actuating rod 13 is pushed in the distal direction, which leads to an opening movement of the jaw parts in the conventional design of the actuating kinematics for the jaw parts. The two embodiments of Figs. 1 and 2 are only preferred examples of possible embodiments of the invention, in which it is essential to change the bearing point on which the movable handle is mounted on the fixed handle, with respect to the position of the actuating rod so can that the bearing is either on one or the other side of the actuating rod. As a result, the relationship between the directions of movement on the handle pieces and on the jaw parts is reversed.

1, the actuating bearing 18 is located substantially centrally between the bearing points 9 and 16. As a result, the actuating bearing 18 always moves on a very flat arc around the respectively used bearing point, and in particular without a larger, the actuating rod bending lateral deflections of the actuating bearing 18 out of the axis of the shaft 2 out.

Claims

CLAIMS: 1. A surgical instrument (1) with a shaft (2), at the proximal end of a manual operation device (7, 11) and at the distal end of a mouth device ⁽ A. 5) is arranged, the two jaws (4, 5) relative to each other of an actuating rod (13) extending along the length of the shaft (2) and engaging at its proximal end with a movable handle (11) of the manual override (7, 11) which moves by hand relative to a fixed movement piece (7) is movable, characterized in that a switching device (10, 9, 16, 17, 10, 20, 22) is provided, with the ratio of the direction of movement of the jaws (4, 5) to the direction of movement of the grips (7, 11) is reversible. 2. Instrument according to claim 1, characterized in that the movable handle piece (11) either at one of two bearing points (9, 16) on the fixed handle piece (7) can be stored, which is in relation to the actuating direction of the actuating rod (13 ) are substantially opposite. 3. Instrument according to claim 2, characterized in that a the actuating rod (13) on the movable handle piece (11) articulating actuating bearing (18) substantially on the line connecting the bearings (9, 16) between them. 4. Instrument according to claim 2 or 3, characterized in that at each bearing point (9, 16) with an axle pin (10) connectable bearing bores (9, 16, 17) are provided in alignment with the two gripping pieces (7, 11) an axle pin (10) is optionally used at one of the bearings. 5. An instrument according to claim 2 or 3, characterized in that a bearing device (10, 20) for supporting the movable handle piece (11) on the fixed Griffstiick (7) on both grips between the two bearing points (23, 24) is designed to be displaceable ,