[go: up one dir, main page]

WO2018233773A1 - Instrument médical - Google Patents

Instrument médical Download PDF

Info

Publication number
WO2018233773A1
WO2018233773A1 PCT/DE2018/100578 DE2018100578W WO2018233773A1 WO 2018233773 A1 WO2018233773 A1 WO 2018233773A1 DE 2018100578 W DE2018100578 W DE 2018100578W WO 2018233773 A1 WO2018233773 A1 WO 2018233773A1
Authority
WO
WIPO (PCT)
Prior art keywords
jaw
medical instrument
joint
sleeve
instrument according
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/DE2018/100578
Other languages
German (de)
English (en)
Inventor
Josef Heinen
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 WO2018233773A1 publication Critical patent/WO2018233773A1/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
    • 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
    • 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
    • A61B2017/2939—Details of linkages or pivot points
    • 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
    • A61B2017/2939—Details of linkages or pivot points
    • A61B2017/294—Connection of actuating rod to jaw, e.g. releasable
    • 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

  • a so-called "Overholt” is a surgical instrument in the form of a slightly curved dissecting clamp with pointed but rounded ends, which are used, for example, for clamping and dissecting vessels.
  • This type dissecting clamp is named after the American thoracic surgeon Richard Overholt.
  • a surgical dissecting clamp is described according to Overholt. This has two branches with mostly fluted jaws, so you can capture the tissue better, but without damaging it.
  • the Dissecting Clamp after Overholt has a spectacle handle and is operated by hand.
  • a Overholt dissecting clamp is provided as a functional unit at the distal end of the laparoscopic instrument and thus can be operated from outside the abdominal cavity during a minimally invasive procedure.
  • the gripping element comprises two mutually movable pliers arms, each with a clamping surface for preferably atraumatic clamping of hollow organs, organs or vessels.
  • the clamping mechanism for the movement of the pliers arms comprises
  • a displaceably arranged in the tubular housing of the gripping member piston in the displacement of the forceps arms can be opened and closed via a kind of articulated parallelogram.
  • the two mutually movable gun arms with the jaws are identical in this known device and functionally equivalent.
  • a disadvantage of the known medical instruments of this type is, inter alia, the fact that they can not be dismantled or not easy. This has the consequence that the cleaning of the device is quite complex.
  • both jaws end proximally approximately at the level of the coupling ball of the joint rod. It then connects to the proximal end of an annular body and as a separate component to the two jaws, a tubular body is provided with a distal extension, which in turn receives a pull / push rod over which the joint rod is operated, the distal extension turn in the shaft of the instrument is added.
  • a tubular body is provided with a distal extension, which in turn receives a pull / push rod over which the joint rod is operated, the distal extension turn in the shaft of the instrument is added.
  • the mounting of the bearing pin should be facilitated here, but it is not intended that the two jaws can be easily disassembled after moving the sleeve. Rather, this is a disposable instrument, that is a disposable article for single use, so that here the question of disassembly of the jaws for the purpose of better cleaning of the instrument does not arise.
  • the sleeve here has a continuous slot in the axis-parallel direction, so it is open at the periphery.
  • US 2016/0199087 A1 also describes a medical instrument of this type in which the jaws open via a hinge rod with a ball at the front end to let. Again, a kind of pin or sap extending in the transverse direction is used to connect the jaws together. Since the sap does not protrude laterally in the installed state, it can not be disassembled by the user without further ado.
  • One of the jaws is also screwed by a thread at its proximal end with a threaded sleeve, which concentrically surrounds an extension of the joint rod.
  • the object of the present invention is to provide a medical instrument of the aforementioned type, which can be disassembled well, so that the resulting after dismantling items can be cleaned better.
  • Another object of the present invention is to provide a medical instrument of the aforementioned type which has greater versatility with respect to the use of the instrument in endoscopic procedures.
  • the medical device according to the invention further comprises a sleeve which is removable from the medical instrument and which is pushed onto a shaft portion of the second longer jaw, such that they are in a mounted end position to the hinge portion of the articulated connection of the two Jaws extending, wherein after removing the sleeve of the shaft portion of the second longer jaw, the two jaws and the hinge rod are removable.
  • the medical instrument can thus be dismantled easily by the user in a few simple steps. This only has to move the sleeve to the proximal region and then already the two jaws and the hinge rod can be solved with the coupling ball from each other.
  • inventive solution neither screw nor pins or cotter pins in the joint area, which require the aid of a tool for the release of fasteners and / or special expertise.
  • the device can be cleaned so thoroughly that it is then absolutely germ-free and meets the high hygienic requirements in the surgical field and can therefore be reused.
  • the sleeve is advanced to its final position and then rotated, for example, about its axis until a locking takes place, so that a fixation of the sleeve is given in this end position from which they themselves can not solve unintentionally. Due to the remaining components received by the sleeve, a tension is also created after the assembly process, so that they are securely bordered by the sleeve, but the latter can not yield outward in the radial direction.
  • the sleeve is made of a rigid metallic material. The determination of the sleeve in the deferred end position could also be achieved in other ways, for example by means of a screw connection achieved by means of rotation, if a thread is provided on the sleeve.
  • the coupling ball at the front end of the hinge rod cooperates with the ball seat on the shorter jaw and forms the hinge about which the shorter jaw pivots when it opens, which is done by advancing the hinge rod in the axial direction.
  • the longer jaw continues on its back beyond the joint out to the proximal end of the instrument away and takes the joint rod axially displaceable in itself.
  • the longer jaw further has a positive reception for Generalkugelanformung in the joint region of the shorter jaw, so that the shorter jaw is guided and held in its pivotal movement in this recording of the longer jaw.
  • the shorter jaw can not be moved in the axial direction with axial feed of the joint rod and instead performs a pivoting movement about the arranged in the center of Generalkugelanformung hinge axis.
  • the opening and closing of the two jaws is thus effected in the inventive solution by three components, namely the shorter jaw with Ambikugelanformung, the longer jaw with their inclusion for Generalkugelanformung, these two component areas form the joint area, and by a piece in axial direction movable joint rod, which forms the actuating element for the joint function.
  • a joint fork is provided in the joint region of the shorter jaw, which forms the ball seat for the coupling ball of the joint rod.
  • the coupling ball of the joint rod can thus act directly on the joint area during advancement of the joint rod and cause the pivoting movement of the shorter jaw to open the jaws.
  • the hollow shaft is preferably formed by an axial extension of the second longer jaw toward the proximal end of the instrument. The hollow shaft can thus be mounted directly on the second jaw or formed integrally therewith. This reduces the number of components required for the function of the medical instrument.
  • a preferred embodiment of the invention provides that the hollow shaft has a proximal portion in which a preferably thickened trained area of the hinge rod is guided approximately positively. This allows a good guidance of the hinge rod in the hollow shaft of the longer jaw.
  • a preferred advantageous feature is that adjoins the thickened trained portion of the hinge rod to the distal end, a shaft portion of the hinge rod with a smaller diameter at the distal end of which is the coupling ball of the joint rod. Due to this smaller diameter of the joint rod in the hollow shaft of the instrument has some radial play.
  • the shaft portion of the joint rod with a smaller diameter is formed slightly curved in itself. This makes it possible to achieve a lever effect on the joint rod, by means of which one can achieve a pivotal movement of the shorter jaw and thus the opening of the jaws of the instrument.
  • the sleeve is removable by pulling the proximal end of the instrument out of the shaft portion of the second longer jaw.
  • the sleeve is located at the distal end of the sleeve in a side view approximately rectangular recess on the circumference of the sleeve, which is there to ensure the mobility of the upper jaw in the joint area.
  • the sleeve is closed over its circumference, particularly preferably up to a distal region in which there is a rectangular recess. Due to the closed sleeve results in an all-round enclosure of the components in the joint area, which is not yielding in the radial direction in the presence of forces due to the handling of the jaws, so does not spread.
  • Figure 1 is a side view of the front portion of a medical instrument according to the invention according to a possible embodiment of the present invention in the open state;
  • Figure 2 is a plan view of the medical instrument of Figure 1 in partial longitudinal section;
  • Figure 3 is a cross-section of the medical instrument taken along the line A-A of Figure 2;
  • FIG. 4 a longitudinal section through the medical instrument of FIG. 1 in the opened state
  • FIG. 5 shows a corresponding longitudinal section through the medical instrument of FIG. 1 in the closed state
  • Figure 6 is a partial view of the upper jaw of the instrument seen from below;
  • Figure 7 is a side view of the upper jaw of Figure 6;
  • Figure 8 is a view of the upper jaw from above;
  • Figure 9 shows a cross section through the upper jaw along the line BB of Figure 6;
  • Figure 10 is a partial view of the lower jaw of the instrument seen from above;
  • Figure 11 is a side view of the upper jaw;
  • Figure 12 is a sectional view through the upper jaw taken along the line E-E of Figure 1 1;
  • Figure 13 is a sectional view through the upper jaw taken along line D-D of Figure 10;
  • Figure 14 is a sectional view through the upper jaw taken along the line C-C of Figure 10;
  • Figure 15 is a view of the hinge rod of the medical instrument;
  • Figure 16 is a view of the sleeve of the medical instrument; 17 shows a longitudinal section through the sleeve of FIG. 16.
  • the medical instrument 10 comprises two clamping jaws 11, 12, which are each shown in the opened state in FIGS. 1 and 4 and are shown in the closed state in FIG.
  • the medical instrument 10 consists essentially of four components in the front region relevant here, which is shown in FIGS. 1 to 5. These are the lower clamping jaw 11, the upper clamping jaw 12, the inner joint rod 13 and a sleeve 14, which is pushed over the lower clamping jaw 11 in the joint region and surrounds this in its shaft region.
  • both clamping jaws 1 1, 12 each have a type of saw tooth profile 15 in the area facing each other in longitudinal section, so that a better clamping effect is achieved.
  • the front end of the hinge rod 13 has an integrally formed coupling ball 16 which engages in a yoke 12 a with a spherical shell 17, this receptacle 17 is located at the rear end of the upper jaw 12.
  • This spherical shell-shaped receptacle 17 and the connection between the spherical shell-shaped receptacle 17 of the upper clamping jaw and the coupling ball 16 of the joint rod 13 can also be clearly seen in FIG.
  • the section exactly in the region of the seat of Coupling ball 16 is located in the spherical shell 17, these relationships are also clear.
  • FIG. 2 also shows how the rear (proximal) region of the upper jaw 12, on which the receptacle for the coupling ball 16 is located, lies inside the hollow shaft 18 of the lower jaw 11, this hollow shaft extending towards the proximal end of the lower jaw 11 (ie to the rear end) connects to the actual jaw region of the jaw.
  • This hollow shaft 18 is in turn concentrically within the sleeve 14th
  • FIGS. 6 to 9 Further details regarding the upper jaw 12 will become apparent from FIGS. 6 to 9, to which reference will now be made.
  • the ground plan form of the jaw which is slightly curved in the front distal end region at the tip 12 b, as is usual with dissecting clamps according to Overholt.
  • FIG. 6 The cross section through the upper jaw 12 is shown in FIG. It can be seen that the upper jaw 12 is rounded on the upper side, while it is flat on the underside, since it rests there on the top of the lower jaw 11 in the closed state.
  • the bottom view according to FIG. 6 shows that the upper jaw 12 is somewhat wider in the region facing the joint in front of the cross section BB, then a section towards the distal end follows with approximately constant width and then the upper jaw 12 tapers towards the top 12 b and thereby describes a slight arc.
  • the lower jaw 11 is described below with reference to FIGS. 10 to 14, which, like FIG. 10, has a similar outline shape in the front sections as described above for the upper jaw 12, towards the tip Tapered and bent slightly to the side.
  • the lower jaw 11 On the upper side, the lower jaw 11 is flat, while it is rounded on the underside, as the cross section C-C illustrated in FIG 14.
  • the lower jaw 1 1 is longer than the upper jaw 12, since the former extends beyond the hinge portion 11 a, which is shown in the section DD of Figure 13, further to the rear (ie towards the proximal end of the instrument out), wherein There, the lower jaw 1 1 is formed as a hollow shaft 18, as can be seen also on the basis of the cross section EE, which is shown in Figure 12. It can also be seen from FIGS.
  • FIG. 1 shows the assembled state, which shows the end position of the sleeve 14 pushed over the joint area.
  • the hollow shaft 18 has a smaller diameter.
  • a bayonet 23 In the proximal rear portion of the shaft of the lower jaw 1 1 is also a bayonet 23, so that one can attach the shank of the lower jaw and thus the Overholt to a tubular shaft or the like of a laparoscopic instrument, by which the handling of the opening function of the jaws 11, 12 and the medical instrument in total.
  • the articulated rod 13 shown by itself in FIG. 15 with its coupling ball 16 at the front end has a rear proximal thickened shaft portion 21 which is guided in the hollow shaft 18. Since this shaft portion 21 is thickened, it is approximately suitably received and guided in the tubular cavity 22 (see FIG.
  • the sleeve 14 is shown by itself. It can be seen that, in principle, it is a tubular, hollow-cylindrical component which is open at its two axial ends. Only at the distal end 14 a of the sleeve 14 is a side view approximately rectangular recess 14 b on the circumference of the sleeve 14, which is there to make the mobility of the upper jaw 12 in the joint area safe.

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

La présente invention concerne un instrument médical destiné des interventions laparoscopiques en chirurgie mini-invasive, qui peut être introduit par le biais d'un trocart dans la cavité abdominale d'un patient et qui comporte à son extrémité distale une unité fonctionnelle se présentant sous la forme d'un élément de préhension. Cette unité fonctionnelle peut être actionnée par le biais d'une unité de commande située à l'extrémité proximale de l'instrument. L'élément de préhension est conçu comme une pince de dissection pourvue de deux mâchoires de serrage (11, 12) mobiles de façon articulée par le biais d'un mécanisme d'articulation et, selon l'invention, le mécanisme d'articulation comprend une barre d'articulation (13), pouvant coulisser dans la direction axiale et munie d'une rotule d'accouplement côté extrémité (16), en outre une première mâchoire de serrage pivotante plus courte (12) qui comprend un siège de rotule (17) destiné à la rotule d'accouplement (16) de la barre d'articulation (13) et une deuxième mâchoire plus longue (11) qui est munie d'un arbre creux (18) dans lequel la barre d'articulation (13) est guidée de manière à pouvoir coulisser axialement.
PCT/DE2018/100578 2017-06-21 2018-06-20 Instrument médical Ceased WO2018233773A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE202017103689.8U DE202017103689U1 (de) 2017-06-21 2017-06-21 Medizinisches Instrument
DE202017103689.8 2017-06-21

Publications (1)

Publication Number Publication Date
WO2018233773A1 true WO2018233773A1 (fr) 2018-12-27

Family

ID=59382413

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE2018/100578 Ceased WO2018233773A1 (fr) 2017-06-21 2018-06-20 Instrument médical

Country Status (2)

Country Link
DE (1) DE202017103689U1 (fr)
WO (1) WO2018233773A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN118873183A (zh) * 2024-08-19 2024-11-01 中国医学科学院北京协和医院 一种可控制方向及大小的新型活检钳

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108161785A (zh) * 2018-01-31 2018-06-15 黄河科技学院 一种医疗器械专用夹具

Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE6808486U (de) 1968-11-25 1969-08-07 Gerhard Dr Med Metz Praeparier- und unterbindungsrinne zur praeliminaren blutstillung
DE29701050U1 (de) * 1997-01-22 1997-03-06 Aesculap Ag, 78532 Tuttlingen Chirurgisches Instrument
US5810864A (en) * 1995-09-03 1998-09-22 Schaller; Guenter Surgical instrument system
US5893875A (en) * 1994-10-07 1999-04-13 Tnco, Inc. Surgical instrument with replaceable jaw assembly
DE202007013372U1 (de) 2007-09-18 2007-11-22 Aesculap Ag & Co. Kg Chirurgisches Rohrschaftinstrument
WO2010121282A1 (fr) 2009-04-23 2010-10-28 A.M.I. Agency For Medical Innovations Gmbh Instrument chirurgical
WO2012051200A2 (fr) * 2010-10-11 2012-04-19 Cook Medical Technologies Llc Dispositifs médicaux avec mâchoires pivotantes amovibles
US9044258B2 (en) * 2011-12-27 2015-06-02 Specialty Surgical Instrumentation Inc. Instrument with removable tip
DE102014117393A1 (de) 2013-12-19 2015-06-25 Karl Storz Gmbh & Co. Kg Dreh- und abwinkelbares medizinisches Instrument
US20160199087A1 (en) 2012-06-20 2016-07-14 Peter Scott Borden Adjustable tissue cutter tool

Patent Citations (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE6808486U (de) 1968-11-25 1969-08-07 Gerhard Dr Med Metz Praeparier- und unterbindungsrinne zur praeliminaren blutstillung
US5893875A (en) * 1994-10-07 1999-04-13 Tnco, Inc. Surgical instrument with replaceable jaw assembly
US5810864A (en) * 1995-09-03 1998-09-22 Schaller; Guenter Surgical instrument system
DE29701050U1 (de) * 1997-01-22 1997-03-06 Aesculap Ag, 78532 Tuttlingen Chirurgisches Instrument
DE202007013372U1 (de) 2007-09-18 2007-11-22 Aesculap Ag & Co. Kg Chirurgisches Rohrschaftinstrument
WO2010121282A1 (fr) 2009-04-23 2010-10-28 A.M.I. Agency For Medical Innovations Gmbh Instrument chirurgical
WO2012051200A2 (fr) * 2010-10-11 2012-04-19 Cook Medical Technologies Llc Dispositifs médicaux avec mâchoires pivotantes amovibles
US9044258B2 (en) * 2011-12-27 2015-06-02 Specialty Surgical Instrumentation Inc. Instrument with removable tip
US20160199087A1 (en) 2012-06-20 2016-07-14 Peter Scott Borden Adjustable tissue cutter tool
DE102014117393A1 (de) 2013-12-19 2015-06-25 Karl Storz Gmbh & Co. Kg Dreh- und abwinkelbares medizinisches Instrument

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN118873183A (zh) * 2024-08-19 2024-11-01 中国医学科学院北京协和医院 一种可控制方向及大小的新型活检钳

Also Published As

Publication number Publication date
DE202017103689U1 (de) 2017-06-29

Similar Documents

Publication Publication Date Title
DE19704580C2 (de) Chirurgischer Fadenschneider
DE19832303C2 (de) Schraubendreher
EP0977513B1 (fr) Instrument medical a tige coulissante
DE19833600A1 (de) Medizinische Zange mit zwei unabhängig voneinander beweglichen Maulteilen
EP1176912A2 (fr) Retracteur utilise en chirurgie endoscopique, instrument medical pour l'introduction d'un retracteur, et procede d'utilisation d'un retracteur en chirurgie endoscopique
EP0613660A1 (fr) Pince chirurgicale
EP2335609A1 (fr) Instrument chirurgical
EP2497433B1 (fr) Système de trocart multiple
EP2769682A1 (fr) Instrument endoscopique et tige pour un instrument endoscopique
EP3005957A1 (fr) Instrument chirurgical
EP0871403B1 (fr) Dispositif pour effectuer des manipulations a l'interieur du corps humain, notamment de l'uterus
EP0797407B1 (fr) Instrument chirurgical
DE19707374C2 (de) Medizinischer Dissektionsspatel mit spreizbaren Spatelmaulteilen
WO2018233773A1 (fr) Instrument médical
EP0926994B1 (fr) Pince chirurgicale de prehension et de maintien
EP1587434B1 (fr) Instrument medical pour la dissection de tissus
DE10341561A1 (de) Uterus-Manipulator
DE10145107B4 (de) Füllstab für Endoskope
EP1199989B1 (fr) Instrument medical pour creer une cavite afin de pratiquer une intervention endoscopique
DE202007000427U1 (de) Chirurgischer Haltegriff und chirurgisches Instrument
DE102013005874A1 (de) Griffstück für ein chirurgisches lnstrument
DE102017113717A1 (de) Medizinisches instrument
DE10022861C2 (de) Führungsstab für in eine Körperhöhle einzuführende Rohrschaftinstrumente
DE102007001752B4 (de) Chirurgischer Handgriff und chirurgisches Instrument
DE7817887U1 (fr)

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 18737800

Country of ref document: EP

Kind code of ref document: A1

122 Ep: pct application non-entry in european phase

Ref document number: 18737800

Country of ref document: EP

Kind code of ref document: A1