DE10159470A1 - Surgical device to be used in endoscopy, comprising pre-shaped wire tips for removal of slippery tissue - Google Patents

Surgical device to be used in endoscopy, comprising pre-shaped wire tips for removal of slippery tissue

Info

Publication number
DE10159470A1
DE10159470A1 DE2001159470 DE10159470A DE10159470A1 DE 10159470 A1 DE10159470 A1 DE 10159470A1 DE 2001159470 DE2001159470 DE 2001159470 DE 10159470 A DE10159470 A DE 10159470A DE 10159470 A1 DE10159470 A1 DE 10159470A1
Authority
DE
Germany
Prior art keywords
sleeve
instrument
needles
head end
gripping device
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.)
Granted
Application number
DE2001159470
Other languages
German (de)
Other versions
DE10159470B4 (en
Inventor
Andreas Kirschniak
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.)
Ovesco Endoscopy AG
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
Priority to DE2001159470 priority Critical patent/DE10159470B4/en
Publication of DE10159470A1 publication Critical patent/DE10159470A1/en
Application granted granted Critical
Publication of DE10159470B4 publication Critical patent/DE10159470B4/en
Anticipated expiration legal-status Critical
Expired - Lifetime 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, e.g. tourniquets
    • A61B17/50—Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00349—Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A61B2017/22034—Gripping instruments, e.g. forceps, for removing or smashing calculi for gripping the obstruction or the tissue part from inside

Abstract

The shaft (7) to be moved inside the surgical tube (6) is provided with three pointed wires (3) made of an elastic synthetic material and pre-shaped in order to form hooks when released. When the tool head (4) has reached the tissue to be removed the inner shaft (7) is pushed, the wires (3) unfolded and inserted tangentially into the slippery matter which is safely held during the process of retraction.

Description

Die Erfindung betrifft ein Instrument, das an seinem Kopfende eine Greifvorrichtung aufweist und das vorzugsweise als chirurgisches Instrument mittels eines biegsamen Führungsschlauches endoskopisch mit der Greifvorrichtung voran in das Innere eines hohlen Organs einführbar ist, wobei die Greifvorrichtung mittels einer Handhabe am anderen Ende des Instrumentes betätigbar ist, indem die Greifvorrichtung in eine am Kopfende des Instrumentes vorhandene Hülse eingezogen oder aus dieser ausgefahren wird. The invention relates to an instrument that has a gripping device at its head end and preferably as a surgical instrument by means of a flexible guide hose endoscopically with the gripping device in front the inside of a hollow organ is insertable, the gripping device by means of a Handle on the other end of the instrument can be actuated by the gripping device in a Head end of the existing sleeve retracted or extended.

Alle in der Technik schlechthin und in der chirurgischen Praxis gängigen Greifvorrichtungen bestehen aus zwei- oder mehrarmigen Mechanismen, die den zu ergreifenden Zielgegenstand bzw. das zu ergreifende Zielgewebe von außen übergreifen und beim Schließen der Greifvorrichtung festhalten. Bei chirurgischen Instrumenten ist es bekannt, die Greifvorrichtung am Kopfende einer Hülse zu positionieren, und die Greifarme durch Einziehen der Greifvorrichtung in die am Kopfende des Instrumentes vorhandene Hülse zu schließen. Das geschieht üblicherweise mittels einer Handhabe am anderen Ende des Instrumentes, die mittels eines Zug-Druck-Drahtes oder mittels eines einfachen Zugdrahtes in Art eines Bowdenzuges mit der Greifvorrichtung verbunden ist. All in technology and in par excellence surgical practice common gripping devices consist of two- or multi-arm mechanisms, which the target object to be taken or the Reach over the target tissue to be gripped from the outside and when closing the gripping device hold tight. It is with surgical instruments known, the gripping device at the head of one Position the sleeve and the gripper arms through Pulling the gripping device into the Head end of the instrument's existing sleeve conclude. This is usually done using a handle on the other end of the instrument, by means of a push-pull wire or by means of a simple pull wire in the manner of a Bowden cable connected to the gripping device is.

Solche Greifvorrichtungen arbeiten aus chirurgischer Sicht dann nicht zufriedenstellend, wenn das zu ergreifende Zielgewebe krankhaft verändert oder in der Oberfläche glatt und/oder organbedingt gleitend ist. Das Ergreifen und Festhalten des Zielgewebes ist dann schwierig und unsicher. Such gripping devices work from surgical Visibility is not satisfactory if that's too moving target tissues morbidly changed or the surface is smooth and / or organ-related is sliding. Grasping and holding on to the Target tissue is then difficult and unsafe.

Aufgabe der Erfindung ist es, ein verbessertes Instrument der gattungsgemäßen Art vorzuschlagen, das insbesondere in der chirurgischen Praxis ein sicheres Erfassen und Festhalten des jeweiligen Zielgewebes gewährleistet. The object of the invention is an improved To propose an instrument of the generic type, this is particularly important in surgical practice safe grasping and recording of the respective Guaranteed target tissue.

Diese Aufgabe wird erfindungsgemäß durch eine neue Greifvorrichtung mit den Merkmalen des Kennzeichens des Anspruches 1 gelöst. This object is achieved by a new gripping device with the features of Characteristic of claim 1 solved.

Die neue Greifvorrichtung ist vorzugsweise mit drei Nadeln auszuführen, die relativ zueinander um jeweils 120° versetzt angeordnet sind. Für Sonderfälle sind auch Greifvorrichtungen mit zwei Nadeln auszuführen. The new gripping device is preferably with run three needles that are relative to each other are arranged offset by 120 °. For Special cases are also gripping devices with run two needles.

Die Nadeln der Greifvorrichtung müssen gemäß der Lehre der Erfindung aus einem elastischen Material gefertigt sein. Gemäß Anspruch 2 eignen sich grundsätzlich alle sogenannten Formgedächtnislegierungen, die in dem Anwendungstemperaturbereich superelastische Eigenschaften aufweisen. Insbesondere gilt dies für NiTi-Legierungen. Nadeln aus diesen Legierungen sind extrem elastisch biegsam und können bei entsprechenden Materialabmessungen auch mit sehr geringer Kraft in die kopfseitige Hülse des Instrumentes eingezogen werden. The needles of the gripping device must be in accordance with the Teaching of the invention from an elastic Material be made. According to claim 2 are basically all so-called Shape memory alloys used in the Application temperature range super elastic Have properties. This is especially true for NiTi alloys. Needles out of these Alloys are extremely elastic and flexible can with appropriate material dimensions even with very little force in the head Sleeve of the instrument.

Die Geometrie der Nadelenden in ihrer entlasteten Ursprungsform ist so zu wählen, daß sie in das Zielgewebe möglichst tangential einstechen, damit vollständige Durchstechungen (Perforationen) des Zielgewebes vermieden werden. The geometry of the needle ends in their Relieved original form is to be chosen so that them into the target tissue as tangentially as possible plunge in for complete punctures (Perforations) of the target tissue can be avoided.

Sobald die neue Greifvorrichtung in dem Zielgewebe "verankert" ist, kann dieses mittels des Instrumentes verschoben oder in jede gewünschte Position angehoben werden, was bei chirurgischen Eingriffen und Begutachtungen von besonderem Vorteil ist. As soon as the new gripping device in the Target tissue is "anchored", this can be done using of the instrument shifted or into each desired position to be raised, which at surgical interventions and assessments of is a particular advantage.

Gemäß Anspruch 4 können die Nadeln der neuen Greifvorrichtung auch mit zusätzlichen Befestigungsvorrichtungen zum lösbaren Befestigen von Adaptern versehen sein. Solche Adapter können z. B. Hilfsinstrumente oder zusätzliche Bewegungshilfen sein, aber auch Kapseln o. dergl. zur medikamentösen Versorgung des jeweiligen Zielgewebes. According to claim 4, the needles of the new Gripping device also with additional Fastening devices for releasable fastening be provided by adapters. Such adapters can z. B. auxiliary instruments or additional Be exercise aids, but also capsules or the like drug supply of each Target tissue.

Die neue Greifvorrichtung kann auch für eine Dauerbefestigung von Adaptern an einem Zielgewebe verwendet werden, und zu diesem Zweck sieht Anspruch 3 vor, daß die Nadeln mit dem Grundkörper, von dem sie sich hinwegerstrecken, einstückig ausgebildet sind und daß diese Baueinheit vom Kopfende des Instrumentes lösbar und mit dem Kopfende wieder verbindbar ist. The new gripping device can also be used for one Permanent attachment of adapters to one Target tissues are used and for this purpose provides claim 3 that the needles with the Basic body from which they extend, are integrally formed and that this Unit detachable from the head end of the instrument and can be connected to the head end again.

Nachfolgend wird ein Ausführungsbeispiel der Erfindung anhand der Zeichnungen näher beschrieben. Es zeigen: An embodiment of the Invention with reference to the drawings described. Show it:

Fig. 1 einen Längsschnitt durch die Greifvorrichtung gemäß der Erfindung mit eingezogenen Nadeln, Fig. 1 shows a longitudinal section through the gripping device according to the invention with retracted needles,

Fig. 2 einen Längsschnitt durch die Greifvorrichtung gemäß Fig. 1 mit ausgefahrenen Nadeln. FIG. 2 shows a longitudinal section through the gripping device according to FIG. 1 with the needles extended.

Dargestellt ist eine Greifvorrichtung gemäß der Erfindung mit drei Nadeln 3, die relativ zueinander um jeweils 120° versetzt und einstückig mit einem Grundkörper 4 ausgebildet sind, der im Inneren der Hülse 5 axial verfahrbar gelagert ist. Shown is a gripping device according to the invention with three needles 3 , which are offset by 120 ° relative to each other and are formed in one piece with a base body 4 , which is axially displaceably mounted in the interior of the sleeve 5 .

Die Hülse befindet sich am Kopfende eines chirurgischen Instrumentes, das mittels des biegsamen, spiralgestützten Führungsschlauches 6 mit der Greifvorrichtung voran in das Innere eines Organs eingeführt und bis zu dem Zielgewebe (nicht dargestellt) herangeführt werden kann derart, daß die Nadeln 3 beim Vorfahren des Grundkörpers 4 in Richtung des Kopfendes der Hülse 5 (siehe Fig. 2) in das Zielgewebe einstechen. The sleeve is located at the head end of a surgical instrument which can be inserted into the interior of an organ by means of the flexible, spiral-supported guide tube 6 with the gripping device first and can be brought up to the target tissue (not shown) in such a way that the needles 3 when the body is advanced 4 into the target tissue in the direction of the head end of the sleeve 5 (see FIG. 2).

Fig. 1 zeigt die Nadeln 3 mit dem Grundkörper 4 im vollständig eingezogenen Zustand, in dem die Nadeln elastisch verformt sind und im Inneren der Hülse im wesentlichen achsparallel ausgerichtet und positioniert sind. Fig. 1 shows the needles 3 with the base body 4 in the fully retracted state, in which the needles are elastically deformed and are aligned and positioned essentially axially parallel in the interior of the sleeve.

Fig. 2 zeigt die Nadeln 3 mit dem Grundkörper 4 im vollständig ausgefahrenen Zustand, in dem die Nadeln aufgrund ihrer elastischen Materialeigenschaften in ihre entlastete Ursprungsform zurückgekehrt sind und in der sie sich hakenförmig in dem Zielgewebe verankert haben. Fig. 2 shows the needles 3 with the base body 4 in the fully extended state, in which the needles have returned to their relieved original shape due to their elastic material properties and in which they have anchored in the shape of a hook in the target tissue.

Dabei ist wesentlich, daß das Elastizitätsverhalten der Nadeln dafür sorgt, daß diese beim Vorfahren des Grundkörpers 4 in Richtung des Kopfendes der Hülse 5 in einem etwa radial endenden Bogen aus dem Kopfende der Hülse auslaufen. It is essential that the elasticity behavior of the needles ensures that they run out in an approximately radially ending arc from the head end of the sleeve when the base body 4 is advanced in the direction of the head end of the sleeve 5 .

Das Vorfahren und Zurückfahren des Grundkörpers 4 in der Hülse 5 wird mittels des Drahtes 7 bewirkt, der zug- und druckfest in dem spiralgestützten Führungsschlauch 6 geführt ist und der mittels einer Handhabe am anderen Ende des Instrumentes (nicht dargestellt) betätigt wird. The advancement and retraction of the base body 4 in the sleeve 5 is effected by means of the wire 7 , which is guided in the spiral-supported guide hose 6 in a tensile and compressive manner and which is actuated by means of a handle at the other end of the instrument (not shown).

Claims (4)

1. Instrument,
das an seinem Kopfende eine Greifvorrichtung aufweist
und das vorzugsweise als chirurgisches Instrument mittels eines biegsamen Führungsschlauches endoskopisch mit der Greifvorrichtung voran in das Innere eines hohlen Organs einführbar ist,
wobei die Greifvorrichtung mittels einer Handhabe am anderen Ende des Instrumentes betätigbar ist, indem die Greifvorrichtung in eine am Kopfende des Instrumentes vorhandene Hülse eingezogen oder aus dieser ausgefahren wird,
dadurch gekennzeichnet,
daß die Greifvorrichtung durch zwei oder mehrere elastisch verformbare Nadeln (3) gebildet ist, die sich in Richtung des Kopfendes der Hülse (5) von einem Grundkörper (4) hinwegerstrecken, der im Inneren der Hülse axial verfahrbar gelagert ist,
daß die Nadeln beim axialen Zurückfahren des Grundkörpers in die Hülse eingezogen werden und dabei elastisch verformbar und im Inneren der Hülse im wesentlichen achsparallel ausgerichtet und positioniert sind
und daß die Nadeln beim Vorfahren des Grundkörpers in Richtung des Kopfendes der Hülse in einem etwa radial endenden Bogen und entgegengesetzt zueinander aus dem Kopfende der Hülse auslaufen und dabei in ihre entlastete Ursprungsform zurückkehren, in der sie hakenförmig in einem Zielgewebe des hohlen Organs zu verankern sind. 1. instrument,
which has a gripping device at its head end
and which, preferably as a surgical instrument, can be introduced endoscopically into the interior of a hollow organ with the gripping device first, using a flexible guide tube,
wherein the gripping device can be actuated by means of a handle at the other end of the instrument, by pulling the gripping device into or extending from a sleeve provided at the head end of the instrument,
characterized by
that the gripping device is formed by two or more elastically deformable needles ( 3 ) which extend in the direction of the head end of the sleeve ( 5 ) from a base body ( 4 ) which is axially displaceably mounted in the interior of the sleeve,
that the needles are retracted into the sleeve during the axial retraction of the base body and are elastically deformable and are aligned and positioned essentially axially parallel inside the sleeve
and that the needles run out in an approximately radially ending arc in the direction of the head end of the sleeve in the direction of the head body of the sleeve and opposite to one another from the head end of the sleeve and thereby return to their relieved original form, in which they are to be anchored in the form of a hook in a target tissue of the hollow organ , 2. Instrument nach Anspruch 1, dadurch gekennzeichnet, daß die Nadeln (3) aus einer superelastischen Formgedächtnislegierung, vorzugsweise aus einer NiTi-Legierung gefertigt sind. 2. Instrument according to claim 1, characterized in that the needles ( 3 ) are made of a super-elastic shape memory alloy, preferably of a NiTi alloy. 3. Instrument nach Anspruch 1, dadurch gekennzeichnet,
daß die Nadeln (3) mit dem Grundkörper (4) einstückig ausgebildet sind
und daß diese Baueinheit vom Kopfende des Instrumentes lösbar und mit dem Kopfende des Instrumentes wieder verbindbar ist. 3. Instrument according to claim 1, characterized in
that the needles ( 3 ) with the base body ( 4 ) are integrally formed
and that this unit is detachable from the head end of the instrument and can be connected to the head end of the instrument again. 4. Instrument nach Anspruch 1, dadurch gekennzeichnet, daß die Nadeln im Bereich des Grundkörpers mit einer oder mehreren Befestigungsvorrichtungen zum lösbaren Befestigen von Adaptern versehen ist. 4. Instrument according to claim 1, characterized, that the needles in the area of the body one or more fastening devices is provided for releasably attaching adapters.
DE2001159470 2001-12-04 2001-12-04 Surgical instrument with anchor device at the head end Expired - Lifetime DE10159470B4 (en)

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DE10159470B4 DE10159470B4 (en) 2012-12-13

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EP1721587A1 (en) * 2005-05-13 2006-11-15 Ovesco Endoscopy GmbH Medical device for the modification of the shape of human hollow organs
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US7815655B2 (en) 2005-05-20 2010-10-19 Neotract, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
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EP1721587A1 (en) * 2005-05-13 2006-11-15 Ovesco Endoscopy GmbH Medical device for the modification of the shape of human hollow organs
US9549739B2 (en) 2005-05-20 2017-01-24 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US7905889B2 (en) 2005-05-20 2011-03-15 Neotract, Inc. Integrated handle assembly for anchor delivery system
US7780682B2 (en) 2005-05-20 2010-08-24 Neotract, Inc. Apparatus and method for manipulating or retracting tissue and anatomical structure
US11504149B2 (en) 2005-05-20 2022-11-22 Teleflex Life Sciences Limited Median lobe destruction apparatus and method
US7815655B2 (en) 2005-05-20 2010-10-19 Neotract, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US7896891B2 (en) 2005-05-20 2011-03-01 Neotract, Inc. Apparatus and method for manipulating or retracting tissue and anatomical structure
US10143461B2 (en) 2005-05-20 2018-12-04 Neotract, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US7909836B2 (en) 2005-05-20 2011-03-22 Neotract, Inc. Multi-actuating trigger anchor delivery system
US7914542B2 (en) 2005-05-20 2011-03-29 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US7951158B2 (en) 2005-05-20 2011-05-31 Neotract, Inc. Devices, systems and methods for retracting, lifting, compressing, supporting or repositioning tissues or anatomical structures
US8007503B2 (en) 2005-05-20 2011-08-30 Neotract, Inc. Apparatus and method for manipulating or retracting tissue and anatomical structure
US10195014B2 (en) 2005-05-20 2019-02-05 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US8157815B2 (en) 2005-05-20 2012-04-17 Neotract, Inc. Integrated handle assembly for anchor delivery system
US7758594B2 (en) 2005-05-20 2010-07-20 Neotract, Inc. Devices, systems and methods for treating benign prostatic hyperplasia and other conditions
US8211118B2 (en) 2005-05-20 2012-07-03 Neotract, Inc. Apparatus and method for manipulating or retracting tissue and anatomical structure
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