DE3490450C2 - Instrument zum Einsetzen von chirurgischen Befestigungselementen - Google Patents
Instrument zum Einsetzen von chirurgischen BefestigungselementenInfo
- Publication number
- DE3490450C2 DE3490450C2 DE19843490450 DE3490450A DE3490450C2 DE 3490450 C2 DE3490450 C2 DE 3490450C2 DE 19843490450 DE19843490450 DE 19843490450 DE 3490450 A DE3490450 A DE 3490450A DE 3490450 C2 DE3490450 C2 DE 3490450C2
- Authority
- DE
- Germany
- Prior art keywords
- arrangement
- anvil
- instrument
- holding
- 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.)
- Expired
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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
Description
Die Erfindung betrifft ein Instrument zum Einsetzen von chirur
gischen Befestigungselementen in Körpergeweben nach dem Oberbe
griff des Patentanspruchs 1.
Ein derartiges Instrument ist aus der US-PS 43 83 634 bekannt.
Dabei sind die Klammernhalteanordnungen gegenüber dem Amboß
schwenkbar gelagert, aber auch begrenzt verschiebbar. Mit Hilfe
von Schwenkhebeln wird die Klammernhalteanordnung zu dem Amboß
hingeschwenkt, um das Gewebe zwischen diesen Teilen einzuklem
men. Nach dem Einklemmen des Gewebes werden durch Betätigen
eines Schwenkgriffes mehrere Metallklammern gleichzeitig durch
das Gewebe hindurch vorgetrieben.
Da bei dem vorbekannten Instrument der Abstand zwischen der
Klammernhalteanordnung und dem Amboß nicht einstellbar ist, kann
man nach dem Einklemmen des Gewebes die Lage des Instruments
gegenüber dem Gewebe nicht mehr ändern. Es ist nur möglich, das
Instrument wieder zu öffnen und in eine andere Lage zu bringen,
wenn die zunächst erzielte Lage nicht befriedigend ist.
Aufgabe der Erfindung ist es daher, ein Instrument nach dem Ober
begriff des Patentanspruchs 1 zu schaffen, bei dem eine Verände
rung der Lage des Instruments gegenüber dem Gewebe möglich ist,
ohne daß das Instrument wieder geöffnet werden muß.
Erfindungsgemäß wird diese Aufgabe gelöst durch die kennzeich
nenden Merkmale des Patentanspruchs 1. Die Antriebsanordnung be
sitzt eine Rasteinrichtung, die dazu dient, die Anordnung zum
Halten von Befestigungselementen in einer vorherbestimmten Stel
lung zu verrasten, die zwischen der Stellung liegt, in der die
Antriebseinrichtung beginnt, die Anordnung zum Halten von Be
festigungselementen zu der Amboßanordnung hinzubewegen, und der
Stellung, in der das Gewebe eingeklemmt ist. Dadurch kann die
Lage des Instruments gegenüber dem Gewebe verändert werden, ohne
daß das Instrument wieder geöffnet werden muß.
Vorteilhafte Weiberbildungen der Erfindung sind in den Unteran
sprüchen beschrieben.
Ein Ausführungsbeispiel der Erfindung wird nachstehend anhand
der Zeichnung näher beschrieben. In dieser zeigt
Fig. 1 schaubildlich ein Ausführungsbeispiel des
erfindungsgemäßen Instruments zum Einset
zen von chirurgischen Befestigungselemen
ten,
Fig. 2 im Längsschnitt das Instrument gemäß
der Fig. 1,
Fig. 3 schaubildlich im Detail einen Teil
des Instruments gemäß der Fig. 2,
Fig. 4 in einer der Fig. 3 ähnlichen Dar
stellung das Instrument in einer anderen Phase seines
Arbeitsspiels,
Fig. 5 in einer den Fig. 3 und 4 ähnlichen
Darstellung, in der einige weitere Elemente sichtbar sind,
das Instrument in einer weiteren Phase seines Arbeitsspiels,
Fig. 6 in einer der Fig. 2 ähnlichen Dar
stellung das Instrument in dem in Fig. 4 gezeigten Betriebs
zustand,
Fig. 7 in einer der Fig. 7 ähnlichen Dar
stellung das Instrument in dem in Fig. 5 gezeigten Betriebs
zustand,
Fig. 8 als Teildarstellung einen Schnitt
längs der Linie 8-8 in Fig. 7 und
Fig. 9 in einer der Fig. 7 ähnlichen Dar
stellung das Instrument in seiner weiteren Phase seines
Arbeitsspiels.
In dem dargestellten Ausführungsbei
spiel besitzt das Instrument 10 zum Einsetzen von chirurgi
schen Befestigungselementen einen langgestreckten Schaft 12,
mit dem an seinem proximalen Ende ein Handgriff 14 fest ver
bunden ist und mit dem an seinem distalen Ende eine Anord
nung 16 zum Einsetzen von chirurgischen Befestigungselementen
verbunden ist. Die Anordnung 16 zum Einsetzen von Befesti
gungselementen hat zwei Hauptteile, und zwar eine
Amboßanordnung oder einen Amboß 18, die bzw. der starr mit
dem Schaft 12 verbunden ist, und eine Anordnung 20, die
zum Halten von chirurgischen Befestigungselementen dient
und gegenüber dem Amboß 18 schwenkbar und begrenzt gerad
linig bewegbar gelagert ist. Die Anordnung 20 zum Halten von
chirurgischen Befestigungselementen enthält zunächst eine
Mehrzahl von U-förmigen chirurgischen Metallklammern 22 (Fig. 7),
die in zwei parallelen Reihen angeordnet sind. Gegebenen
falls kann man anstelle der Metallklammern 22 auch zwei
teilige chirurgische Befestigungselemente aus Kunststoff
verwenden, wie sie beispielsweise in der US-PS 40 60 089
(Noiles) gezeigt sind.
Die Anordnung 20 zum Halten der Befesti
gungselemente ist im Bereich ihres in Fig. 2 unteren Endes
mit dem übrigen Instrument verbunden, und zwar durch einen
Zapfen 24, dessen Enden in Langlöcher 26 der Anordnung 20
zum Halten von Befestigungselementen eingreifen. Die Ver
bindung stellt grundlegend eine Schwenklagerung dar. Die
Langlöcher 26 erstrecken sich jedoch parallel zu der Längs
achse des Schaftes 12, so daß sie eine gewisse geradlinige
Bewegung der Anordnung 20 zum Halten von Befestigungsele
menten gegenüber dem Amboß 18 gestatten. Zwischen der
Amboßanordnung 18 und der Anordnung 20 zum Halten von
Befestigungselementen ist eine vorgespannte Druckfeder
28 eingesetzt, die diese Teile auseinanderzudrücken
trachtet, wie dies beispielsweise in den Fig. 1 und
2 gezeigt ist. Dabei liegt die Wirkungslinie der Feder
28 in Fig. 2 oberhalb des Zapfens 24, so daß die Feder
28 auch trachtet, den oberen Teil 20 der Anordnung 20
zum Halten von Befestigungselementen von dem benachbarten
Teil des Ambosses 18 wegzuschwenken.
Die Anordnung 20 zum Halten von Befestigungs
elementen trägt ferner an ihrem von den Langlöchern 26 ent
fernten Ende einen Zapfen 30, der zu der Längsachse des
Schaftes 12 im wesentlichen parallel und in der Anordnung
20 parallel zu seiner Längsachse hin- und herbewegbar ge
lagert ist. Das proximale Ende des Zapfens 30 ist im oberen
Ende der Blattfeder 32 festgelegt, die an ihrem unteren Ende
mit der Anordnung 20 zum Halten von Befestigungselementen
verbunden ist und beispielsweise gemäß den Fig. 1 und 2
den Zapfen in der proximalen Richtung belastet, so daß das
distale Ende des Zapfens 30 zunächst nicht über die distale
Seite der Anordnung 20 zum Halten von Befestigungselementen
vorsteht.
In dem Schaft 12 ist eine Stößelanordnung
50 parallel zu der Längsrichtung des Schaftes 12 hin- und
herbewegbar gelagert. Die Stößelanordnung 50 besitzt zwei
Hauptteile, und zwar den Klemmstößel 52 und den Vortriebs
stößel 54. Der Vortriebsstößel 54 ist in dem Klemmstößel
52 derart gelagert, daß der Vortriebsstößel 54 gegenüber
dem Stößel parallel zu der Längsachse des Schaftes 12 hin-
und herbewegbar ist. Mit dem Schaft 12 einerseits und einem
von dem Vortriebsstößel 54 abwärts vorstehenden Lappen 58
andererseits ist eine vorgespannte Druckfeder 56 verbunden,
die die beiden Teile der Stößelanordnung 50 in der proximalen
Richtung elastisch belastet. Die von der Feder 56 ausgeübte
Rückstellfederkraft wird auf den Klemmstößel 52 durch den
Zapfen 60 übertragen, den der Klemmstößel 52 trägt und der
ein in Fig. 7 gestrichelt angedeutetes Langloch des Vor
triebsstößels 54 durchsetzt und am distalen Ende dieses
Langloches angreift, so daß der Vortriebsstößel 54 sich
gegenüber dem Klemmstößel 52 nur aus der in der Fig. 2
gezeigten Stellung dieser Teile bewegen kann. Im Ausgangs
zustand des Instruments ist das distale Ende der Stößel
anordnung 50 im Abstand von der proximalen Seitenwand der
Anordnung 20 zum Halten von Befestigungselementen angeordnet.
Im Bereich des proximalen Endes der Stößel
anordnung 50 ist der Klemmteil 70 vorgesehen, der zwei
Hauptteile besitzt, und zwar den Klemmhebel 72 und den mit
dem Vortriebsstößel verbundenen Stößelmitnehmer 74. Der
Klemmteil 70 ist durch einen Schwenkzapfen 76 mit dem
Schaft 12 schwenkbar verbunden. Der Stößelmitnehmer 74 ist
im Innern des Hebels 72 parallel zu dessen Längsachse hin-
und herbewegbar gelagert. Zu diesem Zweck sind Zapfen 76
und 78 vorgesehen, die ein (in Fig. 7 gestrichelt ange
deutetes) Langloch des Stößelmitnehmers 74 durchsetzen.
Vorstehend wurde bereits erwähnt, daß die
Rückstellfeder 56 die Stößelanordnung 50 proximal zu bewegen
trachtet. Wie nachstehend näher beschrieben wird, greift
während des größten Teils der Verschwenkung des Klemmteils
70 ein Teil des proximalen Endes der Stößelanordnung 50
in Fig. 2 unterhalb des Schwenkzapfens 76 an dem Klemm
teil 70 an, so daß die Feder 56 über die Stößelanordnung
50 den Klemmteil in Fig. 2 im Gegensinn des Uhrzeigers
um den Zapfen 76 zu verschwenken trachtet.
In dem Schaft 12 ist auf der proximalen
Seite des Klemmteils 70 der Handgriff 90 um den Zapfen
92 schwenkbar gelagert. Der Zapfen 92 ist konzentrisch von
einer nicht gezeigten Schraubenfeder umgeben, die trachtet,
den Handgriff 90 im Uhrzeigersinn um den Zapfen 92 in eine
Stellung zu verschwenken, in der der Handgriff 90 zunächst
mit einem Sicherungsflügel 100 verrastet ist, der durch
einen Zapfen 102 schwenkbar mit dem Handgriff 14 verbunden
ist.
Jetzt sei die Arbeitsvorgangsfolge des
Instruments erläutert. In den Fig. 1 bis 3 ist das Instru
ment in seinem Ausgangszustand gezeigt. Zum Gebrauch des
Instruments wird das festzulegende Gewebe 40 zwischen dem
Amboß 18 und der Anordnung 20 zum Halten von Befestigungs
elementen in das Instrument eingeführt und wird dann der
Klemmteil 70 in die in den Fig. 4 und 6 gezeigte Zwischen
stellung abwärtsgeschwenkt. Während dieser Bewegungsphase
des Klemmteils 70 greift der am distalen Ende des Klemm
hebels 72 ausgebildete Führungsflächenteil 80 a an dem An
schlagflächenteil 62 a an, der am proximalen Ende des Klemm
stößels 52 vorgesehen ist. Infolgedessen wird die Stößel
anordnung 50 distal bewegt. Dabei tritt das distale Ende
des Vortriebsstößels 54 durch ein nicht gezeigtes, vertikales
Langloch der Blattfeder 32, während das distale Ende des
Klemmstößels 52 an der Blattfeder 32 angreift und sie zur
proximalen Seite der Anordnung 20 zum Halten von Befesti
gungselementen hinbewegt. Infolgedessen wird das distale
Ende des Zapfens 30 aus der distalen Seitenwand der Anordnung
20 zum Halten von Befestigungselementen ausgefahren und be
ginnt die Verschwenkung der Anordnung 20 zum Halten von
Befestigungselementen um den Zapfen 24 zu der Amboßanordnung
18 hin. Vorzugsweise ist die Feder 28 so stark, daß sie
während dieser Bewegungsphase der Anordnung 20 zum Halten
von Befestigungselementen den Zapfen 24 im Bereich des
distalen Endes der Langlöcher 26 hält.
Ungefähr in dem Zeitpunkt, in dem der
von dem Zapfen 24 entfernte Teil der distalen Seiten
wand der Anordnung 20 zum Halten von Befestigungselementen
an der Amboßanordnung 18 angreift, greift der Führungs
flächenteil 80 b an dem Anschlagflächenteil 62 b an. Der
Führungsflächenteil 80 b ist ein Teil eines Vorsprunges,
der von der übrigen Führungsfläche 80 a, 80 c vorsteht.
Der Anschlagflächenteil 62 b ist eine dazu komplementäre
Vertiefung in der übrigen Anschlagfläche 62 a, 62 c. Der
Führungsfächenteil 80 b und der Anschlagflächenteil 62 b
sind gegenüber dem übrigen Teil der Führungs- bzw. An
schlagfläche so abgewinkelt, daß sie als Rasteinrichtung wir
ken. Wenn der Klemmteil 70 so weit verschwenkt worden ist,
daß der Führungsflächenteil 80 b und der Anschlagflächenteil
62 b aneinander angreifen, wirken diese Flächenteile derart
miteinander zusammen, daß sie dem Rückwärtsschwenken des
Klemmteils 70 einen Widerstand entgegensetzen. Durch die
Rückstellfeder 56 ist die Stößelanordnung zwar ständig
in der proximalen Richtung belastet, aber nicht genügend
stark, um die Rastwirkung der miteinander zusammenwirkenden
Flächenteile 80 b und 62 b zu überwinden. Daher bleibt das
Instrument infolge der Rastwirkung der Flächenteile 80 b
und 62 b in der in den Fig. 4 und 6 gezeigten Stellung,
auch wenn die Bedienungsperson den Klemmteil 70 vollständig
von dem von Hand ausgeübten Verschwenkungsdruck entlastet.
Daher wird hier manchmal gesagt, daß das in dieser Stellung
befindliche Instrument in einer Zwischenstellung verrastet
ist.
In der Fig. 6 erkennt man, daß bei in
der Zwischenstellung verrastetem Instrument das festzu
legende Gewebe 40 von der Anordnung 16 zum Einsetzen von
chirurgischen Befestigungselementen vollständig umschlossen
ist. Dabei steht der von dem Zapfen 24 entfernte Teil der
Anordnung 20 zum Halten von Befestigungselementen mit der
Amboßanordnung 18 in Berührung oder fast in Berührung und
ist das distale Ende des Zapfens 30 aus der Anordnung 20
zum Halten von Befestigungselementen ausgefahren und hat
es mit dem Eintritt in die Ausnehmung 42 der Amboßanordnung
18 begonnen. Dagegen ist das Gewebe noch nicht mit dem
vollen Klemmdruck beaufschlagt. Daher kann erforderlichen
falls die Lage des Instruments gegenüber dem Gewebe leicht
verändert werden, ohne daß das Instrument wieder geöffnet
wird. Während dieser Lageänderung kann das Gewebe nicht
aus dem Instrument heraustreten, weil das Gewebe in der
vorstehend beschriebenen Weise von dem Instrument voll
ständig umschlossen ist.
Wenn die das Instrument bedienende Person
mit der Anordnung des Gewebes in dem Instrument zufrieden
ist, schwenkt die Bedienungsperson den Klemmteil 70 weiter
abwärts in eine zu dem Schaft 12 parallele Stellung.
Während dieser Bewegungsphase des Klemmteils 70 bewirkt
der Führungsflächenteil 80 c durch seinen Angriff an dem
Anschlagflächenteil 62 c, daß die Stößelanordnung 50 weiter
distal bewegt wird. Dadurch wird die Feder 32 stärker
gespannt, so daß sie die Anordnung 20 zum Halten von
Befestigungselementen näher an die Amboßanordnung 18 heran
bewegt. Dabei wird die Feder 28 zusammengedrückt, der Zapfen 24
zu dem proximalen Ende der Langlöcher 26 hinbewegt und der
Zapfen 30 weiter in die Ausnehmung 42 ausgefahren.
Wenn der Klemmteil 70 vollständig in die in
den Fig. 5, 7 und 8 gezeigte Stellung verschwenkt worden
ist, in der er zu dem Schaft 12 parallel ist, stützt sich
das proximale Ende des Klemmteils 70 an einem Innenteil
des Handgriffes 14 ab. In dieser Stellung ist der Klemm
teil 70 verrastet, weil der Berührungspunkt zwischen den
Flächenteilen 80 c und 62 c oberhalb einer zu dem Schaft 12
parallelen, in Fig. 7 horizontalen Linie liegt, die durch
den Zapfen 76 geht. Im Bereich des proximalen Endes des
Stößelmitnehmers 74 tritt der Handgriffeinsatz 94 in ein
Langloch des Klemmteils 70 ein, und der Zapfen 24 befindet
sich in der Nähe des proximalen Endes der Langlöcher 26.
Die Anordnung 20 zum Halten von Befestigungselementen ist
zu der Amboßanordnung 18 im wesentlichen parallel, und das
Gewebe 40 ist zwischen diesen beiden Anordnungen einge
klemmt. Jetzt ist das Instrument für das Einsetzen der
Befestigungselemente in das Gewebe bereit.
Zum Einsetzen der Befestigungselemente wird
der Sicherungsflügel 100 in Fig. 9 abwärtsgeschwenkt und
der Handgriff 90 zu dem Handgriff 14 hingeschwenkt. Infolge
dessen bewegt der Handgriffeinsatz 94 den Stößelmitnehmer
74 in der distalen Richtung, so daß der Stößelmitnehmer 74
mit seinem distalen Ende an dem Vortriebsstößel 54 an
greift und diesen distal bewegt. Infolgedessen tritt das
distale Ende des Vortriebsstößels 54 in ein Langloch in der
proximalen Seitenwand der Anordnung 20 zum Halten von Be
festigungselementen ein und bewegt mehrere je einem
Befestigungselement zugeordnete Einzelstößel 34 in der
distalen Richtung. Infolgedessen schieben die Einzel
stößel 34 je eine zugeordnete Klammer 22 aus der Anordnung
20 zum Halten von Befestigungselementen heraus. Die Schenkel
jeder Klammer treten durch das Gewebe hindurch und werden
zum Festlegen des Gewebes von der Amboßanordnung 18
gebogen.
Zum Entfernen des festgelegten Gewebes
aus dem Instrument läßt die Bedienungsperson zunächst
den Handgriff 90 los, so daß die Rückstellfeder 56 den
Stößel 54 und den Stößelmitnehmer 74 zurückzieht und den
Handgriff 90 in seine Ausgangsstellung zurückstellt. Dann
drückt die Bedienungsperson das proximale Ende des Klemm
teils 70 aufwärts, wobei sie die Rückstellfederkraft über
windet, die in der vorstehend beschriebenen Weise den
Klemmteil während des Einsetzens von Befestigungselementen
verrastend niederhält. Wenn die Rastkraft überwunden ist,
zieht die Rückstellfeder 56 die Stößelanordnung 50 ein und
schwenkt den Klemmteil in den Fig. 1, 2, 6, 7 und 8
im Gegensinn des Uhrzeigers. Dabei kann der Klemmteil 70
in der Zwischenstellung in der der Führungsflächenteil
80 b und der Anschlagflächenteil 62 b eine Verrastung bewirken,
angehalten werden oder nicht. Wenn der Klemmteil 70 in
der genannten Stellung nicht angehalten wird, bewegt er
sich mit Unterstützung einer schwachen von Hand ausgeübten
Kraft weiter. Am Ende des Rückstellhubes des Instruments
befinden sich der Klemmteil 70, die Stößelanordnung 50
und die Anordnung 20 zum Halten von Befestigungselementen
alle in ihren beispielsweise in den Fig. 1 und 2 gezeigten
Ausgangsstellungen und kann das festgelegte Gewebe aus dem
Instrument herausgenommen werden.
Es versteht sich, daß der Erfindungsgedanke
nur beispielsweise erläutert worden ist und daß der Fachmann
im Rahmen des Erfindungsgedankens verschiedene Abänderungen
vornehmen kann. Beispielsweise können, wie vorstehend
erwähnt wurde, anstelle der in der vorstehend beschriebenen
Ausführungsform verwendeten Metallklammern auch zwei
teilige chirurgische Befestigungselemente der in der
US-PS 40 60 089 dargestellten Art verwendet werden.
Claims (8)
1. Instrument zum Einsetzen von chirurgischen Befestigungselemen
ten in Körpergewebe, bestehend aus
einer Antriebseinrichtung, die eine Amboßanordnung trägt,
und einer Anordnung zum Halten von Befestigungselementen, die gegenüber der Amboßanordnung bewegbar gelagert und von der Antriebseinrichtung zu der Amboßanordnung hinbewegbar ist, um das festzulegende Körpergewebe dadurch einzuklemmen,
dadurch gekennzeichnet, daß die Antriebseinrichtung eine Rasteinrichtung (62 b, 80 b) besitzt, die dazu dient, die Anordnung (20) zum Halten von Befestigungselementen (22) in einer vorherbestimmten Stellung zu verrasten, die zwischen der Stellung liegt, in der die An triebseinrichtung beginnt, die Anordnung (20) zum Halten von Befestigungselementen (22) zu der Amboßanordnung (18) hinzu bewegen, und der Stellung, in der das Gewebe (40) eingeklemmt ist.
einer Antriebseinrichtung, die eine Amboßanordnung trägt,
und einer Anordnung zum Halten von Befestigungselementen, die gegenüber der Amboßanordnung bewegbar gelagert und von der Antriebseinrichtung zu der Amboßanordnung hinbewegbar ist, um das festzulegende Körpergewebe dadurch einzuklemmen,
dadurch gekennzeichnet, daß die Antriebseinrichtung eine Rasteinrichtung (62 b, 80 b) besitzt, die dazu dient, die Anordnung (20) zum Halten von Befestigungselementen (22) in einer vorherbestimmten Stellung zu verrasten, die zwischen der Stellung liegt, in der die An triebseinrichtung beginnt, die Anordnung (20) zum Halten von Befestigungselementen (22) zu der Amboßanordnung (18) hinzu bewegen, und der Stellung, in der das Gewebe (40) eingeklemmt ist.
2. Instrument nach Anspruch 1, dadurch gekennzeichnet, daß die
Antriebseinrichtung ein schwenkbares Betätigungsglied (70)
besitzt und die Rasteinrichtung (62 b, 80 b) geeignet ist, das
Betätigungsglied (70) in einer vorherbestimmten Stellung zu
verrasten.
3. Instrument nach Anspruch 2, dadurch gekennzeichnet, daß die
Antriebseinrichtung einen Stößel (50) besitzt, der mit der
Anordnung (20) zum Halten von Befestigungselementen (22) in
Wirkungsverbindung steht und durch ein Verschwenken des Be
tätigungsgliedes (70) geradlinig verschiebbar ist.
4. Instrument nach Anspruch 3, dadurch gekennzeichnet, daß an
dem Betätigungsglied (70) eine Führungsfläche (80) und an dem
Stößel (50) eine an der Führungsfläche (80) anliegende
Anschlagfläche (62) vorgesehen ist.
5. Instrument nach Anspruch 4, dadurch gekennzeichnet, daß die
Rasteinrichtung miteinander zusammenwirkende Segmente der Füh
rungsfläche (80 a, 80 b, 80 c) und der Anschlagfläche (62 a, 62 b,
62 c) umfaßt.
6. Instrument nach einem der vorhergehenden Ansprüche, dadurch
gekennzeichnet, daß die Amboßanordnung (18) und die Anordnung
(20) zum Halten von Befestigungselementen (22) beide langge
streckt sind und die Längsachsen der Amboßanordnung (18) und
der Anordnung (20) zum Halten von Befestigungselementen (22)
während der Betätigung der Antriebseinrichtung stets in einer
Ebene liegen.
7. Instrument nach Anspruch 6, dadurch gekennzeichnet, daß die
Anordnung (20) zum Halten von Befestigungselementen (22) im
Bereich eines ihrer Enden um ein Ende der Amboßanordnung (18)
schwenkbar gelagert ist und im Bereich ihres von der Schwenk
lagerung (24) entfernten Endes eine Einrichtung (30) besitzt,
die dazu dient, an der Amboßanordnung (18) im Bereich deren
von der Schwenklagerung (24) entfernten Endes anzugreifen,
wenn die Anordnung (20) zum Halten von Befestigungselementen
(22) um einen vorherbestimmten Winkel zu der Amboßanordnung
(18) hin verschwenkt worden ist.
8. Instrument nach Anspruch 7, dadurch gekennzeichnet, daß die
Rasteinrichtung (62 b, 80 b) wirksam wird, wenn die Einrichtung
(30) zum Angriff an der Amboßanordnung (18) an dieser
angreift.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US06/538,830 US4530453A (en) | 1983-10-04 | 1983-10-04 | Surgical fastener applying apparatus |
PCT/US1984/001436 WO1985001428A1 (en) | 1983-10-04 | 1984-09-10 | Surgical fastener applying apparatus |
Publications (1)
Publication Number | Publication Date |
---|---|
DE3490450C2 true DE3490450C2 (de) | 1987-10-08 |
Family
ID=24148597
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19843490450 Pending DE3490450T (de) | 1983-10-04 | 1984-09-10 | Instrument zum Einsetzen von chirurgischen Befestigungselementen |
DE19843490450 Expired DE3490450C2 (de) | 1983-10-04 | 1984-09-10 | Instrument zum Einsetzen von chirurgischen Befestigungselementen |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19843490450 Pending DE3490450T (de) | 1983-10-04 | 1984-09-10 | Instrument zum Einsetzen von chirurgischen Befestigungselementen |
Country Status (10)
Country | Link |
---|---|
US (1) | US4530453A (de) |
EP (1) | EP0136950B1 (de) |
JP (1) | JPS60501993A (de) |
AT (1) | ATE28123T1 (de) |
AU (1) | AU568879B2 (de) |
BR (1) | BR8407102A (de) |
CA (1) | CA1235973A (de) |
DE (2) | DE3490450T (de) |
GB (1) | GB2158387B (de) |
WO (1) | WO1985001428A1 (de) |
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US4060089A (en) * | 1975-09-03 | 1977-11-29 | United States Surgical Corporation | Surgical fastening method and device therefor |
US4354628A (en) * | 1980-09-29 | 1982-10-19 | United States Surgical Corporation | Surgical stapler apparatus having pivotally related staple holder and anvil |
US4383634A (en) * | 1981-05-26 | 1983-05-17 | United States Surgical Corporation | Surgical stapler apparatus with pivotally mounted actuator assemblies |
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US2853074A (en) * | 1956-06-15 | 1958-09-23 | Edward A Olson | Stapling instrument for surgical purposes |
US2891250A (en) * | 1956-10-15 | 1959-06-23 | Hirata Yasuhiro | Bronchus seaming instrument |
DE1835500U (de) | 1961-04-07 | 1961-07-27 | Heinrich C Ulrich | Verklammerungsgeraet zur blutungsstillenden quetschung und verklammerung des bronchialstumpfes und der mit diesem in verbindung stehenden lungenlappen mit ihren segmenten. |
US3273211A (en) * | 1963-11-29 | 1966-09-20 | Archer Daniels Midland Co | Process of molding exothermic compositions |
US3275211A (en) * | 1965-05-10 | 1966-09-27 | United States Surgical Corp | Surgical stapler with replaceable cartridge |
US4296881A (en) * | 1980-04-03 | 1981-10-27 | Sukoo Lee | Surgical stapler using cartridge |
US4402444A (en) * | 1981-04-20 | 1983-09-06 | United States Surgical Corporation | Surgical stapling instrument with automatic frame reinforcement |
-
1983
- 1983-10-04 US US06/538,830 patent/US4530453A/en not_active Expired - Lifetime
-
1984
- 1984-09-10 DE DE19843490450 patent/DE3490450T/de active Pending
- 1984-09-10 DE DE19843490450 patent/DE3490450C2/de not_active Expired
- 1984-09-10 WO PCT/US1984/001436 patent/WO1985001428A1/en active Application Filing
- 1984-09-10 BR BR8407102A patent/BR8407102A/pt unknown
- 1984-09-10 JP JP59503309A patent/JPS60501993A/ja active Granted
- 1984-09-10 GB GB08513119A patent/GB2158387B/en not_active Expired
- 1984-09-21 AU AU33371/84A patent/AU568879B2/en not_active Expired
- 1984-09-27 EP EP84401938A patent/EP0136950B1/de not_active Expired
- 1984-09-27 AT AT84401938T patent/ATE28123T1/de not_active IP Right Cessation
- 1984-10-01 CA CA000464424A patent/CA1235973A/en not_active Expired
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4060089A (en) * | 1975-09-03 | 1977-11-29 | United States Surgical Corporation | Surgical fastening method and device therefor |
US4354628A (en) * | 1980-09-29 | 1982-10-19 | United States Surgical Corporation | Surgical stapler apparatus having pivotally related staple holder and anvil |
US4383634A (en) * | 1981-05-26 | 1983-05-17 | United States Surgical Corporation | Surgical stapler apparatus with pivotally mounted actuator assemblies |
Also Published As
Publication number | Publication date |
---|---|
CA1235973A (en) | 1988-05-03 |
GB2158387A (en) | 1985-11-13 |
BR8407102A (pt) | 1985-08-27 |
ATE28123T1 (de) | 1987-07-15 |
EP0136950A3 (en) | 1985-05-22 |
AU568879B2 (en) | 1988-01-14 |
DE3490450T (de) | 1985-10-17 |
JPS6332457B2 (de) | 1988-06-30 |
WO1985001428A1 (en) | 1985-04-11 |
EP0136950A2 (de) | 1985-04-10 |
GB8513119D0 (en) | 1985-06-26 |
EP0136950B1 (de) | 1987-07-08 |
US4530453A (en) | 1985-07-23 |
GB2158387B (en) | 1987-02-04 |
JPS60501993A (ja) | 1985-11-21 |
AU3337184A (en) | 1985-04-18 |
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