WO2010046014A1

WO2010046014A1 - Surgical instrument

Info

Publication number: WO2010046014A1
Application number: PCT/EP2009/006922
Authority: WO
Inventors: Thomas Aue
Original assignee: Olympus Winter & Ibe Gmbh
Priority date: 2008-10-22
Filing date: 2009-09-25
Publication date: 2010-04-29
Also published as: DE102008052623A1

Abstract

The invention relates to a surgical instrument (1) having a curved or slightly flexible shaft, a jaw unit (3) being attached to the distal end thereof and a handle unit (4) being attached to the proximal end thereof, the shaft comprising an outer shaft tube (2) and an actuating element (10) longitudinally disposed therein, wherein the jaw unit (3) comprises two jaw parts (12, 13) pivotally disposed relative to each other, and pivotally attached to the distal end of the shaft tube (2), and connected to the actuating element (10) for pivotally displacing, wherein the actuating element (10) extends through the shaft tube (2) to a contact (11) located beyond the proximal end of the shaft tube (2) at one of the handles part (6) of the handle unit (4) displaceable relative to each other, the other handle part (5) thereof being attached to the proximal end of the shaft tube (2), wherein a rotating hose (21) made of flexible bending, rotationally rigid material is disposed within the shaft tube (2) and extending along the length thereof and encompassing the actuating element (10), being rotationally rigidly engaged (23, 24) with a rotational actuator (25) beyond the proximal end of the shaft tube (2) and to the jaw unit (3) on the distal end (22) thereof.

Description

Surgical instrument

The invention relates to a surgical instrument with curved shaft. Depending on the design of the jaw parts, such jaw instruments can be designed as pliers or scissors and can be used for different surgical purposes.

Such instruments are suitable, for example, to reach the larynx from outside through the mouth and throat. There are many other applications, including in laparoscopy, if z. B. several instruments are routed through a port and must have curved or angled shafts to avoid mutual interference.

When working with a jaw instrument, the jaw unit must always be aligned by rotation about the shaft axis to the object to be processed. When working with a straight jaw instrument, the entire instrument or its rotatable shaft can be rotated about the shaft axis. This is not possible with jawed instruments. Therefore, in such jaw instruments, the jaw unit must be rotatable relative to the shaft.

Curved jaw instruments, like straight mouth instruments, have an actuating element which provides the pressure or tension transmission between the handle unit and the mouth unit. In known pliers with a bent shaft, the actuator is also used for rotary transmission. This must be But actuator have a larger cross-section, z. B. be designed as a tube. When bent installation of such an actuator is a twist but not, or very difficult. There are contradictory requirements for the actuator, the forces must be transmitted both in the compression and traction direction for mouth actuation as well as in the direction of rotation for rotation of the mouth.

The object of the present invention is to provide a curved-shaft surgical jaw with improved sliding and turning operation.

This object is achieved with the features of claim 1.

According to the invention, the actuating element is used only for pressure and tension actuation of the mouth unit, that is to say for opening and closing the jaw parts. It is completely relieved of the rotary actuator, for a separate element, namely the rotary hose is provided. This in turn is completely relieved of tensile and compressive forces and serves only for torque transmission. The separation of the two transmission elements for the pressure and tension actuation on the one hand and for the rotary actuation on the other hand results in improved design possibilities. Another positive effect of this design is the arrangement of the rotary tube in the gap between the actuator and shaft tube, so that the game between these two parts is reduced in terms of a clean rattle-free guidance.

All essential parts of the jaw instrument can be provided in permanently connected construction. Such a jaw instrument would be very difficult to clean and could be used for surgical use only as a disposable item. Advantageously, therefore, the features of claim 2 are provided. The rotary hose releasably connected to the mouth unit can, after he is released, pulled out in the proximal direction of the shaft tube. This results in a very large gap between the actuator and the shaft tube, which can be rinsed well, so that the forceps can be sufficiently cleaned and disinfected for surgical reuse. For reassembly, the rotary tube only has to be advanced through the shaft tube from the proximal end until it again comes into rotationally fixed engagement with the jaw part.

Advantageously, the features of claim 3 are provided. As a result, the mouth unit together with the actuating element of the shaft tube is designed to be removable in a conventional manner. The jaw unit must be releasably secured to the distal end of the shaft tube, namely rotatable. At the proximal end of the actuating element, which may be formed, for example, as flexurally flexible, pressure-resistant steel wire, the usual ball may be provided for engagement on the handle part. With this construction, in turn, the cleaning ability is significantly improved.

Due to the advantageous embodiment according to claim 4, the handle unit can be separated from the shaft tube. This measure also promotes cleanability.

The rotary hose must be bend flexible and torsionally stiff. He could z. B. made of suitable plastic material with fiber reinforcement. Preferably, however, according to claim 5, the rotary tube consists of a wire coil. Particularly suitable is a flat wire coil. If the helix has a single layer, the rotary tube only allows a transmission of torque in one direction. A rotary tube formed from two reversed spirals arranged with crossed layers can also transmit rotational forces in both directions. In the drawings, the invention is shown for example and schematically. Show it:

1 is a side view of a bent pliers according to the invention,

2 is an enlarged section along line 2 - 2 in Figure 1,

Fig. 3 is an enlarged side view of the dismantled mouth unit and the distal end of the rotary tube and

Fig. 4 is an enlarged side view of the distal end of the shaft tube.

The surgical instrument according to the invention is a jaw instrument that can be designed as a pair of pliers or scissors. In the following the invention will be explained with reference to a pair of pliers.

1 shows a side view of a surgical forceps 1 with an elongated curved shaft tube 2, which carries a mouth unit 3 at the distal end and a handle unit 4 at the proximal end. In this case, the shaft tube can be rigid. It may optionally be designed to be difficult to bend. Thus, a shank formation is referred to, in which the shaft tube is so easily bendable that it is still bendable by hand, but on the other hand so heavy that it can withstand the loads occurring during work without bending.

The shaft tube 2 is, as shown in FIG. 1, executed bent. It has a proximal straight section, which merges with a sharply bent kink area into a distal section with a larger bending radius. There are also other bending configurations possible. Thus, for example, the distal region of the shaft tube 2 may also be straight, so that the shaft tube is formed of two straight pieces with a bent with a small radius kink. The Shaft tube 2 can also be bent uniformly as a whole, depending on the application.

The handle unit 4 has two handle parts, namely a stationary handle part 5 and a movable handle part 6, which are articulated to one another with a bearing axis 7. At the free ends of the handle parts 5, 6, the usual finger rings are provided in which fingers can attack a hand to pivot the grips 5, 6 against each other.

At the stationary handle portion 5, the distal end of the shaft tube 2 is removably attached to a nozzle 8 with a union nut 9.

The shaft tube 2 is longitudinally displaceable by an elongated actuator 10, for example, a bend-flexible thin steel rod. The actuator 10 passes beyond the proximal end of the shaft tube 2, the nozzle 8 and the stationary handle portion 5 and ends with a ball in a spherical engagement 11 at the end of the movable handle portion 6. The ball can be removed from the engagement 11 and snap into this again and thus provides a detachable, sufficiently tension and compression-resistant coupling of the actuating element 10 with the movable handle portion 6. The actuating element 10 must be flexible so that it is movable with longitudinal forces with small forces through the bends of the shaft tube 2.

FIG. 3 shows, in magnification, the jaw unit 3 with two jaw parts 12, 13 which are mounted pivotably about an axis 14 in a fork part 15. The fork part has a guide piece 16 projecting in the proximal direction. The actuating element 10 engages the jaw unit 3, namely on an inner joint mechanism, not shown, in order to adjust the longitudinal movement of the operating mechanism. In order to open the jaw members 12 and 13 relative to the fork part 15, or to close.

The connection of the mouth unit 3 with the shaft tube 2 shown enlarged in Fig. 4 should be rotatable, but longitudinally fixed. In the construction shown by way of example in FIGS. 3 and 4, for this purpose, the distal end of the shaft tube 2 has a plurality of tongues 17, which are laterally bendable as shown by the example of a tongue and carry the cams 18 pointing inwardly at the ends , The guide piece 16 of the mouth unit 3 has a groove 19 at a distance from its proximal end. The shaft tube 2 can be pushed with the tongues 17 from the proximal direction over the guide piece 16 until the cams 18 grasp into the groove 19 and thus produce a tension-resistant connection. A sliding sleeve 20 on the shaft tube 2 can now be pushed from the position shown in Fig. 4 in the distal direction to over the tongues 17 and secures the engagement of the cam 18 in the groove 19. Thus, there is now between the shaft tube 2 and the mouth unit 3 a tensile connection, which is also rotatable, since the cams 18 can be rotated in the groove 19 circumferentially.

So far as described so far there is a rotatable, longitudinally fixed connection of the mouth unit 3 with the shaft tube 2, which is usually designed to be rigid in itself or possibly with larger forces bendable. The opening and closing movement for the jaw parts 12 and 13 can be controlled via the actuating element 10. To rotate the jaw unit relative to the shaft tube 2 would have to be attacked at the mouth unit itself.

It is desirable, however, that the rotational adjustment can also take place from the proximal part of the forceps 1 located outside the body. But not the actuator 10 should be used for this purpose. For this purpose, a rotary tube 21 is provided which, like FIG. 2, is provided between the inner actuating element 10 and the outer shaft tube 2, the length of which is continuous. It is intended to transmit rotational forces, ie it must be torsionally rigid, but on the other hand it must be flexurally flexible in order to be able to pass through the bends of the shaft tube 2. In the exemplary embodiment, the rotary tube 21 is therefore designed as a wire helix, specifically as a flat wire helix, as shown in FIG. 3. If it is a single-layer helix, then rotary transmission is only possible in one direction of rotation. Several superimposed cross-wound coils can transmit in both directions of rotation.

At the distal end of the rotary tube 21 sits an end piece 22 which can engage with distally extending tongues 23 in longitudinally extending grooves 24 on the guide piece 16. As a result, a releasable longitudinally rotatable coupling is formed, wherein the position z. B. two 180 ° opposite tongues in the corresponding grooves 24 is secured by the abutting externally shank tube 2.

The rotary tube 21 passes through the neck 8 and the stationary handle portion 5 at the proximal end of the shaft tube 2 and ends there in the open with a thumbwheel 25 on which the rotational adjustment can be made. The thumbwheel 25 is securable with a lockable lever 26 in its axial position.

To disassemble the pliers 1 shown for cleaning purposes, first the engagement 11 at the distal end of the actuating element 10 can be snapped out. Then, the sliding sleeve 20 is retracted in the proximal direction at the distal end of the shaft tube 2 and the tongues 17 are brought out of engagement with the groove 19. Now, the mouth unit 3 can be pulled out with the attached actuating element 10 in the distal direction of the shaft tube 2. Subsequently, the shaft tube 2 can be separated from the handle unit 4 by loosening the union nut 9. The then remaining on the handle unit rotary tube 21 can be deducted in the proximal direction of the stationary handle part 5, for which purpose first the lever 26 must be pivoted aside to release the thumbwheel 25.

Claims

CLAIMS:

1. Surgical instrument with bent or hard bending shaft, at the distal end of a mouth unit (3) and at the proximal end of a handle unit (4) are fixed, wherein the shaft is an outer shaft tube (2) and a longitudinally displaceably arranged actuating element (10 ), wherein the jaw unit (3) has two jaw parts (12, 13) arranged so as to be pivotable relative to one another and rotatably fastened to the distal end of the shaft tube (2) and is connected to the actuating element (10) for pivoting adjustment, wherein the actuating element (10 ) extends through the shaft tube (2) to an engagement (11) located on one of the mutually adjustable grip parts (6) of the grip unit (4) up to an end beyond the proximal end of the shaft tube (2), the other grip part (5) at the proximal end of the grip element (5) Shaft tube (2) is fixed, wherein within the shaft tube (2) one of its length continuous, the actuating element (10) surrounding rotary hose (21) a is arranged bending elastic, torsionally stiff material which beyond the proximal end of the shaft tube (2) with a rotary actuator (25) and at its distal end (22) with the jaw unit (3) in a rotationally fixed engagement (23, 24).

2. Instrument according to claim 1, characterized in that the rotary tube (21) with the jaw unit (3) is detachably connected.

3. Instrument according to claim 1, characterized in that the mouth unit (3) with the distal end of the shaft tube (2) and the actuating element (10) with the engagement (11) are detachably connected.

4. Instrument according to claim 1, characterized in that the shaft tube (2) on the handle unit (4) is releasably attached.

5. Instrument according to claim 1, characterized in that the rotary tube (21) is designed as a wire helix.