DE10257760A1 - Surgical instrument - Google Patents
Surgical instrument Download PDFInfo
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- DE10257760A1 DE10257760A1 DE10257760A DE10257760A DE10257760A1 DE 10257760 A1 DE10257760 A1 DE 10257760A1 DE 10257760 A DE10257760 A DE 10257760A DE 10257760 A DE10257760 A DE 10257760A DE 10257760 A1 DE10257760 A1 DE 10257760A1
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- surgical instrument
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- cannula
- holder
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
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- 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
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
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- 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
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00336—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means with a protective sleeve, e.g. retractable or slidable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00473—Distal part, e.g. tip or head
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0409—Instruments for applying suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0417—T-fasteners
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/1205—Introduction devices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3405—Needle locating or guiding means using mechanical guide means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
- A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (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
Bei einem chirurgischen Instrument zum Fixieren eines Elementes, insbesondere eines Implantates, in einem Körper mittels einem Fixierelement, wobei das Fixierelement in oder an einer Halterung (25), insbesondere in einer Kanüle, an einem Zug- und/oder Druckelement (4) angeordnet ist, welches in einer Führung (3) entlang einer Längsachse (A) geführt ist, soll die Halterung (25) um die Längsachse (A) drehbar und/oder gegenüber der Längsachse (A) schwenkbar sein.In the case of a surgical instrument for fixing an element, in particular an implant, in a body by means of a fixing element, the fixing element being arranged in or on a holder (25), in particular in a cannula, on a pulling and / or pushing element (4) which is guided in a guide (3) along a longitudinal axis (A), the holder (25) should be rotatable about the longitudinal axis (A) and / or pivotable with respect to the longitudinal axis (A).
Description
Die vorliegende Erfindung bezieht sich auf ein chirurgisches Instrument zum Fixieren eines Elementes, insbesondere eines Implantates, in einem Körper mittels eines Fixierelementes, wobei das Fixierelement in oder an einer Halterung, insbesondere in einer Kanüle an einem Zug- und/oder Druckelement angeordnet ist, welches in einer Führung entlang einer Längsachse geführt ist.The present invention relates on a surgical instrument for fixing an element, in particular an implant, in a body by means of a fixing element, wherein the fixing element in or on a holder, in particular in a cannula on a train and / or Pressure element is arranged, which is in a guide along a longitudinal axis guided is.
Derartige chirurgische Instrumente sind in vielfältiger Form und Ausführung bekannt und gebräuchlich. Sie werden beispielsweise dafür verwendet, Implantate beispielsweise in Blutbahnen einzusetzen, welche der Gefahr von Aneurysmen ausgesetzt sind.Such surgical instruments are in more diverse Shape and design known and in use. she for example used to insert implants, for example, in the bloodstream, which are at risk of aneurysms.
Derartige Implantate sind beispielsweise dünne Drahtgeflechte, welche zumeist in einem vorgespannten Zustand in eine Vene od. dgl. eingeführt werden und sich an der betreffenden Stelle öffnen, um als eine Art zusätzliches Rohr die Venenwand aufzuweiten oder zumindest zu Verstärken und zu Entlasten.Such implants are, for example thin wire mesh, which are usually in a prestressed state in a vein or the like. introduced and open up at the point in question as a kind of additional Tube to widen the vein wall or at least to reinforce it to relieve.
Nachteilig bei dieser Art des Vorgehens ist, dass das Implantat mittels eines chirurgischen Instrumentes an die betreffende Stelle eingeführt, dort jedoch nicht fixiert wird. Dies kann dazu führen, dass das Implantat verrutscht und, gerade wenn es sich beispielsweise um ein Drahtgeflecht zur Verstärkung einer Blutbahn handelt, zu Bruch gehen oder eventuell die Blutbahn durchstossen kann, wodurch es zu inneren Blutungen und folglich zu lebensbedrohlichen Situationen kommen kann.A disadvantage of this type of procedure is that the implant is made using a surgical instrument introduced to the place in question, but is not fixed there. This can cause the implant to slip and, especially if it is a wire mesh for example reinforcement a bloodstream, break or possibly the bloodstream can pierce, causing internal bleeding and consequently can lead to life-threatening situations.
Diese Methode wurde durch die WO 99/33402 dahingehend verbessert, dass das Implantat, welches sich in einer Vene od. dgl. befindet, nun mittels eines Befestigungselementes wie beispielsweise eines T-Ankers an der Wand der Blutbahn od. dgl. befestigt wird. Dieser T-Anker wird von ausserhalb der Blutbahn durch die Wand der Blutbahn eingestossen, im Inneren öffnet sich sozusagen das T und liegt mit dem Querbalken von innen her dem Implantat an. Der Stamm des T wird mittels weiteren Befestigungselementen auf der Aussenseite der Wand der Blutbahn befestigt, beispielsweise verdrillt. Anschliessend kann die Kanüle wieder herausgezogen werden.This method was developed by WO 99/33402 improved in that the implant, which is in a vein or the like is now by means of a fastener such as a T-anchor on the wall of the bloodstream or the like. is attached. This T-anchor is from outside the bloodstream pushed through the wall of the bloodstream, opens up inside the T, so to speak, and lies with the crossbar from the inside of the implant on. The trunk of the T is made using additional fasteners attached to the outside of the wall of the bloodstream, for example twisted. The cannula can then be pulled out again.
Nachteilig hierbei ist, dass sich die Kanüle, in welcher sich der T-Anker befindet, nicht festlegen lässt. Sie bewegt sich frei an dem Instrumentenende und ist deshalb schwer zu führen.The disadvantage here is that the cannula, in which the T-anchor is located cannot be determined. she moves freely at the end of the instrument and is therefore heavy respectively.
Aufgabe der vorliegenden Erfindung ist es, die o.g. Nachteile zu verhindern und ein chirurgisches Instrument zu schaffen, welches ein Handling einer Halterung, insbesondere einer Kanüle, mit einem Fixierelement, insbesondere einem T-Anker, vereinfacht und die Möglichkeit eröffnet, die Halterung an eine bestimmte Position und in eine bestimmte Stellung zu dirigieren und dort festzulegen.Object of the present invention is it the above Prevent disadvantages and a surgical instrument to create a handling of a bracket, in particular a cannula, simplified with a fixing element, in particular a T-anchor and the possibility opened, the bracket to a certain position and in a certain position to conduct and fix there.
Zur Lösung dieser Aufgabe führt, dass die Halterung um die Längsachse drehbar und/oder gegenüber der Längsachse schwenkbar ist.The solution to this task is that the bracket around the longitudinal axis rotatable and / or opposite longitudinal axis is pivotable.
Wird als Halterung eine Kanüle gewählt, so ist diese in einer Kanülenaufnahme geführt, welche wiederum über ein Gelenk mit einem Hauptteil verbunden ist. Zusammen bilden sie den Kanüleneinsatz. Der Kanüleneinsatz ist einends mit einer Rasteinrichtung versehen, welche in Gebrauch mit einer Aufnahme einer Zug- und Druckstange bzw. einer Halteaufnahme am Ende des Aussenrohres in Eingriff kommt. Die Rasteinrichtung verbindet den Kanüleneinsatz lösbar mit dem Zug- und Druckelement und dem Aussenrohr. Das Zug- und Druckelement, hier handelt es sich bevorzugt um eine Stange, ist wiederum in dem Aussenrohr des chirurgischen Instrumentes geführt.If a cannula is chosen as the holder, so is in a cannula holder guided, which in turn is about a joint is connected to a main part. Together they form the cannula insert. The cannula insert is provided at one end with a locking device which is in use with a holder for a pull and push rod or a holder holder comes into engagement at the end of the outer tube. The locking device connects the cannula insert solvable with the tension and pressure element and the outer tube. The pull and push element, this is preferably a rod, is again in the Outer tube of the surgical instrument guided.
Die Rasteinrichtung setzt sich im Einzelnen aus einer Kugel am Ende eines Zug- und Druckstangenabschnittes zur Einlage in die Aufnahme der Zug- und Druckstange und zumindest zwei sich gegenüberliegenden Zapfen an einem Führungsansatz zusammen, welche in eine Nut bzw. Ausnehmung der Halteaufnahme am Ende des Aussenrohres einfahren. Wie die Rastverbindung im einzelnen Fall aussehen kann, ist von untergeordneter Bedeutung. Hauptsache ist, dass eine lösbare Verbindung zwischen dem Kanüleneinsatz und dem Aussenrohr bzw. der Zug- und Druckstange entsteht. Daher sollen all die verschieden Möglichkeiten einer Verbindung von der vorliegenden Erfindung umfasst sein.The locking device sits in Individual from a ball at the end of a pull and push rod section for insertion in the receptacle of the pull and push rod and at least two facing each other Pin on a guide lug together, which in a groove or recess of the holding receptacle on Retract the end of the outer tube. Like the detent connection in detail Case can look like is of minor importance. main thing is that a detachable Connection between the cannula insert and the outer tube or the pull and push rod is created. Therefore should all the different possibilities a compound of the present invention.
Die Zug- und Druckstange des Kanüleneinsatzes ist an ihrem distalen Ende mit der Kanülenaufnahme gelenkig verbunden. Durch eine Bewegung des Zug- und Druckstangenabschnittes, ausgelöst durch eine Bewegung der Zug- und Druckstange in dem Aussenrohr, wird auch die Kanülenaufnahme bewegt und mit ihr die darin geführte Kanüle. Die Bewegung erfolgt dabei um einen beliebigen Winkel von 0° bis 90° gegenüber der Längsachse.The pull and push rod of the cannula insert is articulated to the cannula receptacle at its distal end. By movement of the pull and push rod section, triggered by a movement of the pull and push rod in the outer tube, too the cannula holder moved and with it the guided in it Cannula. The movement takes place at any angle from 0 ° to 90 ° with respect to the longitudinal axis.
Die Zug- und Druckstange in dem Aussenrohr ist an ihrem proximalen Ende in einem Griffschenkel eines Griffes gelenkig und drehbar gelagert. Durch Bewegung dieses Griffschenkels bzw. des Griffes lässt sich auch die Zug- und Druckstange in dem Aussenrohr vor und zurückbewegen. Ist demnach der Kanüleneinsatz über die Rasteinrichtung mit der Zug- und Druckstange verbunden, so lässt sich, bei Bewegung des Griffschenkels, auch der Zug- und Druckstangenabschnitt vor- und zurückbewegen, wodurch die Kanüle, welche in der Kanülenaufnahme des Kanüleneinsatzes befestigt ist, gegenüber der Längsachse verschwenkt werden kann.The pull and push rod in the outer tube is at the proximal end in a handle leg of a handle articulated and rotatable. By moving this handle leg or the handle the train and Move the push rod back and forth in the outer tube. So is that Cannula insert over the Locking device connected to the pull and push rod, so when moving the handle leg, also the pull and push rod section move back and forth, whereby the cannula, which in the cannula holder of the cannula insert attached, opposite the longitudinal axis can be pivoted.
Um die Kanüle um bevorzugt 360° um die Längsachse drehen zu können, ist ein Drehknauf an dem chirurgischen Instrument vorgesehen, welcher mit dem Aussenrohr verbunden ist. Da die Zapfen der Rasteinrichtung des Kanüleneinsatzes fest in der Ausnehmung der Halteraufnahme am Ende des Aussenrohres eingerastet sind, lässt sich durch eine Drehung des Drehknaufes nicht nur das Aussenrohr, sondern auch der mit den Zapfen verbundene Kanüleneinsatz drehen. Weitere Möglichkeiten der Drehung des Aussenrohres bzw. der Ausgestaltung des Drehknaufes sollen von der vorliegenden Erfindung umfasst sein.In order to be able to rotate the cannula preferably through 360 ° about the longitudinal axis, a rotary knob is provided on the surgical instrument, which is connected to the outer tube. Because the cones of the Rastein direction of the cannula insert are firmly engaged in the recess of the holder receptacle at the end of the outer tube, not only the outer tube but also the cannula insert connected to the pin can be turned by turning the rotary knob. Further possibilities of rotating the outer tube or the design of the rotary knob are intended to be included in the present invention.
Die vorliegende Erfindung bezieht sich ebenfalls auf ein chirurgisches Instrument mit einem Aussenrohr und zumindest einem Arbeitselement, das mit dem Aussenrohr verbunden ist.The present invention relates also refer to a surgical instrument with an outer tube and at least one working element that is connected to the outer tube is.
Nachteilig bei derartigen chirurgischen Instrumenten ist, dass vor allem das Arbeitselement, welches an der Spitze des Aussenrohres befestigt ist, ohne Schutz ist. Das Aussenrohr mit dem Arbeitselement wird in den Körper eingeführt und kann dort aufgrund des fehlenden Schutzes hängen bleiben und womöglich Verletzungen im Inneren des Körpers verursachen oder selbst beschädigt werden.A disadvantage of such surgical Instruments is that, above all, the work element that is on the tip of the outer tube is attached without protection. The Outer tube with the working element is inserted into the body and can there due to of lack of protection stay and possibly Injuries inside the body cause or damaged itself become.
Aufgabe der vorliegenden Erfindung ist es daher, ein chirurgisches Instrument zu schaffen, welches das Arbeiten mit einem Arbeitselement zulässt, ohne im Inneren des Körpers Verletzungen zu verursachen oder das Arbeitselement selber zu beschädigen.Object of the present invention is therefore to create a surgical instrument that the Working with a work item allows for no injuries inside the body cause or damage the work element itself.
Zur Lösung dieser Aufgabe führt, dass auf das Aussenrohr ein Schutzrohr aufgesetzt ist, welches aus zwei teleskopartig ineinander verschiebbaren Rohrabschnitten besteht, wovon ein Rohrabschnitt das Arbeitselement zumindest teilweise entfernbar umhüllt.The solution to this task is that a protective tube is placed on the outer tube, which consists of two consists of telescopically displaceable pipe sections, from which a pipe section at least partially removes the working element envelops.
Dem einen Schutzrohr ist dabei ein trichterförmiger Aufsatz zugeordnet, mit welchem der Rohrabschnitt und damit das Schutzrohr an einem Verbindungselement des Aussenrohres angeordnet werden kann. Der Anordnung des Schutzrohres dient beispielsweise ein Sprengring, der sich erweitern kann und somit auf das Verbindungselement aufklickbar ist. Jede beliebige andere Verbindung zwischen dem trichterförmigen Aufsatz und dem Verbindungselement ist denkbar und soll von der vorliegenden Erfindung umfasst sein.The one protective tube is one funnel-shaped Assigned essay with which the pipe section and thus the Protective tube arranged on a connecting element of the outer tube can be. The arrangement of the protective tube serves, for example a snap ring that can expand and thus on the connecting element is clickable. Any other connection between the funnel-shaped attachment and the connecting element is conceivable and should be from the present Invention to be included.
Die beiden Rohrabschnitte sind mittels einer bajonettartigen Verbindung miteinander verbunden und ineinander verschiebbar.The two pipe sections are by means of a bayonet-like connection with each other and into each other displaceable.
Ein knaufartiges Element, welches mit dem inneren Rohrabschnitt durch den äusseren Rohrabschnitt verbunden und auf letzterem gleitbar ist, dient einer besseren Handhabung bei der Verschiebung der beiden Rohrabschnitte. Eine andere Haltung ist denkbar.A knob-like element, which connected to the inner pipe section by the outer pipe section and slidable on the latter, is used for better handling when moving the two pipe sections. Another attitude is conceivable.
Hinter der bajonettartigen Verbindung kann an dem einen Rohrabschnitt desweiteren ein Ring vorgesehen sein, welcher die Verschiebung des anderen Rohrabschnittes begrenzt.Behind the bayonet-like connection a ring can also be provided on the one tube section be, which limits the displacement of the other pipe section.
Das Schutzrohr ist durch seine beiden verschiebbaren Rohrabschnitte dazu geeignet, unterschiedlich grosse Arbeitselemente zu schützen.The protective tube is through its two sliding pipe sections suitable for this, different sizes Protect work items.
Ein weiterer Vorteil des Schutzrohres der vorliegenden Erfindung ist, dass dieses sich einfach auseinandernehmen lässt, wodurch eine Reinigung der einzelnen Bestandteile des Schutzrohres möglich ist. Verjüngt sich das Rohr sogar nach unten hin, so erhöht sich der Spüldruck und eine bessere Reinigung wird erzielt.Another advantage of the protective tube of the present invention is that it is easy to take apart leaves, thereby cleaning the individual components of the protective tube possible is. rejuvenated If the pipe even goes down, the flushing pressure increases better cleaning is achieved.
Die vorliegende Erfindung bezieht sich weiterhin auf ein chirurgisches Instrument mit einem in einem Aussenrohr geführten Zug- und/oder Druckelement, wobei dem Zug- und/oder Druckelement eine Fixiereinrichtung zugeordnet ist.The present invention relates continue to rely on a surgical instrument with one in an outer tube out Tension and / or pressure element, wherein the tension and / or pressure element a fixing device assigned.
Bisherige derartigen chirurgischen Instrumenten weisen den Nachteil auf, dass sich zwar das Zug- und/oder Druckelement in dem Aussenrohr beliebig hin und herschieben, sich jedoch nicht feststellen lässt. Dadurch gibt es keine Möglichkeit, beispielsweise den an dem Zug- und/oder Druckelement befestigten Kanüleneinsatz mit der Kanüle zu führen und in einer bestimmten Position festzulegen. Ein Dirigieren der Kanüle findet beispielsweise durch Anlage an ein Element oder ähnliches statt, was jedoch nur eine geringe Sicherung der Kanüle darstellt.Previous surgical such Instruments have the disadvantage that the train and / or Push the pressure element back and forth in the outer tube as desired but cannot be determined. Thereby is there no possibility, for example the one attached to the tension and / or pressure element cannula use with the cannula respectively and fix it in a certain position. Conducting the Cannula finds for example by placing an element or the like instead, but what represents only a slight securing of the cannula.
Aufgabe der vorliegenden Erfindung ist es daher auch, ein chirurgisches Instrument zu schaffen, welches es ermöglicht, die Zug- und/oder Druckstange in dem Aussenrohr und damit den Kanüleneinsatz mit der Kanüle in einer bestimmten Position und Stellung festzulegen.Object of the present invention it is therefore also to create a surgical instrument which allows, the pull and / or push rod in the outer tube and thus the cannula insert with the cannula in a specific position and position.
Zur Lösung dieser Aufgabe führt, dass die Fixiereinrichtung eine auf das Zug- und/oder Druckelement aufgesetzte Spannhülse aufweist, deren Durchmesser veränderbar ist.The solution to this task is that the fixing device is placed on the tension and / or compression element clamping sleeve has whose diameter can be changed is.
Die Spannhülse, welche im Bereich des vorderen Griffschenkels des Griffes die Zug- und Druckstange umgreift, weist hierzu einen durchgehenden Schlitz mit einer gewissen Breite auf. Da die Spannhülse auf einer Mulde eines Zylinderkörpers einer Welle aufliegt, wird die Breite des Schlitzes, wenn die Welle mittels eines Klemmhebels gedreht wird, verringert, wodurch sich der Durchmesser der Spannhülse verringern kann und somit das Zug- und Druckelement eingeklemmt wird und nicht mehr bewegt werden kann. Die Mulde in dem Zylinderkörper der Welle ist dabei bevorzugt exzentrisch angeordnet und weist eine Sichelform auf. Anstelle der Mulde kann in der Welle beispielsweise auch ein Element angeordnet werden, welches durch Drehen der Welle eine Verringerung der Breite der Spannhülse hervorruft und die Zug- und Druckstange einklemmt. Die unterschiedlichen Möglichkeiten sollen von der vorliegenden Erfindung umfasst sein.The adapter sleeve, which in the area of front handle leg of the handle grips the pull and push rod, has a continuous slot with a certain width on. Because the adapter sleeve on a hollow of a cylinder body a shaft rests on the width of the slot when the shaft is rotated by means of a clamping lever, which reduces the diameter of the adapter sleeve can reduce and thus pinched the tension and compression element will and can no longer be moved. The trough in the cylinder body of the The shaft is preferably arranged eccentrically and has one Sickle shape on. Instead of the trough, for example, in the shaft an element can also be arranged by rotating the shaft a reduction in the width of the adapter sleeve and the tensile and push rod clamped. The different options are intended to be encompassed by the present invention.
Um die Welle mittels des Klemmhebels drehen zu können, weist die Welle einen Zahnkranz auf, der in Gebrauchslage mit Zähnen einer Bohrung des Klemmhebels in Eingriff steht. Die Welle kann dabei nur soweit gedreht werden, wie es die mit einem Zapfen an dem Griff zusammenwirkende Aussparung an dem Klemmhebel zulässt. Eine andere Möglichkeit der Begrenzung der Bewegung des Klemmhebels und damit der Welle in dem Griffschenkel des Griffes ist denkbar und soll von der vorliegenden Erfindung umfasst sein. Ebenso ist eine andere Anordnung des Klemmhebels auf der Welle oder der Drehung der Welle überhaupt denkbar und soll ebenfalls von der vorliegendend Erfindung umfasst sein.In order to be able to rotate the shaft by means of the clamping lever, the shaft has a ring gear which, in the position of use, engages with teeth in a bore in the clamping lever. The shaft can only be rotated as far as the recess on the handle, which cooperates with a pin on the handle Clamping lever allows. Another possibility of limiting the movement of the clamping lever and thus the shaft in the handle leg of the handle is conceivable and is intended to be encompassed by the present invention. Another arrangement of the clamping lever on the shaft or the rotation of the shaft is also conceivable and should also be encompassed by the present invention.
Auch bei diesen Elementen ist eine gute Zerlegbarkeit gegeben, wodurch das Reinigen des gesamten chirurgischen Instrumentes vereinfacht wird. Dadurch kann verhindert werden, dass aufgrund beispielsweise komplizierten Aufbaus nur eine nachlässige Reinigung erfolgt, was im schlimmsten Fall zu einer gefährlichen Infektion im Körper führen könnte, wenn solch nachlässig gereinigte Geräte erneut verwendet werden.There is also one with these elements given good disassemblability, which makes cleaning the entire surgical Instrumentes is simplified. This can prevent due to, for example, complicated construction, only negligent cleaning occurs, which in the worst case could lead to a dangerous infection in the body if so careless cleaned devices be used again.
Obwohl auch Schutz separat für die einzelnen Elemente begehrt wird, ist mit der vorliegenden Erfindung insgesamt ein chirurgisches Instrument geschaffen worden, welches das Arbeiten im Körper wesentlich vereinfacht, indem die Kanüle sowohl in Längsachse um 360° gedreht, als auch gegenüber der Längsachse in einem Winkel von 0° bis 90° verschwenkt werden kann. Ferner ist es möglich, die Kanüle in jeder gewünschten Position zu positionieren und festzulegen, indem die Fixiereinrichtung am Handgriff betätigt wird.Although protection is also separate for the individual Items is sought after with the present invention as a whole a surgical instrument has been created that works in the body significantly simplified by placing the cannula both in the longitudinal axis rotated by 360 °, as well as opposite the longitudinal axis in an angle of 0 ° to Swiveled 90 ° can be. It is also possible the cannula in any desired Position and fix position by the fixing device operated on the handle becomes.
Eine Beschädigung der Kanüle selber oder eine Verletzung durch die Kanüle wird durch das Schutzrohr verhindert, welches durch die beiden ineinander verschiebbaren Rohrabschnitte in beliebigen Längen verfügbar ist.Damage to the cannula itself or an injury from the cannula is through the protective tube prevents which by the two telescoping pipe sections in any length available is.
Die gute Zerlegbarkeit des chirurgischen Instrumentes ermöglicht ferner eine optimale Reinigung der einzelnen Elemente, soweit sie, wie beispielsweise die Kanüle, keine Produkte für den Einmalgebrauch sind.The good disassembly of the surgical Instrumentes optimal cleaning of the individual elements, insofar as like the cannula, no products for are single use.
Das vorliegende Instrument dient vor allem der Reparatur einer anatomischen Gefässwand oder der Wand eines hohlen Organs, wie z. B. des Esophagus, insbesondere im menschlichen Körper. Es dient insbesondere als Anlegezange für ein Verschlusselement zur Fixierung eines Implantats, wie z.B. eines Stent oder Stent-graft, in einem vaskulären oder hohlen Organ von ausserhalb der Gefässwand.The present instrument serves especially the repair of an anatomical vessel wall or the wall of a hollow organ, such as B. the esophagus, especially in human Body. It is used in particular as application forceps for a closure element Fixation of an implant, e.g. a stent or stent graft, in a vascular or hollow organ from outside the vessel wall.
Weitere Vorteile, Merkmale und Einzelheiten der Erfindung ergeben sich aus der nachfolgenden Beschreibung bevorzugter Ausführungsbeispiele sowie anhand der Zeichnung; diese zeigt inOther advantages, features and details The invention is more preferred from the following description embodiments as well as from the drawing; this shows in
Gemäss
Das der Griffschlaufe
Das der Griffschlaufe
An dem sich an die Krümmung anschliessenden
Ende des Griffschenkels
Das dem Ansatzelement
Die Zug- und Druckstange
Das Ende der Zug- und Druckstange
Für
den Schieber
Die Kanülenaufnahme
Die Rasteinrichtung
Die Kugel
Auf nicht näher gezeigte Weise ist der
in dem Hauptteil
Desweiteren ist, gemäss
An dem einen Ende des Rohrabschnittes
Die Rohrabschnitte
Von dem Ansatzelement
Gemäss
Desweiteren ist in dem oberen Bereich
Das Griffstück
Die Welle
Die Mulde
Sowohl der Ring
Gemäss
Die Funktionsweise der vorliegenden
Erfindung ist folgende: Um das chirurgische Instrument
Zunächst werden die Griffschenkel
Anschliessend werden die beiden Griffschenkel
Aufgrund der Lagerung der Zapfen
Neben der Drehung und Bewegung des
Kanüleneinsatzes
Um nun den Kanüleneinsatz
Ist die Kanüle
Hierzu kann die Kanüle
Soll die Zug- und Druckstange
Der Zapfen
Durch die Drehung der Mulde
Anschliessend kann beispielsweise
ein sich in der Kanüle
befindender T-Anker mittels eines weiteren, hier nicht näher gezeigten
Instrumentes aus der Kanüle
Soll die Festlegung des Kanüleneinsatzes
Ein Lösen des Kanüleneinsatzes
Positionszahlenliste Position Number List
Claims (31)
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE10257760A DE10257760A1 (en) | 2002-11-26 | 2002-12-10 | Surgical instrument |
PCT/EP2003/012246 WO2004047653A2 (en) | 2002-11-26 | 2003-11-03 | Surgical instrument |
AU2003276245A AU2003276245A1 (en) | 2002-11-26 | 2003-11-03 | Surgical instrument |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE10255246.0 | 2002-11-26 | ||
DE10255246 | 2002-11-26 | ||
DE10257760A DE10257760A1 (en) | 2002-11-26 | 2002-12-10 | Surgical instrument |
Publications (1)
Publication Number | Publication Date |
---|---|
DE10257760A1 true DE10257760A1 (en) | 2004-06-17 |
Family
ID=32395011
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE10257760A Ceased DE10257760A1 (en) | 2002-11-26 | 2002-12-10 | Surgical instrument |
Country Status (3)
Country | Link |
---|---|
AU (1) | AU2003276245A1 (en) |
DE (1) | DE10257760A1 (en) |
WO (1) | WO2004047653A2 (en) |
Cited By (1)
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EP3000404A1 (en) * | 2014-09-23 | 2016-03-30 | Karl Storz GmbH & Co. KG | Medical instrument and coupling device for connecting two components of a medical instrument |
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EP3000404A1 (en) * | 2014-09-23 | 2016-03-30 | Karl Storz GmbH & Co. KG | Medical instrument and coupling device for connecting two components of a medical instrument |
US10123822B2 (en) | 2014-09-23 | 2018-11-13 | Karl Storz Se & Co. Kg | Medical instrument, and coupling mechanism for connecting two structural parts of a medical instrument |
Also Published As
Publication number | Publication date |
---|---|
AU2003276245A1 (en) | 2004-06-18 |
WO2004047653A3 (en) | 2004-09-23 |
WO2004047653A2 (en) | 2004-06-10 |
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