DE10328514B3 - Endoscopic surgical scissor instrument has internal pushrod terminating at distal end in transverse cylindrical head - Google Patents

Endoscopic surgical scissor instrument has internal pushrod terminating at distal end in transverse cylindrical head Download PDF

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Publication number
DE10328514B3
DE10328514B3 DE10328514A DE10328514A DE10328514B3 DE 10328514 B3 DE10328514 B3 DE 10328514B3 DE 10328514 A DE10328514 A DE 10328514A DE 10328514 A DE10328514 A DE 10328514A DE 10328514 B3 DE10328514 B3 DE 10328514B3
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Germany
Prior art keywords
force
proximal end
instrument according
limiting element
transmission member
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DE10328514A
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German (de)
Inventor
Bernhard Dipl.-Ing. Kupferschmid
Rupert Dipl.-Ing. Mayenberger
Dieter Dipl.-Ing. Weißhaupt
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Aesculap AG
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Aesculap AG
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • 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
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2919—Handles transmission of forces to actuating rod or piston details of linkages or pivot points
    • A61B2017/292—Handles transmission of forces to actuating rod or piston details of linkages or pivot points connection of actuating rod to handle, e.g. ball end in recess
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B2018/146—Scissors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/031—Automatic limiting or abutting means, e.g. for safety torque limiting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation

Abstract

A surgical scissor instrument has a bipolar grip linked via a pushrod shaft to a tool at the distal end of the shaft. The pushrod is linked to the tool by a force-limiter acting directly on the tool. The proximal end of the pushrod has a cylindrical head that is transverse to the shaft and engages with the tool.

Description

Die vorliegende Erfindung betrifft ein chirurgisches Instrument mit einem Schaft, mit einem an einem distalen Ende des Schafts angeordneten beweglichen Werkzeug, mit einem an einem proximalen Ende des Schafts angeordneten beweglichen Betätigungselement, mit einem dem Betätigungselement zugeordneten Kraftübertragungsglied zum Übertragen von Zug- und/oder Schubkräften vom Betätigungselement auf das Werkzeug und mit einer Kraftbegrenzungsvorrichtung zum Begrenzen einer vom Betätigungselement auf das Kraftübertragungsglied wirkenden Zug- und/oder Schubkraft, wobei die Kraftbegrenzungsvorrichtung ein Kraftbegrenzungselement umfaßt und wobei das Kraftbegrenzungselement direkt auf das proximale Ende des Kraftübertragungsglieds wirkt.The The present invention relates to a surgical instrument having a shaft, with one disposed at a distal end of the shaft movable tool, with one at a proximal end of the shaft arranged movable actuator, with an associated with the actuator Power transmission member to transfer of tensile and / or shear forces from the actuator on the tool and with a force limiting device for limiting one from the actuator acting on the power transmission member Pulling and / or pushing force, wherein the force limiting device a force limiting element comprises and wherein the force limiting element acting directly on the proximal end of the power transmission member.

Chirurgische Instrumente der eingangs beschriebenen Art finden überwiegend Anwendung in der endoskopischen Chirurgie. Um das mindestens eine am Schaftende angeordnete Werkzeug durch zu große Krafteinwirkung nicht zu zerstören, ist häufig eine zwischen zwei Branchen angreifende Kraftbegrenzungsvorrichtung vorgesehen. Mit der Kraftbegrenzungsvorrichtung ist es möglich, eine vom Betätigungselement auf das Kraftübertragungselement wirkende Zug- und/oder Schubkraft zu begrenzen. Dies ist wichtig, da ein Anwender Kräfte nicht direkt auf das Werkzeug übertragen kann, wie beispielsweise bei einer Schere mit zwei relativ zueinander beweglich gelagerten Scherenblättern. Der Aufbau der Kraftbegrenzungsvorrichtung und damit des gesamten Instruments sind sehr aufwendig und voluminös.surgical Instruments of the type described above find predominantly Application in endoscopic surgery. At least one Tool located at the end of the shank not possible due to excessive force to destroy, is often one provided between two branches attacking force limiting device. With the force limiting device, it is possible, one of the actuator acting on the power transmission element Limit traction and / or thrust. This is important as one User forces not transferred directly to the tool can, as with a scissors with two relative to each other movably mounted scissor blades. The structure of the force limiting device and thus the entire Instruments are very elaborate and voluminous.

Aus der DE 101 10106 A1 ist eine chirurgische Zange mit einer Stellstange zum Öffnen und Schließen eines Zangenmauls bekannt, wobei das proximate Ende der Stellstange mit einem Schenkel eines zweischenkligen, verschwenkbaren Griffteils in Verbindung steht, und mindestens ein gewundenes Federelement als Überlastschutz gegen Bruch von Zangenteilen umfaßt, wobei das Federelement aus schlangenlinienartig gewundenem Flachmaterial mit in einer Ebene liegenden Windungen besteht. Ferner sind aus der US 5 451 227 A , der US 5 147 357 A und der DE 94 22 450 U1 weitere chirurgische Instrumente bekannt, die eine Kraftbegrenzungsvorrichtung aufweisen.From the DE 101 10106 A1 a surgical forceps with an actuating rod for opening and closing a forceps jaw is known, wherein the proximal end of the actuating rod with a leg of a two-limbed, pivotable handle part is in communication, and at least one coiled spring element as overload protection against breakage of Zangenteilen includes, wherein the spring element Schlangenlinieartig wound flat material with lying in a plane turns. Furthermore, from the US 5,451,227 A. , of the US 5 147 357 A and the DE 94 22 450 U1 Further surgical instruments are known, which have a force limiting device.

Es ist daher Aufgabe der vorliegenden Erfindung, ein chirurgisches Instrument der eingangs beschriebenen Art so zu verbessern, daß es besonders einfach aufgebaut ist, daß es auf einfache Weise aus seinen Einzelteilen zusammengebaut werden kann und daß eine Lagerung des proximalen Endes des Kraftübertragungsglieds vereinfacht wird.It is therefore an object of the present invention, a surgical Instrument of the type described above to improve so that it is particularly simple it is constructed that be easily assembled from its individual parts can and that one Storage of the proximal end of the power transmission member simplified becomes.

Diese Aufgabe wird bei einem chirurgischen Instrument der eingangs beschriebenen Art erfindungsgemäß dadurch gelöst, daß proximate Ende des Kraftübertragungsglieds einen zylindrischen Kopf trägt, daß eine Längsachse des Kopfes quer zur Längsachse des Schafts verläuft und daß das proximale Ende des Kraftübertragungsglieds in einer Aufnahme des Betätigungselements beweglich geführt und/oder gehalten ist und daß sich das Kraftbegrenzungselement an mindestens einem Ende der Aufnahme und am proximalen Ende des Kraftübertragungsglieds proximalseitig abstützt.These Task is in a surgical instrument of the type described above Type according to the invention thereby solved, that proximal End of the power transmission element wearing a cylindrical head, that one longitudinal axis of the head transverse to the longitudinal axis of the shaft runs and that proximal end of the transmission member in a receptacle of the actuating element movably guided and / or is held and that itself the force limiting element on at least one end of the receptacle and at the proximal end of the power transmission member supported on the proximal side.

Dadurch, daß das Kraftbegrenzungselement direkt auf das proximate Ende des Kraftübertragungsglieds wirkt, kann das Instrument insgesamt sehr kompakt aufgebaut werden. Des weiteren läßt sich so die Zahl der erforderlichen Bauelemente des Instruments minimieren und der Zusammenbau vereinfachen. Dadurch, daß das proximale Ende des Kraftübertragungsglieds in einer Auf nahme des Betätigungselements beweglich geführt und/oder gehalten ist und daß sich das Kraftbegrenzungselement an mindestens einem Ende der Aufnahme und am proximalen Ende des Kraftübertragungsglieds distalseitig und/oder proximalseitig abstützt, können sowohl Zug- als auch Schubkräfte auf einen maximalen Wert begrenzt werden. Zudem läßt sich das Instrument besonders kompakt aufbauen und die Kraftbegrenzungsvorrichtung im wesentlichen in das Betätigungselement integrieren. Um gleichzeitig ein Angreifen des Kraftbegrenzungselements am Kraftübertragungsglied zu optimieren und eine Lagerung des proximalen Endes des Kraftübertragungsglieds zu vereinfachen, ist es günstig, daß das proximale Ende des Kraftübertragungsglieds einen zylindrischen Kopf trägt und daß eine Längsachse des Kopfes quer zur Längsachse des Schafts verläuft. Der Kopf kann dann beispielsweise zentral oder seitlich auf einfache Weise in einer Nut geführt werden.Thereby, that this Force limiting element directly on the proximal end of the power transmission member acts, the instrument can be built very compact overall. Furthermore, can be so minimize the number of required components of the instrument and simplify the assembly. Characterized in that the proximal end of the power transmission member in an on acceptance of the actuator movably guided and / or is held and that itself the force limiting element on at least one end of the receptacle and at the proximal end of the power transmission member supported on the distal and / or proximal side, both tensile and shear forces on be limited to a maximum value. In addition, the instrument can be special compact build and the force limiting device substantially in the actuator integrate. At the same time engaging the force limiting element on the power transmission element to optimize and storage of the proximal end of the power transmission member to simplify, it is convenient that this proximal end of the transmission member wearing a cylindrical head and that one longitudinal axis of the head transverse to the longitudinal axis of the shaft runs. The head can then, for example, centrally or laterally to simple Way guided in a groove become.

Günstig ist es, wenn das Kraftbegrenzungselement direkt am proximalen Ende des Kraftübertragungsglieds anliegt. Auf diese Weise läßt sich die Zahl der erforderlichen Bauelemente des Instruments weiter verringern. Darüber hinaus kann das Instrument noch kompakter aufgebaut werden.Cheap is it when the force limiting element directly at the proximal end of Power transmission member is applied. In this way can be further reduce the number of required components of the instrument. About that In addition, the instrument can be built even more compact.

Vorzugsweise ist das Kraftbegrenzungselement in einer Grundstellung, in der vom Betätigungselement keine Kraft auf das Kraftübertragungsglied ausgeübt wird, federnd gegen das proximate Ende des Kraftübertragungsglieds vorgespannt. Dadurch ist es möglich, mit dem Betätigungselement eine Kraft auf das Kraftübertragungsglied auszuüben und das proximate Ende desselben in einer gewünschten Stellung zu halten. Erst wenn eine maximale Betätigungskraft überschritten wird, verformt sich das Kraftbegrenzungselement in vorher bestimmter Weise, so daß eine Bewegung des Betätigungselements nicht mehr auf das Kraftübertragungsglied übertragen wird.Preferably, the force limiting element is biased resiliently against the proximal end of the power transmission member in a basic position in which no force is exerted on the force transmission member by the actuating element. This makes it possible to exert a force on the force transmission member with the actuator and to keep the proximal end thereof in a desired position. Only when a maximum actuation force is exceeded, the force limiting element deforms in a predetermined manner, so that a movement of the actuating element is no longer transmitted to the power transmission member.

Gemäß einer bevorzugten Ausführungsform der Erfindung kann vorgesehen sein, daß das Kraftbegrenzungselement am proximalen Ende des Kraftübertragungsglieds in proximaler und/oder distaler Richtung angreift. Auf diese Weise lassen sich sowohl Zug- als auch Schubkräfte auf einen maximalen Wert begrenzen. Beispielsweise könnte das Kraftbegrenzungselement hierzu einerseits fest mit dem Betätigungselement, andererseits mit dem Kraftübertragungsglied verbunden sein, so daß eine Bewegung des Betätigungselements auf das Kraftübertragungsglied hin zu einer Stauchung des Kraftbegrenzungselements, eine Bewegung des Betätigungselements vom Kraftübertragungsglied weg zu einer Dehnung des Kraftbegrenzungsglieds führt.According to one preferred embodiment of Invention may be provided that the force limiting element at the proximal end of the power transmission member engages in the proximal and / or distal direction. In this way Both tensile and shear forces can be set to a maximum value limit. For example, could the force limiting element on the one hand firmly with the actuator, on the other hand with the power transmission member be connected, so that a Movement of the actuator on the power transmission member towards a compression of the force limiting element, a movement of the actuating element of Power transmission member leads away to an expansion of the force limiting element.

Um eine gewünschte maximale Betätigungskraft auf einfachste Weise einzustellen, ist es vorteilhaft, wenn das Kraftbegrenzungselement elastisch ist, insbesondere federelastisch.Around a desired one maximum operating force In the simplest way to adjust, it is advantageous if the Force limiting element is elastic, in particular resilient.

Besonders günstig ist es, wenn das Kraftbegrenzungselement eine Feder oder ein elastischer Kunststoff ist, insbesondere ein Elastomer. Derartige Kraftbegrenzungselemente lassen sich einfach, kostengünstig und nahezu in jeder beliebigen Form herstellen.Especially Cheap it is when the force limiting element is a spring or an elastic plastic is, in particular an elastomer. Such force limiting elements can be easily, inexpensively and produce in almost any shape.

Besonders kompakt wird der Aufbau des Instruments, wenn das Betätigungselement das Kraftbegrenzungselement trägt.Especially becomes compact the construction of the instrument when the actuator carries the force limiting element.

Günstig ist es, wenn das Kraftbegrenzungselement das proximate Ende des Kraftübertragungsglieds im wesentlichen umgibt und wenn das Kraftübertragungsglied in distaler Richtung aus dem Kraftbegrenzungselement herausgeführt ist. Aufgrund dieser Ausgestaltung ist selbst dann eine Begrenzung der maximalen Zug- und/oder Schubkraft möglich, wenn das Betätigungselement schwenkbar gelagert ist, und es daher nicht stets in Verlängerung der Achse des Schafts Schub- und Zugkräfte auf das Kraftübertragungsglied überträgt.Cheap is it, when the force limiting element, the proximal end of the power transmission member essentially surrounds and when the force transmission member in distal Direction is led out of the force limiting element. Due to this configuration, even a limitation of maximum tensile and / or thrust possible when the actuator is pivotally mounted, and therefore not always in extension the shaft of the shaft transmits thrust and tensile forces on the power transmission member.

Eine besonders gute und allseitige Kraftübertragung auf das Kraftübertragungsglied wird erreicht, indem das proximate Ende des Kraftübertragungsglieds im Querschnitt kreisförmig ausgebildet ist. Beispielsweise kann es insgesamt kugelig, konisch oder zylindrisch ausgestaltet sein.A particularly good and versatile power transmission to the power transmission element is achieved by the proximal end of the transmission member circular in cross-section is trained. For example, it may be globular, conical or cylindrical.

Günstig ist es, wenn der Kopf mit einer in Längsrichtung des Kopfes in einer Richtung quer zur Längsachse des Schafts verlaufenden Nut auf ein durch eine Ringnut gebildetes zylindrisches Ende des Kraftübertragungsglieds aufschiebbar ist. Auf diese Weise läßt sich das distale Ende des Kraftübertragungsglieds einfacher mit einem schwenkbar gelagerten Betätigungselement verbinden.Cheap is it if the head with a longitudinal direction of the head in a direction transverse to the longitudinal axis of the shaft Groove on an annular groove formed by a cylindrical end of the Power transmission member is deferrable. In this way, the distal end of the Power transmission member easier to connect with a pivotally mounted actuator.

Gemäß einer bevorzugten Ausführungsform der Erfindung kann vorgesehen sein, daß die Aufnahme eine quer zur Längsachse des Schafts angeordnete, im wesentlichen zylindrische Bohrung umfaßt, welche eine im wesentlichen in distaler Richtung weisende Öffnung aufweist, die schmaler ist, als ein Durchmesser der Bohrung. Auf diese Weise kann ein zylindrischer Kopf in der Aufnahme gehalten werden, ohne daß er distalseitig aus der Aufnahme austreten kann. Außerdem bietet eine derartige Aufnahme die Möglichkeit, sowohl distalseitig als auch proximalseitig Stützflächen für ein Kraftbegrenzungselement auszubilden.According to one preferred embodiment of Invention may be provided that the recording a transversely to longitudinal axis the shaft arranged, comprises substantially cylindrical bore, which has a substantially distally facing opening, which is narrower than a diameter of the bore. In this way a cylindrical head can be held in the receptacle without that he can emerge distally from the recording. In addition, such offers Recording the possibility form support surfaces for a force limiting element both on the distal side and on the proximal side.

Günstig ist es, wenn die Aufnahme zwei seitliche Führungen für den Kopf aufweist, und wenn das Kraftbegrenzungselement in einer zu seiner äußeren Form korrespondierenden Ausnehmung eingesetzt ist. Das Kraftbegrenzungselement wird auf diese Weise sowohl gehalten als auch geführt. Durch die seitliche Führung des Kopfes ergibt sich eine besonders große Angriffsfläche für das Kraftbegrenzungselement.Cheap is if it has two lateral guides for the head, and if the force limiting element in a corresponding to its outer shape Recess is inserted. The force limiting element is on this way both kept and guided. Due to the lateral guidance of the Head results in a particularly large attack surface for the force limiting element.

Vorteilhaft ist es, wenn die Aufnahme als eine mit einem in distaler Richtung weisenden Schlitz versehene Querbohrung ausgebildet ist. In eine solche Aufnahme kann beispielsweise ein zylindrischer oder kugelförmiger Kopf eingepaßt werden, welcher von einem elastischen Kraftbegrenzungselement im wesentlichen vollständig umgeben ist. Das proximale Ende des Kraftübertragungsglieds läßt sich somit auf einfache Weise sicher am Betätigungselement lagern.Advantageous it is when the shot is taken as one with a distally facing slot provided transverse bore is formed. In a such a receptacle may for example be a cylindrical or spherical head fitted which of an elastic force limiting element substantially Completely is surrounded. The proximal end of the power transmission member can be thus easily store securely on the actuator.

Die nachfolgende Beschreibung bevorzugter Ausführungsformen der Erfindung dient im Zusammenhang mit der Zeichnung der näheren Erläuterung. Es zeigen:The following description of preferred embodiments of the invention used in conjunction with the drawings for further explanation. Show it:

1: eine Längsschnittansicht einer erfindungsgemäßen Schere; 1 a longitudinal sectional view of a pair of scissors according to the invention;

2: eine vergrößerte Ansicht des Verbindungsbereichs zwischen dem Kraftübertragungsglied und dem Betätigungselement; 2 an enlarged view of the connection area between the power transmission member and the actuator;

3: eine Ansicht ähnlich 2 bei einem alternativen Ausführungsbeispiel; und 3 : a view similar 2 in an alternative embodiment; and

4: eine Schnittansicht längs Linie 4-4 in 3. 4 a sectional view taken along line 4-4 in 3 ,

In 1 ist eine Längsschnittansicht einer insgesamt mit dem Bezugszeichen 10 versehenen, als endoskopisches Rohrschaftinstrument ausgebildeten Bipolarschere dargestellt.In 1 is a longitudinal sectional view of a total with the reference numeral 10 provided, designed as endoscopic tubular shaft instrument bipolar shears shown.

Die Bipolarschere 10 umfaßt einen langgestreckten, rohrförmigen Schaft 12, an dessen distalem Ende zwei relativ zueinander verschwenkbare Scherenblätter 14 und 16 auf einem Lagerpin 18 gelagert sind, welcher den Schaft 12 beidseitig und quer zu einer Längsachse 20 des Schafts 12 durchsetzt. Zum Bewegen der Scherenblätter 14 und 16 ist an einem distalen Ende einer in Richtung der Längsachse 20 im Schaft 12 längsverschieblichen Schub- und Zugstange 22 ein Antriebskörper 24 angeordnet, welcher mit zwei Führungsschlitzen 26 versehen ist, in die quer zur Längsachse 20 von den Scherenblättern 14 und 16 abstehende Lagerzapfen 28 eintauchen und in Folge einer axialen Verschiebung des Antriebskörpers 24 zwangsgeführt werden, wodurch die Scherenblätter 14 und 16 geöffnet beziehungsweise geschlossen werden.The bipolar scissors 10 comprises an elongate, tubular shaft 12 , At its distal end two relatively pivotable scissor blades 14 and 16 on a bearing pin 18 are stored, which the shaft 12 on both sides and across a longitudinal axis 20 of the shaft 12 interspersed. To move the scissor blades 14 and 16 is at a distal end one in the direction of the longitudinal axis 20 in the shaft 12 longitudinally movable push-pull rod 22 a drive body 24 arranged, which with two guide slots 26 is provided, in the transverse to the longitudinal axis 20 from the scissors blades 14 and 16 protruding bearing journals 28 immerse and as a result of an axial displacement of the drive body 24 be forced, causing the scissor blades 14 and 16 be opened or closed.

An seinem proximalen Ende 30 ist der Schaft 12 in einer Längsbohrung 32 eines feststehenden Griffteils 34 aufgenommen, von dem sich eine feststehende Branche 36 mit einer Fingeröffnung 38 im wesentlichen quer zur Längsachse 20 von dieser weg erstreckt. Am Griffteil 34 ist eine zweite Branche 40 in einer in proximaler Richtung offenen Ausnehmung 42 um einen quer zur Längsachse 20 die Ausnehmung 42 durchsetzenden Lagerbolzen 44 schwenkbar gelagert und weist an ihrem freie Ende eine weitere Fingeröffnung 46 auf.At its proximal end 30 is the shaft 12 in a longitudinal bore 32 a fixed handle part 34 from which is a fixed industry 36 with a finger opening 38 essentially transverse to the longitudinal axis 20 extends from this path. On the handle part 34 is a second industry 40 in a recess open in the proximal direction 42 around one transverse to the longitudinal axis 20 the recess 42 passing through bearing pin 44 pivotally mounted and has at its free end another finger opening 46 on.

Ein proximales Ende der Schub- und Zugstange 22 ist mit einem kurzen zylindrischen Kopf 48 versehen, welcher in einer sich einstufig erweiternden Lagernut 50 eines Lagerzylinders 52 formschlüssig eingreift und darin gehalten ist. Aus der Lagernut 50 ragt die Schub- und Zugstange 22 hervor, die mit einer elektrischen Isolierschicht 54 bedeckt ist. Eine Längsachse des Lagerzylinders 52 verläuft quer zur Längsachse 20. Der Lagerzylinder 52 wird an der Branche 40 in der Nähe des Lagerbolzens 44 in einer Lagerbohrung 56 gehalten, wel che sich quer zur Längsachse 20 erstreckt und einen sich vom Zentrum der Lagerbohrung 56 in distaler Richtung erweiternden Schlitz 58 umfaßt.A proximal end of the push and pull rod 22 is with a short cylindrical head 48 provided, which in a single-stage expanding Lagerut 50 a bearing cylinder 52 positively engages and is held therein. From the warehouse groove 50 protrudes the push and pull rod 22 It comes out with an electrical insulating layer 54 is covered. A longitudinal axis of the bearing cylinder 52 runs transversely to the longitudinal axis 20 , The bearing cylinder 52 will be in the industry 40 near the bearing pin 44 in a bearing bore 56 held, wel che transverse to the longitudinal axis 20 extends and extends from the center of the bearing bore 56 distally flared slot 58 includes.

Ebenso wie die Schub- und Zugstange 22 ist auch der Schaft 12 von einer elektrisch isolierenden Schicht 60 umgeben. Sowohl der Schaft 12 als auch die Schub- und Zugstange 22 sind in nicht näher dargestellter Weise mit einem bipolaren Anschluß 62 verbunden, über welchen die Bipolarschere 10 mittels Leitungen an eine elektrische Energieversorgungseinheit angeschlossen werden kann. Sowohl über die Schub- und Zugstange 22 als auch über den Schaft 12 wird jeweils eine elektrische Verbindung zu einem der beiden Scherenblättern 14 und 16 hergestellt, die relativ zueinander isoliert sind. Dies ermöglicht es, zum Koagulieren von Gewebe beispielsweise einen Hochfrequenzstrom über die Scherenblätter 14 und 16 zu leiten und das koagulierte Gewebe im Anschluß an den Koagulationsvorgang zu durchtrennen.As well as the push and pull rod 22 is also the shaft 12 from an electrically insulating layer 60 surround. Both the shaft 12 as well as the push and pull rod 22 are in a manner not shown with a bipolar connection 62 connected over which the bipolar scissors 10 can be connected by means of cables to an electrical power supply unit. Both over the push and pull rod 22 as well as over the shaft 12 each becomes an electrical connection to one of the two scissor blades 14 and 16 made, which are isolated relative to each other. This makes it possible to coagulate tissue, for example, a high-frequency current through the scissor blades 14 and 16 to direct and cut the coagulated tissue following the coagulation process.

Des weiteren ist ein relativ zum Schaft 12 drehfester Drehknopf 64 vorgesehen, welcher jedoch relativ zum Griffteil verdrehbar ist, so daß das distale Ende der Bipolarschere 10 mit den beiden Scherenblättern 14 und 16 relativ zu den beiden Branchen 36 und 40 um die Längsachse 20 verdreht werden kann.Furthermore, one is relative to the shaft 12 non-rotating knob 64 provided, however, which is rotatable relative to the handle part, so that the distal end of the bipolar scissors 10 with the two scissor blades 14 and 16 relative to the two industries 36 and 40 around the longitudinal axis 20 can be twisted.

In 2 ist ein Verbindungsbereich zwischen der Schub- und Zugstange 22 und der Branche 40 vergrößert dargestellt. Der zur Längsachse 20 rotationssymmetrisch geformte Kopf 48 ist in der Lagernut 50 des Lagerzylinders 52 formschlüssig gehalten. Der Lagerzylinder 52 wiederum sitzt in einer zylindrischen Ausnehmung, deren Längsachse quer zur Längsachse 20 des Schafts 12 verläuft. Durch einen parallel zur Längsachse des Lagerzylinders 52 verlaufen den Schlitz 58 ist die Schub- und Zugstange 22 aus der Lagerbohrung 56 herausgeführt. Formschlüssig umgeben ist der Lagerzylinder 52 von einem längsgeschlitzten Kunststoffzylinder 66, welcher den Lagerzylinder 52 spielfrei in der Lagerbohrung 56 hält. Wird die Branche 40 in Richtung auf die Branche 36 hin verschwenkt, so wird gleichzeitig die Lagerbohrung 56 in Richtung auf das distale Ende des Instruments hin bewegt. Übersteigt eine über die Branche 40 auf die Schub- und Zugstange 22 eingeleitete Kraft einen maximalen Wert, so wird der Lagerzylinder 52 proximalseitig gegen den Kunststoffzylinder 66 gedrückt, der sich proximalseitig an einer in distaler Richtung weisenden Wand 68 der Lagerbohrung 56 abstützt und dadurch verformt wird.In 2 is a connection area between the push and pull rod 22 and the industry 40 shown enlarged. The to the longitudinal axis 20 rotationally symmetrical shaped head 48 is in the warehouse 50 of the bearing cylinder 52 held positively. The bearing cylinder 52 in turn sits in a cylindrical recess whose longitudinal axis is transverse to the longitudinal axis 20 of the shaft 12 runs. Through a parallel to the longitudinal axis of the bearing cylinder 52 run the slot 58 is the push and pull rod 22 from the bearing bore 56 led out. The bearing cylinder is surrounded by positive engagement 52 from a longitudinally slotted plastic cylinder 66 , which the bearing cylinder 52 free of play in the bearing bore 56 holds. Will the industry 40 towards the industry 36 pivoted towards, so is the bearing bore at the same time 56 moved toward the distal end of the instrument. Exceeds one over the branch 40 on the push and pull rod 22 force introduced a maximum value, then the bearing cylinder 52 on the proximal side against the plastic cylinder 66 pressed on the proximal side of a wall pointing in the distal direction 68 the bearing bore 56 is supported and thereby deformed.

Zwangsläufig wird der Kunststoffzylinder 66 gequetscht und nimmt die, den eingestellten Maximalwert übersteigende Kraft auf, wodurch eine weitere Bewegung der Schub- und Zugstange 22 in distaler Richtung verhindert wird. Umgekehrt wird bei einer Verschwenkung der Branche 40 von der Branche 36 weg beim Übersteigen einer maximal eingeleiteten Zugkraft der Kunststoffzylinder 66 zwischen dem Lagerzylinder 52 benachbart der austretenden Schub- und Zugstange 22 und distalseitigen Wandabschnitten 70 der Lagerbohrung 56 benachbart des Schlitzes 58 gequetscht. Dadurch wird eine Kraft, die eine voreingestellte maximale Zugkraft übersteigt, begrenzt. Die Schub- und Zugstange 22 läßt sich dann nicht mehr weiter in proximaler Richtung bewegen.Inevitably, the plastic cylinder 66 squeezed and absorbs the force exceeding the set maximum value, whereby further movement of the push and pull rod 22 is prevented in the distal direction. Conversely, when there is a swing in the industry 40 from the industry 36 away when exceeding a maximum introduced tensile force of the plastic cylinder 66 between the bearing cylinder 52 adjacent to the exiting push-pull rod 22 and distal wall sections 70 the bearing bore 56 adjacent to the slot 58 crushed. As a result, a force exceeding a preset maximum tensile force is limited. The push and pull rod 22 can then no longer move in the proximal direction.

In den 3 und 4 ist eine zweite Variante einer erfindungsgemäßen Kraftbegrenzung dargestellt.In the 3 and 4 a second variant of a force limitation according to the invention is shown.

Die Schub- und Zugstange 22 ist wiederum mit einem zylindrischen Kopf 48 versehen, welcher in eine Lagernut eines Lagerzylinders 52 eingreift. Der Lagerzylinder 52 wird in einer quaderförmigen Ausnehmung 72 der Branche 40 benachbart dem Lagerbolzen 44 geführt. Die Ausnehmung 72 ist derart bemessen, daß ihre Breite im wesentlichen der Länge des Lagerzylinders 72 entspricht und ihre Dicke im wesentlichen dem Durchmesser des Lagerzylinders 52. Distalseitig ist die Ausnehmung von einem Querschlitz 74 begrenzt, welcher proximalseitig schmaler ist, als eine Breite der Ausnehmung 52. Dadurch kann der Lagerzylinder 52 distalseitig nicht aus der Ausnehmung 72 austreten und schlägt somit beidseitig benachbart dem Querschlitz 74 an Innenkanten 76 der Ausnehmung 72 an. In eine Sacklochbohrung 78, welche sich proximalseitig an die Ausnehmung 72 anschließt, ist eine Schraubenfeder 80 gehalten, die sich proximalseitig an einem Boden 82 der Sacklochbohrung 78 abstützt, distalseitig direkt am Lagerzylinder 52 anliegt.The push and pull rod 22 is in turn with a cylindrical head 48 provided, which in a bearing groove of a bearing cylinder 52 intervenes. The bearing cylinder 52 is in a cuboid recess 72 the industry 40 adjacent the bearing pin 44 guided. The recess 72 is sized so that its width is substantially the length of the bearing cylinder 72 corresponds and their thickness substantially the diameter of the bearing cylinder 52 , Distal side is the recess of a transverse slot 74 limited, which is narrower proximal than a width of the recess 52 , This allows the bearing cylinder 52 not on the distal side of the recess 72 emerge and thus suggests both sides adjacent to the transverse slot 74 at inner edges 76 the recess 72 at. In a blind hole 78 , which are proximal to the recess 72 connects is a coil spring 80 held on the proximal side of a floor 82 the blind hole 78 supports, distal side directly on the bearing cylinder 52 is applied.

Wird die Branche 40 gegen die Branche 36 verschwenkt, so stützt sich der Lagerzylinder 52 so lange an der Schraubenfeder 80 ab, bis die eingeleitete Kraft die dem Lagerzylinder 52 entgegenwirkende Federkraft übersteigt. Die Feder wird zusammengedrückt, und die Schub- und Zugstange 22 kann dann nicht weiter in distaler Richtung bewegt werden.Will the industry 40 against the industry 36 pivoted, so the bearing cylinder is supported 52 so long on the coil spring 80 until the force applied to the bearing cylinder 52 counteracting spring force exceeds. The spring is compressed, and the push and pull rod 22 then can not be moved further in the distal direction.

Claims (13)

Chirurgisches Instrument (10) mit einem Schaft (12), mit einem an einem distalen Ende des Schafts (12) angeordneten beweglichen Werkzeug (14, 16), mit einem an einem proximalen Ende des Schafts (12) angeordneten beweglichen Betätigungselement (40), mit einem dem Betätigungselement (40) zugeordneten Kraftübertragungsglied (22) zum Übertragen von Zug- und/oder Schubkräften vom Betätigungselement (40) auf das Werkzeug (14, 16) und mit einer Kraftbegrenzungsvorrichtung zum Begrenzen einer vom Betätigungselement (40) auf das Kraftübertragungsglied (22) wirkenden Zug- und/oder Schubkraft, wobei die Kraftbegrenzungsvorrichtung ein Kraftbegrenzungselement (80) umfaßt und wobei das Kraftbegrenzungselement (80) direkt auf das proximate Ende des Kraftübertragungsglieds (22) wirkt, dadurch gekennzeichnet, daß das proximate Ende des Kraftübertragungsglieds (22) einen zylindrischen Kopf trägt (52), daß eine Längsachse des Kopfes (52) quer zur Längsachse (20) des Schafts (12) verläuft und daß das proximate Ende des Kraftübertragungsglieds (22) in einer Aufnahme (72) des Betätigungselements (40) beweglich geführt und/oder gehalten ist und daß sich das Kraftbegrenzungselement (80) an mindestens einem Ende (80) der Aufnahme (72) und am proximalen Ende des Kraftübertragungsglieds (22) proximalseitig abstützt.Surgical instrument ( 10 ) with a shaft ( 12 ), with one at a distal end of the shaft ( 12 ) arranged movable tool ( 14 . 16 ), with one at a proximal end of the shaft ( 12 ) arranged movable actuator ( 40 ), with an actuating element ( 40 ) associated force transmission member ( 22 ) for transmitting tensile and / or shear forces from the actuating element ( 40 ) on the tool ( 14 . 16 ) and with a force limiting device for limiting one of the actuating element ( 40 ) on the force transmitting member ( 22 ) acting tensile and / or thrust, wherein the force limiting device is a force limiting element ( 80 ) and wherein the force limiting element ( 80 ) directly on the proximal end of the power transmission member ( 22 ), characterized in that the proximal end of the power transmission member ( 22 ) carries a cylindrical head (52) that a longitudinal axis of the head ( 52 ) transverse to the longitudinal axis ( 20 ) of the shaft ( 12 ) and that the proximal end of the force transmitting member ( 22 ) in a recording ( 72 ) of the actuating element ( 40 ) is movably guided and / or held and that the force limiting element ( 80 ) at least one end ( 80 ) of the recording ( 72 ) and at the proximal end of the force transmitting member ( 22 ) is supported on the proximal side. Instrument nach Anspruch 1, dadurch gekennzeichnet, daß das Kraftbegrenzungselement (80) direkt am proximalen Ende des Kraftübertragungsglieds (22) anliegt.Instrument according to claim 1, characterized in that the force limiting element ( 80 ) directly at the proximal end of the force transmission member ( 22 ) is present. Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß das Kraftbegrenzungselement (80) in einer Grundstellung, in der vom Betätigungselement (40) keine Kraft auf das Kraftübertragungsglied (22) ausgeübt wird, federnd gegen das proximale Ende des Kraftübertragungsglieds vorgespannt ist.Instrument according to one of the preceding claims, characterized in that the force-limiting element ( 80 ) in a basic position in which the actuating element ( 40 ) no force on the force transmitting member ( 22 ) is resiliently biased against the proximal end of the power transmission member. Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß das Kraftbegrenzungselement (80) am proximalen Ende des Kraftübertragungsglieds (22) in proximaler und/oder distaler Richtung angreift.Instrument according to one of the preceding claims, characterized in that the force-limiting element ( 80 ) at the proximal end of the force transmitting member ( 22 ) in the proximal and / or distal direction. Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß das Kraftbegrenzungselement (80) elastisch ist, insbesondere federelastisch.Instrument according to one of the preceding claims, characterized in that the force-limiting element ( 80 ) is elastic, in particular elastic. Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß das Kraftbegrenzungselement (80) eine Feder oder ein elastischer Kunststoff ist, insbesondere ein Elastomer.Instrument according to one of the preceding claims, characterized in that the force-limiting element ( 80 ) is a spring or an elastic plastic, in particular an elastomer. Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß das Betätigungselement (40) das Kraftbegrenzungselement (80) trägt.Instrument according to one of the preceding claims, characterized in that the actuating element ( 40 ) the force limiting element ( 80 ) wearing. Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß das Kraftbegrenzungselement (66) das proximate Ende des Kraftübertragungsglieds (22) im wesentlichen umgibt und daß das Kraftübertragungsglied (22) in distaler Richtung aus dem Kraftbegrenzungselement (66) herausgeführt ist.Instrument according to one of the preceding claims, characterized in that the force-limiting element ( 66 ) the proximal end of the force transmitting member ( 22 ) substantially surrounds and that the force transmission member ( 22 ) in the distal direction from the force limiting element ( 66 ) is led out. Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß das proximale Ende (52) des Kraftübertragungsglieds (22) im Querschnitt kreisförmig ausgebildet ist.Instrument according to one of the preceding claims, characterized in that the proximal end ( 52 ) of the force transmission member ( 22 ) is circular in cross-section. Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß der Kopf (52) mit einer in Längsrichtung des Kopfes (52) in einer Richtung quer zur Längsachse (20) des Schafts (12) verlaufenden Nut (50) auf ein zylindrisches Ende (48) des Kraftübertragungsglieds (22) aufschiebbar ist.Instrument according to one of the preceding claims, characterized in that the head ( 52 ) with a longitudinal direction of the head ( 52 ) in a direction transverse to the longitudinal axis ( 20 ) of the shaft ( 12 ) groove ( 50 ) on a cylindrical end ( 48 ) of the force transmission member ( 22 ) can be pushed. Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß die Aufnahme eine quer zur Längsachse (20) des Schafts (12) angeordnete, im wesentlichen zylindrische Bohrung (56) umfaßt, welche eine im wesentlichen in distaler Richtung weisende Öffnung (58) aufweist, die schmaler ist als ein Durchmesser der Bohrung (56).Instrument according to one of the preceding claims, characterized in that the receptacle is transversely to the longitudinal axis ( 20 ) of the shaft ( 12 ) arranged substantially cylindrical bore ( 56 ), which is a substantially dis taler-directional opening ( 58 ), which is narrower than a diameter of the bore ( 56 ). Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß die Aufnahme (72) zwei seitliche Führungen für den Kopf (52) aufweist und daß das Kraftbegrenzungselement (80) in einer zu seiner äußeren Form korrespondierenden Ausnehmung (78) eingesetzt ist.Instrument according to one of the preceding claims, characterized in that the receptacle ( 72 ) two lateral guides for the head ( 52 ) and that the force limiting element ( 80 ) in a recess corresponding to its external shape ( 78 ) is used. Instrument nach einem der voranstehenden Ansprüche, dadurch gekennzeichnet, daß die Aufnahme als eine mit einem in distaler Richtung weisenden Schlitz (58) versehene Querbohrung (56) ausgebildet ist.Instrument according to any one of the preceding claims, characterized in that the receptacle is in the form of a slot pointing in the distal direction ( 58 ) provided transverse bore ( 56 ) is trained.
DE10328514A 2003-06-20 2003-06-20 Endoscopic surgical scissor instrument has internal pushrod terminating at distal end in transverse cylindrical head Expired - Lifetime DE10328514B3 (en)

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