DE19705091A1 - Device-related method and puncture device for blood extraction from the skin of a living being and connected metabolism measurement - Google Patents

Description

The invention relates to the field of medicine technology, more specifically on the diagnosis of metabolism states.

The invention is essentially based on the explanations in DE 38 06 574 A1 ( FIGS. 3, 5-13), in which it was proposed to increase the safety of the opening of a sufficiently large blood vessel by following the tip of a cannula by rotating it the puncture can describe a circular path in the area of the larger blood capillaries lying below a circular path. The far cheaper lancet was also suggested as a puncture device, which is set in a swinging motion along its cutting edge. Where this movement is not a tilting movement about an axis parallel to the skin, the proposed arrangement was of little use. This is clear from the information about the "resonating skin" (page 14, line 24). A withdrawal of the lance to release the puncture channel is indicated in the text under " Fig. 55". European patent application 0 301 165 A2 essentially repeats the examples just described (with FIGS. 39, 41-46, 49, 53, 55-58) and applies rotation and vibration, ie multiple oscillation of the cannula and lancet. According to claim 12 relates to a puncture pen which is moved transversely to the skin. DE 39 25 940 A1 extends the invention with FIGS . 13 and 20-22. An axis of rotation for the lancet, which is located in a sleeve, is also specified here. According to claim 48, the lancet shaft has a lateral notch (for the axis of rotation), according to claim 53, the lancet shaft is both height-adjustable and laterally tiltable. According to claim 54, the lancet is connected via a device on the side resiliently with the frame of the top of the skin. According to claim 55 ( FIG. 13), a capillary is guided in a furrow (by shaft deformation) for taking blood up to close to the lancet tip. A central slot in the shaft can also be seen on the figure.

All the examples described are for use in designed an injector and therefore relatively elaborate and prone to failure, so that there is apparently none industrial use came.

The present invention aims to simplify by applying to the diagnostic The area has already been limited in terms of the task. A rod guide is supposed to be inside a seal in the suction cup roof still covered by the invention protection become; in fact controls were over Seals in the suction cup and especially in the suction Bell roof saved or avoided entirely. The best way to do this was - where not the suction bell itself became a disposable part - the lancet from the side the suction cup opening is changed.

The particularly high skin elasticity has the consequence that the skin as a membrane under suction more quickly into the Suction cup is raised as a more robust technical Membrane as seen from the suction cup roof under negative pressure can be lowered into the suction cup space. A (tel skop-) rod, under a resilient suction cups roof is fastened, can be excellent to achieve use the lateral tilting movement of a lancet. The Rod end - also over a cam disc at the end of the Width diameter variable - can be done at egg a wedge-shaped lancet shaft projection moves past (both from above with the approach of the Suction cup roofs as from below when for suction generation the roof is raised - for example by spring force).  

The projection on the shaft can also be horizontal and abrupt at the tip, so that a lifting rod with its final projection hooks there and pulls the lancet out of the puncture channel when it is raised ( Fig. 14). In order to drain the blood out of the puncture canal that closes through the highly elastic skin, no special capillaries are required if the stem has suitable stem extensions on its surface, for example in the form of lamellae with capillary gaps or edge bends - also from a punched-out central slot - having. In a special variation, edge edge (s) and slot edge (s) bent over from the shaft plane form almost one (or two) tube (s). The derived blood can be brought into contact with the test field of a commercially available sensor (for example for electrical glucose measurement) in that the shaft with its wide range is brought into contact with the test field in the area of the described lamellae. The test field can also be approached with a strip of blood on the skin after re-ventilation and removal of the suction bell usually with its strip-shaped carrier. A lateral descent of the blood drop can be avoided by the adhesive properties of the lancet shaft still stuck in the skin in that the suction cup is sunk by a deep lancet in its crest until it is ventilated again. Such a lowering of the lancet also allows a jerky pin movement laterally against the lancet shaft when using a so-called "suction switch" (DE 25 51 993 from 1974) against a return spring, the angular size of which can be adapted to the vascularity of the respective skin by means of a stop screw ( Fig. 5). A leaf spring overtaking the tip of the shaft allows the shaft to return to the vertical under the action of a return spring (possibly against a stop), but also due to the elasticity of the skin, which acts back. It is one of the main features of the invention that the tilt axis for the Lan zette is either itself a component of the device itself or, where the tilt axis is a component of the lancet shaft, for example in the form of an axle knob, that an axle bearing for this knob ( and possibly the corresponding excavation on the opposite side). Such an axle bearing can be arranged on a cross strut which starts from the suction bell cylinder; it can be the axle bearing but also mounted in a slot of an intermediate wall, which is part of a (preferably segmented) sleeve, which bell is vertically displaceable within the suction. In one example ( Fig. 1) the partition is loosely connected via a spring with a Kol ben which is centrally attached under an elastic roof membrane. The piston has a wedge-shaped bevel on its underside, which continues vertically into a recess in each case after a bevel of different lengths. When lowering the piston from this wedge bevel the end cap of an angle lever is moved so that its other end acts as a plunger transversely on the lancet shaft or the futile ralike and tiltably mounted receptacle of the lancet. The tilt angle of the lancet depends on the length of the wedge bevels on the piston that is effective on the angle lever. The receptacle for the lancet shaft, into which the lancet is inserted, contains a clamping spring (which may have already been thinned in the plastic injection molding process) and which is preferably opened when the lancet is inserted. This clamp can also be replaced by a permanent magnet, which starts from the mount or from the axle bearing and prevents the lancet from falling prematurely. The clamping spring can itself act as a receptacle for the shaft and can be provided with a tilting device. The vibration of the lancet suggested in earlier applications contradicts the principle of minimal damage and pain: only a single cutting movement across the skin is therefore intended. This cutting movement must be done quickly and jerkily so that the skin capillaries cannot avoid the cutting edge. It is advantageous for the lateral impact movement to be carried out by an electric magnet. This either acts directly on the particularly iron-containing receptacle of the lancet or preferably moves a plunger with spring back with the magnet armature. The electrical supply lines through a freely selectable location in the suction cup area offer no sealing problems. An alternative to the tilting axis, into which the lancet is inserted before the suction is applied (or which tilts on the holder of the shaft), the lancet, or its holder, can also be jerkily moved transversely to a skin that is fixed relative to it. This can be done via a plunger, the movement of which is effected via a suction switch or electromagnetically, or also via the movement of the cross strut for the lancet holder. Since the tip-facing lancet part penetrating the skin is blunted, the epidermis and its vessels are taken along and not injured during the transverse movement of the lancet shaft. The puncture canal can therefore be kept small, an advantage that is significantly increased by reducing the lancet width (compared to the commercially available ones today) and penetrating skin that has been stretched by suction (which contracts again later). The test field of a sensor (such as one from the Medidense product or Glucometer "Elite" from BAYER) can now be brought into direct contact with the blood outlet within the suction cup and while the skin is being raised. For this purpose, the lancet is inserted into the slot of a slide which is pushed sideways in the direction of the lancet cutting edge on a cross strut or even serving as a cross strut by means of a wedge guide in connection with a vertically moved rod or a plunger moved in parallel, for example an armature of an electromagnet . The last right, in the tip area and behind the tip, is bent approximately at right angles to the shaft length above the test field of the sensor strip. The lancet shaft has a window towards the test field or finer passages for the blood emerging from the cut. Finally, the lancet shaft can be completely absent and the cutting lancet part can be firmly placed directly on the test field (with or without a tab clasping the test strip. In the latter case, at least the end section of the strip with the test field itself is moved sideways to the suction bell axis to obtain blood Relative skin fixation is better if the diameter of the suction cup is smaller, as is the case with a pen-like device, ie the device is slender, but the possibility of skin extension is better used via a suction cup with a larger diameter The latter can also advantageously be used for dia phanic skin control for suitability for puncture. The light beam leads tangentially through the small central skin tip, preferably within the hole wall (or the window). A comparison of the radiation attenuation after different uses, but also during the skin movement into the window can be used for control purposes. Nodular skin changes reveal themselves by the fact that no skin enters the window of the perforated plate at all.

For skin control for suitability for puncture either the perforated plate in front of the lancet tip or the higher backing plate for the lancet first determined and if suitable for puncture examination movement will be released. Also a combined approach Both plates are possible. It can go through for manual trigger pins (on an acoustic or otherwise perceptible sign) through the together pressing two buttons. Is more appropriate the withdrawal of at least one locking member by the Electromagnet, which is also the shock to the movement of the Lancet causes. (The movement of the lancet at the Triggering of the spacing device for the skin does not bother).

The lower suction cup can be used for visual skin control some also be polygonal with lens reinforcement Viewing windows on the central (later) puncture site le. It can also be a kind of oblique tube from the suction cups roof from down and with lenses and with one Light measuring device to be equipped. In the latter case becomes the illuminated area around the puncture site expediently broken down into fields whose brightness differences are compared. An even easier one The procedure for optical skin control is the requirement a flexible film on the skin, at least in the the central spot is transparent or punched out. With healthy conditions in the area of this Zen Tralfleckes can circle segments outside the project tion of the suction cup rim with chalk on the skin marked and the suction cup inside the markings be placed. Directional beams of three can also be used Lamps that can enclose the edge of the suction cup, unite in the center and thereby see it mark control. If the central skin is suitable spot or focal point is the suction bell between put the three lamps and the suction triggered.  

The suction cup can also be used without markings using a circle de directly into the central recess of the marking if the intended and tested puncture area surrounding ring highly elastic Connecting cords or strips made of flat two of the film outside the suction cup, so that the ring marking the central puncture area is lifted with the skin in the suction cup. A such connecting strips can be folded and used once articles made of paper. One seems more advantageous integrated visual skin control. For this, minde serve at least a pointer or a projection pole, which pushed you diagonally through the suction cup wall Stop when its tip is the skin area in the center of the suction cup rim, but reached outside of it. The suction cup is so far away from the skin that the user selected the injection I can see from the side before I see the Slide the suction cup onto the skin under the rod guide. One or more vertical bars can also be made from the Suction cup standing out by a marker mark the puncture area and then into the suction to be pushed inside the bell. Such a Marking ring can be in front of the lancet tip - the can also be replaced by a cannula tip - high be pulled or pushed and then the skin fixation serve so that the latter of the lateral cutting movement can dodge less. When introducing a Lan tette in their holder in the suction cup can wedge-shaped shaft projection under the action of a clamp spring can be raised further. The lancet lowering too their removal can be done by lowering a rod sliding from the roof of the suction cup; the ge needed lancet can also pull over from below hooks are engaged in shaft notches. Before this is preferably done via a cover cap, which can also serve to pull out said rods.  

If the applicability of the device for diagnostic use was originally to be kept as wide as possible, an interpretation and further development was now required due to external constraints with regard to the special application by diabetics. Since very small glucometers are now available on the market, the positioning of the glucometer above the suction bell was considered, not just next to it ( Fig. 15). Especially since the hatching was not always adhered to to designate the depth space, Fig. 22 suggests the transition to performing the cutting movement by rotation. (The spring clip in the drawing was only to be interpreted as a sealing ring). The rotation even of an eccentrically arranged lancet tip in the skin now made sense, since the rotational movement, like the oscillating movement, was to be restricted to a short distance according to the invention. The upper layer of the skin is taken along because of its elasticity, without widening the cut, because only the tip area is kept sharp enough. The test strip for a glucometer only needs to be embedded in a cast cylinder in the area of the blood application in order to be able to be rotated within a ring seal to the suction cup space. The photometer itself does not have to rotate, but can be firmly inserted into a bracket above the suction cup. The cast cylinder expediently has above half of the part intended for rotation in the ring seal a diameter-widening caliber jump with lateral flattening or oval or even better polygonal shape.

A rotating part engages in this polygon like a key from above, which preferably continues into a ring arching over the suction bell ( FIG. 39, FIG. 37 top right). Since the lead wires within the test strips (which are usually glucometers based on electricity generation or flow) are kept relatively rigid, almost the entire test strip can be reinforced by the plastic casting compound and the glucometer on a kind of plate " Plate ". The limitations of the rotary movements are manifold: by pins on the turntable that abut a stop, by an adjusting screw between the parts that move. as a rule, it can be individually adjusted for the respective skin type.

The rotation itself can be bowl-shaped arranged cylinder assemblies take place, the rotating coil spring when depressing an over standing part ge over an oblique slot guide is stretched. The sector rotation is triggered by releasing the rotating cylinder in engagement with the Puncture stylus by lifting a locking member after a lead for one the suction bell surrounding (or next to their standing) suction cylinder after vacuum effect on the skin in the suction cup. The same principle of sequential control together hang with the movement of a preferably spring-loaded The vacuum pump will also cross the preferred one Arrangement of the suction cylinder or bellows Suction cup axis applied. (A corresponding off Solver design for triggering also from the edge the suction cup was already made by me in P 25 51 992 1974 in the course of my continuous development described the invention). Outside of the sogerzeu bellows with internal compression spring can be preferred show two rods in projection on the suction cup at or above her with appropriate bars below Compression spring action in places in the opposite direction  Get in touch. Issued at least one Compression rod - usually one one-sided, but also the second via lever between circuit may be - the turntable moment for lancet rotation. This rota tation can also via at least one of rod moving downwards can be created manually, if of this be a side projection or End within a gap or on the verge of one appropriate wedge guide meets and overhauled. The spline can also be on the bar.

The opening of the capillaries requires more suddenness of the lancet side shift than the length of the route, because the capillaries cannot avoid a sudden movement. For this purpose, ball catch-type grids can initially stop the rod movement under force build-up in order to achieve a higher breakaway speed. But it can also - and this can often be the case - direct the forces of a triggering movement according to the forces parallelogram against an axis of rotation so that first a counterweight in a kind of unstable equilibrium is allowed. The overrunning pawl of a rod can also have a spring which, when striking the falling shoulder of the spline, allows the turntable to spring back again. When applying a tilting movement for the lancet cut, the stabilizing vacuum effect on the sealing area in the suction cup roof is a problem. It can be solved in that the lancet carrier behind the cutting edge has a uniform semi-rounding, which is in the same ge-arched channel in the suction cup roof is fitted, this groove has a slot for the passage of the lancet cutting edge. Sealing takes place on the rolling surface, for example when the glucometer fitted with the lancet carrier is pressed in the direction of the suction bell. The tilting movement of the glucometer on a box-like base base can be carried out against a spring via the pull on an eccentric rod, which is generated on a gearwheel with a rack. In a pneumatic solution, the pin of an overpressure switch strikes the then tilting glucometer from above, diagonally downwards towards the side. The overpressure is generated manually using two pairs of book-like hinged plates, which close two air bags. The plates mentioned are knocked off from the broad sides of the glucometer about an axis by two further plate pairs, so that a kind of seesaw is achieved. After air bags between the plates have expanded somewhat towards the suction cup to create suction for skin attraction, the compression of the upper air bags causes the compression for the pressure switch. Latching bolts across the plunger of the overpressure switch can be adjusted to control the breakaway force. The rocker is reset by a ventilation valve on the counter stop for the tilting movement of the glucometer, which is adjustable in length along an Aret rail. Instead of rotating the puncture stylus, the skin can also be taken along by a rotating suction cup. With regard to the oscillating movement, the solution of FIG. 15 is finally used again because of the sealing problem described. The test strip is now inserted through the suction cup roof from above. This is done in connection with the glucometer which is inserted into a kind of clip in the base. The plate of the base base is folded down onto the suction cup roof via a hinge joint (preferably by overcoming an overhaul spring, which guarantees a slight pressure against the suction cup). A seal at the end of the base plate connects with a rubber plate to a counter plate in the suction cup roof that the latter is also sealed around the inserted test strip. The latter ends in the suction cup in a casting with a lancet tip and measuring zone. The cutting movement takes place via a plunger, which is led across by a seal in the suction cup wall. He pushes over a kind of wedge guide operated from the outside jerkily against the casting or the casting cylinder or against the test strip and moves this against a counter pin. The latter is adjustable in length from the outside through a seal in the side wall of the suction bell.

The generation of the negative pressure takes place only as an example and for variation via the manual expansion of a bellows. Also, for example, this movement is used to actuate the tappet for the lancet vibration via a locking grid. With this spatial arrangement, it is particularly easy to introduce a blood-free vacuum channel transversely behind the slot next to the cushion with the measuring zone, which favors the influx of blood. In the cast cylinder, a continuous slot is provided for the insertion of the end of a test strip, which is cemented in if it is not tightly cast ( Fig. 39, bottom right in cross section). The length of the cast cylinder, which can also be flattened in the upper section, is very variable. The suction channel behind the measuring zone can also end from below next to a small spout partially surrounding the lancet. If the casting surrounding the reaction or measuring surface continues in the flat test strip, an expansion of the slot is sufficient, in which the end of the test strip is then fixed on one side (also by subsequent gluing or insertion with a snug fit under a wedge profile). The negative pressure is then also effective away from the blood on the test surface, while a cannula or groove is also closed in the skin and closed down. For the production of such a channel, an insert can be provided by casting technology, which is expediently connected to the strip-shaped insert for the test strip slot ( FIG. 51 middle). The lancet can also be conical, since the cutting action of the cone tip is sufficient to open the capillary.

In order to keep the blood outlet channel free, a sleeve can be provided around the casting or sheet with a lancet tip, which sleeve is pushed downwards over the lancet tip by means of a rotating or pushing action (especially from outside the suction cup or through the inner magnet) after the cutting movement. The skin is pushed out of the lancet and the blood collects directly inside the sleeve. A type of such a sleeve can also serve to regulate the penetration depth, which the user takes before the puncture, depending on his skin type. In order to clear the blood outlet channel, the oscillating or rotating movement of the lancet can also be recorded with a suitable cutting edge selection so that the stretching effect creates a skin gap against the direction of movement. Since the cutting movement is usually too short for this, in this case a slow subsequent or supplementary movement is expediently carried out in the same direction without cutting action. The return movement of the cutting edge can be made possible against a weak spring so that - for example in the case of unintentionally premature suction cup ventilation - there is no widening of the cut in the retracting skin ( Fig. 49). If the cutting movement is carried out by lowering a rod, not only can the lancets be released back into the starting position, but also the opening of a ventilation valve for the suction bell can be linked to the pulling movement of this rod ( Fig. 53 left). With manual vacuum generation, the re-ventilation can also be effected by loosening the pump tappet raster ( Fig. 42 top left). With spring-operated vacuum pumps, the vacuum is of course canceled when the pressure is applied manually against the spring; Usually, however, the axis tilting of the device is sufficient, with the suction bell edge standing out. To prevent this from happening prematurely, the bridge between the suction bell and the pump cylinder is pulled down to the edge of the suction bell or a little lower. The surface of the body that is suitable for puncturing always has a curvature. The widened lower surface of the device can then be supported on this ( Fig. 42). The re-ventilation would take place here by tilting the device around its broad side as an axis or transversely to the image plane.

In order not to favor a premature lifting of the suction bell due to the spring return of the pump, two pumps with a vertical tappet axis can be mounted including the axis parallel to the suction bell ( Fig. 46). The rods for triggering the lancet movement are expediently designed to be pivotable about an axis in order to be able to create them alongside the use of the long side of the device. The lowering movement of the rods can also actuate the triggers for the pumps in the first movement phase. The latter are connected to one another via a web or a strip ( Fig. 52, top right).

A puncture stylus with a dome-shaped end can also be designed as a disposable device. A band-aid with a slot for the lancet tip can fix the skin in relation to the lancet movement in an indentation depression; the skin can also be pulled up like a tent by means of the puncture stylus before the tilting movement for the cut ( FIG. 30).

For optical skin control using brightness measurement compare in a photometer operated in one Example an electromagnet a pen with snails leadership, the light over fibers and / or lenses first towards the skin. Is this free of unsafe shadows (i.e. inside before programmed brightness differences) in the groove rich, the magnetic movement causes the direction change of light to an optical glucose measurement Zone.

However, the subject of the invention was mainly visual skin controls. The easiest way is to press a suction cup or a ring corresponding to its size against the skin, where the mechanical stress can be known for a while. A plate that can expediently be pushed onto the suction bell (for storage) with a jumping edge and a central tip can be useful for this purpose, because the puncture site is exactly noticeable in front ( Fig. 33 below). If the skin is suitable and the puncture stylus is inserted, the suction cup is put back into the impression ring that was created by the stencil ring or the suction cup rim itself. It is also advantageous to have two opposite marking points by lowering the pointed bolts, which are guided in bores of tabs on the outer edge of the suction cup ( Fig. 25). A more complex solution is a transparent cast cylinder (for measuring field and lancet tip), through which light is thrown onto the puncture site from above in the direction of the glucometer. The light is reflected from the skin and the image of the puncture site can be viewed via a prism or a mirror on the side of the handle attachment ( Fig. 40 above). It is particularly advantageous to have a view from above before introducing a puncture pen with test strips. A special instrument with light directed downwards through the ring seal of the suction cup roof can then become effective with the corresponding eyepiece lens. It is far more practical to leave the view into the suction bell wide open when using a vibrating lancet. A lamp with beam concentration, particularly on the puncture site, can be mounted on the base base at the top, but also at an angle in the area of the suction cup wall.

The suction cup is then covered against a wide sealing ring over a cover ring on the glucometer with slot opening for the test strip fenschacht is tightly attached under pressure towards the edge of the suction cup. There is none in the glucometer Sealing around the shaft in front and is the Air space considerably in the glucometer, so an Ab Seal the test strip or puncture stylus be provided in the lid area. Also at This can be done by rotating lancets that above, far from the casting around the measuring field,  a cylinder rounding around the test strip in a Seal in the lid area is inserted, one second seal below also on the rotary stylus can fall. The flat test strip can also be used between two approached rubber sheets to get nabbed. By pressing them against each other follows the seal around the test strip in the lid middle, while the side seal again thanks to a separate ring seal for pressure - done from above. The approach of the rubber sheets can be by a bracket near the inner edges happen, which ver against a wedge guide is pushed. The crosswise closure can also from the outer edges of the rubber sheets if this with a rail guide lateral wedge guide. The rail guide can also correspond to the pressure of the cover ring from above serve the wedge guide. The latter will then follow the wedge guide for the rubber plates is effective so removed from the device on the rail.

State of the art

The feature of introducing the lancet from below as the main claim was used for a common generic term of the variety of models; In the meantime, examples of cannula insertion from below have also been found in my previous applications. From the original summary, the main task is already to couple the puncture device directly with a glucometer. The usability of the invention Euro Pat. Note 0 301 165 (published on February 1, 1989) was initially not recognized because the devices described therein provided multiple oscillating movements of the lancet or no restrictions on its angle of rotation towards the device, and because the tissue destruction caused thereby prevented this The goal of minimally invasive diagnostics ran counter to this. In April 1996 at the latest, as a feature of the current FIG. 23, I had the very brief, jerky rotation of a slightly eccentric lancet, the end of the tube around the lancet, to prevent the blood from flowing away from the top of the skin in the factory. . . presented. I also proposed, for example, to create a vacuum around the lancet using a compressed coil spring with a membrane seal and to couple the movement of the coil spring with the triggering of the sector movement of a rotary spring for the torque of the lancet. The goal presented should be to have the blood drawn directly from the test field of a glucometer in connection with the collection process.

Description of the embodiments

Fig. 1 shows a longitudinal section through a point tion device on a scale of 2: 1 again. The commercially available injection syringe for suction generation held in place in an edge nozzle by means of the locking screw ( 16 ) was omitted. The hole for the sealed connection with the syringe cone inside the cylindrical suction bell ( 1 ) was filled in black.

The piston ( 2 ) is centrally connected via a screw connection (not shown) between the head of the piston axis ( 3 ) and the retaining washer for the sealing ring ( 5 ) with the elastic cover or roof membrane ( 4 ). (The clamping ring ( 19 ) can be mounted on a slope of the piston axis).

The hexagon screw ( 20 ) is firmly tightened against the clamping ring ( 21 ) on the piston axis, which is in a depression of the piston of angular cross-section. The piston can be rotated at the head of the piston axis, which influences the contour of the wedge bevels ( 6 ) on the piston (cf. FIG. 3). The wedge-shaped bevel lies against the dome-shaped end of the angle lever ( 14 ), the axle bearing ( 18 ) of which is worn on the carrier plate ( 7 ) of the sliding sleeve ( 12 ) bent rag. An arm leads from the angle lever to the tip of the lancet shaft ( 13 ). A registration in the latter lever arm end serves as a stop against raising the lancet in its receptacle ( 10 ). A torsion spring guides the angle lever into the longitudinal groove ( 22 ) of the suction bell with a spur. The resulting guidance prevents rotation of the sliding sleeve and its emergence from the bottom of the suction cup (if the angle lever is not actuated). The axis of the acquisition for the lancet with the torsion spring ( 11 ), which acts against the stop ( 12 ), is connected to the carrier plate in the tongue ( 23 ).

The cavity in the piston ( 2 ) is used to accommodate the battery ( 83 ) insofar as the inclined tube ( 31 ) for optical skin control (cf. FIG. 4 above) allows it.

Fig. 2 is a cross section through the device of FIG. 1 at the level of the support plate ( 7 ). Through the boring ( 33 ) in the latter, observation takes place via the inclined tube, as demonstrated in FIG. 4. The axis ( 25 ) for the receptacle ( 10 ) for the lancet shaft ( 13 ) is opposed by the permanent magnet pin ( 26 ), which can prevent the lancet from falling out. The axis can also (here within its bore) be sprung towards the lancet pin and penetrate into a hole or into a cavity ( 76 , FIG. 10) of the lancet shaft and the lancet can be pulled out of it again after use as a result of a slight bevel or rounding of the axis . In the slot ( 27 ) of the support plate, the clamping spring ( 28 , detail at the bottom right) with its axle knobs ( 29 ) can snap into the bearing bores, the inner clamp legs also serving to hold the lancet shaft. The latter function is performed in detail in the lower center by the spring tongue ( 30 ), which may have broken out of the wall of the receptacle ( 10 ).

On the right above the detail of the spring clip, another cut along the section line AB of the longitudinal section, the manner of representation also of the detail at the bottom center. The longitudinal section of a lancet is reproduced in the top center, in which the side edges of the tip were bent open at a right angle, as can be seen from the cross section on the right. On the far right another cross-section along the section line AB of the longitudinal section, in which inner edge bends ( 36 ) were additionally made from a central window opening ( 37 ). (The window opening is shown a little too narrow).

In Fig. 3, the function of the wedge bevels on the underside of the piston, to which the end of the angle lever ( 14 ) rests, is demonstrated approximately in a reduction to 70 percent in schematic longitudinal sections on the left and cross sections on the right through the detail of the upper suction bell. The arrow on the right of the cross-section symbolizes a pointer which indicates the stages of the piston rotation, which lever deflections against the lancet (not shown) shorten from top to bottom.

Fig. 4 shows schematically the inclined tube ( 31 ), which has a sealed top window in the elastic cover membrane ( 4 ) and the lens ( 32 ) below. The latter extends through the bore of the support plate ( 33 , Fig. 2) and lets the future point of observation through the window in the cover membrane be observed. The light source ( 17 ) can replace the one shown in FIG. 1. Instead of the eyepiece lens (not shown) in the window cut-out ( 33 ) of the cover membrane ( 4 , FIG. 1), the sensor ( 34 ) is drawn with its line in dashed lines. The beam path from the light source ( 17 ) via the lens ( 32 ) to the puncture area on the skin and back to the sensor is sketched in broken lines. The proximity of the carrier plate ( 33 ) is only indicated. Below is a cross section of a device for lancet rotation after the puncture, as can be used in a device according to FIG. 5. The receptacle ( 10 ) here is a sleeve, in which the transverse axis is shown schematically, namely at a stage already rotated at right angles to the cutting direction of the lancet. The rotation took place via the swivel lever ( 38 ) on the hand pins ( 39 , 40 ) against a torsion spring ( 41 ). The cut is spread open by the transverse lancet (not shown).

Against the torsion spring, the receptacle ( 10 ) is prevented by the raster ball ( 42 ), which is pressed into a recess of the receptacle ( 10 ) by the U-slide ( 44 ), the ball lying in a transverse bore in the guide bar ( 43 ), which can be part of the support bar ( 63 , Fig. 7). The rotary movement is released when the U-slide ( 44 ) is pushed against its compression spring by the push of the transmission rod ( 53 , FIG. 5) after the tilting movement of the lancet is shifted to the right. The grid ball can then escape into the gap ( 45 ) of the U slide.

To start up a device according to FIG. 1, the sliding sleeve ( 8 ) is lowered while taking the receptacle ( 10 ) under the action of the spring ( 15 ) in that pressure is exerted by the head of the piston axis ( 3 ). Since the cover membrane ( 4 ) is only attached to the top of the suction bell cylinder and around the piston axis, its elasticity can be exploited, which also restores the starting position. The electrical lines between the battery ( 83 ) and light source ( 17 ) are rolled out of their course in a groove of the suction bell cylinder (right) so that they do not interfere with the height shift of the inner parts (dashed lines). After it has been carried out, the spring ( 15 ) is releasably fastened to a hook under a gap in the carrier plate ( 7 ). After lowering, a used lancet can be removed from the holder or a new one inserted into it. That is, the latter happens until the shaft engages in the axis ( 25 , FIG. 2) or until the lancet tip abuts the arm of the angle lever ( 14 ). An injection syringe is now inserted into the cone (black) in the suction cup wall and fixed there using the locking screw ( 16 ). The suction cup is placed on the skin, its suitability checked via the inclined tube ( 31 , Fig. 4 above) and then the syringe plunger is withdrawn. The skin is raised by the negative pressure in the suction cup area, but the lancet tip is also lowered into the skin by lowering the elastic cover membrane, where there is hardly any resistance. Against the stop then given on the broad side of the lancet shaft, the piston lowers further and its wedge bevel ( 6 ) actuates the angle lever ( 14 ), the side abutting against the end of the lancet shaft and tipping it over. The torsion spring around the axis or even the skin elasticity lead the lancet back to the starting position when the rocker arm leaves the wedge bevel with its end in a gap in the piston ( 2 ) ( Fig. 3). By actuating the injection syringe plunger as for injection, the suction bell is re-aerated, the lancet first leaving the skin under the pulling action of the cover membrane.

Figs. 5 shows a longitudinal section on a scale of 4: 1, an invention example in which the tilting movement of the lancet is caused in its housing around the axis (25) about a laterally arranged bellows (46) against the weak compression spring (48). The latter lies against the suction bell cylinder ( 1 ) or a fastening plate ( 61 , FIG. 6) on the latter and, via the ring ( 49 ), against the bellows, which is connected in a sealed manner to the tappet ( 47 ). The plunger ends in a hole in the suction cup wall and lies on the side with a rounded tip of the sliding sleeve ( 8 ). This in turn is connected via a collar directly to the elastic cover membrane ( 4 ). Again, an inclined tube ( 31 ) is used as a means for optical skin control (shown in detail). Above the contact with the plunger ( 47 ), the sliding sleeve has the funnel ( 52 ). In this and in the support ( 54 ) standing on the support plate ( 7 ), the transmission rod ( 53 ) is mounted, on the end facing the lancet shaft a bridge arch as a movement limitation for the lancet displacement upwards and the leaf spring ( 55 ) are fastened. In the version shown, the lancet shaft ( 13 ), the axis ( 25 ) of which is carried by the (advantageously paired) tongue ( 23 ), is displaced from the depth plane with the transmission rod ( 53 ), so that the lancet shaft is supported by the leaf spring ( 55 ), which extends into the plane of the lancet shaft. The transmission rod itself reaches the lancet shaft past the gallows ( 58 ) with a guide sleeve, which determines the movement distance of the transmission rod in an adjustable manner by means of the adjusting screw ( 57 ). This gallows can expediently have a cross pin on which the tilting movement of the lancet shaft detects its limitation. The unimpeded further movement of the transmission rod, insofar as this is displaced by the plunger penetrating into the funnel ( 52 ), can serve the actuation of a further function (as indicated, for example, in relation to FIG. 4 below). The rotation lock for the sliding sleeve he follows here by the guide pin ( 51 ) in the groove ( 50 ). The start-up and function are largely the same as described for FIG. 1. Only after the sliding sleeve has been lowered can the plunger ( 47 ) penetrate the funnel ( 52 ) and develop its thrust force, which is built up under the action of the plunger, against the weak return spring ( 56 ) for the transmission rod.

At the bottom is a lancet in longitudinal section with the window opening ( 37 ) and the inner edge bends ( 36 ) made of the material of this window opening. Above it two cross sections along the section lines AB and CD of the longitudinal section and on the right a vertical section along the section line EF. A part of the dome ( 59 ) for evading the top of the skin is shown.

Fig. 6 shows a cross section through the direction of Fig. 5 also on a scale of 4: 1 at the level of the support plate ( 7 ). In the two opposite notches ( 60 ) are the hand pins ( 39 , 40 , detail in vertical section at the bottom left), on which the pivot lever ( 38 ) for the rotation of the receptacle ( 10 , Fig. 4 below) is actuated. When the hand pins within the edge notches approach, the clamping spring ( 28 ) is opened like a hose clamp for changing a lancet. On the left you can see the mounting plate ( 61 ) for the GE sprung bellows ( 46 ). The funnel ( 52 ) with the hole in the support ( 54 ) and the transmission rod ( 53 ) are higher. The lancet shaft ( 13 ) next to the leaf spring ( 55 ) are somewhat eccentric. The dashed segment delimitation on the carrier plate denotes a gap for the operation of the adjusting screw ( 57 ). The bore ( 33 ) in projection onto the inclined tube is also drawn. The groove ( 50 ) opposite the cone of the injection syringe (detail) is inserted and fixed with the locking screw ( 16 ).

Fig. 7 shows on a scale of 2: 1 in longitudinal section a puncture device triggering the tilting movement of the lancet by overhauling a wedge bevel during suction generation in a sprung bellows. Here, the bellows ( 69 ) with the strong compression spring ( 70 ) sealed inside on the base plate ( 71 ) attached. On the opposite side, the bellows is delimited by the cover plate with the basket ( 68 ). The latter avoids dead space and can also accommodate the battery and the electronic control center if required. The upper part of the hook rod ( 64 ) with the end plate ( 67 ) runs in it in a central bore. The base plate is sealed to the cylinder of the suction cup ( 1 ) by means of a grommet with a bayonet lock. The latter carries at the bottom the transverse support bar which divides the diameter and comprises the receptacle which can be tilted about the axis ( 25 ) with the lateral guide wedge ( 62 ). Below this lies the end profile plate ( 65 ), which has different distances from the guide wedge depending on the rotational position. This can be seen from the detail below in cross section along section line AB. The Endprofilplat te is held by an axis in the hook rod with end screw; the necessary pressure, possibly along an angular scale on a widening of the larger arm of the hook bar (not shown), is provided by the leaf spring ( 66 ) against this arm. The suction bell cylinder, the attachment ring ( 72 ) is pushed on, which is then placed on the skin. The top ring can be replaced by such a different height or supplemented by more.

At the bottom left you can find the detail of a lancet shaft with a tip in a large magnification, illustrating the manufacture of the outer edge bends ( 35 ). The functional stage shown corresponds to that of the tense compression spring ( 70 ) in the compressed Fal tenbalg by the puncture device can be placed on the skin.

Fig. 8 shows the puncture device of Fig. 7 in the stage of deployment of the bellows for suction generation. The end profile plate briefly displaced the guide wedge of the receptacle for the lancet and caused a tilting movement. The hook bar was only raised after the bellows had unfolded enough to suck in a skin located under the attachment ring. This is evident from the position of the end plate ( 67 ) in the basket ( 68 , Fig. 7).

Fig. 9 shows an enlargement of about 4-1 in the middle of a cross section through a transparent suction cup with lenses ( 32 ) on a polygonal outer surface.

As can be seen from the detail in the longitudinal section at the top left, the lenses are tilted downwards so that the view is directed directly to the center under the suction cup - namely to the skin area intended for puncture. The dashed lines and arrows indicate the beam path from the light source ( 17 ) through the lens of the suction cup ( 1 ) to the cornea of an eye.

Fig. 10 shows in a longitudinal section on a scale of 2: 1 a puncture device similar to that of FIGS. 7 and 8. Instead of the bellows, a special cylinder-piston pump ( 73 ) is used, the upper part of which has been omitted. The pump cylinder has a caliber jump at the bottom and is inserted as a jacket into a suction bell, which is designed as a disposable part (cf. FIGS. 11, 14 above). The lancet is mounted in the trough-like depression of the suction bell (from above) in the central axis ( 25 ) (for example as a knob in a bottom slot which engages in a shaft hole). The bottom sleeve with perforated cover ( 80 ) contains a slot to the right for the lancet deflection, and it also has an almost all-round mirror edge ( 79 ). From the puncturing device belonging to the light source ( 17 ) the light falls through the upper wall ring of the suction bell onto this mirror strip and is projected from there past the pinhole back onto the mirror strip and then passed through the wall ring to the sensor ( 34 ) of the reused puncturing device. This takes place in the stage (shown in dashed lines) of the elevation of the pinhole by the skin, the light being attenuated when it passes through the skin which has entered the hole of the panel. Based on measurement comparisons in the electronic control center (which is not shown, but could be integrated in the piston or connected to the pump cylinder), the suitability of the skin for puncture can be concluded and a signal can be given by the control center.

Until then, lifting the skin through the perforated balls de into the lancet tip through the side Pressure on the highly elastic wall of the suction cup cylinder that are prevented. The prerequisite is the blockage tion of the pump piston opposite the cylinder to it to prevent returning under vacuum.

Light source ( 17 ) and sensor ( 34 ) fit into corresponding niches in the disposable potty or part ( 74 ).

At the bottom, approximately six times the magnification, the view of a lancet shaft with lateral shaft projection ( 75 ) and an axle knob ( 29 ) in the shaft. The latter corresponds to an axle bore ( 76 ) on the opposite side, as can be seen on the cross-section on the left.

The lancet is tilted by passing the hook rod ( 64 ) with its button on the wedge-shaped shaft projection of the lancet while the piston is being raised. Until the abutment of the guide pin ( 51 ) at the end of the hook rod on the locking pin ( 77 ) in an eccentric bore of the piston creates enough negative pressure for the skin to rise. The leaf spring ( 78 ) holds chen during the insertion of the pump into the disposable pot or thereafter the lancet against the displacement by the button of the hook rod in the middle position.

Fig. 11 shows a puncture device under Ver application of disposable potty as shown in Fig. 10. The negative pressure is produced here by means of the storage pot compre hensive bellows (69) with the compression spring (70). The overrunning mechanism of the hook bar ( 64 ) with guide pin ( 51 ) was integrated into a hole in the head of the cover plate of the bellows. There is also space for the battery ( 83 ) and the electronic control center ( 84 ) in the roof cylinder attachment ( 82 ). The base plate ( 71 ) is sealed off from the disposable potty by means of a sealing ring in the base plate.

On the right, for the sake of clarity, the detail of a trigger mechanism for raising the pinhole is drawn out on a scale of 4: 1, as is present on both sides, in order to roll on the hand levers ( 86 ) with rollers and the deflection roller ( 87 ) and roller ( 89 ) Using a cable, pull the torsion spring to pull back the locking plunger ( 88 ), which is membrane-sealed to the suction bell chamber. This action is again carried out on a signal from the control center, which reports the suitability of the skin after an optical inspection (not shown here).

Fig. 12 shows in longitudinal section on a scale of 5: 1 a puncture device for the row application in Kli technology and practice. The lancet is mounted in the axis ( 25 ) like that in a disposable potty as a suction cup ( 1 ). The lower protective film ( 81 ) is still present, the upper one has already been removed; the plastic tube ( 90 ) was pushed into an edge groove. The receptacle ( 10 ) for the end part of the lancet shaft is located in the tube with outwardly projecting supports. If the lower protective film is removed and the edge of the suction cup is placed on the skin, the hose can be connected to a permanent suction source, such as a water jet pump. As soon as the skin is lifted into the lancet, a tilting movement in the direction of the arrow can be carried out within a kind of parallel bars with guide rails (symbolized by dash-dotted lines). The receptacle ( 10 ) and the lancet shaft are taken along, which is why the (black drawn) slot gives freedom of movement.

The Fig. 13 presents a flexible film that is placed to the mark and controlling the areal puncture on the skin. Through the cut out ring segments ( 95 ) the outline of the suction cup can be displayed with chalk and the last can then be placed within the marked circle.

As an alternative, the dashed lines show that the puncture point in the inner ring ( 93 ) is visible. From the inner circle go out highly elastic connecting tabs ( 94 ), which are held by an outer film ring that surrounds the edge of the suction cup. Thanks to the elasticity of the connecting straps, the inner ring can be raised within the suction cup during the formation of skin dome.

Fig. 13 below shows a foil ring within which a suction cup can later be placed. Around the foil ring ( 91 ) three light sources ( 17 ) are mounted on three tabs at equal distances on sloping bases ( 92 ), which are in line connection with the battery ( 83 ). The directional rays of the three light sources combine in the central puncture area.

By moving the film one can be used for puncture suitable skin spot can be selected.

Fig. 14 shows on a scale of 2: 1 a disposable potty as a suction cup, which is closed at the top and bottom by a (drawn with a dashed line) protective film. Also shown in dashed lines is the possibility of lowering a bellows with hook bar ( 64 ) after the action of suction through the opening ( 97 ) in order to generate a lancet tilting movement. A slight re-ventilation via the valve ( 96 ) allows the bellows with the hook rod to rise slightly, the end hook of the hook rod dropping into a profile at the end of the wedge rise on the lateral lancet shaft projection. The lancet is pulled out of the cutting channel.

The longitudinal section shows in detail the possibility of a lancet tilting by an electromagnet. About the magnetic coils ( 99 ), the magnetic core ( 98 ) can be excited, which attracts the magnetic iron ( 100 ) in the receptacle ( 10 ) for the lancet and the tilting movement about the axis ( 25 ) in the support bar.

Below two lancets in supervision in 6: 1 scale. In the upper one, the material from a window cut-out ( 37 ) was used for an inner edge bend ( 36 ) on the same side on which an outer edge bend ( 35 ) was carried out. As the cross-section along the section line AB shows, with a corresponding curvature of the edge almost a tube for blood drainage is created from the cut area under the skin.

In the tip area of the lower cannula, folded or shaped lamellae ( 101 ) for blood drainage can be seen.

Fig. 15 is a longitudinal section on a scale of 3: 1 through a puncture device, which leads the blood derived from puncture directly to the test field of a measuring device, which could even be ruled out even during the puncture. The so-called bellows ( 69 ) with the compression spring ( 70 ) in the cylinder cup ( 111 ) is arranged to the side of the suction cup ( 1 ). It is shown in a compressed state. The cylinder cup ( 111 ) is connected to the roof of the bellows and is displaceable between the jaw segments ( 102 ) which are attached to the suction bell. As the roof of the suction cup, the piston ( 2 ) is redesigned in such a way that a large number of tongues ( 114 ) which, in order to prevent jamming, run in bores of an inner edge projection of the suction cup cylinder. Also from below from the pinhole ( 80 ) pins run in bores of that edge projection of the suction cup, sectorally offset to the piston movements ( Fig. 16). By means of ring-shaped lines ( 112 ), the suction bell cylinder is divided into an upper and a lower part. Under the roof of the piston ( 2 ) an electromagnet with the magnetic coils ( 99 ) is mounted, the armature of which carries an end plate which projects into the fork ( 107 ). The fork ( 107 ) in turn is part of the U-shaped slide ( 109 ), the lower leg of which is widened in a plate shape with a rail guide for inserting the end of a lancet shaft ( 13 ). This is clearly shown in detail as a cross-section (below) along section line AB.

When the piston roof, which is connected to the center of the elastic membrane ( 4 ), is placed on the table, the test tire ( 103 ) can be placed along a (not shown) rail on the housing of the battery ( 83 ) and control center ( 84 ) and the test field ( 104 ) is pushed under the window of the cutting edge of the lancet. The lower part of the suction cup is then put on with the sealing ring and both parts are connected with two opposite clamps ( 105 ) over the edges ( 106 ). However, the latter are offset by 90 degrees from the depicted.

With the upper leg of the slide one end of the Bowden cable ( 108 ) is attached, while the other end as a release pin ( 115 ), which has a gap for the pin ( 113 ) from the pinhole and then enters a gap in a piston tongue ( 114 , Fig. 16 detail on the left). The cross section through the suction pump bottom right of the middle shows the cylinder cup ( 111 ) between the jaw segments ( 102 ), the movement under the action of the spring by the hook on the hand button ( 110 , bottom left detail in scale 6: 1 prevents horizontal ver As soon as the hook is lifted out of a gap in the cylinder cup against the pressure spring of the button, the bellows expands. The air in the suction bell is discharged via the channel ( 116 ). The pinhole is lifted through skin and suction until the widened pin of the pinhole pushes against the release pin ( 115 , Fig. 16, left detail) After the optical skin check according to Fig. 10 has been carried out, the control center actuates the electromagnet and thus the Bowden cable if the result is favorable. (Light source and sensor were not shown here). The trigger pin leaves its gap in the piston tongue and over the widened pin from the pinhole, so that the pinhole can be raised and the piston ( 2 ) lowered. The clip ( 117 ), which engages in a hole in the test strip, pulls the test strip a bit into the interior of the suction cup. Shortly after the contact between the lancet and the skin is reported in the control center, a second magnetic stroke is triggered, which causes a vascular injury due to the sudden lateral displacement of the cutting parts of the tip. (The blunt parts of the lancet - as well as the side edge bends - only slightly move the upper parts of the skin. The spring returns to the starting position and thus also the slide. The suction cup can be re-ventilated by a separate (not shown) Valve done or by pressure on the cylinder cup ( 111 ) of the pump.

Fig. 16 shows a cross-section in the region of the boundary between the upper and lower part.

The position of the pins ( 113 ) from the pinhole is shown and also that of the piston tongues ( 114 ). The position of the test strip ( 103 ) and that of the lancet shaft ( 13 ) are also noted in dashed lines. Above the suction bell ( 1 ), a half of the piston ( 2 ) with a piston tongue ( 114 ) is shown in longitudinal section in detail, to the left below and next to it the further enlarged detail about the trigger mechanism after the optical skin control, which is by means of light source ( 17 ) and Sensor ( 34 ) takes place.

Supplement to Figure 15 center right. The further enlarged end portion of a lancet has in the region of the test field (104) eight slots for a better transfer of blood and tissue fluid into the test area.

The detail on the bottom right shows a window opening ( 37 ) next to the (hatched) lancet blade with a tip bent at right angles. A combination of windowing and slitting is also possible, or a sieve-like breakthrough. Finally, lancet tips can also be applied to the test field without a longer shaft, as shown to the right of the cross section through the pump for the slide design. Puncture tips can also become part of the test strip in the center of their test field. Instead of the clamp ( 117 ) for the passage of a test strip through the seal ( 112 ), a V-shaped kink or bend of the test tire is expediently carried out within the suction cup space.

FIG. 17 shows a longitudinal section at the top through the upper part of a puncture device similar to that described for FIG. 15. While there the slide ( 119 ) was moved past under the test strip clamped at the edge under the seal with the lancet, here both the lancet with the bent puncture tip and the test strip ( 103 ) are moved together, which is caused by a prefabricated kink with extension of the test strip is made possible. For the push movement, the wedge guide of the hook bar ( 64 ) lowers with its wedge bevel through a window in the slide. The drive for this is the elastic cover membrane ( 4 ) which is lowered under suction (the source of which has been omitted) with the piston ( 2 ) on the sliding sleeve ( 8 ). By turning a thread in the piston roof, the effective length of the wedge surface and thus the thrust distance can be regulated from below before use. The scale is 2: 1.

On a scale of about 8: 1, the detail of a puncture tip can be seen in the middle left, which represents the end of a cannula that opens onto the rear ( 13 ) of the shaft. A drop of blood is drawn in there with a dash-dot line. On the right a cross section at the cannula base, the long side corresponding to the direction of movement during the cutting movement.

To the right of it in a longitudinal section, the cannula end ( 119 ) widens to form a funnel which is mounted on the test field of a test strip which is permeated by gas-permeable pores. The sieve-like perforation of the test field (by tiny circles) is to be symbolized on the right in cross-section. The blood is drawn directly into the test field.

Below again a longitudinal section on a scale of 2: 1 through a suction cup as a puncture device. The lancet shaft is inserted in a vertical slot on the slide ( 109 ) with its axis in a clamp ben, the axis knob here only serves to fix the height. The magnetic iron ( 100 ) is on the upper U-leg of the slide ( 109 ) above an elbow as a movement limitation of the lancet movement upwards. The angle piece is part of the support bar ( 63 ), which is transversely connected to the suction cup wall. The magnetic iron can be attracted to the magnetic core ( 98 ) of the electromagnet in order to effect a cut by the slide movement. The set screw ( 57 ), which is sealed to the roof of the suction cup, has a pushing action against the electromagnet (on a carriage, not shown) via an eccentric disc against the tension spring ( 133 ). The push distance can be regulated in this way.

Fig. 18 shows three variants schematically solutions for an integrated visual skin control of the puncture site in longitudinal section and an enlargement by about 50 percent. The opening ( 97 , center right) for the air extraction is shown in each case.

In the upper variant, the round projection rod ( 120 ) was pushed up to the stop of the clamping ring ( 134 ) through an O-ring-sealed oblique hole in the suction cup ( 1 ). The rod tip is now pressed onto a suitable skin area and the suction cup is pushed along the rod to the bottom right. A second projection rod (or rod) is shown with dashed lines. With two or three projection rods, the suction cup is lowered vertically; the bars are pushed up and - in any case - pulled further back. They could be removed completely and the opening closed by a (spring-loaded) sealing flap.

The variant in the middle uses the bracket ( 122 ) with a swivel joint (not explained in more detail) on two lateral edge rods ( 121 ). The latter are height-adjustable in grooves on the inside of the suction bell. The tension springs ( 123 ) go from their upper ends to the middle of the bracket with the tendency to raise the bracket to the horizontal (right figure). A corresponding blockage of this folding movement which can also be achieved by other suspension by the type of groove guide in its lower section can be expedient. For skin control, the bow is pulled down and the marking pin ( 124 ) is placed on a suitable skin area under the middle of the bow. The suction cup is then lowered abge over the bracket.

In the lower variant, three push rods ( 125 ) unite in the center in the marking ring ( 126 ).

 (This is shown in cross section at the bottom right).

The push rods run in the gutters of the suction cups on the inside wall or, after caliber jump, at a sufficient height within wall holes. Their ends are bent in a hook shape and each meet a corresponding guide pin or a channel end. Thanks to their elicity, they can be bent so that their removal from the suction cup (for cleaning purposes, for example) is possible. If necessary, the push rods can be extended as telescopic rods in order to be able to observe the central skin area under the suction cup with the appropriate distance from the marking ring. For puncture, the suction cup is lowered against the marking ring. He and the connecting rods of the rods can be lifted further by the skin if there is negative pressure. (Which can also be supported by suspension, for example in combination with the middle variant of the spring-loaded bracket). As can be seen in the illustration on the right, the stop of the upward movement of the marking ring can be chosen so that the skin bulges up in it. For schematic clarification, the penetration of a lancet tip was drawn in on a carrier strip ( 63 ). The mechanism of lancet tilting or transverse displacement has been omitted. But it is clear that the marking ring prevents the skin from evading before the lancet movement. Excessive pent-up skin (such as that of elderly people) can rise up like a dome between the cross bars of the push rods (shown in dash-dotted lines).

Fig. 19 deals with the lancet assembly and removal from the suction cup. It complements the process of lowering a sliding sleeve with the carrier plate for the lancet by pressing on the elastic cover membrane for changing the lancet (FIGS . 1, 5, 15) and fitting an attachment ring ( FIG. 7).

The push pin (shown in dashed lines) can be pressed against a compression spring through its seal in the suction cup roof against a lancet shaft and the latter can be ejected downwards. This is shown in the longitudinal section at the top left in a slight enlargement. The marking ring ( 126 , in cross section below) is connected here via a horizontal spar to two edge bars ( 121 ) which are raised. The lancet tip is immersed in the small skin bladder raised within the marking ring for demonstration. For the sake of simplicity, the closed bottom cover ( 128 ) was also drawn in, which encompasses the suction bell like a cap. The stripping springs ( 129 ) start from, which engage behind the stripping edge ( 132 , detail below), so that the lancet is pulled from the spring clip on the carrier bar when the cover is removed.

The leaf springs ( 130 ) spring from the lid pot protruding centrally from below into the suction cup and encompass the cross bar of the edge bars ( 121 , left detail in vertical section). When the cover is removed, the marking ring is pulled down out of the suction cup. Under the bottom cover, the cross-section of the marking ring was extended laterally in a fork-like manner to leave space for the lancet insertion. (The lancet was drawn too small within the suction cup, namely about the natural size.)

On the left, a special form of the lancet is shown from above in an approximate 8: 1 scale. The protective film ( 135 ) surrounding it is only sketched in sections (dashed). At the top, its rear sheet protrudes from the front sheet, so that the protective film can be pulled off slightly downwards and inserted into the spring clip ( 28 ) while the tip is still covered. The lancet shaft widens on both sides to form a wedge-shaped projection ( 75 ), which is followed by the notch or waist ( 131 ) into which the narrow side of the clamping spring ( 28 , De tail right) engages. Only one of the two wiper springs is shown on the left side ( 129 , upper figure), which in the variant described here arises from the crossbar of the edge rod near the marking ring. On the right - also in 8: 1 scale - the suspension of the clamping spring ( 28 ) with its two transverse axes is shown in axle knobs protruding from a window. The window is part of the support bar ( 63 ) and is arched by a bridge ( 136 , upper figure), in the slot of which the lancet shaft is laterally held when it is tilted. (The slot is shown in dashed lines). If the lancet is inserted into the clamp from below, the clamp spring legs are pushed apart on its narrow side by the charge of the lancet. If the projections of the lancet have passed the clamping legs with their greatest distance, the resilient re-approaching of these clamping legs on the wedge bevel of the lower half of the lancet projection engages in that the lancet is pushed further up until it is fixed in the waist ( 131 ) . Two variants of the receptacle ( 10 ) for the lancet were reproduced at the top right, in longitudinal section above and in cross section approximately in natural size.

The circular cross-section of the images can be seen. In the left variant, the lancet is in one central slot of the intake. The uniform streak fen-shaped protective film is from the bottom opening and with peeled off the lid. (According to the rule, the Ab pull from the free lid flap while lifting the lid until the removal of the entire film under deduction from the bottom part in one go). Dashed under shaft portion protruding from the lid. Stripped down protruding tip the state after thumb pressure of on top of the shaft.  

The shaft shift can be saved by the Protective cap is arranged around the top and from there is pulled. (In the drawing, the film would be around 180 Degrees of rotation around the x-axis; the dashed, higher lancet position would be eliminated).

In the right variant of a lancet, the carrier points make a cross to the wall of the receiving cylinder Slit with a central axis knob in which one Hole in the lancet shaft is locked. For the tipping movement of the shaft is in opposite directions above and below according to wall slots provided, all again Ver openings through a common film strip are closed by a free tab from all around can be deducted. On the side wedge-shaped The projection of the lancet shaft has the effect (dashed drawn) dome-shaped end of a pin with the top of the following notch when lowered into the Cylinder and causes a short tilt movement. Through oval cross-section of the recording or directional knobs must be the position of the lancet axis to be set up for establishment.

If the receiving cylinder is widened somewhat, the escape slits can be omitted as well as the bottom cover protecting the tip. The tip is then a little behind and the skin itself penetrates from below into the receiving cylinder and thus into the lancet tip under suction. The solution is similar to that using disposable pots ( Figs. 10, 11, 14). The main inventive value lies in the simplification of previous attempts at solution, also with regard to industrial production and functional reliability.

The invention is not intended to be limited to the components and features shown, but also relates to the combination of those which result from their extensive interchangeability.

Addendum:
FIG. 20 is above a longitudinal section through a suction cup in almost natural size, the more equipment was weggelasen. Only a support bar ( 63 ) for identifying the position of a light source ( 17 ) is shown. The light source corresponds approximately to that shown in Fig. 1, but the light beam is clearly aligned with the central skin under the suction cup (here dash-dotted center line). The suction cup is largely surrounded by the casing sleeve ( 137 ) with a wide open gap. The latter is pulled down to an edge stop in the functional stage shown, so that the illuminated central skin patch can be seen through the wide gap. When the suction cup is lowered, the casing sleeve is pushed back onto the latter for use (dashed line). A cross-section in the overlap plane of the suction bell and casing sleeve can be seen below.

Fig. 21 shows in longitudinal section the left half of a suction cup with the detail of an electromagnet to the magnetic core (98), but one may also be with its own armature or plunger. The magnet acts on the slide ( 109 ), which lowers the tip of the pin with the subsequent notch (see Fig. 19, right detail above) against the projection of the lancet shaft ( 13 ), thereby causing the lancet to tilt briefly. The lancet can be tilted about the axis ( 25 ) within the receiving cylinder, the larger diameter (see FIG. 19) of which allows the skin to penetrate under the influence of suction (dash-dotted lines).

Fig. 22 shows in plan view a 99999 00070 552 00004 001000280000000200012000285919988800040 0002019705091 99880n test strip (103), as it is usual in particular for electrical han trade glucose measurement. In the test field ( 104 ), the two measuring surfaces are separated by a gap through which the tip of a lancet shaft ( 13 ) extends from above onto the skin, as can be seen from the vertical section along section line AB. For use with the test strip fixed, the lancet can be moved longitudinally within the slot after the skin puncture; but it can also test strips and lancet shaft through at least one hole ( 138 ) in the test strip, in each of which a cross pin from the lancet engage or otherwise clamped together and moved together horizontally to widen the cut. The blood rising via the guide elements behind the lancet tip (omitted here) passes directly onto the test field, whereby, of course, color-changed chemicals can also be used for measurement purposes.

A variant is shown in the lower center, in which the lancet tip protrudes laterally over the test strip (at the bottom in a view of the test strip). The longitudinal section above shows that the two measuring or test fields lie on either side of the lancet shaft, which is very much shortened near the tip, with its fine meandering fold for blood drainage. On the right, the preferred variant is shown in a natural size on the left in a longitudinal section through the lancet, specifically within a (futural-like) packaging envelope. The test strip ends here on its narrow side in the lancet tip, which allows packaging in the manner customary for lancets and facilitates removal without injury or blunting of the lancet tip. In the case of an electrical measuring method, the two test fields have the separate neutral conductor and thus two measuring wires each to the measuring device (those in the lower field are shown with dashed lines). In the cross-section on the left, the test strip was inserted into the clamping spring ( 28 ) on the slide of a puncture device and is easier to place in a suction cup than in the transverse position.

Lecture on Fig. 46 on page 87, line 4:
In detail at the top right is a longitudinal section from the area of the base plate below between the left inner edge of the suction cup and the junction of the vertical hole in the bellows. A variant of the solution is shown there in order to avoid the oblique bore for the suction channel ( 162 , longitudinal section below), without the channel being able to be closed by the skin lying against the suction cup wall. There is therefore a jump over the lowest suction cup area before the inner edge of the suction cup is provided in a second stage, which experiences a vertical slide ( 405 ) above the mouth of the suction channel ( 162 ). This is illustrated in a cross-sectional detail. The workpiece machining is facilitated by such solutions. On the left, as a further variant, a niche ( 406 ) is provided after the suction cup rim, into which the suction channel ( 162 ) opens.

In addition, a detail with a protrusion ( 407 ) below half the channel opening, keeping the skin from it and partially covering it.

Right in longitudinal section is above the oblique The suction channel line dash-dots a horizontal line shown, which corresponds to a hole, the shortening the threaded nipple for the Bellows or through a wall slot in the same ben a connection between vertical suction channel from the bellows. The suction channel will into the suction that cannot be laid by the top of the skin bell roof angle initiated.

The horizontal bore is at its free end closed by graft.  

Fig. 23 shows a blood sample or a puncture device in low magnification in longitudinal section, above in the state before suction and below in the state after suction of the skin (dashed line). The suction cup ( 1 ) is formed by a spiral spring that is compressed in the upper functional stage. It is covered by the membrane ( 139 ), which extends from the annular suction cup rim ( 140 ) to the piston ( 2 ) and thus seals side wall and roof with a certain elasticity. A kind of pot rim ( 141) is drawn in on the top right, which extends from the edge of the suction cup and can accommodate the relaxed membrane. The central bore of the piston has the sealing ring ( 5 ) into which the sleeve-shaped receptacle ( 10 ) for the test strip ( 103 ) with the Test field ( 104 , on the right as a detail replacing the key described above) is pushed in. The key ( 142 ) is inserted into open slots (not shown) in the receiving sleeve. When rotated, it causes a roof sleeve ( 143 ) with hexagon fit the tension of the torsion spring ( 11 ), one end of which rests on the roof sleeve and the other end of which on the spiral spring lies over the ring ( 144 ), which is fastened to one of several radial downwardly sprung supports ( 145 ) Effect of the torsion spring attached to it The supports extend from slots in the lower coil spring coil from the adjacent coil angle ig down. The cover ( 147 ) has radial bores into which the stop pin ( 148 ) is inserted. The latter limits the angle of rotation of the torsion spring by inhibiting the cross arm ( 149 ) which is attached to the key.

When the compressed spiral spring is released from the skin, the latter is lifted into the lancet tip by the resulting negative pressure. The lifting of the supports ( 145 ), of which only one has been drawn in, causes one of them to protrude inwards depending on intervals at ordered tooth-like projections of the ring ( 144 ) and release the rotational movement of the torsion spring until to inhibit the arm ( 149 ) on the stop pin ( 148 ). Since the top of the skin is sucked somewhat into the lower end of the receiving sleeve, the blood can penetrate into the test field ( 104 ) with hygroscopic properties. After removing the key, the test strip is connected to a glucometer. Below the detailed drawing of the receptacle for the test strip at the bottom right, a cross-section at the cutting line AB of the longitudinal section.

. 24 shows in the scale of 2: 1 a detail of a puncture device according to FIG. 5; above in cross and below in longitudinal section. The lancet oscillation is effected by the compression spring ( 150 ), the stop plate ( 151 ) of which is attached to the pipe segment ( 152 ). (Both eccentrically behind the lancet, as shown in longitudinal section below). The filling of the piston ( 2 ), in the bore of which the tube segment is supported, with a slot for the leaf spring ( 55 ) or the pin for the lancet tilting has been omitted for the sake of clarity. The inner bolt ( 153 ) in the pipe segment is pushed by a compression spring in the direction of the suction cup cylinder ( 1 ). Spring-backed transverse bolts ( 154 , top) engage in an annular groove in the inner bolt through funnel-shaped bores in the pipe segment.

The tappet ( 47 ) lies with its tip through a bore in the cylinder wall of the suction bell against the piston ( 2 ). He is under pressure from a spring within the cap sleeve ( 155 ), generated by lowering the wedge slide ( 156 ). (The tension of the compression spring ( 150 ) he follow by inserting a pin from below behind the slope of the stop plate).

The suction source was not shown, only the opening ( 97 ) is drawn in for it below in longitudinal section. Under suction, the elastic cover membrane ( 4 ) is lowered, and with it the piston ( 2 ). The funnel-shaped bore comes to lie in front of the plunger ( 47 ). This penetrates the bore and displaces the inner tappet ( 153 ) to the right. The two cross bolts are also pushed outwards by the slope of the ring groove. The locking of the movement of the pipe segment in its bore is released. The strong compression spring moves the pipe segment and thus the leaf spring ( 55 ) to the right. The latter takes the lancet with it and overtakes its round shaft end so that it can swing back into the vertical again. The vibration takes place around the axle bearing ( 9 ) in the slot of a bridge bar in the lower hollow part of the piston ( 2 ).

FIG. 25 is a longitudinal section above and below a cross section through a puncture device in their actual size in a concentric arrangement. The sealing ring ( 5 ) is formed as a lip seal, the puncture stylus has been omitted. The suction cup rim is widened like a pot and surrounded by a ring with a tubular segment ( 156 ) on the inside. An annular cavity accommodates the powerful compression spring ( 70 ), which is supported against the roof of the cylinder cup ( 111 ). The latter is sealed both at the bottom against the widest projection of the pot and at the top against the narrower pipe segment ( 156 ) by means of the ring seals ( 157 , 158 ). Two symmetrically arranged segment bridges ( 159 ) emerge from the cylinder cup . These are in contact with the spring ( 70 ) tensioned by manual pressure on the projection of the cylinder cup after lowering the cylinder cup along the tube segment of the latter at the top.

On the cross-section below, which follows the section line AB of the longitudinal section, the segment bridges higher above roofing are shown in dashed lines. The segment slider ( 167 ) running behind the wall of the roof sleeve is shown in dashed lines in the center. In its vertical slot, the locking pin ( 168 ) is immersed, held by the connecting ring ( 169 , see also in cross section below). The latter is held by the two spars of the segment bridges. The torsion spring ( 11 ), which is in tension, lies in a channel almost reaching the bottom and surrounds the suction bell. The torsion spring is on the one hand connected to the base part of the fixed pipe segment, on the other hand to the roof sleeve.

The funnel ring ( 170 ), whose screw connection to the pipe segment has not been shown, is located in the top with the pipe segment (bridge for the segment shown when the lateral passage is shown). The holding clip ( 171 ) for the glucometer extends from the funnel ring at the top.

The hand button ( 110 ), which is designed as a rocker, was also drawn in. The axle bearing of the rocker is attached to the cylinder cup. The lower fe derender bracket arm includes the outermost suction cup edge. At the other end of the rocker, a pointed pin points against a rubber seal with a central hole in the cylinder cup ( 160 ). When you press the pen on the hand button, the pen tip is pressed into the rubber seal against the compression spring ( 161 ) and the bore is sealed off; shortly afterwards the end of the clamp leaves the suction cup rim. The stronger pressure spring ( 70 ) can now take effect and thus the pump effect via the suction channel ( 162 ) within the suction bell. (The suction channel and therefore the suction cup wall must be dimensioned a little larger). After the start pressure on the hand buttons, the hand goes up slightly on both sides with the pump movement, which favors the slipping of the skin into the suction cup (by manual pressure reduction on the suction cup edge). The axle bearing can also be attached to the outer edge of the suction cup and the suction channel can be sealed there, if the cylinder cup is clamped tight.

The roof sleeve ( 143 ) is rotatable around the suction cup roof with the sealing ring ( 5 ) there and fits with its hexagonal profile around the hexagonal edge of the puncture pen (not shown here). The narrower lower cross section of the puncture stylus is circular and is enclosed by the lip of the sealing ring ( 5 ). On the cross section below, two tabs ( 163 ) extending from the outermost suction cup edge are shown, which serve to control the visual skin.

In longitudinal section on the right, one of the two associated marking pens ( 164 ) is drawn out in detail, which can be pressed against the skin. After the puncture device has been lifted off the skin, the indentations of the skin can still be seen for a while through the marker pins. The condition of the skin can be checked in the middle of an imaginary connecting line between the marking points because the puncture is to take place there. To remove blood, the puncture device is placed on the skin again after tensioning the compression spring ( 70 ) in such a way that the two marking pens come to lie exactly over the marking dents.

There can also be colored pigment (such as chalk) on the tops of the mar marker pens are applied to the skin emerging.

Below in cross section, inside the roof sleeve ( 143 ), the symmetrical wedge slot slots ( 165 ) open at the top for the tension of the torsion spring ( 11 , top in longitudinal section) can be seen. From the connecting ring ( 170 ) lead from the bridge segment spars rotated at a right angle down the locking pins ( 168 ) into the slots of the segment slide ( 167 ). The latter are limited in their sliding movement by the two guide pins ( 172 ) in the roof sleeve thinned here with appropriate guide slots in the segment slides.

FIG. 26 illustrates in longitudinal section through the left half of the puncture device according to FIG. 25, with schematic details on the right, the mechanism of the puncture stylus rotation in two functional stages.

The functional details on the right represent roll-ups of one Side view from the inside (i.e. from the left).

In the figure above, which corresponds to a stage after the skin has been sucked in, the two segment bridges ( 159 ), around which the connecting ring ( 169 ) closes, segment slits ( 165 ) - behind them - are shown at the upper end of the slopes of their wedge . The transverse pins ( 166 ) protrude from the ends of the spars of the segment bridges into the wedge segment slots. As shown in detail below, their roll on the bevels of the wedge segment slots can be favored by rollers ( 173 ). The two locking pins ( 168 ) are displaced to the left by the force of the torsion spring, and their clamping springs ( 174 ) have left the slots of the segment slider ( 167 ) pulled up by them. The guide pins ( 172 ) in the roof sleeve ( 143 ) prevent further lifting of the segment slider. In longitudinal section below a variant of this mechanism is indicated by strip overlap; below, in a top view, the assembly of the segment slides is clearly marked out by a dovetail fit. On the left in longitudinal section it can be seen that the hand button ( 110 ) has been pulled up; by releasing the finger pressure, the hole in the rubber seal is free to re-vent the suction cup. The roof sleeve had rotated clockwise. The functional stage below corresponds to the lowering of the cylinder cup ( 111 ) with the segment bridges under tension of the powerful spring ( 70 ) for the suction pump. With the spars of the segment bridges, their transverse pins ( 166 ) in the wedge segment slots are lowered almost to the end of their narrowed vertical slot. With the torsion spring exciting rotation counterclockwise, the locking pins ( 168 ) penetrate into the slots of the segment slides.

You have lowered them - if not already done by gravity - and penetrated almost to the end of the vertical slots. The segment bridges are lowered against rotation. (The appropriate arrangement is in the passage for the segment bridge in the funnel ring ( 170 ) and by the pressure of the spring ( 70 )).

Fig. 27 shows the puncture device of FIG. 25 above again in a longitudinal section in the functional stage of the relaxed spring ( 70 ) after successful rotation of the roof sleeve ( 143 ) in natural size. The puncture stylus ( 175 ) has a slightly eccentric tip at the bottom. Within the sealing ring ( 5 ) around the test field ( 104 ), the puncture handles have a circular average and widen upwards with a caliber jump into a hexagon around which the roof sleeve closes.

The puncture stylus can continue upwards into the narrower test strip ( 103 ), the end of which is inserted into the glucometer ( 176 ). The latter is fixed in position by the retaining clip ( 171 ) extending from the funnel ring. The set screw ( 57 ) runs diagonally above the cylinder cup ( 111 ) through the pipe segment ( 156 ). In the illustration, the set screw was rotated by 90 degrees, it lies at the rear and leads with its conical end into the segment slot ( 177 ) of the roof sleeve, as can be seen below on the cross section at cutting height AB of the longitudinal section. The set screw has a part screwed from below into an oblique thread guide in the pipe segment, which ends in a narrow square. The knurled screw, which can have a radial scale to a projection line on the upper edge of the cylinder cup, is placed on the latter from the outside like a key. The conical end allows the rotation angle for the roof sleeve to be regulated to a fraction of a millimeter, as is given by the abutment of the edge of the segment slot ( 177 ).

The cross sections through the lower end of the puncture point between longitudinal and cross-section the different eccentricity of lancet tips. The arrangement of one in the bevel of a wedge segmented recessed non-rotating cross pins to tension one of the rotation of one Puncture pen partially surrounding roof sleeve  a locking pin, the effect of which in height a sliding segment is extended, solves the task the rotational movement of the puncture stylus in the Skin abruptly.

The inventive idea of the tension of a spring for the rotation of a puncture cannula with an eccentric Tip in a seal lowering to the spring The pump was tensioned before the gentlemen Dipl.-Ingenieu Ren Kolbe and Schulz in the spring of 1996 carry.

The segment slides ( 167 ) can work together with the locking pins ( 168 ) to be replaced by sleeves which surround these locking pins and are pulled out by a predetermined amount from these locking pins from holes in the roof sleeve (* 178 , Fig. 27, detail center right) Outside).

Fig. 28 shows in a longitudinal section in natural size by a solution example for pneumatic drive. A puncture stylus with a cross-section at the height of the lancet attachment is shown at the top left in scale 2: 1. The longitudinal section through the ventilation valve is repeated on a 2: 1 scale at the top center. Below this is the small detail on the edge curvature of the border ( 179 ) of the glucometer ( 176 ) from above. Elongated to the right is a side wall of the frame of the border with the hinge joints ( 180 , 181 ) and the axle knobs ( 182 ). The approaches of the narrow parts of the border show passage slots. At the bottom right, the detail of a latching of the puncture stylus on the glucometer by means of springs which protrude from the bottom flap of the border and engage in locking knobs ( 183 ). Under the longitudinal section in cross section.

The detail at the bottom left shows the longitudinal section at the top behind the lancet tip area and below it in even more restricted detail when cutting through the lancet tip at a scale of 2: 1 the support of the rounded lower edge of the puncture pen on a correspondingly round recess in the suction cup roof with a central slot for the passage of the lancet tip and the peripheral spout ( 184 ) surrounding it. There are also two of the fin-like lamellae ( 185 ) shown on the cross section through the suction cup roof in the middle in their arrangement, which inhibit the movement of the skin surrounding the puncture area. (In the cross-section in the middle there is no edge grommet around the lancet tip, which can reduce the slot and the air pressure on the roof.).

On the longitudinal section through the device below, the skin (dash-dotted) is pulled up into the suction bell, the negative pressure being produced by air discharge via the sealed pipe socket ( 186 ) and further via the hose ( 90 ). The pipe sockets allow the suction cup to be removed against wedge-shaped bevels so that the puncture stylus, which is flat here, can be inserted into the shaft of the glucometer through the vacant gap. The glucometer is book cover-like at least from one side wall ( 187 , Fig. 29 top left), which have curved slots ( 188 ) for receiving the axle knobs ( 182 , side view on the right). The slots support the guide during the tilting movement of the glu cometer, the fulcrum of this tilting being in the plane of the suction cup roof. The dash-dotted line shows the outline of the tilted gluometer. (The corresponding inclination of the dot stylus was not taken into account). The inclination was caused by the impact of the bolt of the compressed air switch (dashed outline). This is fed from the compressed air hose ( 190 ). The return of the glucometer from the tilted position is carried out by the tension spring band, the ends of which are attached to the func- tion shaft ( 199 ), and the tension spring band ( 191 ) is wrapped on the right side of the glucometer. The decisive pressure for the sealing of the suction cup roof from above on the rounding of the puncture pen is exerted by the flat spring arch ( 192 ) on the device border, which is supported against the rigid curve rail ( 193 ) of the side wall.

The hollow piston ( 194 ) can be moved in the cylinder of the compressed air switch with a central pin. The movement of the hollow piston is inhibited by two spring-loaded locking bolts ( 195 ) (which are actually rotated by 90 degrees), which can be adjusted in their pressure by means of hand screws. Of the pressure relief valve ( 196 ), the shut-off valve ( 197 ) and the valve of the vacuum regulator ( 198 ), only cross-sectional rings are shown in the function shaft ( 199 ). The ventilation valve for the vacuum system is shown enlarged at the top. In order to be able to better represent the roof suspension, it is folded up around its pivot axis ( 200 ) of the rail guide ( 201 ) attached to the edge. The fork ( 202 ) of the valve piston is snapped onto an elastic fork (not shown in longitudinal section) in the functional shaft ( 199 ) for the function. The amount of displacement of the valve cylinder ( 203 ) can be adjusted using a screw. The compression spring between the regulating screw and the valve piston is very weak.

The annular groove between the Sogschlaucheinmün openings, so that the re-ventilation of the suction bell will be effective. This is only the case when the tension spring band ( 191 ) has moved by moving the stops on the rail against the stops on the valve cylinder last over its valve piston. The prerequisite for this operation is relieving the pressure on the compressed air system and returning the hollow piston in the compressed air switch ( 189 ). The maximum tilting movement of the glucometer in its border is determined by its stop on the valve tappet ( 204 ) with a wide ring groove. The latter is moved with the plunger so that the opposite pressure hose openings (shown as a dashed circle), which were previously closed by the valve plunger between seals, open into the surrounding air.

Before using the device, the above valve cap ( 205 ) must be pressed in. It can be rotated around a thread of the valve lifter to regulate the tilting radius of the glucometer.

As a variant for visual inspection of the puncture site on the skin, two light sources or lamps ( 17 ) are shown, which emanate from elastic arms of the pipe socket. The lamps are aligned with the puncture site and are pushed back by the skin when the suction cup is removed. Via line contact with the pipe socket, the current flow after coupling via the detent springs along the dashed lines to the battery ( 199 ) in the function shaft, or to the electrical hand pressure button ( 206 ).

Fig. 29 further explains the pneumatic drive system to a puncture device according to Fig. 28. Top left shows a cross section through the glucometer, like this after the side wall ( 187 ) of the two fold-out from below ( 207 ) and the two up from the lower foldable ( 208 ) plate pairs is surrounded. The hinges indicated as rectangles are dealt with in more detail in FIG. 30. The folding bags, one of which comes to rest between a pair of plates, have been omitted from the figure above.

The vertical section below shows the folding bag (dash-dotted) attached to the panels in a broad base and almost unfolded on the right side by spreading, creating a negative pressure. The latter is transferred via the hose ( 90 ) into the suction cup ( 1 ). The hinge joints of two adjacent to each other of the plates have stops which, after the upper (outer) plate has been folded up, result in the lower plate having to be carried along after a fixed spreading angle when the upper plate moves inwards in a rocker construction. The folding bags of the upper (outer) panels are attached to their outer surface. They are inflated via the mouthpiece ( 209 ) with a check valve. (The latter is expediently attached to the edge of one of the upper plates.) The upper folding bags shown unfolded are connected to one another via the compressed air hose ( 190 ) and via the shut-off valve ( 197 ), the pressure relief valve ( 196 ) and the vent valve with the valve tappet ( 204 ) Air switch ( 189 ) connected.

In detail on the right are the right-hand panels shown; also the upper one (outer right) plate has been created. It is your folding bag dash-dotted lines, one side but is glued to it.

The vacuum regulator ( 198 ) is explained in the longitudinal section on the right at a scale of 2: 1. The suction hose ( 90 ) is interrupted by the body of the valve lifter in the valve cylinder. The suction hose also leads with a branch behind the valve tappet or piston and pulls it down against a compression spring. If the vacuum reaches a certain level, the valve tappet moves its annular groove between the mouths of the suction hose and allows an outside air to penetrate into it. (In our example, air is introduced into a single suction hose opening on the valve cylinder). The strength of the suction required to open the valve can be adjusted using a hand screw that acts against the compression spring.

Below the vacuum regulator, the longitudinal sections are shown at the top by the pressure relief valve ( 196 ) and below by the check valve ( 197 ).

Behind a pressure hose inlet is a ball, which is adjustable by a hand screw Ball is pressed into the valve seat. Happened before the compressed air (according to the dash-dot Arrow line) the shut-off valve. Here is the ring groove the valve lifter so displaced by a compression spring ben that the body of the valve lifter the space between the mouths of the compressed air hose closes. The vertical section shows that this valve tappet movement under compression spring effect can only occur when the upper one (outer) plate has been folded down.

To use the device, the upper (outer) lid folded up. It will the upper folding bags are inflated over the mouthpiece. A changing overpressure cannot occur accumulate because the overpressure is via the relief valve can compensate. The vent valve the compressed air system is ge when the lid is closed  closed. (The associated tab with wedge guide laterally from a plate is not shown). The valve lifter can also be used without a ring notch ends. The end of the ram is then caliber jump through the thin pin behind the seal conditions for the compressed air hose openings pushed (in the stage of the tilting and cutting moment). If the top plates are pressed together, then the lower ones in a forcible coupling drawn under vacuum to the skin installed suction bell. The top folding bags are dimensioned in such a way that only now becomes more significant Pressure accumulates in them until the latching of the Compressed air switch for the tilting movement overcome is. In the functional phase just described the vacuum regulator temporarily opens in accordance with the attitude which is adapted to the skin type that can. (The vascularity of the skin is individual duel also different the capillary fragility under suction). Without a vacuum regulator compression of the two upper folding bags does not possible because of a pull from the lower fold bag here.

. The 30 shows on a scale of 4: 1 on the left above the connection of three hinges for the panels through the front (211) and rear (212) hinge tab in a side view. The maximum angle of rotation is determined by the stop pin ( 213 ). The hinge joints are staggered in height - as shown below - for a denser packing of the panels. In segmentation similar to a door hinge, they can alternately be set to each other as shown in the top view on the left.

In the middle left, the variation of a compressed air switch for a puncture device according to FIGS. 28 and 29 is shown. The metal membrane ( 214 ) inside the pressure cell drives the central bolt after accumulation of over the upper bags in the compressed air hose, as soon as the inhibition of the locking bolt ( 195 ) is overcome. The direction of impact is directed obliquely from above onto the elastic spring arm ( 215 ) on the border ( 179 ) of the glucometer. This increases the pressure from above on the seal in the rolling area of the stylus in the suction cup roof. If the border of the opposite side abuts against a locking screw that limits the tilting movement, the elastic spring arm springs back and lets the top of the bolt of the compressed air switch over. It is a longitudinal section of approximately natural size.

In the center right is a side view in natural size. It is shown how the side wall ( 187 ) is conveniently folded down in a lower hinge and can be hooked over the glucometer to the edge. The hinge joints for the plate pairs ( 207 , 208 ) are on top.

FIG. 31 shows the reduction of the task solution to a single-use pen with a curve and lancet tip below the test field ( 104 ). The stylus is shown in natural size in longitudinal section only in its lower detail. The adhesive plaster ( 217 ) shown below in supervision is glued to the skin after removing the protective film ( 216 ) in order to fix it. If the stylus is pressed into the skin, when the puncture stylus is tilted, the lancet tip under the skin performs the necessary cutting movement and the blood can rise to the test field ( 104 ). When pulling on the puncture stylus, the skin can also be raised like a tent before the cutting movement that takes place in the slot ( 218 ). (This variant is shown as little as the connection of the puncture stylus with the glucometer).

The Fig. 32 schematically shows an example of a puncture device with suction cup (1) for a of a test strip based on optical measurement of the degree of blackening glucometer (176). Between each two plates ( 208 ) which pivot against a hinge against the torsion spring ( 219 ), two folding bags are spread out and glued to the plates over a large area. The suction hoses ( 90 ) lead from the folding bags into the suction bell. Before placing the latter on the skin, the upper plates are pressed together against the torsion spring and their spread is released for skin suction, with the hand resting on the glucometer. The rays are directed diagonally from a light source onto the skin of the future puncture site. A second horizontal beam of rays is shown, which, when the skin is suitable and after it has been sucked in, is directed to a signal, as is directed against the test field ( 104 ) after a short rotary movement of the puncture stylus in the seal of the recessed suction cup roof. This can be seen more clearly in detail in the middle on a 2: 1 scale in longitudinal section. The elastic tube end ( 220 ) is pushed onto the lancet tip for better blood collection.

The suction bell has two opposite conical indentations ( 221 ) of the wall for attaching the glucometer with an auxiliary device and for radiation centering on the small measuring field. The Gluko meter is for this purpose in a housing with an annular to elliptical passage for the suction bell, in the wall indentation a pin of the glucometer housing is inserted on the right. Locking takes place from the left using the conical spring-loaded retaining bolt ( 222 ).

The slightly enlarged schematic cross section below shows the switching mechanism from the optical Skin control for metabolism measurement.

A light beam symbolized by the dashed line falls from the light source ( 17 ) onto the prism ( 224 ), which is mounted on a rotatable round pin. Depending on the angular position of the prism, the light beam is thrown through a lens centered on the skin or the test field. (The beam path after the lens is greatly shortened). The reflected light is collected by a second lens via the prism to the photosensor ( 223 ) for measurement. The rotation of the prism against lateral displacement takes place with the abrupt right shift of the magnetic core ( 98 ) in the electrically excited magnet coil ( 99 ) via a retaining pin ( 226 ) in the spiral groove ( 225 ). This magnetic action takes place only when the skin control with a positive result and signaling for further operation is complete. By moving the valve tappet of the check valve ( 197 ) with the magnetic core. Against its compression spring, the annular groove of the valve tappet with the suction hose orifices coincides, so that the skin in the suction cup is raised. (The shut-off valve was omitted in the longitudinal section at the top for simplification. For the same reasons, the battery, electronic control unit and lead wires were not shown in the lower section).

. The 33 shows the top of the longitudinal section of a scale of 2: 1, a puncture device which uses memory potty a vacuum. From the industrially prefabricated vacuum storage space ( 227 ), the trigger pin ( 228 ) protrudes through the suction cup space to its periphery. In the center is the passage for the round to the passage sealed point pen with slightly eccentric cutting tip. The protective film ( 216 ) is removed from the skin before use. The protective cap around the end of the test strip ( 103 ) has already been removed and the test strip is inserted into the shaft of the glucometer ( 176 ). The latter is held by the retaining clips ( 171 ) on the turntable ( 219 ). To remove the protective film, the suction cup ( 1 ) is placed on the skin, which builds up due to the pressure and raises the release pin ( 228 ). The waxed seal for the suction cup roof in a small neck is broken open. As a result of the conical pin with widening upwards, the air can escape from the suction cup space into the vacuum storage space, so that the skin is lifted up into the cutting tip. The glucometer is now rotated with its rotating plate, an edge ( 230 ) protruding from there jerkily overriding a knob ( 231 ) to the next knob. By increasing the nub height, a certain turning radius can be achieved with some practice with regard to the use of force. For re-ventilation, the suction bell is levered off if an adhesive strip cannot be released over a wall hole in the suction bell (not shown).

Below in a longitudinal and below in a cross cut a skin control disc on a 2: 1 scale with edge ring and central marking pin. Against the A recognizable imprint remains pressed in which the suction cup put in for use can be. The skin control is expedient pane transparent, maybe in the center magnifying lens effect, so that the puncture can be assessed more precisely.

Fig. 35 shows particularly in the details above, a highly schematic in about natural size, a solution of example with rotation of the suction cup at a standstill puncture pen (in the center in longitudinal section). The schematic top view shows the base plate ( 232 ) on which the glucometer is placed in the holding bracket ( 171 ). Only parts of the pair of plates ( 207 ) that reach up along the glucometer are indicated and the counter plates parallel on the broad sides of the base plate have been omitted, as have the two folding bags for generating negative pressure in the suction cup ( 1 ). Two joint columns ( 233 , 234 ) on the glucometer extend from two corners of the base plate, around which the plates for generating suction are spread outwards via the tension spring ( 235 ), after they have been pressed together and clamped together in the waiting position before being clamped in parallel position ( not shown). The wing plate ( 236 ) swings out from under the base plate and runs under the left, protruding edge of the suction bell ( 1 , see longitudinal section). In the longitudinal section (middle of the sheet), the glucometer is omitted and only its retaining clip ( 171 ) is drawn in and the high end of the test strip ( 103 ) above the puncture pen with a cutting tip, which is sealed in an annular seal of the suction cup roof ( 237 ). While the base plate ( 232 ) is held on the glucometer, the suction hood can be rotated. There is therefore a further ring seal ( 238 ) near the edge of the suction bell ( 1 ) required. The suction cup itself is secured against rotation by pressing against the skin (not shown). The rotation takes place through the torsion spring ( 11 ), one end of which is connected to the suction bell roof, while the other is attached to the roof sleeve ( 143 ) - actually a ring. The rotation of the roof sleeve is prevented by the locking pin ( 239 ) pressed by means of a leaf spring into a wedge gap below in the roof sleeve. The latter is passed through a hole in the protruding collar ring of the suction bell ( 1 ). (The function is explained at the bottom right in a slightly vertical roll-up). The locking pin is made via the wedge guide ( 240 ) on both sides of the slot segment ( 241 ) in the longitudinal section above).

The state of unlocking the power transmission from the roof sleeve ( 143 ) to the suction cup roof ( 237 ) is shown on the left. This is done by lowering the locking pin ( 243 ) from the Keilvor jump in an annular groove of the suction cup roof. The retraction of the locking pin ( 243 ) takes place under the effect of the leaf spring ( 244 ) as soon as the roof sleeve rotates the locking pin located in a hole over the wedge trough of the sector slide that can be moved on the cross pin ( 245 ) and can be determined by the set screw ( 57 ) on the suction cup roof comes to rest, which also prevents further rotation of the roof sleeve. (The operating room of the sector movement is exaggerated with the dashed ring segment). At the bottom, the function mechanism is demonstrated again in a roll-up on the side. The wedge guide ( 240 ) does not come under the locking pin ( 239 ) until the folding plate is folded out and the folding bag is expanded. To tension the rotary spring, the suction cup roof is rotated counterclockwise at its preferably corrugated edge, whereby the locking pin ( 243 ) and the gap for the locking pin ( 239 ) are brought into the locking position. A similar overrunning pawl mechanism can also be built for the puncture device according to FIGS . 25-27 if the return of the cutting tip of the puncture stylus to the starting position is desired due to the effect of skin elasticity.

With regard to the pump arrangement to the vacuum printer, reference is also made to FIG. 32 (above). For the rotational movement of the skin surrounding the fixed cutting tip, the radially arranged lamellae (also Fig. 28 below in cross-section) are essential, between which the skin is sucked up in segments.

Fig. 35 shows a puncture device with a lateral bellows ( 46 ) as a pump. It is a longitudinal section of natural size at the top and a cross section at the height of the grid bars ( 247 ) below.

The suction channel ( 162 ) can also be used as a bore through the wide base plate ( 232 ) when the nipple is shortened for mounting, reducing the dead space in the bellows and for suction line towards the suction bell. The pot ( 248 ) with the ring seal for the puncture stylus reduces the dead space within the suction cup. The roof sleeve ( 143 ), with a fixed roof of its inner and outer portion including the torsion spring ( 11 ), can be mounted on balls, of which only one is provided.

There are four retaining clips here, the curved spring end of which engages behind a locking edge on the glucose meter ( 176 ). To the right of the glucometer, the actuating rod ( 249 ) is shown in longitudinal section with an upper cross member to the (not shown) second analog actuating rod. The actuating rod slides in a tube which has two slits (or a wide slit) at the bottom for the movement of the transverse rods ( 251 , 252 ) which protrude from the actuating rod at different heights and angles. As you can see on the detail of the side view between the main drawing and the actuating rod, the cross pin ( 251 ) stands above the edge notch with a wedge guide ( 250 ) in the roof sleeve. When lowering, the latter describes a small clockwise rotation. The angle of rotation can be determined by depressions of various lengths marked in millimeters on the rear side (not shown) of the roof sleeve. For each of the troughs, a bore is provided in a segment sleeve ( 253 ) fixed on the base plate. (Each of the holes is marked by a pen, but only one is used).

Between the longitudinal section and the cross section, two trigger rockers are shown with the end of the actuating rod above the rounded rocker end ( 254 ) spring-backed by a compression spring. The length of the rocker on the left corresponds to the cross-section below. The rocker hook ( 255 ) is engaged in a recess of the rest post, two of which are connected to the cover ( 256 ) of the bellows, which is extended by the compression spring ( 70 ). The raised rocker on the right would correspond to the functional stage demonstrated to the right of the longitudinal section.

The torsion spring ( 11 ) should be chosen weakly because it only serves the counterclockwise return movement. The puncture stylus has the cross pin ( 257 ) in a slot recess in the roof sleeve. Its downward movement is inhibited and its rotation is guaranteed. In order to make the sector rotation jerky, the variant of FIG. 40 was specified for a trigger rocker.

The cross-section below shows that the glucometer ( 276 ) is inclined according to the arrangement of the holes for the insertion of the actuating rods into the base plate. The cutting line AB shows the cutting direction of the above detail through the edge notch with wedge guide. The functional assignment of the cross pins ( 252 , 253 ) on the actuating rods is also clearer.

On the right is a vertical view of a futural for the puncture device with function rods attached and (dashed) cross bar behind the base plate ( 232 ). Before use, the spring ( 70 ) must be applied by applying pressure until the locking notch or rocker hooks ( 255 ) snap into the notches of the locking rods ( 256 ).

Fig. 36 shows the detail of a special sliding lid closure with better view from above of the skin to check suitability. It supplements the topic of FIGS. 52, 53. Above is the view of part of the outer, upper cover slide ( 257 ) and the inner side cover slide ( 258 , in the process of being opened). The two rubber plates ( 259 , 260 ) shown in later positions are shown in dashed lines, the rubber sealing ring ( 267 ) over the suction cup roof is hatched.

At the center of the test tires ( 103 ).
The longitudinal section in the middle shows the rubber strips ( 259 , 260 ) which are in contact with the test strips, ie pushed together, and which are provided with the edging ( 261 ) made of plastic or sheet metal. Such edging favors the lateral movement of the inner slide ( 258 ). This is accordingly further than shown here first under the outer slider (above) and is first brought to cover with the side bar of the latter ( 257 ). The side wedges ( 259 ), ie their wedge-shaped profile that widens up to a constant thickness, press the rubber plates together around the test. The outer slide ( 257 ) is supported with upper wedges ( 263 ) in pairs against the edge ( 264 ) and presses the rubber plates but also the rubber sealing ring ( 267 ) below them into their holding cases in the base plate ( 232 ). The device for the lateral tilting movement of the lancet tip has been omitted here.

There is still a device for height regulation of the suction cup edge specified, which affects the puncture depth. In the middle plane in longitudinal section, the sealing ring ( 265 ) between the screwed cylinder of the suction cup ( 1 ) and the base plate is quite deep. After the clearance for the shift, a caliber jump follows inwards and then the screw thread.

In the vertical section of the cover area, one of the edge strips ( 264 ) is cut, and underneath a part of the outer slide with the two wedges ( 263 ) arranged one behind the other.

The adjustable suction cup sleeve is a double wall ( 266 ) closed to the lower edge and pushes with the inner cylinder past the sealing ring ( 265 ) in the suction cup. The outer wall cylinder, which forms a U-shaped bridge with the inner one around the inner cylinder of the suction bell ( 1 ), is screwed to the outside of the suction bell cylinder (right half of the picture). On the left half of the picture, a variant is visible, in which the sealing ring ( 265 ) is not mounted inside the suction cup ( 1 ) but outside the thread for screwing to the suction cup sleeve ( 266 ), which can also be single-walled, and its edge preferably inwardly has a protruding collar which terminates approximately with the inner edge of the suction bell ( 1 ) in projection and through the screwing adjustable distance, covering this like a shield. There may also be a detent spring with or without edge ridges or pimples to fix the height adjustment and / or make it felt or visible in steps. Since the test strip for the solution just presented can only be inserted into the gap between the rubber plates from above, expediently in conjunction with the glucometer, the light-measuring skin control would also be preferable here. From the light source ( 17 ), the light beam is directed to the skin in the center of the skin and the reflected light is received in the photosensor ( 223 ) and sent to the photometer and the control center for a warning signal. The latter is only symbolized by a (too small) rectangle with dashed lines for the line connections.

Fig. 37 is in natural size a white teres example of a puncture device below in cross section through the middle of the pump bellows, above in longitudinal section with vertical section details above left and right. Instead of a torsion rotation, the puncture stylus rotation is effected by the compression spring ( 268 ), which rests with the compression spring ( 70 ) for expanding the bellows ( 46 ) in an axis on the opposite side of the suction bell of the base plate. When the locking bars ( 256 ) are pressed to the right and the bellows are reduced, a locking notch ( 271 ) occurs in each of the locking notches of these bars, which runs perpendicular and perpendicular to the locking bar in a hole in the base plate ( 232 ) or the base block (see cross-sectional detail the grid area). The locking button is raised by the compression spring ( 272 ) between the end plate ( 277 ) and base plate ( 232 ). The sliding rods ( 275 ), the ends of which are connected via a cross plate and which encompass the compression spring ( 268 ), are locked after the inward displacement of both the locking rods and the push rods by means of the locking bolt ( 276 ). The latter is namely displaced from its locking recess in the locking rod after the locking recess of the push rod has been approached. This is clear in the longitudinal section detail along the section line AB below in the cross section lying above it. (The stage before locking is shown, the locking stage is shown under C in Fig. 38). When you press one of the two locking buttons ( 271 ) or its end plate ( 277 ), which is curved at the height of the roof sleeve, the gaps ( 274 ) in the locking buttons let the locking bars pass, so that the bellows ( 46 ) can be used to generate negative pressure under the action of the spring ( 70 ) can expand. Even before the final stage of this pumping movement, the locking recess in the locking rods ( 256 ) releases the displacement of the locking bolt ( 276 ) from the locking recesses of the sliding rods (stage C of FIG. 38). Under the action of the compression spring ( 268 ), the leaf spring arch ( 279 , also the vertical section at the top right) slides on the sliding bar over the wedge nose ( 278 ) in the sector cutout of the roof sleeve; previously this was taken from the leaf spring arch ( 278 ) to the right, as shown in the segment details below the longitudinal section of the device in cross-section at the height of the lower part of the roof sleeve and in the roll-up on the right next to it. After passing the steep flank of the wedge nose on the push rod over the leaf spring, the latter exerts pressure on the wedge slope of the wedge nose and moves it back to the left. The prerequisite for this is that the push rod movement is determined (only one is used for the rotation mechanism) by the stop with the adjusting screw ( 57 ) for regulating the angle of rotation of the roof sleeve. (The function of the leaf spring arch for returning the cutting tip is shown in dashed lines on the right). The stop with adjusting screw ( 57 ) in vertical section at the top right is shown; As can be seen in detail in the middle (sector shifted), the set screw attached to the rod guide of the base plate is directed against a stop on the roof sleeve. The push rods are wider than the locking rods, so that the leaf spring protrudes from below into the sector slot of the roof sleeve to meet the wedge nose there (right vertical section).

While on the right vertical section the retaining clip ( 171 ) sits directly on the roof sleeve and the glucometer rotates with the sector movement, on the left vertical section a plate carrying the bracket is rotatably connected to the roof sleeve, so that the rotational movement of the test strip is carried out while the glucometer is held in place becomes. In this case, a useful bridge between the base plate and the plate with the retaining clip was not drawn.

To the right of the longitudinal section is shown the detail of an adhesive strip ( 280 ) which can be glued around the glucometer so that the retaining clips can snap in behind its wedge step.

The detail of an oval sleeve under the bellows corresponds to a cross section through the longitudinal tube of the nipple with a plate around the suction channel ( 162 ) inside the bellows. The oval shape makes it easier to screw the nipple thread into the base plate while mounting the bellows. The end of the test strip ( 103 ) is inserted into the shaft of the glucometer ( 176 ). The two Blattfe fenders ( 281 ) fix it there in his waist ( 131 ) by pulling the contacts out of the shaft. The projection of the casting of the puncture pen at the bottom rests on the roof insert ( 282 ) which is firmly connected to the suction cup ( 1 ) and which carries the sealing ring ( 265 ) for receiving the narrower round part of the casting or casting ( 283 ). Its projection reaches into the hexagon of the roof sleeve with its hexagon.

Fig. 38 denotes in longitudinal section the grid function mechanism between the rear locking rod ( 256 ) and the associated push rod ( 275 ) and the locking bolt ( 276 ) in the functional stages AC. The functional stages were described in relation to FIG. 37. The dash-dotted vertical lines indicate the end points of the rod movements, the arrows the displacement paths. The recessed trough length must be adapted to the function.

Fig. 38 shows different puncture stylus variants and a type of packaging at the top in the longitudinal and at the bottom in cross section in a slight enlargement.

These size specifications relate to the conditions shown in the puncture devices: in reality, for cost reasons, you will progress to a reduction to the test field width, perhaps even further reduce the test fields. The wall thickness of the plastic tub ( 284 ) for inserting the puncture stylus into depressions and the adhesive and removable protective film ( 216 ) for covering it is also exaggerated.

The cross section through a puncture stylus just above the cutting tip ( 285 ) leaves the trough with the test field of the test strip ( 103 ) open from above with the shaft ( 286 ) open for the blood. (Below the longitudinal section is a cross section through the hexagon of the casting ( 283 ) along the cutting line AB. The longitudinal section on the right shows the broad side of the test strip ( 103 ) and its upper end with the three contact wires for insertion into the glucometer.

Fig. 40 shows a variant of the rocker scarf ters of FIG. 35 in the side view. The cross pin ( 252 ) of the actuating rod lies on the roller ( 287 ), the axis of which passes through the end of the support ( 288 ). The support is prevented from moving to the right by an angular reinforcement against which it rests. The unstable equilibrium with the pressure from above is finally overcome by deviating the roll to the left. The cross pin actuates the rocker end ( 254 ) against the compression spring of the rocker. The subsequent actuation of the torsion mechanism for the cutting tip is also made more sudden.

Fig. 41 shows in the middle above a cross section through the trough-like border ( 179 ) for receiving the glucometer ( 176 ), as shown below in longitudinal section. The cross section follows the section line CD of the longitudinal section. The glucometer is pressed down by the tension spring band ( 191 ). The puncture stylus inserted into the glucometer shaft with its end is pressed with its round end, which protrudes through a bottom opening in the border trough, into the corresponding rounding of the arching of the suction cup roof. The cutting tip protrudes there through a slot in the area of the arch of the roof depression in the slot area, where the sealing of the suction bell takes place (see FIG. 28). The rail-like shape below in the curved roof recess with a slot for the cutting tip is visible on the cross section below. There are also shown radial lamellae ( 185 ) that protrude from the suction cup roof to fix the skin surrounding the interface. The dash-dotted skin is pulled up into the suction bell, the compression spring ( 70 ) of the bellows of the suction pump accordingly in a de-tensioning position. The tilting movement for the cutting guide of the cutting tip lies in the center of the rounding of the depression in the suction cup and is pulled along by the border of the glucometer. To guide support, the border has axle knobs ( 182 ) which can move within the curved slots ( 188 ). The curved slots are in wall plates ( 290 ) which are fixed on the base plate ( 232 ). The tilting movement is carried out via a kind of eccentric rod ( 291 ), which continues in an oblique bore of the border of the glucometer in a tension spring, which ends in the pin ( 292 ). Depending on the desired tilt angle, this pin is inserted into one of the holes in the gearwheel ( 293 ), which are at different distances from the gearwheel axis. The gearwheel is driven via the relevant push rod ( 275 ), which is designed as a toothed rack at the top. The connection to the push rod via the compression spring (not shown here) corresponds to the arrangement in FIG. 37 (located on the right-hand side there). In the middle left, in a vertical section, it is shown how the axle ( 294 ) of the gearwheels ( 293 ) driven on both sides by the push rods in this variant drive a wheel with the holes for the pin ( 292 ) when the axle is fixed. The axis deviates in a U-shaped arc from the pin movement. When the gear is turned clockwise, the tension spring is initially tensioned. Compared to the eccentric pin, pulling this out, the spring tension only becomes effective when the pin comes approximately to the extension line to the eccentric pin. This favors a jerky tipping movement. The extent of the tilting movement can be finely adjusted using the adjusting screw ( 57 ). The border is returned with the glucometer via the tension spring ( 296 ). A puncture stylus is shown on both sides in a 1.5: 1 scale, which is equipped with for visual monitoring of the puncture site. The light source ( 17 ) is located in the shaft of the glucometer. The light beam falls in the shaft ( 297 , right-hand vertical section) past the test field ( 104 ) onto the skin near the cutting tip and through the shaft on the other side of the test field, the light reflected by the skin from the mirror or prism ( 224 ) becomes rectangular turned towards the eye of the observer. This is done through a (not shown slot) in the wall plate ( 290 ) in the space between the glucometer shaft and base plate ( 232 ) of the puncture device. As in the solution example of FIG. 28, the suction bell is detachably connected to the base plate by means of two or three pipe sockets ( 186 ), only one of which is shown.

Fig. 42 describes above in a longitudinal and down in a cross section in natural size a solution example for a vibrating lancet. As a variant, drive springs for generating negative pressure as well as for generating the oscillating movement are avoided.

The edge of the suction cup ( 1 ) is slightly above half the ruler-like lower edge of the pot ( 298 ) for the bellows ( 46 ) and the base plate ( 232 ). Since the human body surface has arches everywhere and also springs back elastically over the puncture area, an accidental tilting of the suction cup with premature re-ventilation can be prevented better by appropriate installation of the "ruler".

The border ( 179 ) for the clamping insertion of the glucometer ( 176 ) has the axle knobs ( 182 ) on both sides of a holding fork of the base plate. In longitudinal section, the border around the axle knobs is slightly folded up against the tension of the leaf spring ( 300 ). On the screw ( 301 ) through an extended base plate of the border, the extent of possible folding can be limited. Around the test strip ( 103 ), which is inserted into the shaft of the glucometer, the pot ( 248 ) can be seen to reduce dead space within the suction bell. The rubber sealing ring ( 267 ) takes effect after the border has been folded down with the glucometer onto the base plate. The negative pressure is generated in that the bellows ( 46 ) is deployed into the pot ( 298 ) by means of the actuating rod (shown interrupted and shortened). The resulting negative pressure in the bellows takes effect via the hose ( 90 ) in the suction bell. The bellows is sealed by the sealing ring around the actuation rod. For the latter, a shortened game is provided within a fork or here of the cylinder ( 303 ), with the actuating rod ending in the form of a plate within the cylinder in our illustration. The plate remains in the cylinder end even when pressure is exerted on the cylinder in the direction of the bellows. But only until the locking effect of the locking bolts ( 195 ) in the cylinder is overcome in an annular groove in the actuating rod. (Actually, the locking member here is a ball, behind which there is a compression spring, the pressure of which can be changed against the ring groove on the adjusting screw). The angular pushrod ( 275 ) guided along the pot for the bellows in a channel casing is shown in a longitudinal section below. Its end is connected to the cylinder rim by a pin. The movement of the push rod experiences a jerky acceleration after the locking grid is released, the inclined leaf spring ( 304 ) displacing the cross pin ( 305 ) on the plunger ( 306 ). The plunger is inserted through a hole in the suction cup cylinder and seals to the outside air in the suction cup wall. Its free end meets the test strip ( 103 ) close to its end and gives a lateral movement impulse. Determines the length of the distance which the counter tappet, which is also provided with a seal for the suction bell wall, has in the interior of the suction bell. This length can be adjusted by means of the adjusting screw ( 57 ) in the threaded bore of a nozzle attached to the suction bell. If the internal movement of the plunger is blocked, the leaf spring ( 304 ) dodges the end of the cross pin and passes through it. The second leaf spring, directed in a counter-bevel, brings the plunger back outwards before it passes through the cross pin. To prevent the bellows from retracting after overcoming the locking grid in the cylinder ( 303 ) of the palm for pump actuation, the actuating rod ( 249 ) is prevented from moving back by the locking groove ( 307 ) by means of a spring-loaded bolt ( 308 ). The positioning of this locking grid at the end of the pot for the bellows is indicated by the dash-dotted arrow. The trapezoidal bearing ( 309 ) for the axis of the seesaw beam ( 310 ) is accordingly located on the pot ( 298 ) above the bellows. To re-vent the suction bell after a beep from the glucometer, which denotes the blood saturation of the measuring field, pressure on the free end of the rocker bar raises the bolt ( 308 ) and releases the lock on the actuation rod. Before re-use, after replacing the test strip while temporarily unfolding it over the suction cup, the palm at the end of the actuating rod must be withdrawn while reducing the bellows in order to restore the initial phase shown.

FIG. 43 shows three variants of the closure of the Saugglockendaches especially when using oscillating tilting or lancets or cutting tips.

The left variant shows a natural size at the top in the longitudinal section, and a sealing mechanism similar to that described in FIG. 36 at the bottom in the cross section at the height of the rubber visible ring ( 267 ).

The rubber plates ( 260 ) are thinner here. A leaf spring ( 311 ) is leaning against its inner contact angle. Its wedge projection rests on a bevel of the upper inner cylinder of the suction cup ( 1 ).

Before use, the pot is inserted into the shaft of the glucometer ( 176 ) with its rubber sealing ring ( 267 ) before or after the end of the test strip is attached to the surface with the glucometer. (For example, by permanent magnets, not shown). When lowering the pot into the interior of the suction cup up to two or three stop pins protruding from the inside of the suction cup, the wedge projections of the leaf springs are pushed inwards. They communicate this movement to the rubber plates, the edges of which are metically closed over the test strip. The seal to the outside between the glucometer and the upper suction cup cylinder is provided by the compressed rubber sealing ring, which is all around in a thin elastic membrane connection with the rubber plates.

The variant of the solution in the middle - again in longitudinal section at the top and below in cross section at the level of the cover ring ( 312 ) - consists of the latter, which is glued tightly around the glucometer shaft. By means of side clamp springs ( 313 ) from the outer wall of the suction cup cylinder, after the test strip has been fitted, the cover ring is pressed against the rubber sealing ring ( 267 ) on the suction curl cylinder.

In the variant on the right (in longitudinal section), the test strip for the system on the rubber sealing ring of the suction bell cylinder has a rounded profile widening ( 315 ) for pressing it on by means of springs.

The Fig. 44 shows an example of solution for the withdrawal of the cutting tip after the cut from the wound area to let emerge better to the blood. The solution relates to the rotating lancet procedure. Above is a top view, below a longitudinal section and below a puncture stylus detail on a scale of 2: 1.

The lever ( 316 ) is firmly connected to the roof sleeve ( 143 ), which surrounds the puncture stylus ( 175 ) with a polygonal (approximately hexagon) above the sealing ring ( 265 ). The puncture pen (detail below) is narrowed here, for example, in its lower round section and surrounded by the edge sleeve ( 317 ) in the sliding seat. The upper edge of the edge sleeve runs in a spiral bevel, in the lowest area of which the leaf spring ( 318 ) engages from the suction cup roof. The edge ring ( 320 ) of the roof sleeve reaches through only with one segment ( 320 ) and the slot is blocked in its rotation by the adjusting screw ( 57 ) in a direction adjoining the segment. The thread of the set screw lies in a hole in the ring ( 321 ) that can be rotated on the suction cup. The screw is fixed by the clamping effect at the front of the screw end opposite the ring-shaped roof boundary of the suction cup. The resilient lever ( 316 ) lies over a segmental link guide (detail below the lever in side view), whose steep curve rise makes the rotation of the hand jerky. The spiral guide of the edge sleeve is chosen so that in the final phase of the rotation the edge sleeve is pushed down so that it pushes the skin away from the cutting tip. The blood can rise inside the marginal sleeve and is sucked up by the test field (not shown). The puncture stylus must be inserted at an angle according to a marking on the upper inner edge of the roof sleeve.

FIG. 45 is a cross-sectional detail an analog mechanism for lowering sleeve edge at a Schwinglanzette. At the same time demonstrates how the swinging movement and its return in counter-oscillation can take place from both sides of the suction bell by means of two push rods.

The extent of the inward movement of the plunger ( 306 ) via the sliding movement of the leaf spring ( 304 ) on the push rod under the plunger is determined here by the freedom of movement of the non-rotatable screw sleeve for the set screw ( 57 ) in its grommet. For example, the casting with the test field was chosen to be round. Below shows the longitudinal section through the push rod, the gap in the same, which allows the elastic evasion of the leaf spring ( 304 ) in front of the cross pin ( 305 ) of the plunger. After the leaf spring ( 304 ), the leaf spring on the slide rod on the opposite side of the suction cup meets the cross pin of the counter-plunger. The end of the casting of the test strip pushes back. Before that, however, his suspension fork ( 322 ) pushes the edge sleeve down with its wedge shoulders over the cutting tip. (Left and right of the suction cup in vertical section detail before and after the edge sleeve has been pushed off).

Addendum to Fig. 43:
For the visual skin control of the puncture site, a light source ( 17 ) is built into the suction cup wall (the lamp holder and its seal in the suction cup wall have been omitted). There lead wires over the battery ( 83 ) to the circuit via the switch with the Handta ste ( 110 ), which is mounted next to the glucometer similar to a photo trigger on the base plate. Before the lid is closed, the hand button can be pressed and the skin checked.

Fig. 46 shows above in longitudinal section and below in cross section at the height of the upper edge of the housing block or the base plate ( 232 ) a puncture device, which is placed for a rotary stylus in natural size.

The suction cup ( 1 ) can also be part of the base plate ( 232 ), the lower edge of which slightly projects beyond the suction cup edge to stabilize the system on the curved body surface of the user. Two bellows ( 46 ) with their compression springs ( 70 ) are provided as pumps. The circular cover ( 147 ) with a cross bar leads from the bellows roof to the locking bar ( 256 ). The actuating rod ( 249 ) has the transverse pin ( 251 ), which engages in a wedge shoulder in a notch (250, right middle detail in FIG. 35) or, as shown here, in a wedge guide on a segmental link guide, such as the lateral detail in FIG . 44 without the steep flank, both arrangements within the rotatable roof sleeve (143). Another variant is described in FIG. 48. Between the pot attached to the suction cup ( 248 ) with the sealing ring ( 265 ) for the puncture stylus ( 175 ), the ball bearing ( 323 ) is provided. The manual pressure from the glucometer ( 176 ) is intercepted by the edge ring ( 319 ), which is connected to the base plate and carries the rubber sealing ring ( 267 ) to the cover ring ( 312 ) glued to the glucometer shaft. The round casting of the puncture pen continues into the glucometer shaft in the flat test strips ( 103 ). The glucometer is located between the retaining clip ( 171 ). The cover ring of the glucometer is locked to the base plate by means of the cover slide ( 258 , cf. Fig. 36) and pressed against the rubber sealing ring ( 267 ). With the right actuating rod the cross bar ( 325 ) is connected via the hinge joint ( 324 ). After it has been bent, its free end is locked by means of a leaf spring ( 326 ) with holes in a fork of the left actuating rod ( 249 ) (left in vertical section detail).

The right operating rod is drawn out in vertical section. Both actuating rods have the hinge joint ( 327 ), even if slightly offset in height, in order to be able to fold the rods at right angles after operation of the device (cf. the right-hand top view of FIG. 52).

The vertical section detail at the bottom right shows a preferred axis mounting of the hinge joint ( 324 ) with a rectangular knuckle in a slot ( 328 ) of the actuating rod, as is expedient for the function of a rod variation according to FIG. 47 (right longitudinal section).

In the cross-section below, the set screw ( 57 ) is shown in a bar that is fixed on the base plate, which abuts the segment slide ( 167 ) rotating with the roof sleeve. In a bore crossing the bores for the release button and rods, the hatched reproduced two locking balls are stored for their raster mechanism (see FIG. 47 in vertical section). The two locking buttons ( 271 ) are rigidly connected by the bar ( 330 ). From the latter leads an inclined arm with the detent spring at the end ( 331 ) in the operating rod. The mechanism is symmetrical on both sides in the notch ( 232 ).

The symmetry of the strong compression spring ( 70 ) and its direction of action has a favorable effect against a premature lifting of the suction cup as a result of a return blow effect. However, a puncture device can also be built in which one of the bellows and its controls are saved.

At the edge ring ( 319 ), the light source ( 17 ) was also drawn in the longitudinal section of the device, which shines its light on the skin through the transparent puncture stylus. The reflected light is received by the photosensor ( 223 ). The power and signal connections and the photometer were not shown. The light source and photosensor can also be mounted under the pot ( 248 ). The actuating rods are erected to put the puncture device into operation. The cross bar of the right operating rod is folded to the end of the left operating rod ( 249 ) and locked with the leaf spring ( 326 ). The crossbar is now pulled up to the stop of a (not shown) pin bolt at the end of a longitudinal groove in the hole in the base plate (see Fig. 56). By pressing on the cover of the bellows they are pressed together until they lock by the locking ball (see Fig. 47). The glucometer is removed with its lid ring and the puncture stylus is replaced by pulling out the lid slide (unless the glucometer has previously been separated from the glucometer), ie inserting a new test strip with its end into the shaft of the glucometer. The cover ring is then placed back on the rubber sealing ring ( 267 ) above the suction cup and locked by means of the cover slide. After the optical control has been triggered by a switch (not shown) and the suitability of the skin on which the suction cup has been placed is confirmed, the sheet opened and closed over the glucometer is pressed against the skin by pressing on the cross bar ( 325 ) lowered. The notch ( 332 ) takes the oblique arm of the bar ( 330 ) and, after a short switching distance, the detent button ( 271 ) is released. The bellows expand under the influence of their compression springs ( 70 ) and the air is sucked out of the suction cup via the suction channel ( 162 ). The skin rises in and next to the cutting tip of the puncture stylus. After almost maximum unfolding of the bellows, the lowering of the actuating rods in the ball grid ( 334 , Fig. 4) is released. The lowering movement for generating suction was carried out by lowering the cross member in the slots ( 328 , Fig. 46 vertical detail bottom right).

The blocking of the downward movement of the actuating rods in the ball grids favors the jerkiness of the further rod lowering. The cross pin ( 251 ) comes across the slope of the link guide and causes the sector rotation of the roof sleeve, which is caused by the abutment of the adjusting screw on the segment slide ( 167 ). The gap in the cover slide for the passage of the cross pin ( 251 ) is not shown. The re-ventilation after a message from the glucometer can be done by tipping the device to the side. In Fig. 52 a special Wiederbelüf is presented venting valve.

The Fig. 47 are the left side a vertical section through the function-controlling barrier Aster along the transverse bore (335) through the base plate of a puncture device according to FIG. 47 again.

The locking button ( 271 ) is raised by the compression spring ( 336 ). Your notch is thus above the (hatched) grid ball, which prevents the locking rod ( 256 ), which is connected to the cover ( 147 ) of a bellows ( Fig. 46), from moving. Such an obstacle to movement also exists for the actuating rod ( 249 ) in its notch through the grid or locking ball, which che rests on the locking rod.

On the right-hand side, the functional stage is reduced pressing the locking button shown. The locking ball was raised by lifting the locking bar from the Slant the notch into the notch of the rest button pushed away. After raising the locking bar their notch rose to the level of the right Locking ball towards the operating rod. By the manual pressure from above on the actuation the locking notch edge displaces the lock ball into the notch of the locking bar. Latter can because of the oval shape of the grid stretch the bellows a little further rising up. Lowering the operating rod takes place suddenly after force build-up over the grid Lich.

To the right of this illustration, the variant of an actuating rod is shown in longitudinal section in scale 2: 1. The actuating rod ( 249 ) continues in a sleeve with a fork ( 338 ), the fork pieces of which the hinge joint ( 327 ) has. When the actuating rod is lowered within the sleeve, the pressure is initially absorbed by the compression spring ( 337 ) between a cross pin in the actuating rod and the upper edge of the sleeve. If the latching of the sleeve movement in the side locking grids ( 339 ) is overcome, the sleeve is lowered jerkily. For the sake of simplicity, the locking balls of the locking grid ( 339 ) are pressed into the notches in the sleeve by leaf springs; they can also be designed to be adjustable in analogy to the conditions in the locking bolts ( 195 , FIG. 42). The detail below shows a variant of the insertion of the pot ( 248 ) with the rubber sealing ring ( 267 ) on the lid with a hinged hinge ( 340 ). The pot can be pivoted away from the entrance of the suction bell (not shown). The diagonally next to the folding hinge in a recess under the last tension spring ( 341 ) which untensions stabilizes the end positions of the pot. There is a longitudinal section at the top and a top view below, both of natural size.

Fig. 48 branches an actuating rod ( 249 ) which passes through a sector slot (bottom in the plan view) of a roof sleeve ( 143 ). The lower left wedge ( 342 ) meets the left leaf spring arch ( 343 ) on the roof sleeve and causes the sector to rotate. When the actuating rod is lowered further, the upper right wedge on the latter abuts against the right leaf spring arch ( 344 ), which results in the counter movement of the roof sleeve. With (not shown) premature movement lock of the sector rotation (see. Fig. 46 in cross section), the leaf spring arches avoid the wedges on the actuating rod.

The variant of the extended wedge ( 345 ) blocks the downward movement of the actuating rod in the event of a counter-sector movement which exceeds the actual cutting movement in length. This is particularly useful if the cutting tip of the puncture stylus is followed by a short one-sided cutting edge, as shown below in cross-section within a dash-dotted skin area. During the counter movement with the blunt lancet portion, the latter opens a gap for the blood to emerge.

Fig. 49 shows in a cross-sectional detail through a puncture device according to Fig. 46 at the level of the cast piece ( 283 ) of a puncture pen. The latter is moved laterally in the manner of an oscillating lancet in the gap between the plunger ( 306 ) and the counter-plunger ( 321 ) (on the right in a 2: 1 scale after the suction cup has been rotated by about 22 degrees). The actuating rods with the wedges ( 342 , 346 ) are turned horizontally for demonstration. Since the (in reality vertical) Be actuating rods are connected by the cross member ( 325 , Fig. 46), the wedges distributed on the two rods come successively into contact with the plunger or with the counter-plunger for executing the vibration of the puncture stylus. The extent of the tappet movements can be set separately for the tappet and counter tappet on adjusting screws at the edge grommet ( 347 ).

A spring mechanism is also sketched, which serves to fix the cutting tip in a deflected position. The cutting slot for the blood outlet is then kept open (cf. longitudinal detail below for FIG. 52). However, if the suction cup is inadvertently re-aerated, the skin retracting from the cutting tip cannot inflict a cut on the latter, since it directs the cutting tip against the weak spring action. The symmetrical double wire spring ( 348 ) is attached to the inner projection ( 349 ) on a center bow and lies with one end on the wedge projection ( 350 ), with the other on the sliding sleeve ( 351 ) in front of its cross pin. When the plunger ( 306 ) is actuated, the moment comes when the wire spring end leaves the wedge projection. The other end of the wire spring pushes the outer sleeve ( 353 ) in the direction of the casting ( 283 ). It gives the plunger movement on the casting for its Kip pung (ie the pressure of the counter-bearing of the counter-plunger) and holds the casting in the tilt position to the right after retraction of the plunger under the action of the compression spring ( 354 ).

The cross-section on the left shows the narrowing of the puncture device serving rod and grid arrangement radially to the puncture stylus, which causes the glucometer ( 176 ) to be inclined between the function rods (locking buttons, locking and actuating rods).

Fig. 50 demonstrates a 2: 1 scale be a special puncture stylus equipment for the re regulation of the depth of the cutting tip ( 285 ). Above is a top view of how a commercially available test strip for the glucometer can be cut off along the dash-dotted line in order to prevent the blood entry within a casting (not shown here) onto the test field ( 104 ) in which the chemical reaction occurs enable.

Underneath you can see the cut sheet of a thin sheet metal sleeve which, instead of a casting, surrounds the test field ( 104 , in longitudinal section below) in a closely fitting manner (below in cross section).

In the left variant of the cutting bow, the cutting tip ( 285 ) follows a neck strip which is bent inwards towards the middle of the test strip. In the center of the test strip, the cutting tip is then bent downwards at right angles from the neck strip.

In the left-hand variant of the cutting sheet, the cutting tip remains on the side of the test strip. In both cases, the splines are approached one another. In the longitudinal section below it can be seen how an oval inwardly resilient sheet metal ring ( 356 ) engages with an edge fold in the teeth of the sheet metal sleeve. Depending on the desired length of the protrusion of the cutting tip, the sheet metal sleeve can be opened at its opening under lateral pressure and can be shifted again along the toothed bar.

Fig. 51 shows the end of a puncture stylus in longitudinal section in natural size. The test stiff broached in Fig. 51 corresponding to above the test field (104) is opened below embedded in the casting (283). Below is shown in scale 2: 1 above in the longitudinal and below in cross section shows how the insert ( 357 ) from above both the only open up ( 358 ) slot and the continuous shaft ( 359 ) can be created. The latter can extend down to the base of the cutting tip and thus form a blood drainage channel.

On the far right is the cross section of one continuous insert.

Fig. 52 shows for a puncture device according to Figs. 46, 47 the possibility of turning the actuating rods around their hinge joints and their arrangement above the base plate. On the left, a longitudinal section, on the right, a cross section with the variation of a mirror-image arrangement of the rod bores when equipped with a plunger and counter-plunger for a variant of the type of vibrating lancet.

Fig. 53 shows the left over one another Mechanical- mechanism for a tracking of the cutting tip of the jerky cutting movement for the extension of the wound gap. This puncture stylus tracking is shown in the longitudinal section at the bottom and the wound gap is visible. The cutting tip moves at the level of the braid with stronger blood capillaries.

The actuating rod with the wedge ( 342 ) for the movement of the plunger ( 306 ) occurs with the leaf spring arch ( 360 ) when it is lowered via the transverse pin ( 361 ) of the valve rod ( 362 ) of the ventilation valve for the suction bell. The movement of the valve rod is limited by its pin in the guide slot ( 363 ). The extent of the lowering of the actuating rod is determined by its opening on the slope of the wedge slide ( 364 ). In the event of even greater pressure being exerted on the actuating rod, the wedge slide is displaced to the right against a stronger compression spring and blocked with its front blunt rod against the actuating rod. This stage of the wedge slide movement to the right causes the slow oscillation and subsequent blocking of the cutting tip, as can be seen in the figure below. The plunger is fixed to the left. If the actuating rod is pulled up again after the signal from the glucometer, it can leave the end of the front flattening of the wedge slide. This is pushed back to the left by its strong compression spring. The stop ( 365 ) of the wedge slide can be supplemented by an adjusting screw, at which the amount of displacement of the wedge slide is set (see. Fig. 56). When the actuating rod is raised further, its leaf spring arch takes the cross rod of the valve rod upwards, with its long notch ( 366 ) bridging the sealing ring between the valve rod and base plate, so that air penetrates into the suction bell via the ventilation duct ( 367 ).

The Fig. 53 right-hand side describes an Mechanical- mechanism to the lid closing the suction bell. This happens ge in the top view and in the longitudinal section below, left in the opening and right in the closing phase. In contrast to the procedure in Fig. 36, the two rubber plates ( 259 , 260 ) remain on the suction cup roof. The function stylus must therefore be inserted through the slot between them in the suction cup space. The rubber plates rest on the pot ( 248 ). The rubber sealing ring ( 267 ) is held in position by a holder ( 388 ) from the roof clip ( 389 ) centrally over the rubber plates. When the cover slide ( 257 ) moves in the direction of the suction cup roof, the legs of the rubber plates that run in the inner holes of the rubber plates and the wedge bends with their wedge arches on the posts ( 269 , 270 , 271 ) fixed on the base plate move inwards, approximating the rubber plate edges pushed to the test strip ( 103 ).

The cover slide slotted in the middle for the passage past the test strip overtakes with its knobs ( 372 ) on its underside the transverse sleeve guide of the right leg of the spring clip and the left leg of the split spring clip that dips into it. The vertical details at the bottom show how the cover slide with its stepped knob guide exerts pressure on the rubber sealing ring (see longitudinal section) in the end position of its sliding movement against the roof clamp (see longitudinal section) and thus accomplishes the sealing.

The glucometer ( 176 ) is located in the holding clip ( 171 ). The roof complex with the suction cup ( 1 ) is fastened in niches on the surface of the base plate ( 232 ) by means of the (pipe) socket ( 186 ) with end olives by means of spring clips.

Fig. 54 is used to explain design types for the height adjustment of the puncture pen in point tion devices according to the rotation principle. The presentation takes place in longitudinal sections in natural size. In the example in the upper left figure, the height is adjusted in a thread between the wall ring ( 319 ) and roof sleeve ( 143 ). In addition to the sealing ring ( 265 ) between the roof sleeve and puncture stylus, a further sealing ring ( 373 ) is provided between the suction bell ( 1 ) and a downward-pulled edge grommet of the roof sleeve. The edge ring is fixed against the suction cup by means of the swiveling clamping spring ( 374 ).

In the middle example, no grommet is pulled down from the roof sleeve into the suction bell chamber, which is why the sealing ring ( 373 ) in the suction bell - it could also be mounted on the roof sleeve - is higher.

In the example on the right-hand illustration, the casting ( 283 ) of the puncture stylus is tapered downwards for better insertion and sealing. (The lower diameter is determined by the width of the test field). The seal is made at the lower edge of the bellows ( 375 ), the upper edge with the roof of the suction bell ( 1 ). The height of the immersion depth of the cutting tip can be determined from below in the suction cup by screwing the edge ring supporting the lower bellows edge.

The lower row of images begins on the left with a longitudinal section through an example of height regulation by raising and lowering an elongated round part of the puncture pen in the sealing ring ( 265 ) when using the wedge slide ( 257 ). The wedge gate valve is visible on the right in a side view, is supported at the bottom against the suction bell and lifts the same in an oblique parallel guide and slot guide in the edge ring ( 319 ). The extent of the shift is regulated on the S 13302 00070 552 001000280000000200012000285911319100040 0002019705091 00004 13183tellscrew ( 57 ), which is fixed to a holding arm on the suction cup, by means of a clamp in a slot guide of the wedge slide (side view). The small roof sleeve ( 143 ) engages in the hexagon ring of the puncture stylus and can be done through (not shown) segment slots of the edge ring (on the longitudinal section front and back) in the manner previously described.

In the longitudinal section of the variation on the right in the second row of images, the edge ring ( 319 ) is screwed to the suction bell ( 1 ) on the top outside. The edge ring engages in an annular groove of the roof sleeve ( 143 ) which can be freely rotated in the respectively set height. The seal is made between the puncture pen and the suction cup roof.

The rotation of the puncture stylus of the upper row of images can, for example, be inserted into the holes (or notches) in the edge projection of the puncture stylus via the key sleeve ( 376 , with the bellows in the upper right figure with the bellows) by means of pins. To the right, an enlarged detail of the left half of a casting ( 283 ) with an insertion funnel and hole for one of the pins.

FIG. 55 shows an example of a height regulation for a puncture pen with a vibrating lancet in two joined sections, the right half in the longitudinal section, the left in the vertical section in natural size. The lid ( 377 ) with the holding clip (not shown) for the glucometer above it is fastened in hooks on the base plate ( 232 ) by means of three tension springs ( 378 ). (In practice you would choose a snap ring). Edge clips ( 379 ) connect the cover ( 377 ) with the cover ring ( 380 ). The weak tension springs ( 381 ) hold a further cover plate with angle rods ( 382 ) in the weld, which are easily spring back in the holes in the base plate. Extensions ( 383 ) likewise extend from the cover ( 377 ) into depressions in the base plate. Before attaching the tension springs ( 378 ), the test strip is inserted between the rubber plates with hard edge edging ( 261 , Fig. 36) resting on the cover plate with the angle bars and through corresponding slots in the cover and inserted into the shaft of the glucometer. Extensions and angle bars are then inserted into the corresponding recesses in the base plate. The wedge slide ( 257 ) between the cover ( 377 ) and the cover ring ( 380 ) is shifted and screwed in with the analog equipment as shown in Fig. 54 according to the desired puncture stylus depth in the suction cup against the wedge bevel (right in the vertical section). After hooking in the strong tension spring ( 378 ), it lowers the cover ring. Its inner bevel (on the left in longitudinal section) presses the two rubber plates to seal against the test strip. The cover with the angle bars ( 382 ) is then pressed against the rubber sealing ring ( 267 ). To adjust the height of puncture styluses like the vibrating lancet, an edge ring screw connection can of course also be used, such as the one in the right-hand illustration of the second row from above. The narrowing of the suction cup roof for the sealing ring is not necessary.

Fig. 56 shows the example of a setting of two cutting lengths in the event of failure of the first triggering of a tilting movement without the lancet tip having to be removed beforehand from the puncture site. This procedure is gentler, especially with regard to the different vascular abundance of different skin areas. The device is based on that of FIG. 52. This time, however, the wedge slide ( 364 ) is used to determine the depth of the lowering of the actuating rod and thus also the extent to which the plunger ( 306 ) is displaced by the wedge ( 342 ). The effective length of the wedge slide ( 364 ) is determined by the adjusting screw ( 57 ), the thread of which is turned in a bore in the end angle of the slide. The latter is attached to the carriage ( 384 ), the movement of which to the left is limited by the stop ( 385 ). The carriage has the gallows ( 386 ) with a notch for the end of the locking rod ( 387 ) which is sprung downwards. Another wedge gate valve ( 390 ) runs in parallel. The set screw, which rotates and locks into the hole at its end, runs through a hole in a bar fixed on the base plate. In the figure on the top left, which corresponds to the phase before the cut is triggered, the adjusting screw ( 57 ) is screwed in maximally so that only a minimal wedge lowering is possible at the end of the actuating rod. If the glucometer does not report blood saturation in the test field, the user only needs to pull the actuation rod. The premature lifting of the valve rod ( 362 ) is prevented by the spring-loaded bolt ( 391 ) against the cross pin of the valve rod above the base plate or by another grid. When the actuating rod is raised, its leaf spring arch ( 360 ) lifts a cross pin on the locking rod ( 387 ). The gallows (386 and thus the wedge slide ( 364 ) is then unlocked (lower right figure) and thus offers hardly any resistance to the end of the operating rod. It is displaced to the right. The second lowering of the operating rod is now limited by the setting of the The valve pin must be unlocked when the actuating rod is retracted or the additional grid for re-ventilation via the ventilation channel ( 367 , Fig. 52) must be overcome. The valve lifter is lifted by taking the upper one with it Cross pin through the leaf spring arch of the locking rod.

The wedge slide ( 364 ) and its slide are only returned to the left when the operating rod is raised to the maximum. The cross plate ( 392 ) attached to the latter continues in an angular plate with a slot. The length of the slot is adapted to the path of the actuation rod. The slot guide ( 393 ) for the guide pin of the actuating rod can therefore also be omitted in this example. In the final phase of lifting the actuating rod, the plate with slot ( 394 ) is lifted from the cross pin in the cross plate ( 392 ). The cross pin ( 395 ) in the extension of the top slotted plate engages from below into the sloping edge of the frame ( 384 ) which is extended and acts to return it to the left (i.e. from the position in the lower left to that in the upper right) education.

Fig. 57 shows above in longitudinal and down in cross section in natural size the end of a puncture pen. Analogously to the illustration in FIG. 17, the cutting tip represents a type of cannula end, the cavity of which opens into the room with the test field ( 104 ) if the frame is otherwise closed. If the cutting tip lies within the skin, then an air pressure gradient arises with this arrangement towards the test field, the slot ( 358 ) having to be open upwards into the suction space.

Fig. 58 shows above in cross and below in longitudinal section on a scale of 2: 1 a puncture device for two different cutting lengths using a puncture pen according to the principle of rotation. The section line AB of the longitudinal section is slightly lower on the left side than on the right side (dash-dotted line).

The torque is generated by the strong tension spring ( 396 ), which is clamped by a pin in a segment slot of the roof sleeve ( 143 ) to a projection on the roof of the suction bell ( 1 ). The rotation is limited by the cone of the set screw ( 57 ), which projects into the segment slot ( 397 ) of the roof sleeve. The set screw ( 57 ) passes through the swivel lever ( 398 ) with the hinge joint ( 400 ) on the suction bell and is pulled up by the tension spring ( 399 ).

The locking button ( 271 ) is lowered in the functional phase shown against its resetting compression spring ( 336 ) and released the rotational movement of the roof sleeve with an edge notch. The puncture stylus ( 175 ) was rotated in the hexagon of the roof sleeve between the sealing ring ( 265 ) in the roof of the suction bell. Under the action of the pump (not shown) via the opening ( 97 ), the skin had been lifted into the cutting tip of the puncture stylus (dash-dotted line).

If the glucometer (not shown) connected to the test strip above the roof sleeve reports no blood contact, the swivel arm is moved away from the suction bell, the edge of the segment slot then moves under the action of the tension spring ( 396 ) until it stops at the cone the second, somewhat reset and preset adjusting screw ( 401 ), which is connected to the suction cup via the bridge bracket ( 402 ). When the swivel lever is released, the elastic spring band ( 403 ) pushes against the rounded knob ( 404 ) on the edge grommet with its inward movement and rotates it against the action of the tension spring ( 396 ) - supported by the hand - into the latched position for the latch button ( 271 ) back. The spring band has overhauled the knob in the function phase shown, a process which is a prerequisite for the initiation of the rotation process. The roof sleeve can also be turned back from the edge until it is locked using the locking button. The cone of the second adjusting screw ( 401 ) is expediently chosen to be flatter in order to be able to set a larger angle of rotation.

Addendum to Fig. 42 on page 79:
The wide notch between the right edge of the suction cup and the base plate ( 262 ) allows you to put your thumb there to embrace the direction. A thumb loop is used for smaller hands at the front and further up.

It is not just the function shown connections and components must be protected, but also their application in any other combination, to the inventive concept of a limited and firm insertable, jerky cutting tip movement and to fulfill the other inventive features.

Addendum to Fig. 58:
To the left in the middle is a natural-sized point device with a particularly low roof design. The puncture stylus is sealed in analogy to the conditions in FIGS. 28 and 41 by rounding it to form a correspondingly smooth trough recess in the suction cup roof. The lower end of the stylus is preferably hemispherical and the roof trough for receiving it accordingly. A cannula or a very slightly eccentrically mounted lancet tip can be selected as the cutting tip and the passage in the suction bell can thereby be kept small.

The puncture stylus rotates from the hexagon its outreach over the suction cup roof over the Roof sleeve in one of the ways already described. The roof sleeve has cross pins or knobs or one Edge ring on top of the edge projection of the Griffels presses. It is represented by springs in Ver bond with the suction cup pressed down to the To ensure sealing of the suction cup roof.

By means of the puncture devices shown in FIGS . 1-58, substances other than glucose - possibly like acetone as well - can be determined by dividing the test field or by selecting a test field with the appropriate chemistry.

Addendum to Fig. 54 page 96:
The roof sleeve engages under the protruding edge of the puncture stylus with an inner edge strip.

Addendum to Fig. 56 page 99:
If the guide slot ( 393 ) is omitted, the sealing ring and the long notch ( 366 ) for opening the ventilation duct (see FIG. 52) can advantageously also be located directly on the actuating rod, eliminating the valve rod.

Addendum to Fig. 53:
The material for the casting with a cutting tip can be glass, plastic or metal.

Claims (50)

1.Device for obtaining blood from the skin of a living being and connected metabolism measurement by means of the cutting tip of a puncture agent which is inserted into a suction bell in connection with a suction source into the skin raised by negative air pressure and then moved transversely or laterally to the skin surface,
characterized by
that means are available to limit the movement of the cutting tip of the puncture means transversely or laterally to the skin surface to a single cutting movement of an application length of only exceptionally up to ten millimeters and that at least one test field with chemicals for at least one substance determination of the Blood exit point is approached in such a way that the blood can penetrate the test area, the test field in question being able to be connected to a measuring device by means of signal transmission, preferably directly to a commercially available glucometer,
and preferably means are provided for the optical control of the skin area intended for the puncture in order to exclude the puncture of a pathologically altered skin area. 2. Device according to claim 1, characterized, that at least in places in the puncture stylus a test strip of commercially available equipment is stored, the measuring contacts in the measuring shaft a commercially available glucometer.   3. Device according to claim 1, characterized, that means are present, the range of cutting tips To change movement in a predeterminable amount. 4. Device according to claim 1, characterized, that means are present to control the movement of the cutting pointed jerkily across or to the side of the skin surface to design. 5. Device according to claim 1, characterized, that means are present, the penetration depth of the cutting Gradually step the tip of the puncture into the skin going to change. 6. Device according to claim 1, characterized, that means are present, the movement of the cutting tip swinging or tilting to the side and doing so limit in their rash. 7. Device according to claim 1, characterized, that means are present inside the puncture stylus Rotate half of a sealing ring in the suction cup roof to let and the angle of rotation to Be limit the cutting movement of the cutting tip lay. 8. Device according to claim 1, characterized, that the movement of the cutting tip in one position of the test field approximately parallel to the skin surface  parallel to this is done with special means. 9. Device according to claim 1, characterized, that the means of limitation is an adjusting screw represents the movement of the puncture agent, which which hits a stop in the thread direction, taking stop or set screw with the suction cup are established. 10. Device according to claim 1, characterized, that the means of limiting the movement of the puncture represents by means of a set screw that with a End cone transverse to the direction of one with the puncture agent moving part is arranged. 11. The device according to claim 1 characterized, that the sealing of the puncture agent to the roof of the Suction cup over the fitting of the curved end surface of the puncture agent in a suitably tight fitted trough in the suction cup roof, which for the opening of the cutting tip points to the puncture agent under pressure Towards the suction cup roof. 12. Device according to claim 1, characterized, that with sideways movement of the puncture the cutting tip at least one plunger through a Seal in the side wall of the suction cup Height above the cutting tip and the skin bell is introduced into the suction cup chamber.   13. Device according to claim 1, characterized, that the movement of the puncture means is perpendicular Actuating rod moved towards the skin takes place under Application of the passage of a wedge profile, which the Puncture stylus preferably with interposition at least one additional moving part for cutting across or to the side of the skin surface set in motion. 14. Device according to claim 1, characterized, that a rotational movement of the puncture means over a Kind of sleeve takes place over the suction cup roof, which in designs of a deviating from the circular shape protruding above the seal to the suction cup compartment Edge of the puncture, which is rounded at least in places engages and ver this in the sector rotation puts. 15. Device according to claim 1, characterized, that the suction ring is fixed on the skin bell against this and against one by holding on roof part also prevented from rotating are available and the proportion of suction Bell limitation of the special surface shape preferably with radially descending plates, the skin that has risen under suction is used for conditioning, rotated sector by sector and the skin on the firm stationary cutting tip is moved past. 16. Device according to claim 1, characterized, that the sideways movement of the cutting tip  a rest before a part of the movement direction includes, the movement being manually operated is carried out. 17. Device according to claim 1, characterized, that lowering an actuating rod with action on the movement of the cutting tip through a cross wedge is inhibited, preferably on the Rod end meets or preferably a cross pin on the operating rod when using two crosses wedges for different drawer lengths of the cutting tip. 18. Device according to claim 1, characterized, that when moving parts to generate the Movement of the cutting tip using an obstacle of the parallelogram of forces is interposed from an unstable balance of moving parts Change in the direction of the force cancels and the jerky movement shapes. 19. Device according to claim 1, characterized, that between moved for the movement of the cutting tip Share an overrunning mechanism so that the cutting tip in its starting position in the skin can return. 20. Device according to claim 1, characterized, that a spring when moving the cutting tip is activated, against the tension of which the skin easily the cutting tip back to the starting position  can be pulled out of the cutting tip. 21. Device according to claim 1, characterized, that at least one bellows as a suction pump with his Unfolding axis parallel to the axis of the suction cup is arranged. 22. Device according to claim 1, characterized, that the movement of a part when enlarged Suction pump room a locking grid for movement Sharing triggers the movement of the cutting tip cause. 23. Device according to claim 1, characterized, that first over an operating rod by hand Suction pump room expanded and that the rod to the bottom maintenance of pressure is then initially fixed in a blocking grid is held while overcoming a grid lock on one in front of the operating rod for the Suction pump stored part of this on its strength transmits a part for moving the cutting tip. 24. Device according to claim 1, characterized, that a folding bag serves as a suction pump which between two plates connected by a hinge joint is generated when spreading. 25. Device according to claim 1, characterized, that with the upward movement of the operating rod for the movement of the cutting tip is a valve for ventilation  channel of the suction bell is opened. 26. Device according to claim 1, characterized, that a swivel lever with adjusting screw the lifting the lock at the stop of moving parts for the movement transfer allowed to the cutting tip, so that the moving parts a new freedom of movement win up to another set screw. 27. Device according to claim 1, characterized, that a sliding sleeve is on a puncture is located, which covers at least one Part of the cutting tip lowered over this can be. 28. Device according to claim 1, characterized, that the movement of the cutting tip via a pneumati pressure switch takes place, the compressed air in a manually operated pump is generated. 29. Device according to claim 1, characterized, that for height adjustment of the cutting tip in the suction bell an insert ring in the suction bell to this additionally sealed around with the roof with the gasket the rounded puncture device is screwed in height can be. 30. Device according to claim 1, characterized, that for height adjustment of the cutting tip in the suction bell in the sealing area to the suction cup roof  round puncture means on its widened edge ring, which is in engagement with a rotating roof sleeve with this by screwing an edge ring can be changed with the suction cup by the edge ring with at least one part in an annular groove engages in the roof sleeve. 31. Device according to claim 1, characterized, that for height adjustment of the cutting tip in the suction bell the roofing with its inner edge the porridge under the puncture ring and by means of a lockable wedge between Roof sleeve and roof area of the suction cup in height or the distance to the sealing area around the puncture can be changed in the suction cup roof. 32. Device according to claim 1, characterized, that for height adjustment of the cutting tip in the Suction cup an adjustable and lockable Wedge between measuring device, preferably glucometer, and uppermost suction cup area the immersion depth the cutting tip into the suction cup. 33. Device according to claim 1, characterized, that to close the roof opening of the suction bell a cover ring tight around the shaft of the measuring device is attached against a sealing ring the upper suction bell entrance by suitable means is pressed. 34. Device according to claim 1, characterized,  that to lock the lid one to the shaft of the measuring device performed test strips as part of the puncture means two rubber plates using a wedge guide together and also against a sealing ring above the upper suction bell entrance with suitable Sliders and springs are pressed. 35. Device according to claim 1, characterized, that a holding device in a lid in attachment with the measuring device to two rubber plates, which by measuring the wedge around the shaft device led test strips as part of the punk be pressed together in connection to be able to hold with the measuring device. 36. Device according to claim 1, characterized, that the connecting line between functional parts to the side of the suction cup in its lowest contour with which preferably by undercut the edge set the suction cup rim somewhat downwards project so that when in the appropriate position the body arch an unintentional tilting of the Suction cup is prevented from the skin. 37. Device according to claim 1, that to tension a spring for rotation of a Cutting tip the roof sleeve over the lowering little at least one pin is turned in a wedge guide, but when that pen is raised again under spring tension by pulling apart Locking members jerky the rotation of the roof sleeve only occurs when the locking members apart have kicked.   38. Device according to claim 1, characterized, that a puncture for single use is equipped and with its round end by means of a Adhesive plaster strip with hole for the passage the cutting tip into the skin against the skin strengthened and tipped on it. 39. Device according to claim 1, characterized, about the tracking of a wider wedge after the Cutting movement of the cutting tip with its sharp Edge behind the narrower tip area a movement in the opposite direction is against a blunt side edge behind the actual cutting tip, so that the wound gap is kept open. 40. Device according to claim 1, characterized, that light from above through a transparent support part for the test field of a puncture agent on the skin thrown from there on reflected and over an optical Deflection surface is directed laterally to the eye. 41. Device according to claim 1, characterized, that from a light source in conjunction with battery and hand button inside the suction cup light on the future puncture site is thrown. 42. Device according to claim 1, characterized, that from the suction cup edge opposite tabs with Bore holes in which marker pens for visual skin control to be pressed against the skin.   43. Device according to claim 1, characterized, that an additional over the suction cup rim screwable against the suction cup and additional Lich edge grommet the height adjustment of the cutting allowed inside the suction cup. 44. Device according to claim 1, characterized, that of which the test field in the puncture agent surrounding jacket up to the suction cup roof So facing away from the cutting tip Gap space in the suction cup compartment opens. 45. Facility-related method for obtaining blood from the skin of a living being and connected metabolism determination by means of the cutting tip of a puncture agent, which is inserted into a skin within a suction cup in connection with a suction source and is then moved transversely or laterally to the surface of the skin, due to negative air pressure,
characterized,
that the movement transverse or laterally to the skin surface is usually limited to a single cutting movement with an application length of only exceptionally ten millimeters and that at least one test field with chemicals for at least one substance determination of the blood exit site is approached in such a way that the blood is on the test area can penetrate, the test field in question being introduced into the circuit of a signal exchange to a measuring device,
preferably in such a glucose meter that is commercially available and that is to be connected to the puncture agent,
and that there are preferably means for the optical control of the skin area intended for puncture in order to exclude the puncture of a pathologically altered skin area. 46. Device according to claim 1, characterized in that a storage vacuum is used as the suction source.
Addendum: Analogue signals produced by a sensor in the area of the puncture device, the content of the substance to be determined, can also be transmitted wirelessly to a measuring device outside. 47. Device according to claim 1, characterized, that a sensor is present within the facility for the for the production of signals that the content of the substance to be examined roughly analogous to the test field of the puncture agent and means for converting these signals and for their line-free transfer to a measuring device outside the facility tung. 48. Device according to claim 1, characterized, that the suction channel following the suction source in the base plate of the suction cup is guided horizontally and into a kind of slot inside the suction bell ends, which preferably under caliber jump in the area around the confluence the inner edge of the suction cup is separated.   49. Device according to claim 1, characterized, that below the mouth of the suction channel to the source of suction, the horizontal in the base a suction cup is guided within the Suction cup a protrusion is provided preferably at least partially the one mouth covered. 50. Device according to claim 1, characterized, that the suction channel is perpendicular from a portion to the suction source in the base plate of a suction cup is continued in a horizontal hole, which opens into the roof corner of the suction bell, which are not relocated from the top of the skin can.