DE3103976C2 - Chirurgisches Näh- und Schneidinstrument - Google Patents
Chirurgisches Näh- und SchneidinstrumentInfo
- Publication number
- DE3103976C2 DE3103976C2 DE3103976A DE3103976A DE3103976C2 DE 3103976 C2 DE3103976 C2 DE 3103976C2 DE 3103976 A DE3103976 A DE 3103976A DE 3103976 A DE3103976 A DE 3103976A DE 3103976 C2 DE3103976 C2 DE 3103976C2
- Authority
- DE
- Germany
- Prior art keywords
- jaws
- cutting instrument
- jaw
- instrument according
- cutting
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/282—Jaws
- A61B2017/2825—Inserts of different material in jaws
Description
Die Erfindung bezieht sich auf ein chirurgisches Näh- und Schneidinstrument nach dem Oberbegriff des
Hauptanspruchs.
Ein chirurgisches Näh- und Schneidinstrument der gattungsgemäßen Art ist aus der DE-PS 15 66175
bekannt, die der US-PS 34 99 591 entspricht. Ein solches chirurgisches Näh- und Schneidinstrument ermöglicht
die Befestigung zweier Körperhohlorgane mit zueinan-
der parallelen Längsachsen seitlich aneinander und mit
Hilfe des an dem Instrument vorgesehenen Messers wird ein Längsschnitt durch die sich berührenden
Wände der beiden Organe gelegt Hierdurch werden die beiden Organe gegeneinander geöffnet un.i stellen längs
des Schnittes ein einziges Hohlorgan dar. Die auf jeder Seite des Schnittes befindlichen Wände werden dabei
jeweils durch mindestens eine Reihe von Klammern zusammengehalten. Die Ausstoßplatten in der
Klammernpatrone sind hierbei mit an ihren beiderseitigen Schmalseiten vorgesehenen Federn in Nuten
geführt, die an den schmalen Seitenwänden der Klammernschlitze ausgebildet sind und gleichzeitig die
seitlichen Schenkel der Klammern halten und führen. Hierdurch werden beim Ausstoßen der Klammern
Verklemmungen vermieden, so daß sich der Patronenkörper aus billigem Material mit Toleranzen herstellen
läßt, die wesentlich größer als zuvor üblich sind. Die Backenträger und die Backen sind bei diesem
chirurgischen Näh- und Schneidinstrument mehrmalig verwendbar und aus widerstandsfähigem und daher
teurem Material hergestellt Zum Einspannen des zu klammernden Gewebes und zum Ausstoßen der
einzelnen Klammern in der Form, daß sie in das eingespannte Gewebe eindringen, wozu die Klammern
gegen den Amboß gedrückt und umgebogen werden, sind hohe Kräfte erforderlich. Diese Kräfte versuchen
die Backen in senkrechter Richtung voneinander weg zu bewegen und dieselben zur Seite hin zu verformen, so
daß ein zuverlässiges und genaues Setzen der Klammern hierdurch bedingt schwierig wird. Zudem ist
man auf dem Gebiet der Chirurgie bestrebt, ein wiederholtes Sterilisieren von Instrumenten und Instrumententeilen
zu vermeiden, indem man versucht. Teile der Instrumente aus möglichst billigem Material
wirtschaftlich herzustellen. Bildet man aber die Backen und die Backenträger aus billigen Werkstoffen aus, so
versuchen die beim Gebrauch des Instruments auftretenden relativ starken Kräfte die Funktionsfähigkeit
dieser Teile zu beeinträchtigen.
Aus der US-PS 30 79 606 ist ein Klammerninstrument für lineare Klammernähte bekannt, bei dem das
optimale Fluchten und Festlegen der Backen mit Hilfe von mehreren Paßstiften erreicht wird. Eine solche
Auslegung ermöglicht nur dann ein optimales Fluchten und Festlegen der Backen, selbst bei den hohen
auftretenden Kräften, wenn die Paßstifte in widerstandsfähige und starre Teile greifen.
Der Erfindung liegt die Aufgabe zugrunde, ein chirurgisches Näh- und Schneidinstrument der gattungsgemäßen
Art derart auszubilden, daß trotz einer Ausbildung der Backen und der Backenträger in
Leichtbauweise die zum Ausstoßen, Einführen und Umbiegen der einzelnen Klammern erforderlichen
großen Kräfte keinen nachteiligen Einfluß auf das zuverlässige und genaue Setzen der Klammern haben.
Diese Aufgabe wird nach der Erfindung mit den Merkmalen des Kennzeichens des Anspruchs 1 gelöst.
Weiterbildungen der Erfindung sind in Unteransprüchen wiedergegeben.
Erfindungsgemäß sind die Vorschub- und Schneidanordnung und die Backen mit Abstützeinrichtungen
versehen, die eine örtliche Abstützung etwa an dem Punkt gestatten, an dem die beim Ausstoßen und
Umbiegen der Klammern auftretenden Kräfte am stärksten sind, die versuchen, die Backen voneinander
weg zu bewegen. Durch die erfindungsgemäßen Abstützeinrichtungen werden die nachteiligen Auswirkungen
dieser beim Setzen und Umbiegen auftretenden großen Kräfte weitgehend vermieden, so daß sich die
Backen und die Backenträger in Leichtbauweise ausführen und aus Werkstoffen herstellen lassen, die für
einen einmaligen Gebrauch des chirurgischen Näh- und Schneidinstruments geeignet sind.
Bei der Ausbildung des chirurgischen Näh- und Schneidinstruments nach Anspruch 2 ist eine solche
örtliche Abstützung vorgesehen, daß sowohl den Kräften, die versuchen, die Backen voneinander weg zu
bewegen, als auch Kräften ein Widerstand entgegengesetzt
wird, die versuchen, die Backen zur Seite hin zu verformen. Die Schuhe sind in den Kanälen gegen in
Querrichtung und vertikaler Richtung gerichtete Bewegungen festgelegt so daß sie beim Verformen der
Klammern auch vertikalen Kräften zusätzlich einen ausreichenden Widerstand entgegensetzen. Diese Schuhe
bewegen sich zusammen mit der Vorschub- und Schneidanordnung längs der Backen und sind in den
zugeordneten Längskanälen geführt
Wie in Anspruch 5 angegeben, sind die Schuhe
zweckmäßigerweise an Teilen des Messerhalters angebracht bzw. ausgebildet, der aus relativ starrem
Werkstoff besteht. Somit stützt der Messerhalter die Schuhe in Querrichtung genügend steif ab.
Die Ausbildungsform des chirurgischen Näh- und Schneidinstruments nach den Ansprüchen 7 bis 11
ermöglicht, daß sich die vertikal vorstehenden Teile des Messerhalters längs den Backen bewegen können, wozu
die Klammernpatrone und der Amboß jeweils aus zwei langgestreckten und im Querabstand voneinander
angeordneten Teilen bestehen, wobei sich der Messerhalter durch einen Schlitz zwischen jeweils zwei
langgestreckten Teilen bewegt.
Die Erfindung wird nachstehend an einem Beispiel unter Bezugnahme auf die Zeichnung näher erläutert.
Darin zeigt
Fig. 1 eine Seitenansicht eines chirurgischen Näh- und Schneidinstruments im zusammengesetzten und
geschlossenen Zustand,
F i g. 2 eine Seitenansicht des chirurgischen Näh- und Schneidinstruments im offenen Zustand,
Fig. 3 eine Ansicht mit auseinandergezogener Darstellung der Teile des chirurgischen Näh- und
Schneidinstruments,
F i g. 4 eine Seitenansicht der Vorschub- und Schneidanordnung,
F i g. 5 eine Unteransicht der Vorschub- und Schneidanordnung,
Fig.6 eine Schnittansicht längs der Linie 6-6 in
Fig. 1,
F i g. 7 eine Schnittansicht längs der Linie 7-7 in Fig. 1,
F i g. 8 eine Unteransicht der Klammernpatrone, F i g. 9 eine Seitenansicht der Klammernpatrone,
Fig. 10 eine Schnittansicht längs der Linie 10-10 in
Fig. 9,
Fig. Ii eine Draufsicht auf den Amboß,
F i g. 12 eine Seitenansicht des A mboß,
Fig. 13 eine Schnittansicht längs der Linie 13-13 in
Fig. 12 und
Fig. 14 eine Schnittansicht längs der Linie 14-14 in
Fig.l.
Das chirurgische Näh- und Schneidinstrument 10 besitzt einen oberen Backenträger 12 und einen unteren
Backenträger 14. Der obere Backenträger 12 ist an seinem vorderen Ende mit einer mit ihm einstückigen,
langgestreckten oberen Backe 16 versehen. Der untere
■ Backenträger 14 ist an seinem vorderen Ende mit einer mit ihm einstückigen, langgestreckten unteren Backe 20
versehen. Hinter der Backe 20 sitzt der untere Backenträger 14 in einem U-profilförmigen Griffstück
22, das an seinem hinteren Ende mit einer Anlenkleiste 24 versehen ist, die in Kerben 28 am hinteren Ende des
oberen Backenträgers 12 eingreift. Zwischen den Enden des oberen Backenträgers 12 ist dieser mit seitwärts
vorstehenden Lappen 13 versehen, die in zu ihnen komplementäre Öffnungen 15 eingreifen, die in einem
gegabelten Griffstück 26 ausgebildet sind.
Mit Hilfe des Griffstücks 26 lassen sich die Backenträger 12,14 um das Gelenk 24,28 zwischen der
in F i g. 2 gezeigten Offenstellung und der in F i g. 1 gezeigten Schließstellung bewegen.
Zu diesem Zweck ist das Griffstück 26 mit
Langlöchern 17 ausgebildet, die Anschlagflächen 19 bilden, die mit den seitwärts vorstehenden Lappen 21
des Griffstücks 22 zusammenarbeiten. Das chirurgische Näh- und Schneidinstrument 10 weist eine verschiebbare
Vorschub- und Schneidanordnung 30 mit einem zentralen Messerhalter 32 und Stößeln 34 und 36 auf, die
im Querabstand voneinander auf beiden Seiten des Messerhalters 32 angeordnet und an ihren vorderen
Enden mit schräggestellten Nocken 38 und 40 versehen sind. Der Messerhalter 32 trägt kurz hinter den Nocken
38,40 ein Messer 42 mit schräg verlaufender Schneide.
Bei der bestimmungsgemäßen Verwendung des chirurgischen Näh- und Schneidinstruments 10 wird in
die untere Backe 20 eine Einweg-Klammernpatrone 44 eingesetzt, die Klammern in vier im Querabstand
voneinander angeordneten Längsreihen trägt Auf die obere Backe 16 werden zwei Amboßteile 72 gesetzt, die
in ihren Außenflächen mit zum Umbiegen der Klammern dienenden Vertiefungen ausgebildet sind,
deren Anordnung der der einzelnen Klammern in der Klammernpatrone 44 entspricht. Das chirurgische Näh-
und Schneidinstrument 10 wird dann in den Körper eines Patienten eingeführt und so manipuliert, daß das
zu durchschneidende und zu klammernde Gewebe zwischen die Backen 16,20 gelangt nachdem vorher in
dem Gewebe erforderlichenfalls ein Einschnitt zum Aufnehmen einer der Backen 16,20 gemacht worden ist
Dann werden mittels des Griffstücks 26 die Backen 16, 20 geschlossen und festgelegt so daß das Gewebe
zwischen den einander gegenüberliegenden Flächen der Klammernpatrone 44 und des Ambosses 72 fest
eingespannt ist Die zunächst hinter den Backen 16, 20 befindliche Vorschub- und Schneidanordnung 30 wird
dann vorgeschoben, wobei die Nocken 38, 40 in Längsschlitze eintreten, die in der Klammernpatrone 44
ausgebildet und in denen Klarnmeraausstoßer ir. Reihen
angeordnet sind. Die Nocken 38,40 greifen dann derart
an Nockenanschlagflächen aufeinanderfolgender Klammernausstoßer an, daß die Klammern einzeln
nacheinander aus der Klammernpatrone 44 heraus und durch das eingespannte Gewebe hindurch gegen den
Amboß 72 gedrückt werden, in dessen Vertiefungen die Klammern eintreten, wobei durch das Zusammenwirken
der Nocken 38,40 mit dem Amboß 72 Kräfte zum Umbiegen der Klammern aufgebracht werden. In jedem
Schlitz der Klammernpatrone 44 sind zwei Reihen von gegeneinander versetzten Klammern angeordnet, so
daß in das eingespannte Gewebe Klammern in vier Reihen gesetzt werden. Das den Nocken 38,40 folgende
Messer 42 bewegt sich in zentralen Längsschlitzen der Klammernpatrone 44 und des Ambosses 72 und
schneidet das eingespannte Gewebe längs einer Linie zwischen den beiden Paaren von Klammernreihen
durch.
Insbesondere aus den Fig.6, 7 und 14 läßt sich
entnehmen, daß in dem unteren Backenträger 14 und der unteren Backe 20 ein zur Aufnahme der
Klammernpatrone 44 dienender Längskanal 46 und ein T-profilförmiger, äußerer Längskanal 48 ausgebildet
sind, der sich von dem Boden das Längskanals 46 weg erstreckt.
to Der obere Backenträger 12 und die obere Backe 16 sind mit nach innen weisenden Längsschultern SO
versehen, auf denen in der nachstehend beschriebenen Weise die Amboßteile 72 angebracht werden. Der obere
Backenträger 12 und die obere Backe 16 sind so ausgebildet, daß unterhalb der Längsschultern 50 ein
etwa rechteckprofilförmiger Längskanal 52 vorhanden ist.
Gemäß den Fig.3, 4 und 5 erstreckt sich der Messerhalter 32 der Vorschub- und Schneidanordnung
30 vertikal über und unter die Stößel 34,36 hinaus und besitzt einen oberen und einen unteren Endteil, die
bezüglich des Messers 42 nach vorn vorstehen und auf denen ein unterer Schuh 54 bzw. ein oberer Schuh 56
angeordnet sind. Der Vertikalabstand zwischen den Schuhen 54, 56 entspricht dem bei miteinander
verriegelten Backenträgern 12 und 14 zwischen den Längskanälen 48 und 52 des oberen und des unteren
Backenträgers 12, 14 bzw. der oberen und der unteren Backe 16, 20 vorhandenen Vertikalabstand. Der untere
Schuh 54 ist entsprechend dem Profil des Längskanals 48 etwa T-profilförmig und sitzt daher derart passend in
dem Längskanal 48, daß der Schuh 54 im wesentlichen reibungsfrei im Längskanal 48 bewegbar ist
Der obere Schuh 56 sitzt ebenfalls derart passend in dem Längskanal 52, daß der Schuh 56 im wesentlichen
reibungsfrei bewegbar ist. Die Schuhe 56 und 54 sind in geringem Längsabstand von den Nocken 38 und 40
angeordnet so daß im Gebrauch des chirurgischen Näh- und Schneidinstruments 10 die Schuhe 56 und 54 die
Backen 16 und 20 im Bereich der Nocken 38,40 etwa an den Stellen abstützen, an denen die durch das
Zusammenwirken der Nocken 38, 40 mit den Klammernausstoßern erzeugten Kräfte ein Maximum
erreichen. Da jeder Schuh 56, 54 in dem ihn aufnehmenden Längskanal 48,52 in vertikaler Richtung
und Querrichtung festgelegt ist, sind beim Setzen der Klammern ein Festlegen der Backen 16, 20 in der
Querrichtung und ein Widerstand gegen ein vertikales Auseinanderbewegen der Backen 16, 20 gewährleistet.
Am hinteren Ende der Vorschub- und Schneidanordnung 30 sind die Stößel 34, 36 der Messerhalter 32 an
einem Tragklotz 31 angebracht der mit einem Betätigungsknopf 33 versehen ist
Nach den Fig.8, 9 und 10 besitzt die Klammernpatrone
44 einen massiven Kopfteil 58 und zwei Holme 60 und 62, die sich von dem Kopfteil 58 rückwärts
erstrecken und zwischen denen ein die Patrone durchsetzender Schlitz 64 für die Aufnahme des
Messerhalters 32 vorhanden ist Die Holme 60 und 62 eo sind an ihren einander zugekehrten Innenflächen mit
warzenförmigen Vorsprüngen 66 versehen, die zum Festlegen des Messerhalters 32 in Querrichtung dienen.
Jeder Holm 60, 62 ist mit Längsschlitzen ausgebildet welche die Klammernausstoßer und die einander *
gegenüberliegenden Reihen von gegeneinander versetzten Klammern aufnehmen. Ferner sind Reibauflagen
68 vorgesehen, die einen unbeabsichtigten Vorschub der Stößel 34,36 bremsen.
Der Schlitz 64 durchsetzt die Klammernpatrone 44 vollständig und der vertikal vorstehende Messerhalter
32 ist darin beweglich. Im Gebrauch des chirurgischen Näh- und Schneidinstruments 10 sitzt die Klammernpatrone
44 in dem Längskanal 46 der oberen Klammernbacke 16, von der der Kopfteil 58 nach vorn vorsteht.
Dabei ist die Klammernpatrone 44 in der Längsrichtung mittels eines von der Klammernpatrone 44 vorstehenden
Lappens 70 und einer dazu komplementären Ausnehmung in einer der Seitenwände des Längskanals
46 festgelegt.
Die Klammernpatrone 44 läßt sich auch mit der unteren Backe 20 einstückig ausbilden.
Gemäß den F i g. 11,12 und 13 besteht der Amboß aus
zwei gleichen langgestreckten Amboß teilen 72, die gemäß den Fig. 1, 3 und 14 reibungsschlüssig auf den
Längsschultern 50 der oberen Backe 16 sitzen, so daß zwischen den Amboßteilen 72 ein Schlitz für den
Durchgang des vertikal vorstehenden Messerhalters 32 vorhanden ist Jeder Amboßteil besitzt eine Amboßfläehe
76 mit zum Umbiegen der Klammern dienenden Vertiefungen 78, ferner eine Außenwand 80 und eine
kürzere Innenwand 82. Zur Herstellung des Reibungsschlusses mit den Längsschultern 50 verlaufen die
Innen- und die Außenwand 80, 82 etwas schräg nach innen. Jede Außenwand 80, 82 ist mit Vertiefungen 51
versehen, die mit zu ihnen komplementären Vertiefungen in den Seitenwänden der unteren Backe 20 fluchten,
damit die Amboßteile 72 in Längsrichtung festgelegt und die zum Verformen der Klammern dienenden
Vertiefungen mit den Klammern in der Klammernpatrone 44 zur Fluchtung gebracht werden.
Insbesondere bei der Herstellung eines billigen chirurgischen Einweg-Näh- und -Schneidinstruments 10
lassen sich die zum Verformen der Klammern dienenden Vertiefungen direkt in den unteren Flächen
der Längsschultern 50 der oberen Backe 16 ausbilden, so daß man keine gesonderten Amboßteile 72 braucht.
Anhand der F i g. 1 bis 3 sei nun das Zusammensetzen der Einzelteile des chirurgischen Näh- und Schneidinstruments
10 erläutert:
Bei richtig auf der unteren Backe 20 angeordneter Klammernpatrone 44 wird das vordere Ende der
Vorschub- und Schneidanordnung 30 von hinten derart in den unteren Backenträger 14 eingeschoben, daß der
untere Schuh 54 in den Längskanal 48 eingreift. Die Vorschub- und Schneidanordnung 30 wird dann längs
des Backenträgers 14 und der unteren Backe 20 vorgeschoben, bis die Stößel 34,36 in die Längsschlitze
der Holme 60 und 62 der Klammernpatrone 44 eintreten und von den Reibauflagen 68 gestoppt werden. Diese
Stellung der Vorschub- und Schneidanordnung 30
relativ zu dem Backenträger 14 ist in den F i g. 1 und 2 gezeigt. Dann werden der Backenträger 14 mit der darin
eingesetzten Vorschub- und Schneidanordnung 30 in das Griffstück 22 eingesetzt Der Backenträger 14 und
das Griffstück 22 sind mit zueinander komplementären Festlegeeinrichtungen versehen, die nicht gezeigt sind
und dazu dienen, diese Bauteile in der Längsrichtung relativ zueinander festzulegen und zu verhindern, daß
sich beim Auswerfen der Klammern der Backenträger 14 in dem Griffstück 22 vorwärtsbewegt.
Nun werden die Amboßteile 72 auf die obere Backe 16 gesetzt und werden die Lappen 13 des Backenträgers
12 in die öffnungen 15 des Griffstücks 16 gelegt. Bei gemäß Fig.2 aufwärtsgeschwenktem Griffstück 26
wird dann das Anlenkstück 24 zum Eingriff in die Kerben 28 gebracht und das chirurgische Näh- und
Schneidinstrument 10 ist fertiggestellt.
Zum Gebrauch wird das im wesentlichen in dem in F i g. 2 gezeigten Zustand befindliche chirurgische Näh-
und Schneidinstrument 10 so in einen Körperhohlraum eingeführt, daß zu klammerndes Gewebe zwischen die
Backen 16 und 20 gelangt. Dann wird durch Manipulation des Griffstücks 26 und das Zusammenwirken
der Anschlagflächen 19 mit den Lappen 21 das Instrument verriegelt. In den Längsschultern 50 des
oberen Backenträgers 12 sind gemäß F i g. 3 öffnungen 55 vorgesehen, die ermöglichen, daß beim Schließen des
chirurgischen Näh- und Schneidinstruments 10 der Schuh 56 in den Längskanal 52 eintritt. Wenn Gewebe
zwischen den Backen 16,20 eingespannt ist und sich das chirurgische Näh- und Schneidinstrument 10 in dem
Zustand nach F i g. 1 befindet, werden durch Vorschieben des Knopfes 33 die Klammern in das Gewebe
gesetzt.
Nach dem Setzen der Klammern wird die Vorschub- und Schneidanordnung 30 wieder in ihre Ausgangsstellung
zurückgebracht, wobei der Schuh 56 durch die öffnung 55 aus dem Längskanal 52 austritt. Jetzt läßt
sich das chirurgische Näh- und Schneidinstrument 10 öffnen.
Da die Schuhe 54 und 56 in der Querrichtung festgelegt sind und sie von einem relativ starren Teil
getragen werden, bewirken beim Einsetzen der Klammern die sich mit minimalem Spiel in den
Längskanälen 48 und 52 bewegenden Schuhe 54 und 56, daß die Backen 16,20 im Bereich der Nocken 38,40 und
des jeweils betätigten Klammernausstoßers örtlich abgestützt sind. Die Querschnittsform der Schuhe 54,56
und der sie aufnehmenden Längskanäle 48, 52 sind so gewählt, daß dank dieser Abstützung ein Widerstand
gegen Kräfte vorhanden ist, die die Backen 16, 20 seitwärts zu verformen und vertikal auseinanderzubewegen
versuchen. Daher lassen sich die Backen 16, 20 aus relativ leichtem Werkstoff herstellen, was im
Hinblick auf ein Einweg-Instrument zweckmäßig ist
Hierzu 6 Blatt Zeichnungen
Claims (1)
- Patentansprüche:1. Chirurgisches Näh- und Schneidinstrument mit zwei zusammenarbeitenden Backenträgern, die jeweils eine langgestreckte Backe aufweisen, wobei eine der Backen unter Verwendung einer KJammernpatrone wenigstens zwei im Querabstand voneinander angeordnete Längsreihen von Klammem aufnimmt, und mit einer langgestreckten Vorschub- und Schneidanordnung, die relativ zu den Backen längsverschiebbar und aufeinanderfolgende Klammern nacheinander aus der KJammernpatrone auf der Backe ausstößt, gegen eine auf der anderen Backe angeordnete Amboßeinrichtung drückt und derart umbiegt, daß in zwischen den Backen eingespanntes Gewebe Klammern in zwei im Querabstand voneinander angeordneten Reihen gesetzt werden und das Gewebe längs einer zwischen den Klammernreihen befindlichen Linie mit Hilfe eines Messers an einem Messerhalter durchgeschnitten wird, wobei die Vorschub- und Schneidanordnung zwei im Querabstand voneinander angeordnete Stößel besitzt, an deren vorderen Ende je eine Stößelnocke vorgesehen ist sowie dem Messerhalter mit dem zwischen dem Stößel angeordneten Messer, dadurch gekennzeichnet, daß die Vorschub- und Schneidanordnung (30) und die Backen (16,20) mit Abstützeinrichtungen versehen sind, die bei der Bewegung der Stößelnocken (38, 40) längs der Backen (16, 20) die Backen im Bereich der Stößelnocken abstützen.2. Chirurgisches Näh- und Schneidinstrument nach Anspruch 1, dadurch gekennzeichnet, daß die Abstützeinrichtungen in jeder Backe (16, 20) einen Längskanal (48, 52) und einen oberen und einen unteren Schuh (54, 56) an der Vorschub- und Schneidanordnung (30) im Bereich der Stößelnocken (38,40) aufweisen, wobei die Schuhe (54, 56) jeweils in die Längskanäle (48, 52) eingreifen und in denselben während der Längsbewegung der Vorschub- und Schneidanordnung (30) bewegbar sind.3. Chirurgisches Näh- und Schneidinstrument nach Anspruch 2, dadurch gekennzeichnet, daß die Längskanäle (48, 52) und die Schuhe (54, 56) im Querschnitt komplementär zueinander ausgebildet sind.4. Chirurgisches Näh- und Schneidinstrument nach Anspruch 3, dadurch gekennzeichnet, daß wenigstens ein Schuh (54, 56) und der zugeordnete Längskanal (48, 52) in der Backe (16, 20) im Querschnitt etwa T-förmig ausgebildet sind.5. Chirurgisches Näh- und Schneidinstrument nach einem der Ansprüche 2 bis 4, dadurch gekennzeichnet, daß der Messerhalter (32) einen oberen und einen unteren Teil besitzt, die von dem Messer (42) vorstehen und die Schuhe (54, 56) auf den vorstehenden Teil oberhalb bzw. unterhalb der Stößelnocken (38,40) angeordnet sind.6. Chirurgisches Näh- und Schneidinstrument nach einem der Ansprüche 1 bis 5, dadurch gekennzeichnet, daß die Backen (16,20) aus leichtem Kunststoff bestehen und der Messerhalter (32) aus einem relativ starren Werkstoff besteht./.Chirurgisches Näh- und Schneidinstrument nach einem der Ansprüche 1 bis 6, dadurch gekennzeichnet, daß die Klammernpatrone (44) mit den Klammern auf eine der Backen (20) aufsetzbar ist und zwei sich in Längsrichtung erstreckende und dieKlammern tragende Holme (60,62) besitzt, zwischen denen ein Schlitz (64) für den Durchgang des Messerhalters (32) bei auf die Backe (20) aufgesetzter Klammernpatrone (44) vorhanden isc ■ .8. Chirurgisches Näh- und Schneidinstrument nach Anspruch 7, dadurch gekennzeichnet, daß die Klammernpatrone (44) einen Kopfteil (58) aufweist, von dem aus sich die beiden Holme (60, 62) nach hinten erstrecken.9. Chirurgisches Näh- und Schneidinstrument nach Anspruch 7 oder 8, dadurch gekennzeichnet, daß der Schlitz (64) durchgehend ausgebildet ist und sich über die ganze Länge und Höhe der Holme (60,62) erstreckt10. Chirurgisches Näh- und Schneidinstrument nach einem der Ansprüche 1 bis 9, dadurch gekennzeichnet, daß der Amboß zwei langgestreckte Amboßteile (72) umfaßt, die derart auf der anderen Backe (16) angebracht sind, daß zwischen den Amboßteilen (72) ein Schlitz für den Durchgang des Messerhalters (32) vorhanden ist11. Chirurgisches Näh- und Schneidinstrument nach Anspruch 10, dadurch gekennzeichnet, daß jeder Amboßteil (72) einen etwa U-förmigen Querschnitt und die andere Backe (16) einander gegenüberliegende und nach innen weisende Längsschultern (50) besitzt, auf denen die Amboßteile (72) unter Bildung einer Reibschlußverbiiidung aufliegen.12. Chirurgisches Näh- und Schneidinstrument nach einem der Ansprüche 1 bis 11, dadurch gekennzeichnet, daß die Backenträger (12, 14) an ihren hinteren Enden schwenkbar miteinander verbunden sind und daß an einem der Backenträger (16) ein Griffstück (26) schwenkbar gelagert ist, das im Zusammenwirken mit Verriegelungsteilen (19, 21) am anderen Backenträger (20) zwischen einer Offen- und einer Schließstellung bewegbar ist13. Chirurgisches Näh- und Schneidinstrument nach einem der Ansprüche 7 bis 9, dadurch gekennzeichnet, daß wenigstens in jedem Holm (60, 62) der Klammernpatrone (44) ein Längskanal zur Aufnahme der Vorschubeinrichtung ausgebildet ist, die aufeinanderfolgende Klammern aus der Aufnahme bewegt.14. Chirurgisches Näh- und Schneidinstrument nach Anspruch 13, dadurch gekennzeichnet, daß in jedem Längskanal mehrere Klammernausstoßer vorgesehen sind, die zum Ausstoßen der einzelnen Klammern aus der Aufnahme mit der Vorschubeinrichtung zusammenarbeitende Kraftübertragungsflächen haben.15. Chirurgisches Näh- und Schneidinstrument nach Anspruch 13 oder 14, dadurch gekennzeichnet, daß die Aufnahmen in jedem Holm (60, 62) der Klammernpatrone (44) in zwei Reihen angeordnete und gegeneinander versetzte Klammern aufnehmen.
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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US11866480A | 1980-02-05 | 1980-02-05 |
Publications (2)
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DE3103976A1 DE3103976A1 (de) | 1982-01-07 |
DE3103976C2 true DE3103976C2 (de) | 1982-10-14 |
Family
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Application Number | Title | Priority Date | Filing Date |
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DE3103976A Expired DE3103976C2 (de) | 1980-02-05 | 1981-02-05 | Chirurgisches Näh- und Schneidinstrument |
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US (1) | US4520817A (de) |
EP (1) | EP0033548B1 (de) |
JP (1) | JPS56119239A (de) |
AT (1) | ATE19729T1 (de) |
AU (1) | AU534210B2 (de) |
CA (1) | CA1163890A (de) |
DE (1) | DE3103976C2 (de) |
GB (2) | GB2078594B (de) |
HK (2) | HK99885A (de) |
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US2214870A (en) * | 1938-08-10 | 1940-09-17 | William J West | Siding cutter |
DE869527C (de) * | 1951-07-17 | 1953-03-05 | Heinrich C Ulrich | Klammernaehapparat mit gegeneinander verlaufenden Quetschbacken |
US3078465A (en) * | 1959-09-09 | 1963-02-26 | Bobrov Boris Sergueevitch | Instrument for stitching gastric stump |
US3080564A (en) * | 1959-09-10 | 1963-03-12 | Strekopitov Alexey Alexeevich | Instrument for stitching hollow organs |
FR1278616A (fr) * | 1959-09-28 | 1961-12-15 | Appareil pour la suture des organes creux | |
US3079606A (en) * | 1960-01-04 | 1963-03-05 | Bobrov Boris Sergeevich | Instrument for placing lateral gastrointestinal anastomoses |
CH375481A (fr) * | 1960-02-04 | 1964-02-29 | S Bobrov Boris | Instrument chirurgical pour l'exécution des anastomoses latérales gastéro-intestinales |
US3137192A (en) * | 1962-12-21 | 1964-06-16 | Robert M Mcneill | Material cutting device |
US3252643A (en) * | 1962-12-24 | 1966-05-24 | Strekopytov Alexey Alexcevich | Instrument for suturing living tissue |
US3317105A (en) * | 1964-03-25 | 1967-05-02 | Niiex Khirurgicheskoi Apparatu | Instrument for placing lateral intestinal anastomoses |
US3275211A (en) * | 1965-05-10 | 1966-09-27 | United States Surgical Corp | Surgical stapler with replaceable cartridge |
GB1158112A (en) * | 1965-07-06 | 1969-07-16 | Us Surgical Corp 62 1158111 | Surgical Stapling Instruments |
US3315863A (en) * | 1965-07-06 | 1967-04-25 | United States Surgical Corp | Medical instrument |
GB1210524A (en) * | 1966-10-10 | 1970-10-28 | United States Surgical Corp | Staple cartridge for surgical stapling instruments |
US3490675A (en) * | 1966-10-10 | 1970-01-20 | United States Surgical Corp | Instrument for placing lateral gastrointestinal anastomoses |
US3494533A (en) * | 1966-10-10 | 1970-02-10 | United States Surgical Corp | Surgical stapler for stitching body organs |
US3499591A (en) * | 1967-06-23 | 1970-03-10 | United States Surgical Corp | Instrument for placing lateral gastro-intestinal anastomoses |
SU566574A1 (ru) * | 1975-05-04 | 1977-07-30 | Всесоюзный научно-исследовательский и испытательный институт медицинской техники | Аппарат дл наложени линейного скобочного шва на органы и ткани |
US4060089A (en) * | 1975-09-03 | 1977-11-29 | United States Surgical Corporation | Surgical fastening method and device therefor |
US4241861A (en) * | 1977-12-20 | 1980-12-30 | Fleischer Harry N | Scissor-type surgical stapler |
US4207898A (en) * | 1978-03-27 | 1980-06-17 | Senco Products, Inc. | Intralumenal anastomosis surgical stapling instrument |
DE7909218U1 (de) * | 1978-03-31 | 1979-08-16 | Vsesojuznyj Nautschno-Issledovatelskij I Ispytatelnyj Institut Medicinskoj Techniki Ssr, Moskau | Chirurgisches Nähgerät zum Vernähen von Organen |
US4210043A (en) * | 1978-11-09 | 1980-07-01 | Scott Paper Company | Cutting assembly |
-
1980
- 1980-09-01 AU AU61927/80A patent/AU534210B2/en not_active Expired
-
1981
- 1981-01-22 CA CA000369043A patent/CA1163890A/en not_active Expired
- 1981-02-02 GB GB8120470A patent/GB2078594B/en not_active Expired
- 1981-02-02 GB GB8103084A patent/GB2068817B/en not_active Expired
- 1981-02-03 JP JP1490581A patent/JPS56119239A/ja active Granted
- 1981-02-05 DE DE3103976A patent/DE3103976C2/de not_active Expired
- 1981-02-05 EP EP81100826A patent/EP0033548B1/de not_active Expired
- 1981-02-05 AT AT81100826T patent/ATE19729T1/de not_active IP Right Cessation
-
1982
- 1982-03-08 US US06/356,247 patent/US4520817A/en not_active Expired - Lifetime
-
1985
- 1985-12-12 HK HK998/85A patent/HK99885A/xx not_active IP Right Cessation
- 1985-12-12 HK HK995/85A patent/HK99585A/xx not_active IP Right Cessation
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE3819293C1 (en) * | 1988-06-07 | 1989-07-06 | Aesculap Ag, 7200 Tuttlingen, De | Surgical suturing and cutting instrument |
Also Published As
Publication number | Publication date |
---|---|
GB2068817A (en) | 1981-08-19 |
HK99885A (en) | 1985-12-20 |
JPH0359693B2 (de) | 1991-09-11 |
JPS56119239A (en) | 1981-09-18 |
EP0033548B1 (de) | 1986-05-14 |
AU6192780A (en) | 1981-08-13 |
ATE19729T1 (de) | 1986-05-15 |
GB2078594A (en) | 1982-01-13 |
DE3103976A1 (de) | 1982-01-07 |
EP0033548A3 (en) | 1982-03-31 |
CA1163890A (en) | 1984-03-20 |
US4520817A (en) | 1985-06-04 |
GB2078594B (en) | 1984-02-01 |
AU534210B2 (en) | 1984-01-12 |
GB2068817B (en) | 1983-11-23 |
HK99585A (en) | 1985-12-20 |
EP0033548A2 (de) | 1981-08-12 |
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Legal Events
Date | Code | Title | Description |
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OP8 | Request for examination as to paragraph 44 patent law | ||
D2 | Grant after examination |