EP2434939A1

EP2434939A1 - Control device

Info

Publication number: EP2434939A1
Application number: EP10714302A
Authority: EP
Inventors: Theodor Lutze; Olaf Hegemann
Original assignee: Aesculap AG
Current assignee: Aesculap AG
Priority date: 2009-05-29
Filing date: 2010-04-21
Publication date: 2012-04-04
Also published as: WO2010136272A1; DE102009042488A1; US20120116163A1; DE202009012698U1; JP5624610B2; JP2012527917A

Abstract

The invention relates to a control device, especially for using in endoscopes or the like, comprising a proximal and a distal end respectively comprising an articulation region, a central section arranged between said ends, an outer hollow cylindrical shaft, an inner hollow cylindrical shaft, and a control element arranged between said shafts, with at least two longitudinal elements transmitting a force and extending essentially from the proximal end section to the distal end section. For an optimised control function, the longitudinal elements are arranged in the peripheral direction of the control device at essentially regular angular distances and are interconnected in the region of their respective proximal and distal ends in the peripheral direction. The distal ends of the longitudinal elements are fixed in the peripheral direction in angular positions that are different from the angular positions in which the respectively corresponding proximal ends are fixed.

Description

control device

The invention relates to a control device for precision mechanical or surgical applications, for example for use in endoscopes or the like.

More particularly, the invention relates to a control device for instruments for high precision mechanical or surgical applications in the minimally invasive field.

Such control devices are known in the prior art and have a proximal, that is to say the user / surgeon, and a distal or distal end section, which in each case comprises a joint zone, and a central section, which is arranged between the end sections and is often rigidly configured. They further comprise an outer hollow cylindrical shaft, an inner hollow cylindrical shaft and a control element disposed between these shafts with two or more, longitudinally extending force elements extending substantially from the proximal to the distal end portion of the control device. The force-transmitting longitudinal elements are arranged substantially regularly in the circumferential direction of the control device and are connected to each other in the circumferential direction in the region of the proximal and the distal end section. Tensile and compressive forces can be transmitted via the longitudinal elements with which a pivotal movement can be converted at the proximal end section into a corresponding pivoting movement at the distal end section.

Control devices of this type are known, for example, from WO 2005/067785 A1, in which a multiplicity of force-transmitting longitudinal elements are used. be used in the form of wires or cables, which are arranged directly adjacent to each other in the circumferential direction and thus lead each other laterally. For the guidance of the force-transmitting longitudinal elements in the radial direction of the outer and the inner hollow cylindrical shaft are available, so that a guide of the force-transmitting longitudinal elements is ensured in each direction.

At the proximal end of the control device, a hand-operated handle part is mounted in the rule, in its place, of course, motor-operated controls can occur, while tools, cameras, lighting elements and the like can be connected to the distal end, which is also called head ,

With such instruments containing the control device can be in the mechanical field, for example, complicated and difficult to access interiors, such as engines, machines, radiators and the like, inspect and repair or perform the above-mentioned operations in the minimally invasive area.

Previously known control devices generate a movement of the distal end portion with a respective opposite pivoting direction, which is also limited to the same pivoting plane.

Although in some systems pivoting motions in many different directions are possible, this principle of deflection of the distal end in the opposite direction to the deflection of the proximal end in the same plane is maintained.

In a number of applications in both the mechanical and the medical field, movement at the proximal end has certain spatial limits, so that these control devices can not always be used optimally. The object of the invention is to remedy this problem.

In this context, the invention proposes that in the control device according to the invention the distal ends of the longitudinal elements are fixed in the circumferential direction in angular positions, which are different from the angular positions in which the respectively associated proximal ends are fixed.

Depending on the application, it is conceivable for the control device to have a set of control elements in which the difference between the angular positions of the ends of the force-transmitting longitudinal elements varies in the circumferential direction.

Deviations of the angular positions in the circumferential direction, from which an additional benefit in handling is expected to begin at about 10 ° and reach up to about 350 °.

In particular, differences in the angular positions at the proximal and distal end portions in the range of about 45 ° to about 315 ° are of interest, more preferably in the range of about 150 ° to about 210 °.

Of particular importance are control devices of the present invention in which the angular positions have a difference of about 180 °, so that a mirror-image movement of the proximal and distal end portion can be generated in a plane.

In one of the preferred embodiments of the control device according to the invention it is provided that the force-transmitting longitudinal elements of the control element are arranged laterally spaced from each other.

In order to stabilize the laterally spaced force transmitting longitudinal elements in their circumferential position, it can be provided that between the force transferring longitudinal elements spacers are arranged. These may for example be defined in the form of guide eyelets on one of the shafts.

It is also conceivable, however, that additional longitudinal elements are present between the force-transmitting longitudinal elements, which are arranged only between the force transmitting longitudinal elements and act as spacers.

Alternatively it can be provided that the longitudinal elements along the longitudinal direction are arranged at least partially in direct contact with each other, wherein a multiple, substantially point-like contact between the longitudinal elements often sufficient to stabilize them in the lateral direction, that is in the circumferential direction.

In preferred control devices of the present invention, the longitudinal members are radially guided by the outer and inner shafts so that regardless of whether the longitudinal members are laterally spaced or partially in direct contact with each other over the entire length, sufficient stabilization thereof Geometry is given to ensure a precise angular transmission of force from the proximal to the distal end portion.

The arrangement of the longitudinal elements in the circumferential direction to achieve the different angular positions at the proximal and distal ends can be achieved in various ways.

In a first variant, the force-transmitting longitudinal elements are arranged helically between the shafts over at least part of their entire length. In a preferred embodiment, the longitudinal force-transmitting elements are helically disposed between the shafts over their entire length. Here, in view of the typical length of the control device of 10 cm and significantly more and with a typical diameter of a few millimeters results in an extremely high pitch of the helical line or in other words, a very small deviation from the parallelism to the longitudinal direction of the control device, the few degrees to a fraction of an angular degree.

In a further alternative it is provided that the force-transmitting longitudinal elements in the region of the proximal or distal ends are arranged substantially parallel to the longitudinal direction of the control device and are arranged helically in an intermediate region.

In a further variant it is provided that the force-transmitting longitudinal elements have one or more sections in the region between their proximal and distal ends, which are arranged parallel to the control device, wherein other sections, in particular the proximal and distal ends are arranged helically.

Although only a part of the total length of the control element is available for achieving the angular offset in the last two variants, only small angular deviations from the longitudinal direction are still necessary.

According to a variant of the control device according to the invention, the force-transmitting longitudinal elements are formed as cables or wires.

In another variant, the force-transmitting longitudinal elements have a banana-shaped cross-section. In a preferred embodiment of the invention, the control device has a control element, which comprises a hollow cylindrical component, the cylinder wall is divided at least in the region of a portion between the proximal and distal ends in two or more wall segments which form the longitudinal force-transmitting elements.

Here, the two or more wall segments at the distal end of the hollow cylindrical component can be firmly connected to each other via a collar.

Furthermore, the two or more wall segments in the region of the proximal end of the hollow cylindrical member may be firmly connected to each other.

Particularly preferably, the hollow cylindrical component is formed integrally. Here, the handling during assembly of the control device is particularly simple. In addition, the one-piece component can be produced with particular precision with respect to the mutual alignment of the wall segments.

Control devices with this configuration have, in particular, a hollow-cylindrical component which is manufactured from a single tube, wherein the subdivision of the cylinder wall into wall segments preferably takes place by means of laser beam cutting.

Control devices of this type can be further realized with very small outer diameters, for example about 2 mm or less, in particular also about 1.5 mm, and still a sufficiently large lumen is obtained in the interior, can be realized through the other functions. For example, the lumen is still sufficient to remove tissue pieces from the surgical area, in particular to be able to aspirate, or to bring a light source and associated optics to the operating area. Of course, the control devices according to the invention are also possible with arbitrarily large diameters.

As a material for the production of the control device, in particular of the control element in the form of the hollow cylindrical component, steel alloys or nitinol are particularly suitable.

In a particularly preferred embodiment, the cylinder wall is slotted over the largest part, in particular almost over the entire length in the axial direction to form the force-transmitting longitudinal elements. The longitudinal elements are formed by cylinder wall segments, which have a circular arc shape in cross section.

The wall segments preferably have a circular arc shape in cross-section which corresponds to an arc angle of approximately 20 ° or more, in particular 30 ° or more.

The number of wall segments is preferably in the range of 4 to 16, more preferably in the range of 6 to 12.

The distance between the wall segments in the circumferential direction of each other (corresponds to the slot width) is measured in degrees, preferably about 2 ° to 15 °, more preferably about 4 ° to about 8 °.

The slot width, as produced by laser beam cutting, can be increased if necessary, so that the remaining strip-shaped wall segments can be moved without contact relative to each other. Due to the circular segment-like cross sections of the longitudinal elements of the non-contact state of the longitudinal elements is retained even in the case of tensile or compressive stress in the joint areas; This is especially true in a leadership of the longitudinal elements in the radial direction between an inner and an outer shaft. The two end portions of the hollow cylindrical element remain uncut, so that the longitudinal elements remain connected to each other via annular collars.

The proximal and distal articulation zones of the control device can be realized in various ways.

Preferably, the articulation zones of the outer and / or inner shafts have in the circumferential direction extending a plurality of slots, which are separated from each other by wall portions in the circumferential direction or axial direction of each other.

Again, integrally formed tubes may be used for the outer and inner shank.

Together with a control element made of a one-piece tube, as has already been described above, results in the simplest case from three nested tubes with the functions outer shaft, control element and inner shaft a very thin-walled and yet mechanically resilient structure, said means Control device placed control device, such as grippers, can be operated and positioned without causing the crosstalk of the movement of the one to the other element. In particular, e.g. a gripper can be guided and rotated within the control device, without thereby changing the pivot angle and the position of the control element itself or the gripper function is affected as such. Nor are countermovements evoked; Rotary movements of 360 ° are easily possible.

In addition, these control devices can be easily disassembled, sterilized and reassembled. Preferably, a respective wall section in the circumferential direction two or more, in particular three or more slots arranged one behind the other. The slots are preferably arranged in the circumferential direction at equal distances from each other.

In the axial direction, the joint zones of preferred control devices have three or more slots arranged side by side, wherein preferably the juxtaposed slots are arranged offset from one another in the circumferential direction. The distances in which the slots are arranged in the axial direction to each other spaced, may be equal or vary, hereby the joint properties, in particular the bending radius, can be influenced.

Typically, it is provided that the slots are the cylinder wall completely penetrating slots. However, good bending properties can also be achieved if the slots do not completely penetrate the wall of the shaft, but in particular end before reaching the inner circumference. Thus, the wall of the shaft remains closed as a whole, which may be desirable in some applications, in particular the outer shaft.

A preferred geometry of the slots is when the wall surfaces delimiting the slots are disposed at an acute angle to the radial direction. Preferably opposite wall surfaces of the same slot are arranged in mirror image, so that the outer circumference of a shaft results in a larger slot width than adjacent to the inner circumference.

Axially spaced apart slots are preferably circumferentially overlapping but offset from each other so as to provide a regular arrangement of the slots.

The wall surfaces of the slots may be inclined at an angle to the axial direction, which deviates from 90 °, so that the width of the slots is greater on the outer circumference than on the inner circumference of the outer shaft. This makes it possible to realize sufficiently large pivoting angles even with small slot widths without the number of slots having to be increased or the joint area having to extend over a greater axial length.

According to a variant, the inner and / or the outer shaft has a proximal and a distal joint section in the region of the proximal and distal joint zones of the control device. Preferably, at least the outer shaft will include proximal and distal hinge portions.

Typically, the control device is formed rigid in its central portion.

According to one embodiment of the invention, at least one of the outer and inner shanks in the length region between the proximal and distal joint zones is equipped with a rigid portion which realizes the flexural rigidity of the central portion of the control device.

While in many cases the proximal and distal joint zones are identical and in particular have the same extension in the longitudinal direction of the control device, this is not absolutely necessary.

In particular, it may be provided that the proximal and distal joint zones are different, in particular also of different lengths, so that a corresponding pivoting movement of the proximal joint zone has a lesser or greater pivotal movement of the distal end section.

In particular, it can be provided that the pivoting movement of the proximal and / or distal joint zone is adjustable. This can be done, for example, by increasing the extent of the proximal and / or distal steering zone is varied, and thus the pivoting behavior of the two joint zones is changed to each other.

In particular, it may be provided that the control device comprises a holding device with which parts of one of the articulation zones can be fixed in a bending-resistant manner with respect to the central section of the control device or a functional unit adjoining the proximal or distal end section thereof.

Thus, in a variant of the control device according to the invention, the holding device a parallel to the longitudinal axis of the central portion, which is formed rigid in this case, comprise a displaceable, rigid sleeve.

Depending on the position of the sleeve in the longitudinal direction to the central portion of the proximal and / or distal end portion and the joint zone provided there may be influenced in their length and influenced in their pivoting behavior.

Preferably, the rigid sleeve is arranged on the outer circumference of the rigid shaft, so that the lumen of the control device remains unaffected. If the lumen of the control device for certain applications be sufficiently large, of course, a rigid sleeve can also be arranged inside the lumen. However, the displaceability and, in particular, the definition of the rigid sleeve are easier to realize if it is arranged on the outer circumference of the outer shaft.

According to another variant, the holding device on the functional unit, which is coupled to the proximal or distal end of the control device, comprise a supporting holding element. In this way, the joint zone can be influenced in terms of its pivoting behavior from the side of the distal or proximal end. According to a further variant of the control device according to the invention, the holding device can be positioned in a predetermined position and in particular also fixed. This makes it possible to pre-set or readjust the pivoting behavior of the distal and proximal end sections in a repeatable and precisely definable manner.

According to a further variant of the control device according to the invention it is provided that at least one of the joint zones is elastic, so that when the forces introduced for pivoting the end sections stop acting, the control device returns to its original straight position.

These and further advantages of the invention are explained in more detail below with reference to the drawing. They show in detail:

Fig. 1 shows the structure of a control device according to the prior art;

Fig. 2 shows a control device according to the prior art

Fig. 1 in an angled condition;

3 shows an overall view of a control device according to the invention;

4A and B show two variants of a first embodiment of a control element of a control device according to the invention;

FIGS. 5A and B show two variants of a second embodiment of a control element of a control device according to the invention; 6A and B show two variants of a third embodiment of a control element of a control device according to the invention;

Figures 7A and B are a cross-section through a preferred control element or control device of the invention;

8A and B detailed views of preferred variants of the inner and outer shaft of a control device according to the invention;

9 shows an overall view of a further control device according to the invention; and

10 is an overall view of another control device according to the invention.

FIG. 1 shows the structure of a control device 10, as known from the prior art, for example WO 2005/067785 A1.

In this case, the control device 10 comprises an outer hollow cylindrical shaft 12, an inner hollow cylindrical shaft 14 and a control element 16 arranged between these shafts.

The outer and inner shafts 12, 14 and the control element 16 have substantially equal lengths and are dimensioned with respect to their outer and inner diameter or wall thicknesses so that the control element can be inserted accurately into the outer shaft and the inner shaft 14 fit into the interior of the control element 16. The interior of the inner shaft 14 remains free as a lumen for the introduction of instrument controls, leads to a camera or other optical elements, and the like. The control element 16 is in radial direction through the walls of the outer and inner shafts 12, 14 out.

The control device 10 has a proximal end portion 18 and a distal end portion 20, each comprising a hinge zone 22 and 24, respectively.

Typically, the articulation zone 22, 24 is formed by a corresponding configuration of the outer and / or inner shank 12, 14, wherein in the prior art various proposals for this are listed, including in WO 2005/067785 Al.

In Figure 1, the joint zones 21, 24 are indicated only in the form of bellows-like structures.

In FIGS. 1 a, 1 b and 1 c, the individual elements of the control device 10 of FIG. 1 are shown again, wherein FIG. 1 a represents the outer shaft 12, FIG. 1 b the control element 16 and FIG. 1 c the inner shaft 14.

The outer shaft 12 has in the areas corresponding to the hinge zones 22 and 24, a structure that ensures the flexibility or flexibility of the outer shaft 12 in this area. For example, bellows-like structures can be used here, as previously mentioned. Alternatively, the wearability or flexibility can also be produced by weakening the wall of the outer shaft 12 in the sections corresponding to the articulation zones 22, 24.

The inner shaft 14 in Figure Ic may have a similar structure as the outer shaft 12 in Figure Ia, so that reference can be made to the description of Figure Ia. The control element 16 of FIG. 1b comprises a multiplicity, in the present example eight, force-transmitting longitudinal elements which are arranged parallel to the longitudinal direction of the control element 16 and which are laterally interconnected to ring collars 28, 30 at the respective ends of the control element 16 in the circumferential direction.

Due to the guidance of the force-transmitting longitudinal elements 26 between the outer and the inner shafts 12, 14 in the control device 10, pivoting of the proximal end section 18 results in an angling in the same pivot plane in the opposite direction at the distal end section in the region of the articulation zone 24 by the same angle amount. Such a situation is shown in FIG.

In contrast, it is possible with the control device according to the invention to perform a pivoting of the distal joint portion in any other predetermined directions with respect to the pivoting movement of the proximal end, even in directions that are not in the same plane.

An example of this is shown in FIG. 3 with reference to a control device 34 according to the invention, whose control elements to be discussed below with reference to FIGS. 4, 5 and 6, for example in the case of a pivoting movement of the proximal section 36 upwards, also pivot the distal section 38 bring up in the same plane.

In the control elements designed according to the invention, the force-transmitting longitudinal elements with their proximal and distal ends are fixed in angular positions in the circumferential direction, which differ by 180 °.

The typically available embodiments and their variants are shown schematically in Figures 4 to 6. FIG. 4A shows a control element 40 for the control device 34 according to the invention, in which eight force-transmitting longitudinal elements 42 are arranged helically over their entire length and fixed at an offset of 180 ° at proximal and distal annular collars 44, 46.

In view of the fact that the diameters of typical control elements are only a few millimeters, on the other hand the required length of the control elements is 10 cm or significantly more, the angles at which the helically arranged longitudinal elements deviate from the longitudinal direction of the control elements are considerably smaller than the figures 4 to 6 may suggest. To better illustrate this, two numerical examples are presented here:

In an instrument, as is typically used in neurosurgery, the length of the control device is about 30 cm, the length of the associated control element 40 is thus also 30 cm. The outer diameter of the control element 40 is typically 1.7 mm. If one chooses an angular offset of 180 °, with which the proximal and distal ends of the force transmitting longitudinal elements 42 are fixed to the annular collars 44, 46, so results in a helical shape of the longitudinal elements, wherein the helix with an angle of about 0.5 ° is inclined against the longitudinal axis of the element.

In an instrument used in laparoscopy, the control device has a length of, for example, 22 cm, which corresponds to the length of the control element 40. The outer diameter of the control element 40 is relatively large and is about 9.7 mm. With this shorter length of the control device 10 at the same time significantly larger diameter to obtain an angle of 3.9 °, with which the helix, along which the force-transmitting longitudinal elements 42 are arranged, are inclined against the longitudinal axis of the control element 40. The two examples described above can be understood as extreme examples, and in a vast number of control devices 10 according to the invention, the angle of inclination of the longitudinal elements 42 against the longitudinal axis of the control element 40 will remain within the limits indicated in these examples.

Figure 4B shows an alternative embodiment as a control element 40 ', which is made of a one-piece tube 41, for example by laser beam cutting.

The slots 43 formed in the tube 41 by laser beam cutting extend almost the entire length of the tube 41, so that only at the proximal and distal end unslotted annular collars 44 ', 46' remain, which connect the force transmitting longitudinal elements acting wall segments 45 each with each other.

FIG. 5A shows an alternative embodiment to the control element 40 according to the invention in the form of a control element 50, in which eight longitudinal elements 52 are fixed in proximal or distal annular collars 54, 56, wherein in turn an angular offset in the definition of the proximal to the distal ends of 180 ° given is. The longitudinal elements 52 are divided into three different sections, the first section 57 being arranged adjacent to the proximal annular collar 54 and sections of the longitudinal elements 52 aligned parallel to the longitudinal direction of the control element 52.

Accordingly, in a section 59 adjoining the distal annular collar 56, a region of the longitudinal elements 52 is likewise arranged parallel to the longitudinal direction of the control element 50.

In the intermediate section 58, the remaining regions of the longitudinal element elements extending between the sections 57 and 59 run there. te along helical lines, here the helices are employed at a slightly greater angle to the longitudinal direction of the control element 50 than is the case in the embodiment of Figure 4, so that at a shorter distance also an angular offset of the ends of the respective longitudinal elements, the Ring collars 54, 56 are fixed, can be achieved by 180 °.

Even in this example, where only about 50% of the length of the control element is available for the middle section, the angles at which the helixes are made counter to the longitudinal direction of the control element 50 remain at very small values.

Analogous to FIG. 4B, FIG. 5B shows an alternative embodiment of a control element 50 ', which is manufactured from a one-piece tube 51, for example by laser-beam cutting.

The slots 53 formed in the tube 51 by laser beam cutting extend almost the entire length of the tube 51, so that only at the proximal and distal ends unslotted annular collars 54 ', 56' remain, which connect the force transmitting longitudinal elements acting wall segments 55 each.

A further variant is finally shown in FIG. 6, in which a control element 60 comprises eight longitudinal elements 62 which are fixed to proximal or distal annular collars 64, 66 at an angular offset of 180 °.

In order to achieve the angular offset, the longitudinal elements are divided into three sections, wherein the respective terminal, that is connected to the annular collars 64 and 66 connected portions 67 and 69, following a helix, while the intermediate areas 68 parallel to the longitudinal axis of Control element 60 are arranged. Again, with respect to the embodiment in Figure 4 that the angles at which the following shape of a helix following sections of the longitudinal elements are employed with a slightly larger angle to the longitudinal direction, but this can still be considered very small angles.

Selecting a different offset than the 180 °, which have been described above with reference to Figures 3 to 6, one obtains a deviating from the Figure 3 movement direction for the distal end 38, for example, at an offset of 90 ° performs a bend of the proximal Section 36 in the plane of the paper to a deflection of the distal end 38 from the plane of the paper vertically out.

Preferably, the control elements for the control devices according to the invention are interchangeable, so that a control device 34 can be imparted only by replacing the control element different movement geometries.

Analogously to FIGS. 4B and 5B, FIG. 6B shows an alternative embodiment of a control element 60 ', which is manufactured from a one-piece tube 61, for example by laser-beam cutting.

The slits 63 formed in the tube 61 by laser beam cutting extend almost the entire length of the tube 61, so that only at the proximal and distal end unslotted annular collars 64 ', 66' remain, which connect the force acting longitudinal elements wall segments 65 each with each other.

FIG. 7A shows a cross section through a control element 70 analogous to FIGS. 4B, 5B and 6B, but in which only four wall segments 71 are present. The arc segments of Wandsegemente 71 correspond to an arc angle α of about 82 ° to 86 °. The extent of the slots 72 in the circumferential direction corresponds to an angle β of about 4 ° to 8 °. FIG. 7B shows the cross section of a control device 74, wherein the control element 70 of FIG. 7A is used as the control element, with a number of four wall segments 71. The wall segments 71 are spaced apart from one another via the slots 72.

By way of example, an outer diameter D of approximately 2.5 mm and an inner diameter of approximately 1.8 mm may be mentioned for the control device 74.

The control element 70 is guided on its inner surface by an inner shaft 76 and on its outer surface by an outer shaft 78.

The design of the joint portions of the control device 34 or 70 has not been discussed in detail. It may be varied in the form of the flexible portions of the inner and outer shafts 76, 78, respectively.

Figures 8A and 8B show two variants of related embodiments of the flexible sections, here in the form of sections 80 and 80 ', respectively.

Common to the two variants is the use of a slot structure with circumferentially extending slots 82 in the hollow cylindrical shaft. Preferably, two or more slots separated from one another by webs 84 are present along one circumferential line. Since the arrangement of slots along only one circumferential line would allow only a very small pivot angle, in typical slot structures of the hinge zone 80, 80 'a plurality of circumferentially spaced by means of webs 86 circumferential lines with slots 82 is present. Slits 82, which are arranged adjacent to one another in the axial direction, are preferably offset relative to one another in the circumferential direction, so that bending possibilities arise in several planes.

In FIG. 8A, there are two slots 82 per circumferential line, which are separated from one another by webs 84. In Figure 8B there are three slots 82. The Slot structure in both cases typically includes a plurality of slots 82 arranged along a plurality of imaginary and axially spaced lands 86 across spaced circumferential lines. By choosing the slot structure and the number of slots, it is very easy to specify the permissible swivel angle and also to adapt other properties of a joint section, such as the flexural strength, to the particular application.

Finally, FIG. 9 shows the present invention in a further variant with a control device 170 having a proximal end section 172 and a distal end section 174, each having associated joint zones 176 and 178.

To the proximal end portion 172 of the control device 170, a handling device 180 is connected.

The articulation zones 176 and 178 are formed with substantially the same length, so that when the proximal end portion 172 is bent at about the same angle as e.g. 30 ° results in a corresponding bend of the distal end portion 174 also by 30 °. The direction in which the bend of the distal end portion 174 is made depends on the choice of the control element, not shown in detail herein, and the determination of the ends of the longitudinal force-transmitting elements, as described in detail above.

The control device 170 shown in FIG. 9 additionally has a holding device 182 in the form of a sleeve 183, which is arranged so as to be longitudinally displaceable on the outer shaft of the control device 170.

Moving the sleeve 183 in the direction of the proximal end portion 172 and leaves the sleeve 183 overlap with the hinge zone 176, so shortened the hinge zone 176, whereby the maximum bending angle is limited. Thus, the allowable bending angle in the region of the distal can be variably Set end portion 174, so that, for example, in endoscopic removal of pathological structures, a defined work area is adjustable under the surgeon's view.

FIG. 9 contains an alternative solution to the holding device 182 in the form of the holding device 186, which comprises a ring 188 which is fixed longitudinally displaceably via a doubly bent web 190 with a straight guide 192 on the handling device 180. By changing the position of the ring 188 along the portion 176, as explained above with respect to the sleeve 183, the part of the joint zone 176 available for the bending movement of the proximal end section can be shortened, so that again only a limited bending angle on the side of the distal End portion 174 is allowed.

In addition, it is conceivable that both in the case of the sleeve 183 and in the case of the ring 188 a determination in a predetermined position, that is, with a predetermined overlap of the joint zone, can be made, so that the set limited work area on the side of the distal end portion 174 is secured.

On the other hand, it is conceivable to displace the sleeve 183 also in the direction of the distal joint portion 178, wherein then, with a corresponding pivotal movement of the proximal end portion 172, a translated, ie stronger, pivotal movement takes place in the region of the distal end portion 174.

It is also conceivable to provide markings for the position of the sleeve 183 or of the ring 188 or its straight guide 192, so that an angle restriction once found can also be adjusted again and again exactly later. To explain the above-described effect of increasing the pivoting or bending movement at the distal end, reference is made to FIG. 10, which shows a control device 100 having a proximal end portion 102, a distal end portion 104, and an intermediate portion 106 therebetween. While the middle section 106 is designed to be resistant to bending, the proximal and distal end sections 102, 104 each include a hinge zone 108 or 110 having a length Li or L ₂ measured in the axial direction. The length L ₂ is selected to be shorter than the length Li. FIG. 8 a shows the control device 100 in the basic position in which no forces act on the proximal end section 102.

If the proximal end region 102 is pivoted out of the axial direction, as is illustrated in the illustration of FIG. 10b, an increased length of the joint zone 108 of Li + Δi results in the proximal joint zone 108 at the outer radius of the curved end region 102; a shortened length of Li - Δ ₂ . Corresponding changes in the lengths result for the distal end portion 104 with a length at the outer radius L ₂ + Δ ₂ and a length at the inner radius of L ₂ - Δi. Since the lengths Li and L _{2 of} the joint zones 108, 110 are different, an increased bending movement for the distal end section 104 necessarily results in being able to follow the length changes predetermined by the proximal end section.

This effect can also be used, for example, in a proximally restricted work area with relatively small pivoting movements to allow full utilization of the distal given pivot radius and to make distally as large a work area available.

This principle can be used variably with the present invention by varying the length of one joint zone in relation to the other by means of a holding device (see FIG.

Claims

1. Control device, in particular for use in endoscopes or the like, with a proximal and a distal, each having a hinge zone end portion and a central portion arranged therebetween, with an outer hollow cylindrical shaft, an inner hollow cylindrical shaft and a control element arranged between these shafts with two or more, substantially longitudinally extending from the proximal to the distal end portion of the control device, transmitting force longitudinal elements, wherein the longitudinal elements are arranged in the circumferential direction of the control device at substantially regular angular intervals and connected in the region of their proximal and distal ends in the circumferential direction, respectively characterized in that the distal ends of the longitudinal elements are fixed in the circumferential direction in angular positions which depend on the angular positions in which the respectively associated proximal ends are different.

2. Control device according to claim 1, characterized in that the angular positions differ in the circumferential direction by about 10 ° to 360 °, in particular by about 45 ° to 315 °.

3. Control device according to claim 1 or 2, characterized in that the force-transmitting longitudinal elements are arranged laterally spaced from each other.

4. Control device according to claim 3, characterized in that between the force transmitting longitudinal elements spacers are arranged.

5. Control device according to claim 1 or 2, characterized in that the force-transmitting longitudinal elements are arranged along the longitudinal direction at least partially in direct contact with each other.

6. Control device according to one of claims 1 to 5, characterized in that the force-transmitting longitudinal elements are guided by the outer and the inner shaft in the radial direction.

7. Control device according to one of claims 1 to 6, characterized in that the force-transmitting longitudinal elements are arranged at least over part of their length helically between the shafts.

8. Control device according to claim 7, characterized in that the force-transmitting longitudinal elements in the region of the proximal and / or distal ends are arranged substantially helically parallel to the longitudinal direction of the control device and in an intermediate region.

9. Control device according to claim 7, characterized in that the force-transmitting longitudinal elements have one or more sections in the region between their proximal and distal ends, which are arranged parallel to the longitudinal direction of the control device.

10. Control device according to one of claims 1 to 9, characterized in that the force-transmitting longitudinal elements are formed as cables or wires.

11. Control device according to one of claims 1 to 10, characterized in that the force-transmitting longitudinal elements have a bana- nenförmigen cross-section.

12. Control device according to one of claims 1 to 14, characterized in that the control element comprises a hollow cylindrical member whose cylinder wall is divided at least in the region of a portion between the proximal and distal ends in two or more wall segments which form the force-transmitting longitudinal elements.

13. Control device according to claim 12, characterized in that the two or more wall segments are firmly connected to one another at the distal end of the hollow cylindrical component via a collar.

14. Control device according to claim 12 or 13, characterized in that the two or more wall segments are firmly connected to each other in the region of the proximal end of the hollow cylindrical member.

15. Control device according to one of claims 12 to 14, characterized in that the hollow cylindrical component is integrally formed.

16. Control device according to claim 15, characterized in that the hollow cylindrical component is manufactured from a single tube, wherein the division of the cylinder wall into wall segments is preferably carried out by means of laser beam cutting.

17. Control device according to one of claims 12 to 16, characterized in that the hollow cylindrical member is made of a steel alloy or Nitinol.

18. Control device according to one of claims 1 to 17, characterized in that the outer and / or the inner shaft in the region of the proximal and distal joint zones of the control device have a proximal and a distal hinge portion.

19. Control device according to claim 18, characterized in that at least one of the outer and inner shafts has a rigid portion disposed between the proximal and distal hinge zones.

20. Control device according to claim 19, characterized in that the proximal joint zone has an extension in the longitudinal direction of the control device, which is different from the extension of the distal joint zone.

21. Control device according to claim 20, characterized in that the extent of the proximal and / or the distal joint zone is adjustable.

22. Control device according to claim 21, characterized in that the control device comprises a holding device with which parts of a joint zone can be fixed in terms of bending with respect to the central portion of the control device or a functional unit adjoining the proximal or distal end portion thereof.

23. Control device according to claim 22, characterized in that the holding device comprises a parallel to the longitudinal axis of the central portion of the control device displaceable, rigid sleeve.

24. Control device according to claim 23, characterized in that the rigid sleeve is arranged on the outer circumference of the outer shaft.

25. Control device according to one of claims 22 to 24, characterized in that the holding device comprises a support member supported on the functional unit.

26. Control device according to one of claims 22 to 25, characterized in that the holding device can be positioned in predetermined positions.

27. Control device according to one of claims 1 to 26, characterized in that at least one of the joint zones is formed elastically.

28. Control device according to one of claims 1 to 27, characterized in that the articulation zone (s) of the outer and / or inner shaft comprise a wall portion in which a plurality of spaced apart, circumferentially extending slots are arranged.

29. Control device according to claim 28, characterized in that two or more, in particular three or more slots are arranged one behind the other in the circumferential direction.

30. Control device according to claim 28 or 29, characterized in that three or more slots are arranged side by side in the axial direction.

31. Control device according to claim 30, characterized in that the juxtaposed slots are arranged offset from each other in the circumferential direction.

32. Control device according to one of claims 28 to 31, characterized in that the slots are the cylinder wall completely penetrating slots.

33. Control device according to one of claims 28 to 32, characterized in that the slots delimiting wall surfaces are arranged at an acute angle to the radial direction.

34. Control device according to claim 33, characterized in that opposite wall surfaces of the same slot are arranged in mirror image, so that the outer circumference of a shaft results in a larger slot width than adjacent to the inner circumference.