WO2010057576A1

WO2010057576A1 - Clamp coagulator apparatus

Info

Publication number: WO2010057576A1
Application number: PCT/EP2009/007885
Authority: WO
Inventors: Jürgen HILLER
Original assignee: Erbe Elektromedizin Gmbh
Priority date: 2008-11-19
Filing date: 2009-11-03
Publication date: 2010-05-27
Also published as: DE102008058019B4; DE102008058019A1

Abstract

There are known clamp coagulator apparatuses having gripper elements that exhibit opposing coagulation electrodes that can be moved toward one another from an opened to a closed position to clamp a fabric section. At least one spacer element is attached such that the coagulation electrodes exhibit a safety clearance from one another when closed. A plurality of retaining teeth are attached on the coagulation electrodes for holding the fabric and are sized so that they do not contact the opposing coagulation electrodes when closed. To increase the functional reliability while simultaneously simplifying production, the invention proposes to arrange the retaining teeth in groups and to allocate to each group at least one closely spatially neighbored spacer element.

Description

Koagulationsklemme

description

The invention relates to a coagulation clamp according to the preamble of claim 1.

Coagulation clamps for surgical purposes have gripping elements on which coagulation electrodes for clamping a tissue section, in particular a vessel, are provided opposite one another. The gripping elements can be moved toward each other from an open to a closed state. So that no short circuit between the electrodes can occur, at least one spacer element is mounted in such a way that the coagulation electrodes in the closed state have a safety distance from each other. Such a coagulation clamp is known, for example, from EP 1 747 762 A2. As a spacer, in this coagulation clamp, a raised (insulating) portion is mounted on the coagulation electrodes near a hinge through which the gripping members are connected. In order to be able to better hold the tissue grasped, ie the tissue does not slip off the handle, retaining teeth are provided in the known coagulation clamps over the entire electrode surface, which teeth are dimensioned so that they do not touch the opposing coagulation electrode in the closed state of the gripping elements.

In the case of the known coagulation clamp, production must be extremely precise, in particular in the region of the spacer element, in order to reliably prevent a short circuit on the one hand and to keep the "residual gap" present in the closed state low enough, in particular in the case of terminals which have long proximal branches , very large forces can occur in the region of the spacer element, which complicates the aforementioned problem.

The invention has for its object to provide a coagulation clamp of the type mentioned in that a secure hold of the tissue and a exactly defined residual gap between the coagulation electrodes are ensured even with reduced production costs.

This object is achieved by a coagulation clamp according to claim 1. In particular, the object is achieved by a coagulation clamp with gripping elements and with opposing coagulation electrodes, which are movable toward each other for clamping a tissue section from an open to a closed state, with at least one spacer which is mounted such that the coagulation electrodes in the closed state a safety distance from each other, and with a plurality of holding teeth, which are mounted on the coagulation electrodes for holding the tissue and dimensioned so that they do not touch the opposing coagulation electrode in the closed state, achieved in that the holding teeth are arranged in groups and that each group at least one spatially adjacent spacer element is assigned.

An essential point of the invention lies in the fact that a plurality of spacer elements is provided over substantially the entire surface of the coagulation electrodes, so that the safety distance is absolutely guaranteed when closing the gripper elements. The provided in the vicinity of the spacers retaining teeth then serve not only to hold the tissue, but rather represent additional security elements, which then, if associated spacers should fail, still ensure a safe distance between the coagulation electrodes. Thus, the holding teeth have a dual function and increase the safety when operating the coagulation clamp. On the other hand, the spacer elements additionally act to hold the grasped tissue.

It should be noted that the term "coagulation clamp" is to be understood not only those clamps as they are used in open surgery, but also such terminals, as they are performed in endoscopic operations.

The groups of retaining teeth, to which in this case the associated spacer elements are to be added, preferably have a diameter that is smaller, preferably at most half the size of the distances between the groups. In the "minimal case" a group consists of a single one Distance element and a single holding tooth. Depending on the application, the holding teeth or spacer elements or the groups formed should be distributed over the Koagulationselektrodenflächen so that the tissue to be gripped is securely detected by at least one group.

Preferably, all spacer elements are attached to a coagulation electrode and all holding teeth are attached to the other coagulation electrode. This facilitates the production.

The spacer elements and the retaining teeth are preferably formed as ceramic components. Such ceramic components are commercially available as prefabricated components and have the advantageous properties in terms of insulation and heat resistance.

The ceramic components are preferably rod-shaped and preferably secured in corresponding holes in the coagulation electrodes by gluing. The connection between the ceramic component and the coagulation electrode is thus very easy to manufacture, so the production is simple.

The ceramic components preferably have edge-free end sections, that is to say they are "chamfered." On the one hand, this facilitates insertion into the bores, on the other hand, no unintentional tissue injuries can occur.

In a preferred embodiment of the invention, the ceramic components all have the same length. In one coagulation deeper holes then than in the other coagulation electrode are mounted so that the retaining teeth are formed on the coagulation electrode with the deeper holes and the spacer elements on the other coagulation electrode. This further facilitates the production of the coagulation clamp.

Alternatively, it is possible to make all holes equally deep and to provide two different types of ceramic components, namely shorter and longer. Depending on the manufacturing methods, this can also facilitate the production. It should also be noted that the ceramic components in a conventional coagulation clamp for open surgery have a length of about 2.5 mm and are inserted so deep into the coagulation electrodes that they are still about 200 microns protrude beyond the surface of the coagulation electrodes or slightly more if a spacer element is to be formed.

The gripping elements are provided with an insulating layer of PEEK (polyetheretherketone) outside of those areas in which the coagulation electrodes are located. This insulating material has proved to be particularly advantageous and in particular when this PEEK insulating layer comprises a filling of mica. By such a mica filling of a carbonization of the insulation can be prevented. The filling preferably makes up 5 to 25%, better still 10 to 20%, but in particular 15% of the insulating layer. It has proven to be particularly advantageous if the mica is present in a very small particle size and although the particle size should be less than 25 μm, but preferably less than 15 μm. As a result, the material properties of the insulating layer are further improved.

Hereinafter, an embodiment of the invention will be described in more detail with reference to drawings. Show here

1 is a side view of an end portion of a coagulation clamp,

2 is a front view taken along the line II-II of FIG. 1,

Fig. 3 is a section along the line III-III of Fig. 2 and

4 is an enlarged view of the marked area IV of FIG. 3.

In the following description, the same reference numerals are used for the same and like parts.

In Fig. 1, an end portion of a coagulation clamp is shown. This comprises gripping elements 10, 11, which are pivotally connected to one another via a joint 9 and merge into proximal arm sections or branches 7, 8. Instead of such proximal arm portions 7, 8, other actuating elements for opening and closing the gripping elements 10, 11 may be provided.

On inner surfaces of the gripping elements 10, 11 coagulation electrodes 12, 13 are arranged, as shown in FIGS. 2 and 3. From the surface of a coagulation electrode 13 protrude spacer elements 20-24, which are dimensioned so long that when closing the gripping elements 10, 11 the Coagulation electrodes 12, 13 have a safety distance d (see Fig. 2) from each other.

Furthermore, in the vicinity of the spacer elements 20-24 holding teeth 30-36 are provided, as shown in particular in Fig. 3. These can be individual holding teeth, as shown by the reference numerals 30-32, or a plurality of holding teeth, as shown by the reference numerals 33-36, each of which in turn may also comprise different arrangements in the region of the spacer elements 20-24. In any case, the retaining teeth 30-36 are always assigned spacer elements 20-24. In this way, if spacers 20-24 fail in their function for some reason, it is ensured that this function can be taken over by holding teeth 30-36. In this case, although the safety distance d is slightly lower, with a suitable dimensioning it is still so large that a short circuit between the coagulation electrodes 12, 13 is avoided.

The spacer elements 20-24 and retaining teeth 30-36 are rod-shaped formed of ceramic material, and have, as shown in Fig. 4, end portions 25 which are rounded. In this way, these ceramic elements can be used in a simple manner in holes 16 which are provided in the coagulation electrodes 12, 13. For attachment in Koagulationselektroden 12, 13 is particularly suitable for gluing. On the other hand, this rounding of the end portions 25 leads to the fact that an unwanted mechanical injury of the tissue when using the coagulation clamp is reliably avoided.

Finally, it should be mentioned that - as can be seen in particular from FIG. 3 - the coagulation electrodes 12, 13 have insulation 14, 15, which completely surround the coagulation electrodes 12, 13 so that only the mutually facing surfaces of the coagulation electrodes are uninsulated. The insulating material has already been described in more detail above.

LIST OF REFERENCES

7, 8 proximal arm portion

9 joint

10, ii gripping element

12, 13 coagulation electrode

14, 15 insulation Bore -24 spacer

End section-36 holding tooth

Claims

claims

1. coagulation clamp with gripping elements (10, 11) and with opposing coagulation electrodes (12, 13), which are for clamping a tissue section from an open to a closed state toward each other, with at least one spacer element (20-24), the like in that the coagulation electrodes (12, 13) in the closed state have a safety distance (d) from each other, and with a plurality of holding teeth (31-36) mounted on the coagulation electrodes (12, 13) for holding the tissue and so on are dimensioned so that they do not touch the opposing coagulation electrode (12, 13) in the closed state, since they are designed in such a way that the holding teeth (30-36) are arranged in groups, and that each group at least one spatially closely adjacent spacer element (20-24) is assigned.

2. Coagulation clamp according to claim 1, characterized in that the groups have a diameter which is smaller, preferably at most half the size of the distances between the groups.

3. Coagulation clamp according to one of the preceding claims, characterized in that all spacer elements (20-24) on a coagulation electrode (13) and the holding teeth (30-36) are attached to the other coagulation electrode (12).

4. Coagulation clamp according to one of the preceding claims, characterized in that the spacer elements (20-24) and / or the retaining teeth (30-36) are formed as ceramic components.

5. The coagulation clamp according to claim 4, characterized in that the ceramic components are rod-shaped and are fastened in corresponding bores (16) in the coagulation electrodes (12, 13), preferably by gluing.

6. coagulation clamp according to one of the preceding claims, in particular according to one of claims 4 or 5, d ad u rch geken nzei c h n et that the ceramic components have edge-free end portions (25).

7. Coagulation clamp according to one of the preceding claims, in particular according to claim 5, characterized in that the ceramic components (20-24; 30-36) all have the same length and the bores (16) for inserting the Holding teeth (30-36) are deeper than those for inserting the spacer elements (20-24).

8. Koagulationsklemme according to any one of the preceding claims, in particular according to claim 5, d ad u rch g e ken nzei ch n et that the holding teeth (30-36) are shorter than the spacer elements (30-36) and in the

Holes (16) are all equally deep.

9. Koagulationsklemme according to any one of the preceding claims, as you rch ge chine nze i ch net, that the gripping elements (10, 11) outside of the areas in which the coagulation electrodes (12, 13) lie, with an insulating layer (14, 15) made of PEEK (polyetheretherketone).

10. coagulation clamp according to one of the preceding claims, in particular claim 9, dad u rch g eken n zei ch n et et that the PEEK insulating layer (14, 15) comprises a filling of mica.

11. The coagulation clamp according to one of the preceding claims, in particular according to claim 10, characterized in that there are many examples that the filling 5-25%, preferably 10-20%, particularly preferably 15% of

Insulating layer.

2. Koagulationsklemme according to any one of the preceding claims, in particular according to one of claims 10 or 11, d a d u rch eken nzeich n et that the mica is present in a particle size of <25 microns, preferably <15 microns.