DE102018100688A1 - Surgical jaw instrument with central activation element - Google Patents

Abstract

The present invention relates to a surgical jaw instrument, at the distal end of a jaw part is arranged, which is formed with two mouth branches, wherein at least one mouth sector is pivotally mounted, and at the proximal end of the jaw instrument, a handle for actuating the jaw part is arranged, wherein the handle two relative to each other, each movable parallel to or in a common plane of movement movable handle parts, which are movable in at least one open and a closed position, and each handle part is connected via a leg with a hinge, characterized in that arranged between the legs an actuating element is.

Description

background

The invention relates to a surgical jaw instrument mentioned in the preamble of claim 1, in particular a scissor-like trained and / or electrosurgical jaw instrument.

Surgical jaws of the type according to the invention are typically scissor-like or equipped with an elongated shaft and are preferably used for laparoscopic abdominal surgery. The jaw part of a jaw instrument according to the invention has at least one movable jaw industry, which is used for gripping or manipulating tissue or for holding surgical tools, such. As needles or the like, can be opened or closed against another mouth sector. There are, for. B. off US 5,607,449 A , surgical forceps known to close the pliers mouth when squeezing the handle with the normal gripping movement of the hand.

If the jaw instruments additionally have an electrosurgical function, they can be used to heat tissue to varying degrees and to coagulate or sever it through the action of heat. Usual coagulation forceps are z. In DE 10 2008 028 992 B3 and DE 10 2005 051 367 A1 described. An example is the PKS SEAL Open Forceps (Olympus). Depending on the length of application and temperature, coagulation leads to denaturation of the proteins, vaporization of fluid from the tissue, and finally tissue burns. Such a coagulation function can, for. B. for hemostasis or ablation of tissue.

Alternatively or additionally, the surgical jaws may include mechanical knife assemblies for mechanically severing tissue held between the jaw branches. In the DE 10 2008 028 992 B3 described electrosurgical instruments additionally have such a mechanical knife assembly.

Usually, such knife assemblies and / or electrical devices in the Maulbranchenbereich by outside, z. B. laterally, attached to the handle mounted actuators. So z. B. in the DE 10 2008 028 992 B3 described blade assembly operated by a lever which is mounted on the handle and extends beyond it on the outside.

However, experience has shown that these actuation systems are relatively inflexible. For example, they are less accessible after a hand or direction change because they are optimized for one direction and one hand. A non-symmetrical arrangement of the controls complicates in particular the operation of non-symmetrical Maulbranchen, such as curved scissors, which must be reversed in a change in direction in the cut. The design and installation of instruments with externally mounted controls is not trivial.

The invention is therefore based on the object to provide simplified controls, which also contribute to the fact that the surgical jaws are flexible and versatile.

description

The object is achieved by a surgical jaw instrument with the features of claim 1. In particular, the object is achieved by a surgical jaw instrument in which an actuating element is arranged between the handle legs. The actuating element is preferably operable from both sides of the common plane of movement of the handle parts in the same way and preferably formed and arranged symmetrical movement plane.

Thus, in a first aspect, the invention relates to a surgical jaw instrument, at the distal end of which a jaw part is formed, which is formed with two mouth branches, wherein at least one jaw branch is pivotally mounted, and at the proximal end of the jaw instrument, a handle for actuating the jaw part is arranged wherein the handle comprises two handle parts movable relative to one another, parallel to or in a common movement plane, which are movable into at least one open and one closed position, and each handle part is connected to a hinge via a leg, characterized in that between the two Legs an actuator is arranged.

The jaw instrument can z. As used to seal body tissue by coagulation and subsequent mechanical, mechanical / bipolar or bipolar cutting of the body tissue. Alternatively, the jaw instrument can also be used for purely mechanical manipulation of tissue. The surgical jaw instrument according to the invention has the advantage that the instrument can be used equally comfortably with both hands and in any orientation and thus, inter alia, the costs for the acquisition of several different instruments can be saved. In addition, the placement of the actuator between the legs of the jaw instrument also saves space, so that a maximum compact jaw instrument can be provided. The fact that it is not necessary to attach buttons or switches outside of the instrument body, the instrument is particularly well suited for fine work.

The actuator is suitable for controlling one or more end effectors. The term "controlling" in this context means that by actuation of the actuating element, the one or more end effectors can be activated and / or deactivated. Endeffectors are z. B. means for electrical heat generation, such as electrodes, on the tissue contact surfaces of one or both mouth branches or reversibly displaceable in the axial direction knife assembly, which are suitable to cut held between the jaw tissues.

It is conceivable that the actuating element is designed only for either activation or deactivation of the end effector (s). In general, however, the actuator will be designed both for activation and for deactivation of the end effector or, z. B. by an active position and an inactive position of the actuating element or alternatively in the manner of a button which can be moved by an actuating movement from an initial position temporarily in an operating position. An inactive position is the position of the actuator in which the controlled end effector (s) are not activated. It is conceivable to provide several activation stages or a stepless regulation of the end effector (s) by the actuating element. In addition, multiple end-effectors can be controlled with the same actuator. Therefore, the actuator may have more than one active position, wherein the different active positions are characterized in that different end effectors are activated and / or the active positions are characterized by different activation strengths. So z. B. the movement of the actuating element from an initial or inactive position in a direction in a first active position, first, a first end effector, z. B. with an electrical function, and the further movement of the actuating element in the same direction in a second active position, a second end effector, z. B. with a mechanical function, activate.

The actuating element is preferably, in at least one position, for. B. the inactive position or starting position, with respect to the movement plane described herein level symmetrically arranged and / or formed. As plane symmetrical, the actuator can be considered when it is transferred under reflection at the plane of movement substantially in itself. In this way it is ensured that the actuator is equally comfortable to use from both sides of the jaw instrument. In order to be able to optimally utilize this positive property of the actuating element, it is understood that the actuating element is arranged on the jaw instrument in such a way that it is equally accessible from both sides of the movement plane.

In order to enable the rotation of the jaw instrument, without limiting the operability, may additionally or alternatively be provided that the actuating element in at least one position, for. B. the inactive position or starting position, with respect to a tissue plane arranged symmetrically and / or is formed. The tissue plane passes through the longitudinal axis of the jaw or a leg of the jaw and across the plane of motion. As a result, tissue held between the mouth branches usually also lies in the tissue plane. With such a design of the actuating element, the jaw instrument can continue to be operated in the same comfortable manner and from the same side even after a 180 ° rotation about the longitudinal axis. This is z. B. desirable if the jaw part has a curvature and cuts are required in different directions during the procedure.

Suitable symmetrical shapes suitable for actuators are known to those skilled in the art. In order to utilize the advantages of the symmetrical arrangement and design of the actuating element, the functions of the actuating element are preferably also formed symmetrically symmetrical to the common plane of movement. In other words, the jaw instrument can be operated from the left and right with the same function. So z. For example, pressing the actuator from the right side will have the same control function as pushing from the left.

In order to ensure a comfortable and safe handling of the actuating element, the actuating element preferably has at least one finger system. A finger attachment is preferably a depression. Shape and size of the recess are usually ergonomically adapted to the shape and size of an average or a large finger. Depending on the direction of actuation, the finger system (s) will generally be arranged on the actuating element such that the opening of the depression faces laterally or distally. In this way, the operation can be effected simply by pulling the actuator in the proximal direction with a finger or by pushing by a finger from laterally. Thus is the actuating element preferably actuated by pulling the actuating element in the proximal direction. In a preferred embodiment, the actuating element has at least one finger attachment, whose opening points distally. In more preferred embodiments, the actuator additionally or alternatively at least one (further) lateral finger system. The actuator may, for. B. be designed as rotatably mounted trigger, ie in the manner of a gun trigger. Alternatively, the actuating element may comprise a finger-ring-like element. Such an actuator comprises an opening which extends in the plane of movement in the actuator. Within the opening, a finger attachment may be provided in the proximal direction. Accordingly, the opening has a diameter which allows at least the intervention in the opening with a finger. The opening may have an elliptical, partially elliptical, round or partially round shape. "Teilelliptisch" or "partially round" in this context means that the opening partially has an elliptical or round shape. The opening can z. B. in their proximal and distal end portions have an elliptical shape and in the intermediate region straight contours. The aforementioned preferred forms are particularly ergonomic. In this case, preferably at least the proximal end region and / or the distal end region of the opening (part) are elliptical.

Regardless of their shape, the actuators are each operatively connected to at least one end effector, e.g. With one end effector, two end effectors or more end effectors. These end effectors may be controllable together or separately from each other by the actuator, in the latter case z. B. by the actuator different actuation directions or distances are provided.

Surgical jaws that may benefit from the inventive arrangement of an actuator are well known to those skilled in the art. The jaw instrument is preferably an electrosurgical jaw instrument. Electrosurgical jaws often have at least one actuator for activating one or more electrical heat generation devices. Alternatively or additionally, the jaw instrument can be an instrument with a knife arrangement displaceable reversibly in the axial direction for cutting tissue between the jaw branches. This knife assembly can be actuated by the actuator of the invention.

The surgical jaw instrument has a jaw part at its distal end. The jaw part according to the invention is designed with two mouth sectors, wherein at least one mouth sector is pivotally mounted. The pivotable mouth sector is movable against the second mouth sector and contacts it in the closed state and / or is able to hold an object to be manipulated (eg tissue) between the mouth branches. In one embodiment, the jaw part is formed with two jaw sectors pivotally mounted about an axis. The mouth sectors are movable relative to each other and can touch each other and / or an object to be manipulated in the closed state.

In one embodiment, it is envisaged that the jaw part is designed as a forceps or gripper with two, suitable for gripping and holding, movable mouth sectors. In other words, the surgical jaw instrument is preferably a grasping instrument. In a particularly preferred embodiment, the surgical jaw instrument is an electrosurgical jaw instrument. Alternatively, the jaw part can be designed as a pair of scissors with at least one mouth sector having a cutting element. In other alternatives, a jaw part with three or more than three mouth sectors is conceivable, for example, to form a multi-armed gripper.

Furthermore, a handle for actuating the jaw part is arranged at the proximal end of the jaw instrument according to the invention. The handle is usually designed as a straight (not angled) handle. The handle is preferably made of two handle parts. The handle parts are usually assigned to a mouth industry in each case. In addition, the handle parts relative to each other, each movable parallel to a common plane of movement or in the common plane of movement. In particular, the gripping members may be moved toward and away from each other in or parallel to the common plane of movement. In other words, the plane of movement is clamped by the direction of movement of the two handle parts when moving apart of the handle parts. In this regard, the handle is thus constructed as the handle part of a commercial scissors. The jaw instrument can thus be designed scissor-like. This means that at least handle parts and legs of the jaw instrument as well as the joint, which connects handle parts and legs with the jaw part, are designed in the manner of a pair of scissors. In addition, the jaw part may be designed in the manner of a pair of scissors. In the latter case, the jaw part has a cutting function. This can be a mechanical and / or electrical cutting function. Suitable mechanical cutting functions include z. B. the formation of the mouth branches as two mutually movable blades and the use of a knife assembly with a displaceable in the distal direction and with a cutting edge at the distal end provided knife. Suitable electrical cutting functions include jawing industries having means for generating electrical heat suitable for introducing cuts in tissue. A combination of mechanical and electrical end effectors in the jaw instrument is also conceivable. Usual Koagulationszangen with and without additional movable in the axial direction blade arrangements are z. In DE 10 2008 028 992 B3 . DE 10 2005 051 367 A1 (Coagulation) US 2005/0107785 A1 and US 2004/0254573 A1 (Coagulation forceps, which comprise an axially displaceable blade assembly) described.

Preferably, the mouth sectors are each connected to one of the handle parts. By squeezing the handle parts of the handle, the mouth branches are usually movable towards each other. Alternatively, it is also conceivable to design a jaw instrument according to the invention such that the mouth sectors can be moved towards each other by pulling the handle parts of the handle apart.

The handle parts are inventively movable in at least one open position and a closed position. In the closed position, the handle parts are approximated to each other maximum. In one embodiment, the handle parts in the closed position touch. Preferably, the distance between the handle parts in the closed position is 5 mm or less, preferably 2.5 mm or less. In the at least one open position, the handle parts are further apart than in the closed position.

Both handle parts each have at least one element for finger attachment. The element for finger attachment can z. B. be designed as a finger ring, d. H. as teilellipsenförmige opening within a handle part. Similar to a commercial scissors z. B. a first handle part comprise an element for the attachment of the thumb and a second handle part comprise an element for the investment of index and / or middle finger.

Each handle part is connected via a leg with a (same) joint. In other words, the leg extends between the handle part and the hinge, i. H. distal to the handle. In this case, the handle part is preferably essentially only the section of the jaw instrument which comprises the elements for finger attachment. The legs can also be referred to as "stalks". The legs are rotatably mounted in the joint. According to the invention, it is preferable to design the mouth sectors and the associated legs and gripping parts in one piece.

The legs have a length which ensures sufficient spacing from the surgical site during a medical procedure. So the legs z. B. have a length of 5 cm or more, z. B. about 5 to 25 cm.

According to the invention, it is provided to arrange the actuating element between the legs. "Between" in this context means that the actuating element is arranged in at least one starting position or inactive position in the movement plane (the two grip parts) described herein. In embodiments in which the two handle parts are slightly offset, d. H. parallel to the plane of movement (eg on different sides of the common plane of motion), the actuator is arranged in at least one position on a plane lying between a first parallel plane to the plane of movement and a second parallel plane to the plane of movement and to both parallel planes and the plane of motion is parallel. The first and second parallel planes are the planes on which the first and second (against each other slightly offset) grip part move. Preferably, however, both handle parts and in particular the actuating element are arranged at least in a starting position or inactive position in a common plane of movement.

The legs are at their (radially, starting from the longitudinal axis of the jaw instrument) inner edge, i. on the side facing the respective other leg, in each case a recess or depression, in which the actuating element is arranged and can also be moved. Together, the recesses of the two legs form an opening which, even when the handle is closed, has a sufficient size for the actuator and its desired movements.

The actuator is operable with the same hand as the handle of the jaw. Therefore, the actuator in its maximum remote from the handle position a distance from the handle, which can be bridged with the free fingers of the operating hand. If the handle z. B. held with thumb and middle finger or made the movement of the handle parts in the movement plane with thumb on a first handle part and middle finder on a second handle part, the actuating element with the index finger can be reached and actuated.

1. a) der Längsachse des Maulinstruments, oder
2. b) der Längsachse eines Schenkels

in axialer Richtung bewegbar sein. In Ausführungsform a) wird das Betätigungselement im geöffneten Zustand des Griffteils weiterhin mittig zwischen den beiden Griffteilen angeordnet sein. Auch die Bewegungsrichtung verläuft stets, im geöffneten und geschlossenen Zustand des Handgriffs, im Wesentlichen mittig zwischen den beiden Griffteilen. In Ausführungsform b) wird das Betätigungselement stets an einem der beiden Schenkel, der hierin als Basisschenkel bezeichnet werden kann, entlang geführt. Diese Anordnung ermöglicht dem Anwender unter Umständen eine etwas komfortablere Bedienrichtung, insbesondere dann, wenn der Basisschenkel während der Verwendung der untere ist. Die erstere, stets mittige Anordnung trägt zur Wahrung einer maximalen Bediensymmetrie des Maulinstruments bei.The actuator may be designed for operation from different directions. So the actuator z. To control one or more end-effectors in parallel with or on

1. a) the longitudinal axis of the jaw, or
2. b) the longitudinal axis of a leg

be movable in the axial direction. In embodiment a), the actuating element in the open state of the handle part will continue to be arranged centrally between the two handle parts. Also, the direction of movement is always, in the open and closed state of the handle, substantially centrally between the two handle parts. In embodiment b), the actuating element is always guided along one of the two legs, which may be referred to herein as a base leg. This arrangement may allow the user a slightly more comfortable operating direction, especially if the base leg is lower during use. The former, always central arrangement helps to maintain maximum operating symmetry of the jaw instrument.

If the actuating element is designed for the actuation in the axial direction, it generally has at least one finger attachment whose opening points distally. This finger system can be arranged in a part-circular or partially elliptical opening in the actuating element. The opening is preferably formed in the plane of movement.

Alternatively or additionally, the actuator may be movable to control an end effector in an angled position from the common plane of movement. According to this alternative, the actuating element for controlling an end effector is moved by means of a transverse to the common plane of movement of the handle parts actuating movement in an active position or operating position. In the angled position, the actuator z. B. form an angle of 20 ° to 45 ° to the plane of movement. In this case, an automatic return movement of the actuating element may be provided in the starting position, i. the actuator be designed as a button.

If the actuating element is designed for the actuation transversely to the plane of movement, then it generally has at least one finger system, the opening of which points laterally, preferably additionally a contralateral finger system. Forming lateral and contralateral finger attachment ensures that the instrument can be used with both hands and upside down. By lateral pressing on the finger system, the actuator can be actuated.

The actuator according to the invention can also be used to control more than one end effector, z. B. for controlling two end effectors. The multiple end effectors may, for. B. distinct devices for electrical heat generation on the tissue contact surfaces of the mouth sectors or a device for generating electrical heat on the tissue contact surfaces of the mouth branches and a reversible in the axial direction between the mouth branches movable knife assembly.

If the actuator is designed to control more than one end effector, the control of the various end effectors can be accomplished by moving the end effector in different directions. Thus, it is conceivable, for example, to control a first end effector in the axial direction by movement of the actuating element and, moreover, to provide that the actuating element for controlling a second end effector can be moved into an angled position from the common plane of movement. Alternatively, it is also conceivable to provide a successive activation / deactivation mode for two or more end effectors, in which the movement of the actuating element from its inactive position or initial position initially leads to the activation of the first end effector and the continuation of the movement in the same direction to the alternative or additional activation of a second end effector results.

Furthermore, according to the invention, devices can be provided on the jaw instrument which lock the actuating element and / or one or both legs in one position. By such a locking element, the z. B. may be formed as described herein actuation locking element or as a handle locking element, it is ensured that the actuating element and the handle parts do not move during a medical intervention at inappropriate opportunity. The actuator can only be operated in certain positions, eg. For example, in one embodiment, the legs must be closed to move the actuator proximally in the axial direction.

In a preferred embodiment, for. B. at least one of the legs have an actuating locking element which is suitable, in a locking position of the legs to each other, in particular in the closed position, to prevent movement of the actuating element or to reduce the freedom of movement. Preferably, further movement of the actuating element is substantially prevented. In other words, the actuating element is locked by the actuating locking element. The term blocking position refers to a particular arrangement of the legs to each other, z. B. a desired degree of opening of the two legs relative to each other. The blocking position can z. B. be the closed position, ie the position in which both handle parts approximate each other maximum are. Alternatively, it is also conceivable that the movement of the actuating element is prevented in an open position. This allows a specific distance between the mouth branches to be set.

The actuating lock element can, for. B. have the form of a radial extrusion, which is arranged on the inside of the leg or, in particular within the recess or recess formed in the leg. The inside of a leg is the side facing the actuator (and the other leg). Preferably, both legs have an actuating locking element. The actuating locking element engages in an at least partially complementary shape recess on the actuating element. As a result, the movement of the actuating element is prevented. The at least partially complementary shape recess may be formed such that it prevents the movement of the actuating element in the axial direction and allows movement of the actuating element from the common plane of movement of the handle parts. Alternatively, both directions of movement - if the actuating element is designed for both directions of movement - be prevented by the formation of at least partially complementary shape depression.

The actuating element may alternatively or additionally comprise at least one handle locking element. The handle locking element is movable by means of movement of the actuating element in a first axial direction into an engagement position and by movement of the actuating element in a second axial direction into a disengaged position, wherein the handle locking element is in engagement position with an arranged on a leg engagement element and the leg in the Closed position locked. The first axial direction can, for. B. proximally, the second to be distal. By locking a certain distance between the mouth branches can be adjusted. The handle locking element can be an elongated element which can be placed radially outside of the engagement element by means of axial displacement in a suitable grip position (eg with maximally closed handles). For this purpose, a recess for the handle locking element is provided in the leg radially outside of the engagement member. By moving in the direction of the engagement element handle locking element and engagement element are brought into engagement (engaged position). In this way, a further opening of the handle is prevented. Preferably, the actuating element has at least two handle locking elements, each leg facing one. Thus, the movement of both handle parts can be prevented.

Finally, it is also possible to resiliently store the handle locking element and engagement element relative to one another or to carry out one or both of the elements flexibly. As a result, the holding force between the mouth branches can be defined. This can be achieved according to the invention by the handle locking element is resiliently mounted on the actuating element. Alternatively or additionally, the handle locking element may be resiliently mounted in the engaged position on the engagement member.

In a second aspect, the invention relates to the use of the jaw instrument in a method of treating the human body. Here, the jaw instrument is used to manipulate tissue, for. B. to hold, coagulate and / or cut through.

list of figures

• 1 eine schematische Seitenansicht eines erfindungsgemäßen Maulinstruments, das ein Betätigungselement mit einer teilellipsenförmigen Öffnung zur Betätigung eines oder mehrerer Endeffektoren umfasst;
• 2 eine schematische Seitenansicht einer Ausführungsform des Maulinstruments aus 1, bei der das Betätigungselement zur Steuerung eines oder mehrerer Endeffektoren parallel zu der Längsachse eines ersten Schenkels in axialer Richtung bewegbar ist;
• 3 eine schematische Seitenansicht einer alternativen Ausführungsform des Maulinstruments aus 1, bei der das Betätigungselement zur Steuerung eines oder mehrerer Endeffektoren parallel zu oder auf der Längsachse des Maulinstruments in axialer Richtung bewegbar ist;
• 4 eine schematische Aufsicht einer Ausführungsform des Maulinstruments aus 1, in der das Betätigungselement zur Steuerung eines Endeffektors mittels einer quer zur gemeinsamen Bewegungsebene gerichteten Betätigungsbewegung in eine aus der gemeinsamen Bewegungsebene abgewinkelte Stellung bewegt ist;
• 5 eine weitere schematische Seitenansicht des Maulinstruments aus 1, in der das Betätigungselement zur Betätigung eines oder mehrerer Endeffektoren in proximaler Richtung entlang der oder parallel zu der Längsachse des Maulinstruments bewegt ist;
• 6 eine schematische Schnittdarstellung eines mittleren Abschnitts des erfindungsgemäßen Maulinstruments, wobei beide Schenkel ein Betätigungssperrelement aufweisen;
• 7 schematische Schnittdarstellungen eines mittleren Abschnitts eines erfindungsgemäßen Maulinstruments, wobei das Betätigungselement ein Griffsperrelement aufweist (7a), das in Eingriff mit einem an einem Schenkel angeordneten Eingriffselement gebracht werden kann (7b);
• 8 schematische Schnittdarstellungen eines mittleren Abschnitts von erfindungsgemäßen Maulinstrumenten, wobei das Griffsperrelement federnd an dem Betätigungselement gelagert ist (8a) bzw. das Eingriffselement eine Feder zur federnden Lagerung des Griffsperrelements an dem Eingriffselement in der Eingriffsstellung aufweist (8b);
• 9 eine perspektivische Seitenansicht eines erfindungsgemäßen Maulinstruments, in dem das Betätigungselement als drehgelagertes Abzugszüngel ausgebildet ist; und
• 10 eine perspektivische Seitenansicht eines alternativen erfindungsgemäßen Maulinstruments, in dem das Betätigungselement eine teilellipsenförmige Öffnung zur Fingeranlage aufweist.

In the drawings, embodiments of the invention are shown schematically. Show it:

• 1 a schematic side view of a jaw instrument according to the invention, comprising an actuating element with a partially ellipsoidal opening for actuating one or more end effectors;
• 2 a schematic side view of an embodiment of the jaw from 1 in which the actuator for controlling one or more end effectors is movable parallel to the longitudinal axis of a first leg in the axial direction;
• 3 a schematic side view of an alternative embodiment of the jaw from 1 in which the actuator for controlling one or more end effectors is movable in the axial direction parallel to or on the longitudinal axis of the jaw instrument;
• 4 a schematic plan view of an embodiment of the jaw from 1 in which the actuating element for controlling an end effector is moved by means of an actuating movement directed transversely to the common plane of movement into an angled position from the common plane of movement;
• 5 another schematic side view of the jaw from 1 in which the actuator for actuating one or more end-effectors is moved in the proximal direction along or parallel to the longitudinal axis of the jaw instrument;
• 6 a schematic sectional view of a central portion of the jaw instruments according to the invention, wherein both legs have an actuation locking element;
• 7 schematic sectional views of a central portion of a jaw instrument according to the invention, wherein the actuating element has a handle locking element ( 7a) which can be brought into engagement with a arranged on a leg engaging element ( 7b) ;
• 8th schematic sectional views of a central portion of jaw instruments according to the invention, wherein the handle locking element is resiliently mounted on the actuating element ( 8a) or the engagement element has a spring for the resilient mounting of the handle locking element on the engagement element in the engaged position ( 8b) ;
• 9 a side perspective view of a jaw instrument according to the invention, in which the actuating element is designed as a rotatably mounted trigger finger; and
• 10 a perspective side view of an alternative jaw instrument according to the invention, in which the actuating element has a partially elliptical opening for finger system.

embodiments

Further advantages, characteristics and features of the present invention will become apparent in the following detailed description of embodiments with reference to the accompanying drawings. However, the invention is not limited to these embodiments.

1 shows a schematic side view of a jaw instrument according to the invention 10 that is an actuator 30 with a partially elliptical opening 32 for actuating one or more end effectors. The end effectors are not shown and can, for. B. from the group of axially between the mouth branches 14 . 16 slidable knife assemblies and one or more means for generating electrical heat.

The jaw instrument 10 has a jaw part in its distal end region 12 on, the two jaw sectors pivoting about an axis 14 . 16 includes. The axis is through the joint 28 educated. The distal end of the mouth branches 14 . 16 is only indicated schematically by dashed lines. The jaw part 12 has at least one end effector, not shown here, by the actuating element 30 can be controlled. The end effector can be removed by pulling the actuator 30 be activated in the proximal direction and by moving the actuator 30 be deactivated in the distal direction. It is also conceivable that the actuating element 30 automatically returns to its distal position as soon as manual pressure in the proximal direction is no longer exerted. In its distal position of origin is the actuator 30 inside of in the two thighs 24 . 26 provided wells 40 essentially displaced maximally in the distal direction. This position is in 1 shown.

The jaw instrument 10 has two legs 24 . 26 on, which can also be referred to as grip legs, scissor blades or straws. Every thigh 24 . 26 connects a mouth industry 12 . 14 about a (same) joint 28 with a handle part 20 . 22 , The handle parts 20 . 22 are parts of the handle 18 , The illustrated jaw instrument 10 is designed scissor-like. Thus, the leg connects 26 the handle part 20 with the mouth industry 14 and the thigh 24 the handle part 22 with the mouth industry 16 , It is in the jaw instrument shown 10 but only the thighs 24 . 26 and handle parts 20 . 22 as well as the connection between jaw parts 14 . 16 and thighs 24 . 26 formed scissor-like while the mouth branches 14 . 16 have no scissor-type, mechanical cutting edge. Instead, the mouth branches can 14 . 16 preferably have tissue contact surfaces with means for electrical heat generation, which are suitable by electrical heat generation cuts in between the mouth branches 14 . 16 To bring retained tissue and / or to coagulate the tissue.

The handle parts 20 . 22 each have a substantially circular opening 34 . 36 on, which is intended for the finger system. That's how the handle works 18 comfortable z. B. be held with thumb and middle finger.

The thigh 24 . 26 each have a recess 40 or recess on. This is in the other leg facing side for receiving the actuating element 30 educated. The through the two wells 40 The opening formed between the legs is therefore preferably at least in sections form and size complementary to the actuating element 30 educated. The through the two wells 40 formed opening is sufficiently large to allow movement of the actuator 30 in the axial direction and / or an angling of the actuating element 30 from the movement of the handle parts 20 . 22 to enable the tensioned movement plane.

The actuator 30 also has an opening 32 on, which is designed as a finger attachment. In the in 1 illustrated embodiment is as finger system (for a movement of the actuating element 30 in the proximal direction) the proximal end of the opening 32 intended. With in the opening 32 inserted finger, the actuator 30 be pulled proximally. For a movement of the actuating element 30 in the distal direction, if no automatic return movement of the actuating element 30 is provided in the manner of a button, and the distal end of the opening 32 be used as a finger attachment. This allows the actuator 30 be moved with the same finger in the distal direction.

The actuator 30 is with the end effector and the joint 28 via a connecting element, not shown here 38 connected (cf. 3 ff).

2 shows a schematic side view of an embodiment of the jaw instrument 10 out 1 in which the actuating element 30 for controlling one or more end effectors parallel to the longitudinal axis of a first leg 24 is movable in the axial direction. Be the handle parts 20 . 22 moved apart in the common plane of motion, the actuator remains 30 on the thigh 24 , This embodiment is particularly comfortable to use.

3 shows a schematic side view of an alternative embodiment of the jaw instrument 10 out 1 in which the actuating element 30 for controlling one or more end effectors parallel to or on the longitudinal axis of the jaw instrument 10 is movable in the axial direction. Be the handle parts 20 . 22 moved apart in the common plane of movement, so remove both legs 24 . 26 from the actuator 30 , This embodiment ideally maintains the desired symmetry of the actuator 30 , both to the tissue plane and to the common plane of motion.

4 shows a schematic plan view of an embodiment of the jaw instrument 10 out 1 in which the actuator 30 for controlling an end effector by means of a transverse to the common plane of movement of the handle parts 20 . 22 directed actuating movement is moved in an angled position from the common plane of movement. The direction of the actuation movement (made, for example, by pressing sideways with an index finger) is indicated by an arrow. It can be seen that the connecting element 38 on the jaw instrument 10 is rotatably mounted. This allows the actuator 30 from its initial position shown in dashed lines (also inactive position) in a hatched illustrated operating position (also active position) moves (angled). In the illustrated operating position is the actuating element 30 moved to control an end effector in an out of the common plane of movement by about 20 ° angled position. Preferably, it is provided that the actuating element 30 from this angled position automatically moved back into the non-angled starting position. In this embodiment, the actuating element 30 designed as a button.

5 shows a further schematic side view of the jaw instrument 10 out 1 in which the actuator 30 for actuating one or more end-effectors in the proximal direction along or parallel to the longitudinal axis of the jaw instrument is moved. The movement already made of the actuating element 30 Proximal is indicated by an arrow. It can be seen that the actuator 30 by means of a connecting element 38 connected to the end effector (s).

6 shows a schematic sectional view of a central portion of the jaw instrument according to the invention 10 , where both legs 24 . 26 one actuating locking element each 42 . 44 respectively. Shown is a slightly open position of the two legs 24 . 26 , In the slightly open position is the actuator 30 freely movable in the axial direction. Be the thighs 24 . 26 further closed, that approximates each other, so grab the two actuating locking elements 42 . 44 in the form-complementary depressions 46 . 48 a, on the actuator 30 are arranged. In the embodiment shown, the actuating element 30 locked or locked in this way in the most distal position (inactive or initial position) against further movement in the axial direction. It is also conceivable, the actuator 30 in other positions, eg. B. an active position to lock or lock.

If the actuator 30 is designed to control more than one end effector, the actuator 30 be movable both in the axial direction, as well as in an angled from the common plane of movement position. The actuator 30 would have z. B. a function as a button and another function as a slide switch or pull switch. Accordingly, actuation locking elements 42 . 44 and form-complementary wells 46 . 48 be designed so that both directions of movement of the actuating element 30 be locked, or just one. For example, the shape-complementary depressions 46 . 48 be designed for these two alternatives as holes or slots.

7 shows schematic sectional views of a central portion of a jaw instrument according to the invention 10 , where the actuator 30 a handle locking element 50 having ( 7a) which engages with an engaging element 52 can be brought ( 7b) on one leg 26 is arranged. Such a system of handle locking element 50 and engaging element 52 may alternatively or in addition to the system of actuation locking element 42 . 44 and form-complementary wells 46 . 48 be provided.

The handle locking element 50 is so with the actuator 30 connected to one on the thigh 26 arranged engagement element 52 between the handle locking element 50 and the actuator 30 can be arranged. To achieve the arrangement, the actuating element 30 including the handle locking element 50 with thighs closed 24 . 26 shifted in the axial direction such that the handle locking element 50 in engagement with the engagement element 52 comes (cf. 7b) , In other words, the handle locking element 50 from the view of the main part 60 of the actuating element 30 at least in sections above or behind the engagement element 52 pushed. The main part 60 of the actuating element 30 is the part that runs between the two legs and not behind or over the engagement element 52 can be moved.

The handle locking element 50 can, in order to ensure a particularly safe guidance, run in rails, which are on the leg 26 are arranged. The attachment of the handle locking element 50 on the actuating element 30 is formed such that it is ensured that the engagement element 52 between the main part 60 of the actuating element 30 and the handle locking element 50 can be arranged. For this purpose, the attachment z. B. as a (narrow) connector, which is parallel to the longitudinal axis of the jaw instrument 10 and parallel to the engagement element 50 runs. For this connector is parallel to the engagement element accordingly 50 to provide a recess.

Be grip lock element 50 and engaging element 52 engaged with each other, so are the thighs 24 . 26 locked in the closed position. The handle 18 of the jaw instrument according to the invention 10 is also locked so that the handle parts 20 . 22 can not be moved apart. In this way, in various embodiments, either the jaw instrument 10 be locked in a position in which the one or the end effectors to be controlled are inactive, or in a position in which the, one or the end effectors are activated. It is also conceivable that the actuating element 30 Also in this locked position can continue to be sufficiently displaced in the axial direction, so that an active control of the end effector or in the locked position is made possible.

Of course, the jaw instrument 10 a second pair of handle locking element 50 and engaging element 52 for blocking the second leg 24 respectively. Alternatively, the two legs 24 . 26 be coupled in another way such that a blocking of the one leg 26 also a blocking of the other leg 24 causes.

8th shows schematic sectional views of a central portion of jaw instruments according to the invention 10 , wherein the handle locking element 50 resilient on the actuating element 30 is stored ( 8a) or the engagement element 52 a spring element 56 for resilient mounting of the handle locking element 50 on the engagement element 52 in the engaged position ( 8b) , The two alternative embodiments correspond in their other details of in 7 illustrated embodiment. In addition to the features shown there, the in 8th shown foot instruments 10 characterized in that the thigh 26 in the locked position resiliently on the actuating element 30 is stored. In this way, z. B. the holding force between the mouth branches 14 . 16 be regulated or defined.

In an in 8a Shown embodiment, the resilient mounting by a resilient attachment of Griffsperrelements 50 on the actuating element 30 causes. The handle locking element 50 is here about at least one, shown here two, spring elements 54 with the actuating element 30 connected. The spring elements can, for. B. be formed as coil springs. Alternatively, the connection between the main body 60 and the handle locking element 50 be flexible. Will be between the mouth branches 14 . 16 Tissue held and the jaw instrument 10 brought into the engaged position, is ensured in this way, that nevertheless a locking of the legs 24 . 26 possible and adequate pressure can be exerted on the tissue. Because the two handle parts 20 . 22 and thighs 24 . 26 at between the mouth branches 14 . 16 held tissue already be easily spaced, a biasing device may be provided which biases the spring elements during movement in the axial direction to the engagement position such that the engagement element 52 between handle locking element 50 and main body 60 of the actuating element 30 is arranged and guided in the engaged position.

Alternatively, the handle locking element 50 permanently in rails in the thigh 26 be arranged. In this way, the handle parts 20 . 22 and thighs 24 . 26 by manual force against the Restoring force of the spring elements 54 be moved apart. By the restoring force of the spring elements 54 become the handle parts 20 . 22 and thighs 24 . 26 automatically brought into a closed position, when the manual force is reduced.

In an alternative, in 8b Shown embodiment, the resilient mounting by a spring element 56 achieved, that on the engagement element 52 is arranged and suitable, the handle locking element 50 from the engagement element 52 to space. The restoring force of the spring acts in the direction of the handle locking element 50 , The spring element 56 can z. B. be designed as a leaf spring.

9 shows a perspective side view of a jaw instrument according to the invention 10 in which the actuator 30 is designed as a rotatably mounted trigger finger. Such constructions are known to those skilled in the art. The trigger blade may be formed as part of a gun trigger-type control unit. In this case, the actuating element 30 preferably designed as a button. In such an actuator 30 is a section 58 for finger attachment preferably formed at a suitable position on the distal side of the preferably ergonomically shaped trigger tongue.

The illustrated jaw instrument 10 not shown means for generating electrical heat in the form of electrodes on the tissue contact surfaces of its jaws 14 . 16 on. These are through the cable 62 connected to a power supply. By actuating the actuating element 30 the electrodes can be activated.

10 shows a perspective side view of an alternative jaw instrument according to the invention 10 in which the actuator 30 a teilellipsenförmige opening 32 for the finger system. The jaw instrument 10 moreover has the same features as the one in 9 shown on.

Although the present invention has been described in detail with reference to the embodiments, it will be understood by those skilled in the art that the invention is not limited to these embodiments, but rather modifications are possible in such a way that individual features omitted or other combinations of individual features presented realized unless the scope of the appended claims is exceeded. The present disclosure includes all combinations of the featured individual features.

LIST OF REFERENCE NUMBERS

10

Maul instrument

12

jaw

14

Maul industry

16

Maul industry

18

handle

20

handle part

22

handle part

24

leg

26

leg

28

joint

30

actuator

32

Opening for finger attachment

34

Opening for finger attachment

36

Opening for finger attachment

38

connecting element

40

deepening

42

Operating locking element

44

Operating locking element

46

complementary form

48

complementary form

50

Grip locking element

52

engaging member

54

spring element

56

spring element

58

Finger attachment section

60

Main part actuator

62

electric wire

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• US 5607449 A [0002]
• DE 102008028992 B3 [0003, 0004, 0005, 0021]
• DE 102005051367 A1 [0003, 0021]
• US 2005/0107785 A1 [0021]
• US 2004/0254573 A1 [0021]

Claims (10)

Surgical jaw instrument (10), at the distal end of which a jaw part (12) is arranged, which is formed with two mouth branches (14, 16), wherein at least one jaw branch is pivotably mounted, and at the proximal end of the jaw instrument (10) a handle ( 18) for actuating the jaw part (12) is arranged, wherein the handle (18) comprises two relative to each other, each movable parallel to or in a common plane of movement handle parts (20, 22) which are movable in at least one open and a closed position , and each handle part (20, 22) is connected via a leg (24, 26) to a hinge (28), characterized in that an actuating element (30) is arranged between the legs (24, 26). Surgical jaw (10) after Claim 1 , characterized in that the jaw instrument (10) is formed scissor-like. A surgical jaw instrument (10) according to any one of the preceding claims, characterized in that the jaw instrument (10) is an electrosurgical jaw instrument (10). Surgical jaw instrument (10) according to one of the preceding claims, characterized in that the actuator (30) for controlling an end effector is movable in the axial direction parallel to or on a) the longitudinal axis of the jaw instrument, or b) the longitudinal axis of a leg. Surgical jaw instrument (10) according to one of the preceding claims, characterized in that the actuating element (30) for controlling an end effector is movable into an angled position from the common plane of movement. Surgical jaw instrument (10) according to one of the preceding claims, characterized in that the actuating element (30) for controlling an end effector is movable into an active position or actuated position by means of an actuating movement directed transversely to the common plane of movement. Surgical jaw instrument (10) according to one of the preceding claims, characterized in that at least one of the legs (24, 26) has an actuation locking element (42, 44) which is suitable for moving in a blocking position of the limbs (24, 26) relative to one another to prevent the actuator (30) or to reduce the freedom of movement. Surgical jaw instrument (10) according to one of the preceding claims, characterized in that the actuating element (30) comprises at least one handle locking element (50) which by means of movement of the actuating element (30) in a first axial direction in an engaged position and by means of movement of the actuating element in a second axial direction is movable to a disengaged position, wherein the handle locking element (50) in the engaged position is in engagement with an engaging element (52) arranged on a leg (26) and locks the leg (26). Surgical jaw (10) after Claim 8 , characterized in that the handle locking element (50) is resiliently mounted on the actuating element (30) and / or the handle locking element (50) in the engagement position is resiliently mounted on the engagement element (52). Surgical jaw instrument (10) according to one of the preceding claims, characterized in that the actuating element (30) is designed as a rotatably mounted trigger finger.

Images