FR2688681A1 - Universal handle for coeliosurgery instrumentation - Google Patents

Abstract

The invention is a handle adapted to the methodology of on-screen coeliosurgery, substantially altering the bodily attitudes of the surgeon. It consists: - of a treated aluminium casing, in two parts joined together by screws, containing the movement mechanism and receiving the tube for translating the instrument, - 2 stainless steel branches which are mobile and sloped, and - in the blockable clamp version, a disengageable rack, with 2 return springs.

Description

UNIVERSAL HANDLE FOR INSTRUMENTATION
CORELOSURGERY
The present invention is a handle specifically designed for laparoscopic instrumentation or closed stomach surgery.

 Laparoscopic surgery is a technique used to perform a surgical procedure with a closed belly, the instruments arriving in the operating area by trocars of appropriate caliber, introduced through the abdomen.

 The evolution of the operating technique should be described to justify the presentation of the invention described.

 Coeliosurgery was inspired by the technique of orthopedic surgery called arthroscopic which consists in operating the joints without opening using an optic equipped with cold light by optical fiber, the surgeon operating seated, the eye glued to an eyepiece .

The instrumentation used necessarily requires an elbow handle with two branches with rings, one movable, the other fixed, the angle of which rises from the revolver handle to ensure horizontal work.

 In 1947, Professor PALMER transposed this technique for procedures with a closed belly avoiding unsightly and painful incisions, particularly in gynecology.

 This transposition, very beneficial for the patient, forced the surgeon to abandon his traditional surgical gestures and attitudes (horizontal hand position) for a comparatively very uncomfortable and tiring position. Standing, he had to bend his body and head to keep his eye glued to the eyepiece of the optics and use the same angled instrumentation to ensure vertical access requiring to hold the elbow lifted above of the head.

 These drawbacks limited the generalization of this innovation until the appearance of the video system using camera and screen.

 From then on, the surgeon found the fully vertical position - working - the eyes fixed on the screen.

 Only the instrumentation has changed little, forcing the operator to always hold the elbow in the high position, limiting the movements of the hand and the handle, not at all suitable for continuous interventions, given the generalization of this very method. scalable.

 The invention presented makes it possible to restore the natural position and the gestural rite attached to open surgery, which was its basic training, for any surgeon, namely the perfect mobility of the arm, forearm, handle and hand assembly without modification. of body attitude.

 The conventional instrumentation is made up of 3 parts - the handle as already described comprising - the tube of variable length intended to be introduced into the trocar and ensuring, thanks to a sliding cable inside, the translation of movement communicated by the handle to the moving parts fixed to the end of said tube (jaws, scissor blades) necessary for the different stages of the operation according to the intended use with or without jaw blocking rack, depending on whether it is a chisel or a gripper.

 The present invention relates only to the handle intended to receive any rigid or flexible tube fitted with ends specifically determined by the surgeon for his needs.

This universal handle of horizontal and sloping type must therefore, apart from the conventional vertical arrangement to be modified, ensure as in the past - the perfect and powerful translation of movement to respect the indis
thinkable precision.

- robustness combined with lightness for intensive use without
fatigue - resistance to different sterilization techniques.

- the ease of interchangeability of the fitted tubes.

The accompanying drawings illustrate the invention - plate I has two figures
Figure 1 is a side view of the handle consisting of
tube holder casing, containing the translation system and two bran
mobile ches with their hand grip rings
Figure 2 is a shell view of the assembly
constituting the handle, showing in detail the configuration
of its different components.

Plate II has a single figure
-representing in a view the handle completed with the rack system
for use as a gripper whose jaws must be blocked
on request, without modification of the translation system inside the
casing. Use in scissors does not require a locking rack
disengageable.

With reference to these drawings, the handle consists
an aluminum casing, treated by chemical hard chromium plating, formed of
2 parts (2 and 3) secured by 4 screws (4) holding the tube
translation by blocking with screws (7) and the axes of rotation (8)
movable arms, made of surgical stainless steel, with 4 hori rings
zontals.

- 2 toothed branches (1) acting simultaneously by pushing.
longitudinal placement of the rack (5) welded to the tube assembly
and cable (6 and 9 - These 2 branches (1) apart from the part inserted in the housing, are sloped so as to allow the forearm, handle and hand assembly a full 360 rotation of the instrument used.

 Strictly straight temples would have halved the desired travel and consequently the flexibility of use.

In addition, in the case of use for lockable grippers, the branches are completed - with a disengageable rack (13) incorporated in one of the branches and held by a pin (10) whose teeth are embedded in the branch opposite by pushing a leaf spring (12) held on a branch by a screw (11-) as well as 2 return springs (13 and 14)
This variant does not modify the mechanical part. Only the housing is shorter to save the location of the rack.

 We therefore have a handle adapted both to the use of laparoscopic surgery and to the position devoid of physiological constraint, now possible since the generation of laparoscopy on screen.

Claims (4)

 REiENDICATIONS  wrist.  to give the instrument thus equipped, a 360 rotation of the  relative to the plane passing through the rod of the instrument so  by the fact that the branches (1) which constitute them are sloping  ++++++++++++++ 1- Universal handle for characterized laparoscopic instrumentation 2- handle according to claim 1 characterized in that these two  branches are movable and toothed in order to simultaneously push a  stainless steel rack (5) fixed on the control cable (6)  jaws or blades inside a treated aluminum casing  in two parts (2 and 3) ensuring the maintenance of the axes of rotation (8)  movable arms and the blockage of the movement translation tube  by a screw (7). 3- handle according to claim 1 or 2 characterized in that it is  additionally equipped, according to the use of locking pliers, with a  stainless steel rack (13) actuated by a fixed leaf spring (12)  by a screw (11) on one of the movable branches and two others  spring blades fixed on the two arms (13 and 14) by 2 screws (15 & 1)  automatically discard these after disengaging the  rack. 4- Application according to any one of claims 1 to 3 to the  laparoscopic surgery on screen.