CA2161248A1 - Tissue resection forceps for treating teat canal stenoses - Google Patents
Tissue resection forceps for treating teat canal stenosesInfo
- Publication number
- CA2161248A1 CA2161248A1 CA 2161248 CA2161248A CA2161248A1 CA 2161248 A1 CA2161248 A1 CA 2161248A1 CA 2161248 CA2161248 CA 2161248 CA 2161248 A CA2161248 A CA 2161248A CA 2161248 A1 CA2161248 A1 CA 2161248A1
- Authority
- CA
- Canada
- Prior art keywords
- knife
- handgrip
- base body
- tissue resection
- legs
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61D—VETERINARY INSTRUMENTS, IMPLEMENTS, TOOLS, OR METHODS
- A61D1/00—Surgical instruments for veterinary use
- A61D1/02—Trocars or cannulas for teats; Vaccination appliances
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Wood Science & Technology (AREA)
- Zoology (AREA)
- Vascular Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgical Instruments (AREA)
Abstract
What is disclosed is a tissue resection forceps (1 ) for treating teat duct stenoses, having a handgrip part (8) comprising two handgrip legs (2, 3) that can be swiveled toward one another, a spring element (4) that presses the handgrip legs (2, 3) in their opening direction, and a cutting device (5) actuatable by means of the handgrip legs (2, 3). The forceps (1) is characterized in that the cutting device (5) has a base body (6) and a knife element (7) that is both axially displaceable therein and rotatable therein about its longitudinal axis, the anterior end of the knife element being embodied as a cutting edge (9) that cooperates with a knife stop face (21 ) of the base body (6), and the posterior end of the knife element being provided with a handle (10) for axial rotation of the knife element (7), and that the base body (6) in the region of its insertion end (19) is embodied essentially as a hollow cylinder with a lateral cutting opening (20), and that by pivoting the handgrip legs (2, 3 ) toward one another, the cutting edge (9) of the knife element (7) is variable in its position in the region of the aforementioned cutting opening (20). The tissue resection forceps (1) makes it possible to trimaway small portions of tissue while baring the adjacent regions of tissue.
Description
1. / G I ~ SL8 TISSUE RESECTION FORCEPS FOR TREATING TEAT DUCT STENOSES
Specification The invention relates to a tissue resection forceps for treating teat duct stenoses. The dairy cows, the problem of difficult milking occurs frequently. Inthat case, the milk can be extracted from the cow only by expending an undesirable amount of force and time. The problems in milk outflow can not only slow down lactation but can even interrupt it in part or entirely.
Milk outflow problems can occur at any point in the milk drainage system, which forms part of the udder of the dairy cow. The udder is a powerful glandular body made up of two anterior quarters and two posterior quarters. Each quarter is a complete mammary gland, with its own teat, sealed off entirely from the other quarters. Such a quarter is made up of a milk-forming glandular tissue and a milk-draining system. The latter comprises the smaller branches of the lactiferous ducts, the lactiferous ducts, the cisterna of the gland, the teat cisterna, and the teat duct.
Difficult milking can be caused by injuries, contusion and inflammations of the udder, and especially of the teat. In approximately 95% of the cases, the cause of difficult milking lies in the teat duct. Its length is approximately 8 to 14 mm.
Various medical methods and devices are known for treating difficult milking caused by teat problems, or for treating so-called teat stenosis. In the teat duct region, medically conservative, possibly surgical treatment must be done with the gentlest possible handling of the tissue in the teat duct, because each of thesekinds of treatment entails the danger of infection and hence the risk of udder inflammation.
~ ~ 6 ~ 8 Known devices for treating teat stenosis include among others the following:
1. Hug's teat ball (with which proliferative growths in the teat duct are nipped off over a broad surface area), 2. Hug's teat lancet (with which the teat duct is enlarged by cutting), 3. the double teat knife, Danish model (with which lengthwise incisions are made in the teat duct), 4. Chrestensan's teat duct scissors (with which lengthwise incisions are made in the teat duct), 5. Ullner's teat curette (with which proliferative growths in the teat duct are scraped off over a broad surface area, thus creating a large wound), 6. the teat reamer, French model (with which the teat stenosis is torn open, producing a large wound), 7. the device of German Patent DE-PS 869 532 for removing growths in the lactiferous duct (with which only relatively large-area incisions can be made in the teat duct, since the knife used engages teat duct tissue over the entire circumference of its cutting edge), 8. the forcepslike teat reamer of the type referred to at the outset in accordance with German Published, Non-examined Patent Disclosure DE-OS 15 41 239 (with which the teat stenosis is torn open, producing a large wound), and 9. the lancing knife for cow teats of German Patent DE-PS 346 011 (with which only relatively large-area incisions can be made in the teat duct, since the knife has a relatively long cutting opening on its side).
In addition to these devices for removing tissue in the teat duct, there are also so-called teat dilators, with which the inside diameter of the teat duct can be widened. However, this is often inadequate or brings about only brief improvement.
If the known devices are used for removing tissue, then they all have the disadvantage of making relatively g large wounds in the teat duct, because they are suitable only for tearing off tissue over a wide surface area but not for enabling purposeful trimming of small regions of tissue. This is true particularly for Hug's teat ball and for the device of German Patent 869 532; when the surgeon uses this, he pulls a cutting ball, introduced into the teat duct, in the direction of the outlet of the teat duct, and in so doing rips away tissue over a wide area along the inside wall of the teat duct.
The object of the invention is to disclose a tissue reactor for treating teat duct stenoses that is easy and safe to manipulate and that makes it possible in a targeted way to trim off small regions of tissue that constrict the teat duct without involving adjacent regions of tissue. Making the smallest possible incision wounds is important not only in order to keep the danger of infection to the dairy cow slight, but also in order to limit the animal's pain during and after the operation.
Moreover, less pain to the cow during the operation reduces the risk to the surgeon, since severe pain can cause the cow to become restless and kick during the operation. It should also be possible to design the tissue resector in such a way that it is easy to clean, so that it can be used many times over a long period of time, and so that in the event of wear or damage, the entire tissue resector will not become unusable but instead only the affected parts of it can be replaced.
The invention attains this object with a tissue resection forceps for treating teat duct stenoses, having a handgrip part comprising two handgrip legs that canbe swiveled toward one another, a spring element that presses the handgrip legs in their opening direction, and a cutting device actuatable by means of the handgrip legs.
The tissue resection forceps is characterized in that the cutting device has a base body and a knife element that is both axially displaceable therein and rotatable therein about its longitudinal axis, the anterior end of the knife element being embodied as a cutting edge that cooperates with a knife stop face of the base body, and the posterior end of the knife element being provided with a handle for axial rotation of the knife element, and that the base body in the region of its insertion and is embodied essentially as a hollow cylinder with a lateral cutting opening, and that by pivoting the handgrip legs toward one another, the cutting edge of the knife element can be varied in its position in the region of the aforementioned cutting opening .
Compared with the known devices, the tissue resection forceps of the invention has various advantages. For example, because of the two handgrip legs,it can be used very securely with one hand, and relatively short incisions can be made in an accurately targeted way, thus avoiding unnecessary large wounds in the teat duct. The goal of not involving healthy regions of tissue in the vicinity of the desired incisions is made substantially easier to reach because the cutting opening in the base body necessarily limits the surface area to be cut; that is, the cutting edge of the knife is exposed for cutting purposes only over a portion of the knife length.
In a preferred embodiment of the tissue resection forceps, the base body of the cutting device is detachably joined to the handgrip part. This not only facilitates cleaning of the forceps but also makes it possible as needed for an initially installed cutting device to be rapidly replaced, during the operation, with a different cutting device having different knife dimensions.
In a suitable embodiment of the tissue resection forceps, the base body has at least one connecting protrusion, which can be secured to one of the handgrip legs by means of a locking screw. This type of connection has the advantage thatit can be made and undone quickly ~ G I ~'~
and easily, and that the forceps functions reliably even after frequent use.
In a special feature of the tissue resection forceps, one of the handgrip legs has a coupling element, which releasably reaches into a recess of the knife element through a lateral longitudinal opening in the base body. As a result, with a cutting device mounted on the handgrip legs, the transmission of force betweenthe handgrip leg and the knife element is assured, and at the same time easy disconnection of the two parts from one another becomes possible as needed.
It has also proved to be expedient to embody the coupling element of the handgrip leg as a slaving pin, and to embody the recess of the knife element as a circumferential groove. Such an embodiment not only enables a secure, nonpositive connection between the handgrip leg and the knife element and rapid disconnection of the two from one another, but also makes it possible to rotate the knife element axially as well during the cutting process, without interrupting the nonpositive engagement between the handgrip leg and the knife element.
It is also favorable if the knife element has a posterior knife guiding part andan anterior tubular knife part detachably joined to it. As a result, the knife itself, or in other words the anterior tubular knife part with the cutting edge, can either be removed for cleaning or after being worn down can be replaced for a new or a resharpened tubular knife part. Moreover, the anterior tubular knife part has the advantage of being hollow on the inside, and in its cavity it can therefore hold a larger amount of the tissue parts that have beentrimmed away from the teat duct;multiple incisions can then be made in succession without having to pull the knife element out of the teat duct for removal of the trimmed-away tissue parts beforereinserting it.
~/6/~
In practice it is advantageous if a length scale for measuring the depth of penetration of the base body into the teat duct to be treated is provided on theoutside of the anterior region of the base body. This makes it easy to gauge thelocation of the point in the teat duct that is to be cut.
Preferably, the knife element has an axial bore, which extends continuously from the cutting edge to the posterior end of the knife element, where it ends in an opening. On the one hand, this creates a long cavity for holding trimmed-off tissue parts, and the cavity is also easily cleaned. On the other hand, the axial bore thus also acts as a supply conduit, making it possible for a line for introducing a gas, such as compressed air, or a liquid, such as a cleaning, disinfecting or therapeutically effective liquid to be attached to the aforementioned opening at the posterior end of the knife element. The gas or the particular liquid can flow through the axial bore of the knife element and emerge again at the anterior end thereof in the region of the cutting edge.
In another useful feature of the invention, a knife blade is detachably joined to a guide body of the base body. This has the advantage not only that the knifeblade is removable and thus can be cleaned more easily but also that it can be removed and replaced with a knife blade of a different size. For example, it is advantageous to have a number of interchangeable knife bladesavailable for the tissue resection forceps, with the various blades having cutting openings of different sizes. The length of the cutting opening in the axial direction of the knife blade is preferably from 3 to 7 mm, preferably 4 to 6 mm. As a result, the cutting opening can be adapted to the size of the tissue region to be trimmed away in the teat duct. In particular, this also increases safety in the manipulation of the tissue resection forceps. For instance, a cutting ~,~G I ~
opening with a length of 4 mm is already small enough that even of the tissue resection forceps is not manipulated in a skilled way, the teat duct cannot be injured to an undesirable extent.
The replaceable knife blades may also have different outside diameters.
Preferably, this diameter is in the range from 2.5 to 4.0 mm and in particular from 2.9 to 3.8 mm.
When one knife blade is replaced with one of a different size, it may be expedient at the same time to replace the anterior tubular knife part of the knife element with a different tubular knife part adapted to the dimensions of the newknife blade.
Correspondingly, it is naturally possible, instead of replacing only the knife blade and possibly additionally the anterior tubular knife part, to replace the entire component instead, namely the entire base body and optionally the entire knife element, so that the desired size of knife blade, of its recess, and optionally of the tubular knife part adapted to it as well, can be kept available.
The detachable or releasable connection between the knife blade and the guide body of the base body is preferably a screw connection. A connection in the form of a bayonet mount has also proved to be favorable. Other types of connections, such as conventional snap connections, can also be used.
The invention is described below in terms of an exemplary embodiment schematically shown in the drawing. Shown are Fig. 1, a tissue resection forceps ready for use;
Fig. 2, the tissue resection forceps of Fig. 1 with the cutting device removed, the cutting device being broken down into the base body and the knife element;
Fig. 3, the knife element shown in Fig. 2, with the ~/G /~S~
knife guide part and tubular knife part separated; and Fig. 4, a tissue resection forceps similar to Fig. 1, but with a screw connection between the knife blade and the guide body of the base body.
In Fig. 1, the tissue resection forceps 1 essentially has two handgrip legs 2, 3 that can be swiveled toward one another, a spring element 4 that presses thesehandgrip legs 2, 3 in their opening direction, and a cutting device 5 that is actuatable by means of the handgrip legs 2, 3.
The cutting device 5 is equipped with a base body 6 and with a knife element 7 that is both axially displaceable and rotatable about its longitudinal axis in the base body.
As Fig. 2 shows, the tissue resection forceps 1 is composed of a handgrip part 8, which encompasses the handgrip legs 2, 3, and of the base body 6 and theknife element 7.
On the knife element 7, its anterior end is embodied as a cutting edge 9, and its posterior end is provided with a handle 10 in the form of a radially protruding pin. The handle 10 may also be embodied in some other way that enables easy axial rotation of the knife element 7.
The knife element 7 substantially comprises a posterior knife guide part 7a and an anterior tubular knife part 7b. These two parts 7a, 7b are axially screwed to one another via a thread 11 for cleaning purposes and for the sake of easy replacement of the tubular knife part 7b, as can be seen in Fig. 3, which shows the two parts 7a, 7b separated from one another. In the state of the tissue resection forceps 1 in which it is ready for use (Fig. 1), the knife element 7 is disposed axially in the base body 6. For guiding the motion of the knife element 7 in the base body 6, both in the axial direction and upon a rotation of the knifeelement 7 about its longitudinal axis, at least one guide face on the circumference of the posterior knife ~/6~
guide part 7a is employed. In the drawing, three guide faces 1 2a, 1 2b, 1 2c are shown. These are jacket faces of the knife element 7, which over the great majority of its length is rotationally symmetrical. In the region of the guide faces 1 2a, 1 2b, 1 2c, the knife element 7 has an outer diameter that is only slightly smaller than the inside diameter of the associated portion of the base body 6. In addition, the posterior knife guide part 7a is provided approximately halfway along its length with a circumferential groove 13, whose functional will be described hereinafter.
In the embodiment described, the diameter of the anterior tubular knife part 7b is smaller than that of the posterior knife guide part 7a in the region of the guide faces 1 2, 1 2b, 1 2c. However, it is not absolutely necessary for the posterior knife guide part 7a to have a larger diameter than the anterior tubular knife part 7b.
It can also be seen from Fig. 2 that the knife element 7 has an axial bore 7c, which extends continuously from the cutting edge to the posterior end 7d, where it ends in an opening 7e. A line for supplying a gas or a liquid, which then emerges from the knife element again in the region of the cutting edge 9, can beconnected to this opening as needed.
In Fig. 2, the base body comprises a hollow-cylindrical guide body 15 for receiving the posterior knife guide part 7a of the knife element 7; a hollow-cylindrical knife blade 16 for receiving the anterior tubular knife part 7b of the knife element 7; and two connecting protrusions 17, 18, aimed parallel to one another, for effecting a connection with the handgrip leg 2. In the region of the insertion end 19 of the base body 6, a lateral cutting opening 20 is provided. It is embodied by having the hollow-cylindrical knife blade 16 open in its region, over a certain lengthwise segment and over a circumferential angle range of approximately 180. If the knife element 7 is located in the base body 6 when the tissue resection forceps 1 is ready for use,the cutting edge 9 of the knife element 7 is variable in its position in the region of the cutting opening 20 both axially and in the sense of a rotation about its longitudinal axis. For the cutting operation, the cutting edge 9 of the knife element 7 cooperates with a knife stop face 21, opposite it, of the knife blade 16 within the cutting opening 20 (Fig. 1).
On the outside of the knife blade 16, a length scale 22 is provided for measuring the depth to which the knife blade 16 is inserted into the teat duct to be treated (Fig. 2). Alternatively or simultaneously, markings may also be provided there that indicate dimensions, such as the diameter of the knife blade 16.
The base body 6 has a longitudinal opening 23 in the guide body 15; this opening extends essentially in the same direction as the connecting protrusions 17, 18.
The base body 6 of the cutting device 5 is releasably connected to the handgrip part 8. This purpose is served by the connecting protrusions 17, 18, which when the base body 6 is mounted on the handgrip part 8 are received on the top thereof by corresponding bores in the one handgrip leg 2. The connectingprotrusions 17, 18 are secured in the aforementioned bores of the handgrip leg 2by means of locking screws 24, 25. The locking screws 24, 25 are tightened against the inserted connecting protrusion 17 from one side of the handgrip leg 2.
for the sake of easy, fast actuation of them with the bare fingers, the locking screws 24, 25 have sufficiently large heads with appropriate knurling on the periphery.
While one handgrip leg 2 is equipped with the aforementioned locking screws 24, 25 and can thus be firmly joined to the base body 6 of the cutting device 5, the ~ ~6 ~
other handgrip leg 3 is equipped with a slaving pin 26 on its end towards the base body 6. Once the cutting device 5 is mounted on the handgrip part 8, or in otherwords once the base body 6 is secured on the handgrip leg 2, the slaving pin 26 protrudes through the longitudinal opening 23 in the base body 6 as far as the inside of the circumferential groove 13 of the knife element 7. The slaving pin 26 thus acts as a coupling element between the handgrip part 8 and the cutting device 5.
The one handgrip leg 2 is provided with a protrusion 27, oriented toward the outside of the tissue resection forceps 1, in order to provide a secure hold on the handgrip part 8 for the hand of the surgeon. A similar protrusion may also be provided on the other handgrip leg.
The spring element 4, in the form of two leaf springs 30, 31, is secured to the inside of each handgrip leg 2, 3 by means of a respective fastening screw 28, 29. This fastening takes place in each case on one end of the leaf springs 30, 31.
On their other two ends, they intersect within the opening angle of the handgriplegs 2, 3 on the side toward the pivot point 32 of these legs 2, 3. At the intersection point 33 of the leaf springs 30, 31, they are braced against one another under tension. As a result, the handgrip legs 2, 3 are pressed into their opening position. Alternatively, the leaf springs 30, 31 may be replaced by a corresponding, identically functioning spring element. An example of one possibility for this helical spring, which is braced between an end face 34 of the posterior knife guide part 7a and an anterior radical inner face 35 of the hollow-cylindrical guide body 15 (Fig. 2).
Fig. 4 shows a special and preferred embodiment of the tissue resection forceps 1, in which the knife blade 16 is joined to the guide body 15 of the base body 6 by means of a screw connection. This connection is realized by means ~ ~G/~
of a male thread 36 on the posterior end of the knife blade 16 and a corresponding counterpart female thread in the anterior end of the guide body 15 of the base body 6. The knife blade 16 can thus be unscrewed from the guide body 15 as needed and replaced by another knife blade 16 having the same male thread 36, but with a different length of cutting opening 20 and/or with a different knife blade diameter.
To use the tissue cutter (1 ) according to the invention, the anterior tubular knife part 7b is screwed into the posterior knife guide part 7a. The knife element 7 thus obtained is inserted into the base body 6. The cutting device 5 thus assembled is mounted on the handgrip part 8 in such a way that the connecting protrusions 17, 18 engage the corresponding bores in the handgrip leg 2. During this mounting process, the knife element 7 is located in side the base body 6, in a position in which the slaving pin 26 of the handgrip leg 3 can engage the circumferential groove 13 of the knife element 7. Next, the connecting protrusions 17, 18 are locked by tightening the locking screws 24, 25 on the handgrip part 8.
If the one handgrip leg 3 is now pivoted toward the other handgrip leg 2, the slaving pin 26 transmits this motion to the knife element 7. As a result, the cutting edge 15 of the anterior tubular knife part 7b is moved in the cutting opening 20 of the knife blade 16 in the direction of the knife stop face 21.
To treat a teat duct stenosis in a dairy dow, the surgeon, with the handgrip legs 2, 3 opened in accordance with the spring action, inserts the interior end 19 of the cutting device 5 into the teat duct until the cutting opening 20 is located next to the region of tissue that is to be trimmed away. Pressing on the outside of the teat promotes the movement of the tissue into the cutting opening 20. by compressing the handgrip legs 2, 3 and simultaneously rotating the Icnife element 7 using the 2l G /~
handle 10, the tissue that is protruding into the cutting opening 20 is cleanly severed between the cutting edge 9 and the knife stop face 21. Adjacent regions of tissue, and in particular the tissue not located in the region of the cuttingopening 20, are spared or in other words are neither nicked nor torn open.
To adapt the tissue resection forceps 1 to the size of the tissue region to be cut away in the teat duct and/or to the diameter of the teat duct, in the embodiment of Fig. 4 the knife blade 16 can be unscrewed from the guide body 15 of the base body 6 and replaced with a different knife blade 16 having the desired length of the cutting opening 20 and/or the desired knife blade diameter.
Specification The invention relates to a tissue resection forceps for treating teat duct stenoses. The dairy cows, the problem of difficult milking occurs frequently. Inthat case, the milk can be extracted from the cow only by expending an undesirable amount of force and time. The problems in milk outflow can not only slow down lactation but can even interrupt it in part or entirely.
Milk outflow problems can occur at any point in the milk drainage system, which forms part of the udder of the dairy cow. The udder is a powerful glandular body made up of two anterior quarters and two posterior quarters. Each quarter is a complete mammary gland, with its own teat, sealed off entirely from the other quarters. Such a quarter is made up of a milk-forming glandular tissue and a milk-draining system. The latter comprises the smaller branches of the lactiferous ducts, the lactiferous ducts, the cisterna of the gland, the teat cisterna, and the teat duct.
Difficult milking can be caused by injuries, contusion and inflammations of the udder, and especially of the teat. In approximately 95% of the cases, the cause of difficult milking lies in the teat duct. Its length is approximately 8 to 14 mm.
Various medical methods and devices are known for treating difficult milking caused by teat problems, or for treating so-called teat stenosis. In the teat duct region, medically conservative, possibly surgical treatment must be done with the gentlest possible handling of the tissue in the teat duct, because each of thesekinds of treatment entails the danger of infection and hence the risk of udder inflammation.
~ ~ 6 ~ 8 Known devices for treating teat stenosis include among others the following:
1. Hug's teat ball (with which proliferative growths in the teat duct are nipped off over a broad surface area), 2. Hug's teat lancet (with which the teat duct is enlarged by cutting), 3. the double teat knife, Danish model (with which lengthwise incisions are made in the teat duct), 4. Chrestensan's teat duct scissors (with which lengthwise incisions are made in the teat duct), 5. Ullner's teat curette (with which proliferative growths in the teat duct are scraped off over a broad surface area, thus creating a large wound), 6. the teat reamer, French model (with which the teat stenosis is torn open, producing a large wound), 7. the device of German Patent DE-PS 869 532 for removing growths in the lactiferous duct (with which only relatively large-area incisions can be made in the teat duct, since the knife used engages teat duct tissue over the entire circumference of its cutting edge), 8. the forcepslike teat reamer of the type referred to at the outset in accordance with German Published, Non-examined Patent Disclosure DE-OS 15 41 239 (with which the teat stenosis is torn open, producing a large wound), and 9. the lancing knife for cow teats of German Patent DE-PS 346 011 (with which only relatively large-area incisions can be made in the teat duct, since the knife has a relatively long cutting opening on its side).
In addition to these devices for removing tissue in the teat duct, there are also so-called teat dilators, with which the inside diameter of the teat duct can be widened. However, this is often inadequate or brings about only brief improvement.
If the known devices are used for removing tissue, then they all have the disadvantage of making relatively g large wounds in the teat duct, because they are suitable only for tearing off tissue over a wide surface area but not for enabling purposeful trimming of small regions of tissue. This is true particularly for Hug's teat ball and for the device of German Patent 869 532; when the surgeon uses this, he pulls a cutting ball, introduced into the teat duct, in the direction of the outlet of the teat duct, and in so doing rips away tissue over a wide area along the inside wall of the teat duct.
The object of the invention is to disclose a tissue reactor for treating teat duct stenoses that is easy and safe to manipulate and that makes it possible in a targeted way to trim off small regions of tissue that constrict the teat duct without involving adjacent regions of tissue. Making the smallest possible incision wounds is important not only in order to keep the danger of infection to the dairy cow slight, but also in order to limit the animal's pain during and after the operation.
Moreover, less pain to the cow during the operation reduces the risk to the surgeon, since severe pain can cause the cow to become restless and kick during the operation. It should also be possible to design the tissue resector in such a way that it is easy to clean, so that it can be used many times over a long period of time, and so that in the event of wear or damage, the entire tissue resector will not become unusable but instead only the affected parts of it can be replaced.
The invention attains this object with a tissue resection forceps for treating teat duct stenoses, having a handgrip part comprising two handgrip legs that canbe swiveled toward one another, a spring element that presses the handgrip legs in their opening direction, and a cutting device actuatable by means of the handgrip legs.
The tissue resection forceps is characterized in that the cutting device has a base body and a knife element that is both axially displaceable therein and rotatable therein about its longitudinal axis, the anterior end of the knife element being embodied as a cutting edge that cooperates with a knife stop face of the base body, and the posterior end of the knife element being provided with a handle for axial rotation of the knife element, and that the base body in the region of its insertion and is embodied essentially as a hollow cylinder with a lateral cutting opening, and that by pivoting the handgrip legs toward one another, the cutting edge of the knife element can be varied in its position in the region of the aforementioned cutting opening .
Compared with the known devices, the tissue resection forceps of the invention has various advantages. For example, because of the two handgrip legs,it can be used very securely with one hand, and relatively short incisions can be made in an accurately targeted way, thus avoiding unnecessary large wounds in the teat duct. The goal of not involving healthy regions of tissue in the vicinity of the desired incisions is made substantially easier to reach because the cutting opening in the base body necessarily limits the surface area to be cut; that is, the cutting edge of the knife is exposed for cutting purposes only over a portion of the knife length.
In a preferred embodiment of the tissue resection forceps, the base body of the cutting device is detachably joined to the handgrip part. This not only facilitates cleaning of the forceps but also makes it possible as needed for an initially installed cutting device to be rapidly replaced, during the operation, with a different cutting device having different knife dimensions.
In a suitable embodiment of the tissue resection forceps, the base body has at least one connecting protrusion, which can be secured to one of the handgrip legs by means of a locking screw. This type of connection has the advantage thatit can be made and undone quickly ~ G I ~'~
and easily, and that the forceps functions reliably even after frequent use.
In a special feature of the tissue resection forceps, one of the handgrip legs has a coupling element, which releasably reaches into a recess of the knife element through a lateral longitudinal opening in the base body. As a result, with a cutting device mounted on the handgrip legs, the transmission of force betweenthe handgrip leg and the knife element is assured, and at the same time easy disconnection of the two parts from one another becomes possible as needed.
It has also proved to be expedient to embody the coupling element of the handgrip leg as a slaving pin, and to embody the recess of the knife element as a circumferential groove. Such an embodiment not only enables a secure, nonpositive connection between the handgrip leg and the knife element and rapid disconnection of the two from one another, but also makes it possible to rotate the knife element axially as well during the cutting process, without interrupting the nonpositive engagement between the handgrip leg and the knife element.
It is also favorable if the knife element has a posterior knife guiding part andan anterior tubular knife part detachably joined to it. As a result, the knife itself, or in other words the anterior tubular knife part with the cutting edge, can either be removed for cleaning or after being worn down can be replaced for a new or a resharpened tubular knife part. Moreover, the anterior tubular knife part has the advantage of being hollow on the inside, and in its cavity it can therefore hold a larger amount of the tissue parts that have beentrimmed away from the teat duct;multiple incisions can then be made in succession without having to pull the knife element out of the teat duct for removal of the trimmed-away tissue parts beforereinserting it.
~/6/~
In practice it is advantageous if a length scale for measuring the depth of penetration of the base body into the teat duct to be treated is provided on theoutside of the anterior region of the base body. This makes it easy to gauge thelocation of the point in the teat duct that is to be cut.
Preferably, the knife element has an axial bore, which extends continuously from the cutting edge to the posterior end of the knife element, where it ends in an opening. On the one hand, this creates a long cavity for holding trimmed-off tissue parts, and the cavity is also easily cleaned. On the other hand, the axial bore thus also acts as a supply conduit, making it possible for a line for introducing a gas, such as compressed air, or a liquid, such as a cleaning, disinfecting or therapeutically effective liquid to be attached to the aforementioned opening at the posterior end of the knife element. The gas or the particular liquid can flow through the axial bore of the knife element and emerge again at the anterior end thereof in the region of the cutting edge.
In another useful feature of the invention, a knife blade is detachably joined to a guide body of the base body. This has the advantage not only that the knifeblade is removable and thus can be cleaned more easily but also that it can be removed and replaced with a knife blade of a different size. For example, it is advantageous to have a number of interchangeable knife bladesavailable for the tissue resection forceps, with the various blades having cutting openings of different sizes. The length of the cutting opening in the axial direction of the knife blade is preferably from 3 to 7 mm, preferably 4 to 6 mm. As a result, the cutting opening can be adapted to the size of the tissue region to be trimmed away in the teat duct. In particular, this also increases safety in the manipulation of the tissue resection forceps. For instance, a cutting ~,~G I ~
opening with a length of 4 mm is already small enough that even of the tissue resection forceps is not manipulated in a skilled way, the teat duct cannot be injured to an undesirable extent.
The replaceable knife blades may also have different outside diameters.
Preferably, this diameter is in the range from 2.5 to 4.0 mm and in particular from 2.9 to 3.8 mm.
When one knife blade is replaced with one of a different size, it may be expedient at the same time to replace the anterior tubular knife part of the knife element with a different tubular knife part adapted to the dimensions of the newknife blade.
Correspondingly, it is naturally possible, instead of replacing only the knife blade and possibly additionally the anterior tubular knife part, to replace the entire component instead, namely the entire base body and optionally the entire knife element, so that the desired size of knife blade, of its recess, and optionally of the tubular knife part adapted to it as well, can be kept available.
The detachable or releasable connection between the knife blade and the guide body of the base body is preferably a screw connection. A connection in the form of a bayonet mount has also proved to be favorable. Other types of connections, such as conventional snap connections, can also be used.
The invention is described below in terms of an exemplary embodiment schematically shown in the drawing. Shown are Fig. 1, a tissue resection forceps ready for use;
Fig. 2, the tissue resection forceps of Fig. 1 with the cutting device removed, the cutting device being broken down into the base body and the knife element;
Fig. 3, the knife element shown in Fig. 2, with the ~/G /~S~
knife guide part and tubular knife part separated; and Fig. 4, a tissue resection forceps similar to Fig. 1, but with a screw connection between the knife blade and the guide body of the base body.
In Fig. 1, the tissue resection forceps 1 essentially has two handgrip legs 2, 3 that can be swiveled toward one another, a spring element 4 that presses thesehandgrip legs 2, 3 in their opening direction, and a cutting device 5 that is actuatable by means of the handgrip legs 2, 3.
The cutting device 5 is equipped with a base body 6 and with a knife element 7 that is both axially displaceable and rotatable about its longitudinal axis in the base body.
As Fig. 2 shows, the tissue resection forceps 1 is composed of a handgrip part 8, which encompasses the handgrip legs 2, 3, and of the base body 6 and theknife element 7.
On the knife element 7, its anterior end is embodied as a cutting edge 9, and its posterior end is provided with a handle 10 in the form of a radially protruding pin. The handle 10 may also be embodied in some other way that enables easy axial rotation of the knife element 7.
The knife element 7 substantially comprises a posterior knife guide part 7a and an anterior tubular knife part 7b. These two parts 7a, 7b are axially screwed to one another via a thread 11 for cleaning purposes and for the sake of easy replacement of the tubular knife part 7b, as can be seen in Fig. 3, which shows the two parts 7a, 7b separated from one another. In the state of the tissue resection forceps 1 in which it is ready for use (Fig. 1), the knife element 7 is disposed axially in the base body 6. For guiding the motion of the knife element 7 in the base body 6, both in the axial direction and upon a rotation of the knifeelement 7 about its longitudinal axis, at least one guide face on the circumference of the posterior knife ~/6~
guide part 7a is employed. In the drawing, three guide faces 1 2a, 1 2b, 1 2c are shown. These are jacket faces of the knife element 7, which over the great majority of its length is rotationally symmetrical. In the region of the guide faces 1 2a, 1 2b, 1 2c, the knife element 7 has an outer diameter that is only slightly smaller than the inside diameter of the associated portion of the base body 6. In addition, the posterior knife guide part 7a is provided approximately halfway along its length with a circumferential groove 13, whose functional will be described hereinafter.
In the embodiment described, the diameter of the anterior tubular knife part 7b is smaller than that of the posterior knife guide part 7a in the region of the guide faces 1 2, 1 2b, 1 2c. However, it is not absolutely necessary for the posterior knife guide part 7a to have a larger diameter than the anterior tubular knife part 7b.
It can also be seen from Fig. 2 that the knife element 7 has an axial bore 7c, which extends continuously from the cutting edge to the posterior end 7d, where it ends in an opening 7e. A line for supplying a gas or a liquid, which then emerges from the knife element again in the region of the cutting edge 9, can beconnected to this opening as needed.
In Fig. 2, the base body comprises a hollow-cylindrical guide body 15 for receiving the posterior knife guide part 7a of the knife element 7; a hollow-cylindrical knife blade 16 for receiving the anterior tubular knife part 7b of the knife element 7; and two connecting protrusions 17, 18, aimed parallel to one another, for effecting a connection with the handgrip leg 2. In the region of the insertion end 19 of the base body 6, a lateral cutting opening 20 is provided. It is embodied by having the hollow-cylindrical knife blade 16 open in its region, over a certain lengthwise segment and over a circumferential angle range of approximately 180. If the knife element 7 is located in the base body 6 when the tissue resection forceps 1 is ready for use,the cutting edge 9 of the knife element 7 is variable in its position in the region of the cutting opening 20 both axially and in the sense of a rotation about its longitudinal axis. For the cutting operation, the cutting edge 9 of the knife element 7 cooperates with a knife stop face 21, opposite it, of the knife blade 16 within the cutting opening 20 (Fig. 1).
On the outside of the knife blade 16, a length scale 22 is provided for measuring the depth to which the knife blade 16 is inserted into the teat duct to be treated (Fig. 2). Alternatively or simultaneously, markings may also be provided there that indicate dimensions, such as the diameter of the knife blade 16.
The base body 6 has a longitudinal opening 23 in the guide body 15; this opening extends essentially in the same direction as the connecting protrusions 17, 18.
The base body 6 of the cutting device 5 is releasably connected to the handgrip part 8. This purpose is served by the connecting protrusions 17, 18, which when the base body 6 is mounted on the handgrip part 8 are received on the top thereof by corresponding bores in the one handgrip leg 2. The connectingprotrusions 17, 18 are secured in the aforementioned bores of the handgrip leg 2by means of locking screws 24, 25. The locking screws 24, 25 are tightened against the inserted connecting protrusion 17 from one side of the handgrip leg 2.
for the sake of easy, fast actuation of them with the bare fingers, the locking screws 24, 25 have sufficiently large heads with appropriate knurling on the periphery.
While one handgrip leg 2 is equipped with the aforementioned locking screws 24, 25 and can thus be firmly joined to the base body 6 of the cutting device 5, the ~ ~6 ~
other handgrip leg 3 is equipped with a slaving pin 26 on its end towards the base body 6. Once the cutting device 5 is mounted on the handgrip part 8, or in otherwords once the base body 6 is secured on the handgrip leg 2, the slaving pin 26 protrudes through the longitudinal opening 23 in the base body 6 as far as the inside of the circumferential groove 13 of the knife element 7. The slaving pin 26 thus acts as a coupling element between the handgrip part 8 and the cutting device 5.
The one handgrip leg 2 is provided with a protrusion 27, oriented toward the outside of the tissue resection forceps 1, in order to provide a secure hold on the handgrip part 8 for the hand of the surgeon. A similar protrusion may also be provided on the other handgrip leg.
The spring element 4, in the form of two leaf springs 30, 31, is secured to the inside of each handgrip leg 2, 3 by means of a respective fastening screw 28, 29. This fastening takes place in each case on one end of the leaf springs 30, 31.
On their other two ends, they intersect within the opening angle of the handgriplegs 2, 3 on the side toward the pivot point 32 of these legs 2, 3. At the intersection point 33 of the leaf springs 30, 31, they are braced against one another under tension. As a result, the handgrip legs 2, 3 are pressed into their opening position. Alternatively, the leaf springs 30, 31 may be replaced by a corresponding, identically functioning spring element. An example of one possibility for this helical spring, which is braced between an end face 34 of the posterior knife guide part 7a and an anterior radical inner face 35 of the hollow-cylindrical guide body 15 (Fig. 2).
Fig. 4 shows a special and preferred embodiment of the tissue resection forceps 1, in which the knife blade 16 is joined to the guide body 15 of the base body 6 by means of a screw connection. This connection is realized by means ~ ~G/~
of a male thread 36 on the posterior end of the knife blade 16 and a corresponding counterpart female thread in the anterior end of the guide body 15 of the base body 6. The knife blade 16 can thus be unscrewed from the guide body 15 as needed and replaced by another knife blade 16 having the same male thread 36, but with a different length of cutting opening 20 and/or with a different knife blade diameter.
To use the tissue cutter (1 ) according to the invention, the anterior tubular knife part 7b is screwed into the posterior knife guide part 7a. The knife element 7 thus obtained is inserted into the base body 6. The cutting device 5 thus assembled is mounted on the handgrip part 8 in such a way that the connecting protrusions 17, 18 engage the corresponding bores in the handgrip leg 2. During this mounting process, the knife element 7 is located in side the base body 6, in a position in which the slaving pin 26 of the handgrip leg 3 can engage the circumferential groove 13 of the knife element 7. Next, the connecting protrusions 17, 18 are locked by tightening the locking screws 24, 25 on the handgrip part 8.
If the one handgrip leg 3 is now pivoted toward the other handgrip leg 2, the slaving pin 26 transmits this motion to the knife element 7. As a result, the cutting edge 15 of the anterior tubular knife part 7b is moved in the cutting opening 20 of the knife blade 16 in the direction of the knife stop face 21.
To treat a teat duct stenosis in a dairy dow, the surgeon, with the handgrip legs 2, 3 opened in accordance with the spring action, inserts the interior end 19 of the cutting device 5 into the teat duct until the cutting opening 20 is located next to the region of tissue that is to be trimmed away. Pressing on the outside of the teat promotes the movement of the tissue into the cutting opening 20. by compressing the handgrip legs 2, 3 and simultaneously rotating the Icnife element 7 using the 2l G /~
handle 10, the tissue that is protruding into the cutting opening 20 is cleanly severed between the cutting edge 9 and the knife stop face 21. Adjacent regions of tissue, and in particular the tissue not located in the region of the cuttingopening 20, are spared or in other words are neither nicked nor torn open.
To adapt the tissue resection forceps 1 to the size of the tissue region to be cut away in the teat duct and/or to the diameter of the teat duct, in the embodiment of Fig. 4 the knife blade 16 can be unscrewed from the guide body 15 of the base body 6 and replaced with a different knife blade 16 having the desired length of the cutting opening 20 and/or the desired knife blade diameter.
Claims (10)
1. A tissue resection forceps (1 ) for treating teat duct stenoses, having a handgrip part (8) comprising two handgrip legs (2, 3) that can be swiveled toward one another, a spring element (4) that presses the handgrip legs (2, 3) in their opening direction, and a cutting device (5) actuatable by means of the handgrip legs (2, 3), characterized in that the cutting device (5) has a base body (6) and a knife element (7) that is both axially displaceable therein and rotatable therein about its longitudinal axis, the anterior end of the knife element beingembodied as a cutting edge (9) that cooperates with a knife stop face (21 ) of the base body (6), and the posterior end of the knife element being provided with a handle (10) for axial rotation of the knife element (7), and that the base body (6) in the region of its insertion and (19) is embodied essentially as a hollow cylinder with a lateral cutting opening (20), and that by pivoting the handgrip legs (2, 3) toward one another, the cutting edge (9) of the knife element (7) is variable in its position in the region of the aforementioned cutting opening (20).
2. The tissue resection forceps (1) of claim 1, characterized in that the base body (6) of the cutting device (5) is detachably joined to the handgrip part (8).
3. The tissue resection forceps (1) of claim 2, characterized in that the base body (6) has at least one connecting protrusion (17, 18), which can be secured to one of the handgrip legs (2, 3) by means of a locking screw (24, 25).
4. The tissue resection forceps (1) of one of claims 1-3, characterized in that one of the handgrip legs (3) has a coupling element (26), which releasably reaches into a recess (13) of the knife element (7) through a lateral longitudinal opening (23) in the base body (6).
5. The tissue resection forceps (1) of claim 4, characterized in that the coupling element (26) of the handgrip leg (3) is a slaving pin, and the recess (13) of the knife element (7) is a circumferential groove.
6. The tissue resection forceps (1) of one of claims 1-5, characterized in that the knife element (7) has a posterior knife guiding part (7a) and an anterior tubular knife part (7b) detachably joined to it.
7. The tissue resection forceps (1) of one of claims 1-6, characterized in that a length scale (22) for measuring depth of penetration of the base body (6)into the teat duct to be treated is provided on the outside of the anterior region of the base body (6).
8. The tissue resection forceps (1) of one of claims 1-7, characterized in that the knife element (7) has an axial bore (7c), which extends continuously from the cutting edge (9) to the posterior end (7d) of the knife element (7), where it ends in an opening (7e).
9. The tissue resection forceps (1) of one of claims 1-8, characterized in that a knife blade (16) is detachably joined to a guide body (15) of the base body (6).
10. The tissue resection forceps (1) of claim 9, characterized in that the knife blade (16) is joined to the guide body (15) by means of a screw connection.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE19944406045 DE4406045C1 (en) | 1994-02-24 | 1994-02-24 | Tissue resector forceps for the treatment of streak canal stenoses |
| DEP4406045.9 | 1994-02-24 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2161248A1 true CA2161248A1 (en) | 1995-08-31 |
Family
ID=6511136
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA 2161248 Abandoned CA2161248A1 (en) | 1994-02-24 | 1995-02-20 | Tissue resection forceps for treating teat canal stenoses |
Country Status (4)
| Country | Link |
|---|---|
| EP (1) | EP0695151A1 (en) |
| CA (1) | CA2161248A1 (en) |
| DE (1) | DE4406045C1 (en) |
| WO (1) | WO1995022943A1 (en) |
Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE19703698C1 (en) * | 1997-01-31 | 1999-01-28 | Maximilian Dr Medl | Stenosis punch |
| US8628557B2 (en) * | 2011-07-11 | 2014-01-14 | Covidien Lp | Surgical forceps |
| RU2608623C1 (en) * | 2015-10-20 | 2017-01-23 | Общество с ограниченной ответственностью "Хирургические инновационные технологии" (ООО "Хирургические инновационные технологии") | Replaceable head piece to electrode-knife of placemaker for dissection of cicatricial tissues surrounding the extravascular fragment of placemaker electrode (versions) |
Family Cites Families (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE346011C (en) * | ||||
| US1663761A (en) * | 1927-02-07 | 1928-03-27 | George A Johnson | Surgical instrument |
| DE869532C (en) * | 1951-07-05 | 1953-03-05 | Walter Pioch | Device for removing growth in the milk duct from cows |
| BE665788A (en) * | 1965-06-22 | 1965-10-18 | ||
| US4667684A (en) * | 1985-02-08 | 1987-05-26 | Bio-Medical Resources, Inc. | Biopsy device |
| WO1989010091A1 (en) * | 1988-04-19 | 1989-11-02 | Zalaform Kft. | Device for taking specimens, in particular for histological examination of human organs |
| SE462916B (en) * | 1989-10-17 | 1990-09-17 | Tripple L Lab Ab | DEVICE AND PROCEDURE FOR SAMPLING FROM DENTAL POCKETS AND A SAMPLE SUGGESTED |
| US5222965A (en) * | 1991-09-06 | 1993-06-29 | Donald Haughton | Teat knife |
-
1994
- 1994-02-24 DE DE19944406045 patent/DE4406045C1/en not_active Expired - Fee Related
-
1995
- 1995-02-20 CA CA 2161248 patent/CA2161248A1/en not_active Abandoned
- 1995-02-20 WO PCT/EP1995/000610 patent/WO1995022943A1/en not_active Application Discontinuation
- 1995-02-20 EP EP95909749A patent/EP0695151A1/en not_active Withdrawn
Also Published As
| Publication number | Publication date |
|---|---|
| EP0695151A1 (en) | 1996-02-07 |
| DE4406045C1 (en) | 1995-08-31 |
| WO1995022943A1 (en) | 1995-08-31 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| US5222965A (en) | Teat knife | |
| US7803159B2 (en) | Disc space preparation device for spinal surgery | |
| EP0910290B1 (en) | Surgical cutting device removably | |
| US5586989A (en) | Microsurgical curette | |
| US8357163B2 (en) | Low cost modular tapered and spherical hollow reamers for medical applications | |
| US5327896A (en) | Suction downbiter | |
| US11389186B2 (en) | Methods and apparatus for removal of intracranial hemorrhage | |
| JP6017480B2 (en) | Medical device and method | |
| EP3868314A1 (en) | Surgical cutting instrument with distal suction capability | |
| AU8923382A (en) | Trocar | |
| JPH07502419A (en) | groin discectomy instrument | |
| JP2009066388A (en) | Trocar cannula | |
| US5354307A (en) | Surgical means for removing a portion of a body | |
| CA2529014C (en) | Interchangeable tissue macerating and sculpting methods and devices | |
| JPH0838500A (en) | Equipment and method to remove tissue which has grown inside | |
| US20140277041A1 (en) | Surgical tool arrangement and surgical cutting accessory for use therewith | |
| CA2161248A1 (en) | Tissue resection forceps for treating teat canal stenoses | |
| US5897561A (en) | Coring device | |
| EP3510948B1 (en) | Reamer with variable sharpness | |
| US20080051813A1 (en) | Adapter Sleeve | |
| US5360433A (en) | Teat knife | |
| CN213047167U (en) | Novel tendon cutting device | |
| EP3510949B1 (en) | Reamer with cutting holes having differing sharpness | |
| CN110448351B (en) | Depth-limiting osteotome for removing acetabulum osteophyte | |
| WO2006031729A2 (en) | Adapter sleeve |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| FZDE | Dead |