CN100493469C - 外科器械 - Google Patents

外科器械 Download PDF

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Publication number
CN100493469C
CN100493469C CN 200580028080 CN200580028080A CN100493469C CN 100493469 C CN100493469 C CN 100493469C CN 200580028080 CN200580028080 CN 200580028080 CN 200580028080 A CN200580028080 A CN 200580028080A CN 100493469 C CN100493469 C CN 100493469C
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surgical instruments
tissue
clamping surface
cutting
blade
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CN101005810A (zh
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阿希姆·布罗德贝克
迪特尔·哈夫纳
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Erbe Elecktromedizin GmbH
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Erbe Elecktromedizin GmbH
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1412—Blade
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
    • A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws

Abstract

存在一种用于进行腹腔镜检查或类似微创手术的外科器械，该外科器械包括两个夹持部件，该两个夹持部件能够彼此相向地移动并具有夹持表面，所述夹持表面用于在闭合时保持住组织；以及包括具有刀刃的切割装置，所述切割装置相对所述的夹持部件移动以切割被保持住的组织。为改进切割动作并提高切割装置的耐用性，本发明建议，在闭合状态下，所述夹持表面相对于纵轴成锐角地延伸。

Description

外科器械
技术领域
本发明涉及一种用于微创手术的外科器械，所述外科器械包括至少两个夹持部件和一个切割装置。
背景技术
这种类型的器械用于切割、准备和凝结组织，特别是用于例如腹腔镜检查的微创手术中。这类应用的基本要求是：能够以简单的方式安全地夹持住组织，然后能够同等安全地切穿该组织。同时，也很重要是：不存在因切穿组织和此过程所需的切割运动导致损伤周围组织的风险。
从US 5,445,638可知构造为管形轴式器械并具有电极以凝结所夹持的组织的这种类型的器械。
与这种器械相关的问题是：一方面，对切割器械存在相当大的磨损，同时另一方面，组织在被切穿时相对容易地从夹持表面滑脱并因此不会被完全切穿。
发明内容
本发明的目的是提供一种开头阐明类型的外科器械，其中永久地确保具有良好和安全操作性的改进的切割作用。
该目的通过一种用于微创手术的外科器械来实现，该外科器械具有：至少两个夹持部件，所述两个夹持部件能够彼此相向移动并具有夹持表面，该夹持表面在处于闭合状态时用于夹牢组织；以及具有刀刃的切割装置，该切割装置能够沿纵轴移动，以切割所夹牢的组织，从而使得在闭合状态下夹持表面相对于所述纵轴成锐角地延伸。其中，所述微创手术包括腹腔镜检查。
因此本发明的基本点是：所述夹持表面不象开头阐明的现有技术那样以切割器械仅在组织上施加使组织离开所述夹持表面的力的方式保持住所述组织。相反地，该成角度的配置确保所施加的切割力中的至少一部分垂直地作用在夹持表面上，因此，该组织倾向于更加牢固地保持被所述夹持表面夹牢。同时，因为该器械能够以如下此方式配置：其使得在夹持部件打开时用于抓牢组织的前进运动基本上可沿两个夹持表面之间的角平分线的方向进行，因此该器械的良好操作性得到保证，这对腹腔镜检查操作是尤其有利的。
该器械的另一基本优点是：在经过位于夹持表面之间的开口时，所述切割器械的刀刃并不是是一直地接触该组织的相同部分，相反地，这个部分越过该刀刃，其结果是，一方面，它被切割而非被挤压，另一方面，利用了该刀刃的较大纵向界截面，因此，磨损较少。
该切割装置可配置为HF外科切割装置，然而或者可配置为机械切割装置(如同解剖刀)。
优选地，该刀刃相对于所述夹持表面成钝角地倾斜，这改善了实际切割动作。另外，切割装置必须移动的路径得以减少。这些相对于切割方向的倾斜角可在该刀刃的整个长度上都是恒定的，或随着类似于在其长度上的弧线地弯曲刀刃而改变。通过这种类似弧形地弯曲的刀刃，可进行“柔和的”第一切割，然后变成一个较陡的、更有力的切割进程。
优选地，该夹持部件之一相对于所述纵轴是固定不动的。因此，操作者在抓牢组织时将会有一个固定的参照点。另外，移动所述夹持部件的机构是简单的。
优选地，该外科器械附连在支座的一个远端，以形成用于微创手术的管形轴式器械。如此构造的器械操纵性好。特别地，因相对于该管形轴的轴线的倾斜，容易抓牢和准备组织。
所述夹持表面优选以基本传统方式设有用于向组织提供高频凝结电流的电极，使得由夹持表面所抓牢的组织能够被凝结，然后被切穿。
附图说明
下面，通过附图更详细地描述了本发明的实施方式示例。在这些图示中：
-图1本发明第一实施方式的透视图，
-图2从另一视角观察的图1所示实施方式的透视图，
-图3切割装置的透视图，
-图4根据图1的实施方式的透视示意图，其中夹持部件闭合，
-图5根据图4的该实施方式的侧视图，
-图6仅具有一个夹持部件的实施方式的示意图，
-图7与根据图6的夹持部件组装在一起的第二夹持部件，
-图8沿图4平面中VIII-VIII平面的横截面视图，
-图9用于解释不同角度的概略剖面示意图，
-图10根据图9的配置的改进实施方式，其具有倾斜的刀刃，以及
-图11与图9或图10对应的示意图，其具有弧形的刀刃。
具体实施方式
在下列描述中，相同参考标号用于相同和相似的工作部件。
如图1-8所示，该外科器械包括位于附图上部的第一夹持部件10和位于附图下部的第二夹持部件20。夹持部件10和20的每个分别具有夹持表面11和21，夹持表面11和21分别以大致传统的方式与电极12和22装配在一起。夹持部件10和20经铰接头9互相连接，其中所述(上部)夹持部件10具有致动装置，其本身是较熟悉的，因此为简要起见，未在附图中图示。
当组织被夹持在两个夹持部件11和21之间时，HF电流可经电极12、22通入该组织内以凝结该组织。
上部夹持部件10和下部夹持部件20各自分别具有沟槽13和23，具有切割表面32和前方刀刃31的切割装置30能够通过推杆33在沟槽13和23内前后移动。
在闭合状态下(图4/5)，夹持表面11、21相对于纵轴X具有角度α(参见图1、9)，其中切割装置30能够通过推杆33前后移动。在图1-8所示实施方式中，这个锐角基本上对应于这两个夹持表面11、21在其打开状态下(图1)的角平分线。下部夹持部件20刚性地附连在支座40上，该支座40形成管形轴式器械的一部分，如通常所熟悉的那样。因此该配置的结果是：可以使该管形轴式器械在其运动方向上沿轴X移往待夹持的组织并抓牢该组织。此运动方向对操作人员是特别有利的。
上部夹持部件的尖端14和下部夹持部件的尖端24各自构造成流线型，从而可以牢固地夹持住哪怕是小的组织部位。
在图1-8所示的本发明实施方式中，当刀刃31到达其最前方(远端)位置时，切割装置30与其刀刃31从上部夹持部件10的沟槽13露出。
在此，为了实现保护周围组织使其不受损坏，上部夹持部件10的前边缘35在图9所示实施方式中向前突出一个距离，从而使得刀刃31在切割装置30的最前方位置处被完全地遮蔽住。
在图10所示实施方式中，刀刃31相对于夹持表面11、21(处于闭合状态下)倾斜的钝角β比图9所示实施方式中的要大。由对比图9和图10能够看出，切割装置30沿轴X运动而从图示的中间位置移动到最前方位置所需要的路径比图9所示实施方式(参照虚线)中的要小。另外，前边缘35可以是斜削的，位于切割装置30最前方位置中的刀刃31不会从该器械露出。该结果是更呈现流线型的构造。
图11所示的本发明的实施方式与图10所示的实施方式的不同之处在于：刀刃31不构建成均匀地倾斜，而是弧形的。结果，一方面，上部夹持部件10可构造地得更呈流线型，而在另一方面，当切割装置32从其缩回位置(附图的左部所示位置)移入其前进位置、从而与所夹持组织的部位之间的角度首先是非常平的、几乎平行于夹持表面11、21时，实现“较柔和的”第一切割，该角度然后相对于这些表面改变，变得越来越陡。
另外，夹持表面1、21还可以构造成直线形以及弯曲形，这对很多准备目的而言尤其有利。
参考标号列表
9         铰接头
10        上部夹持部件
11        上部夹持表面
12        电极
13        沟槽
14        尖端
20        下部夹持部件
21        下部夹持表面
22        电极
23        沟槽
24        尖端
29        杆开口
30        切割装置
31        刀刃
32        切割表面
33        推杆
35        前边缘
40        支座

Claims (7)

1.一种外科器械，用于微创手术，包括
-至少两个夹持部件(10，20)，所述夹持部件能够彼此相向地移动并具有夹持表面(11，21)，所述夹持表面(11，21)在处于闭合状态时用于夹牢组织，以及
-具有刀刃(31)的切割装置(30)，所述切割装置能够沿纵轴(X)移动，以切割被夹牢的组织，
其特征在于
在闭合状态下，所述夹持表面(11，21)相对于所述纵轴(X)成锐角(α)地延伸。
2.如权利要求1所述的外科器械，
其特征在于
所述刀刃(31)相对于所述夹持表面(11，21)成钝角(β)地倾斜。
3.如权利要求1所述的外科器械，
其特征在于
所述刀刃(31)构造为弯曲的弧形。
4.如权利要求1所述的外科器械，
其特征在于
所述夹持部件(10，20)之一以相对于所述纵轴(X)固定的方式附连。
5.如权利要求1所述的外科器械，
其特征在于
所述器械附连在支座(40)的一个远端，以形成用于微创手术的管形轴式器械。
6.如权利要求1所述的外科器械，
其特征在于
所述夹持表面(11，21)包括用于向组织提供高频凝结电流的电极(12，22)。
7.如权利要求1所述的外科器械，
其特征在于
所述微创手术包括腹腔镜检查。
CN 200580028080 2004-08-24 2005-07-12 外科器械 Expired - Fee Related CN100493469C (zh)

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DE102004040959.5 2004-08-24
DE200410040959 DE102004040959B4 (de) 2004-08-24 2004-08-24 Chirurgisches Instrument

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CN100493469C true CN100493469C (zh) 2009-06-03

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EP (1) EP1784137B1 (zh)
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DE (1) DE102004040959B4 (zh)
WO (1) WO2006021269A1 (zh)

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WO2006021269A1 (de) 2006-03-02
US8992526B2 (en) 2015-03-31
EP1784137A1 (de) 2007-05-16
DE102004040959B4 (de) 2008-12-24
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EP1784137B1 (de) 2015-09-02

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