CN102860866A - Device for fusing and cutting blood vessels - Google Patents

Device for fusing and cutting blood vessels Download PDF

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Publication number
CN102860866A
CN102860866A CN2012103832710A CN201210383271A CN102860866A CN 102860866 A CN102860866 A CN 102860866A CN 2012103832710 A CN2012103832710 A CN 2012103832710A CN 201210383271 A CN201210383271 A CN 201210383271A CN 102860866 A CN102860866 A CN 102860866A
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arm
knife
electrode
apparatus
distance
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CN2012103832710A
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Chinese (zh)
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邢丽丽
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邢丽丽
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Priority to CN2012103832710A priority Critical patent/CN102860866A/en
Publication of CN102860866A publication Critical patent/CN102860866A/en

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Abstract

A device (10) for fusing and cutting blood vessels comprises a first arm (19), a second arm (20) and a knife (21), wherein the first arm (19) is provided with an electric insulating substrate (23); the electric insulating substrate (23) is provided with a groove-shaped slot (32) and a guiding narrow groove (25); retaining components (37, 38 and 39) are arranged on the substrate (23) and are used for mounting an electrode (33) with a bent side at a fixed position; the second arm (20) is movably mounted on the substrate (23), accordingly can move towards the electrode (33) or towards a direction far away from the electrode (33), and is provided with a longitudinal narrow groove (31); and the knife (21) is arranged in the guiding narrow groove (25) of the substrate (23), accordingly can longitudinally move and can be inserted in the longitudinal narrow groove (31) or move to the longitudinal narrow groove (31).

Description

用于熔合和切削血管的装置 And fusing means for cutting a blood vessel

技术领域 FIELD

[0001] 本发明涉及一种用于夹持和切削患有疾病的人体或动物体中的软组织或脉管特别是血管的装置。 [0001] The present invention relates to a device for a blood vessel in particular human or animal body having a disease clamping and cutting in soft tissue or vasculature.

背景技术 Background technique

[0002] 动脉粥样硬化是ー种进行性的疾病过程,其中动脉腔内的血流因通常被称为动脉粥样硬化斑块的阻塞而受到限制。 [0002] Atherosclerosis is the process ー kinds of diseases, wherein the intraluminal blood flow due to blocked commonly referred to as atheromatous plaque is limited. 在心脏中,以及在其周边,动脉的阻塞可以导致疼痛,功能丧失和甚至死亡。 In the heart, as well as on its periphery, blocked arteries can lead to pain, loss of function and even death. 多年来曾使用了大量的方法在动脉阻塞的下游组织中进行血管重建。 Over the years I had used a number of methods of revascularization in the downstream of the blockage in the artery tissue. 这些办法包括使用熔合、切削血管的装置对血管进行重建。 These approaches include the use of fusion cutting device vascular vessel reconstruction.

[0003] 这种装置通常包括细长轴,在细长轴远端设置有用于夹持血管的两个臂部。 [0003] Such devices typically comprise an elongate shaft, the distal end of the elongate shaft is provided with two arm portions for clamping a blood vessel. 此外,在细长轴远端还可以设置纵向可调节的小刀,从而可以切断所夹持的和凝结的脉管。 Further, the distal end of the elongate shaft may be provided longitudinally adjustable knife, it can be clamped cutting and coagulation of the vessel. 在细长轴的近端设置具有驱动部件的手柄,通过使用该具有驱动部件的手柄,可以闭合两个臂部并且可以驱动小刀。 A drive member having a handle at the proximal end of the elongate shaft, having a drive by using the handle member, the two arms can be closed and may be driven knife. 两个臂部设计为两个电极,其能够加热夹持在它们之间的血管并且能够凝结血管壁进而将血管壁熔合在一起。 Two arms designed as two electrodes, which is capable of heating nip therebetween and capable of hardening the vascular vessel wall of the vessel wall in turn fused together.

[0004] 在切削血管时,要确保所切断血管的端部紧密密封。 [0004] When cutting the blood vessel, to ensure a tight seal the severed ends of the blood vessel. 还应该满足其他条件,例如,应该尽可能地避免对周围组织的损伤,以及血管的密封与血管的尺寸和血管壁的厚度基本没关系。 Other conditions must also be satisfied, for example, should be avoided as far as possible damage to the surrounding tissue, as well as the thickness dimension of the vessel and seal with the vessel wall of the blood vessel substantially does not matter. 此外,该装置在用于内窥镜或腹腔镜时,还要特别考虑可用的有限空间。 Moreover, the device when used in endoscopic or laparoscopic, but also special consideration the limited space available.

发明内容 SUMMARY

[0005] 基于上面原因,本发明的目的就是提供一种用于熔合和切削血管的装置,通过该装置,血管能够得以高标准的熔合和切削。 [0005] Based on the above reasons, an object of the present invention is to provide a device for fusing and cutting the blood vessel, by means of which the vessel can be fused to a high standard and cutting.

[0006] 根据本发明的一种实施方式,公开了ー种用于熔合和切削血管的装置,它包括远端设置有两个臂部的细长轴,其中至少ー个臂部安装成使得它能够相对另ー个运动,优选地可以枢转运动。 [0006] According to one embodiment of the present invention, discloses an apparatus for fusing ー species and the cutting of blood vessels, comprising a distal end of the elongated shaft is provided with two arms, wherein at least one ー arm mounted such that it another relatively ー motion, preferably pivotally movable. 两个臂部安装成它们能够相对于装置的细长轴运动。 Two arm portions are mounted to the elongated axis motion relative to the device. 并且ー个臂部可以刚性连接至细长轴而另ー个臂部可动地安装其上。ー and arm portions can be rigidly connected to the elongate shaft and the other ー arm portions movably mounted thereon.

[0007] 第一臂部具有电绝缘基体,例如陶瓷或合适的塑料,该绝缘基体具有用于电极的凹槽状的凹窝和用于小刀的引导狭槽。 [0007] The first arm having an electrically insulating substrate, such as a ceramic or a suitable plastic, the insulating substrate having a groove-like recess for the electrode and the slot for guiding the knife. 沟状凹槽与电极的形状相匹配。 Shaped recess shape matches with the electrode. 电极具有凹入凹窝。 Electrode has a concave recess. 该电极例如设计为柱形売,但它还可以设计成具有直翼的U形截面。 The cylindrical electrode may bai design, but it may be designed as a U-shaped cross-section having a straight wing. 在其他可替代实例中,它可以是扁平电极。 In other alternative examples, it may be a flat electrode. 优选地它由薄壁平板部形成,该平板部通过支承于基体中而具有必要的机械稳定性。 Preferably it is formed from a thin flat plate portion, the plate portion having the necessary mechanical stability by the support in the matrix.

[0008] 该电极通过电连接部件连接至延伸穿过轴的线路。 [0008] The electrode is connected to a line extending through the shaft through a connection member electrically. 该连接装置优选为隔离的电导体。 The connecting means is preferably isolated electrical conductors. 它延伸穿过基体中合适的通道或通路,并且能够在其中第二臂部可动地安装在第一臂部的接头附近,沿基体的外侧延伸。 It extends through the base in a suitable channel or passage, and wherein the second arm can be movably mounted in the vicinity of the joint of the first arm, extending along the outside of the base body. 基体设置有满足该要求的纵向延伸的凹窝,其内侧布置有线路。 The base is provided with a longitudinally extending recess meet this requirement, which is arranged inside the line. 这确保装置的头部不会超出最大外截面,并且该装置,例如用于腹腔镜的,可以通过套管针得以推动。 This ensures that the head of the device does not exceed the maximum external cross-section, and the device, for example, the laparoscope can be pushed through the trocar.

[0009] 生理相容材料,诸如银、钛等,优选用作电导体。 [0009] physiologically compatible material, such as silver, titanium, etc., is preferably used as an electrical conductor. 该电导体被设计成实心圆线、空心线、扁平线或编制物,条带等。 The electrical conductor is designed as a solid round wire, a hollow wire, a flat wire or braid, tape and the like.

[0010] 小刀至少在基体的引导狭槽内得以精确引导。 [0010] The knife is guided precisely in the guide slot at least the base body. 这里的小刀优选地引导至电极中心,并且还引导至第二臂部中心,进入它可以运动的纵向狭槽。 Here knife is preferably guided to the center of the electrode, and further guided to the center of the second arm, it can enter the longitudinal slot movement. 在向前推动时,小刀至少部分可以通过第二臂部的纵向狭槽来引导导。 When pushed forward, the knife can be guided at least partially through the longitudinal slot of the second guide arm.

[0011] 小刀的精确引导可以确保切断血管时,该切断发生在血管先前熔合区的中心。 [0011] ensures precise guidance of a knife when cutting a blood vessel, the cutting occurs in cardiovascular previous fusion zone. 因此所切断血管的两端具有相同长度的熔合部。 Thus both ends of the severed blood vessel portions having the same length fusion. 最小化了由于没有在中心进行精确切削而引起的非控制流血的危险。 Minimizes the risk of uncontrolled bleeding due to precise cuts in the center is not caused.

[0012] 小刀优选具有引导带和刀片,它们彼此牢固连接。 [0012] preferably having a knife and a blade guide strip firmly connected to one another. 引导带优选为沿小刀的运动方向延伸的细长元件,例如为塑料导轨的形式。 Preferably with an elongated guide member extending along the direction of movement of the knife, for example in the form of a plastic rail. 它可以连接至金属的刀片上。 It may be connected to the metal blade. 然而刀片还可以是陶瓷、金刚石、塑料或其他材料。 However, the blade may also be a ceramic, diamond, plastic or other material. 引导带还可以为金属。 The guide strip may also be metal. 引导带还可以由刀片的加厚部分形成,这样引导带和刀片形成单件无缝单元。 The guide may also be formed with a thickened portion of the blade, and the blade so that the guide strip form a single piece seamless unit. 然而两部件结构是优选的。 However, two-part structure is preferred. [0013] 小刀在引导狭槽或在纵向狭槽中的横向工作距离优选小于刀片厚度的五倍。 [0013] knife in the guide slot or longitudinal slot in the lateral working distance is preferably less than five times the thickness of the blade. 小刀的横向工作距离优选约等于刀片的最大厚度。 The lateral knife working distance approximately equal to the maximum thickness of the blade is preferably of. 这使得小刀得以精确中间引导,以及由此而来在熔合组织区域中间引导切削。 This makes the intermediate guide knife is precision, and resulting in the cutting area of ​​the intermediate guide fluxing. 小刀的横向引导可通过引导狭槽来提供。 Lateral guide may be provided by the knife guide slot. 可替代地,小刀的横向引导由纵向狭槽来提供。 Alternatively, the lateral knife is guided by the longitudinal slot is provided. 横向引导优选通过弓I导狭槽和纵向狭槽这两个来弓I导。 Lateral guidance is preferably by two guide bow I I bow guide slot and longitudinal slot.

[0014] 这里的小刀横向工作距离理解为小刀处于中间位置时,引导带的侧翼距离引导狭槽或纵向狭槽侧翼的距离。 [0014] The working distance transverse knife when the knife is understood here in the intermediate position, the guide flaps with distance from the guide slot or a longitudinal slot flanks. 这样,小刀的横向运动对应两倍的工作距离。 Thus, lateral movement of the knife corresponding to twice the working distance.

[0015] 小刀优选具有面向并且邻接电极的笔直以及纵向延伸的滑动边缘。 [0015] preferably having a knife and a straight face adjoining electrodes and a sliding longitudinally extending edges. 滑动边缘可以设计的相对较短并且优选地直接邻接小刀的切削边缘。 Sliding edge may be designed relatively short and preferably directly adjacent to the cutting edge of the knife. 由此,确保臂部之间所夹持的血管在其整个横截面上被切断,并且没有切不断的残余组织。 Thus, sandwiched between the arms to ensure that the vessel is cut over its entire cross-section, and not continue to cut the residual tissue.

[0016] 切削边缘优选布置在小刀的前侧。 [0016] The cutting edges are preferably disposed on the front side of the knife. 其优选地与小刀的运动方向成一定角度。 Moving the knife which is preferably at an angle. 该角度可以是锐角。 The angle may be acute. 切削边缘优选设计为笔直的并且沿引导带的方向延伸。 The cutting edge is preferably designed as straight and extends in the guide direction of the belt. 引导带优选地突起超过切削边缘,从而阻止待切断血管的部分在小刀上施压以及由此而来的切削失败。 Preferably protrudes over the guide strip cutting edge, thereby preventing the portion to be cut in the pressure vessel from the cutting knife and thus fail.

[0017] 第二臂部至少在其朝向电极的ー侧具有导电表面。 [0017] at least a second arm having a conductive surface on its side facing the electrode ー. 如果第二臂部是非金属材料,之后该表面可以由薄电极板形成。 If the second arm is a non-metallic material, after which the surface may be formed of a thin electrode plate. 然而第二臂部优选为固体金属。 However, the second arm is preferably a solid metal. 与此相独立的,第二臂部在其朝向电极的ー侧具有遵循电极形状的形状。 Independent of this, the second arm has a shape which follows the shape of the electrode on the side facing the electrode ー. 换句话说,间隙距离基本恒定或朝向中间降低距离间隙在电极和第二臂部之间形成。 In other words, the gap distance substantially constant or decrease towards the center distance of the gap formed between the electrode and the second arm. 与此相独立的,第二臂部的表面可以成形为例如有棱纹的、有绒毛的或其它形状。 Independent of this, the second surface of the arm may be an example, if a ribbed, plush or other molded shapes. 电极还可以设置有表面压型。 The electrodes may also be provided with a surface profiling. 即使电极的压型和第ニ臂部的压型是不同的,它们优选具有彼此匹配并彼此遵循的基本形状,用以限定具有间隙宽度的距离间隙,该间隙宽度优选朝向中间减小。 Even if the electrode pressure and the second arm of the press forming ni are different, they preferably have a shape substantially matched with each other and follow each other, to define a gap having a gap width from the gap width is preferably reduced toward the middle.

[0018] 用于将电极固定至第一臂部的保持部件优选形成在与另ー个相対的凹窝的上边缘。 [0018] for the electrode holding member fixed to the first arm portion is preferably formed on the other phases ー Dui dimples edges. 这些保持部件优选地由电绝缘突起形成,其具有例如与基体材料相同的材料。 The holding member is preferably formed of an electrically insulating projections, having for example the same material as the matrix material. 它们优选沿第二臂部的方向延伸并由此覆盖电极的上边缘。 They are preferably a direction along the second arm portion extends so as to cover the upper edge of the electrode. 在装置闭合时,该突起优选与第二臂部限定间隙,该间隙具有距离B,该距离B在其最大时与距离间隙邻接保持部件处的宽度A相同。 When the device is closed, the projections preferably define a gap with the second arm, the gap having a distance B, which at its maximum distance B and the distance of the gap remains the same width A of the abutment member at the.

[0019] 由于突起的电绝缘性,血管组织可以夹持在第二臂部和该突起之间而不会凝結。 [0019] Therefore, electrical, vascular tissue protrusion may be sandwiched between the second arm without condensing and the projection. 如果臂部因为组织特性而没有严格对称,也能确保组织被夹持。 If the arm because the tissue characteristics without strict symmetry, but also to ensure that the organization is held. 如果,例如夹持的血管具有随其长度变化的截面,这会导致横向距离B具有不同的值,即没有相同的尺寸。 If, for example, a blood vessel having a clamped length changes with its cross-section, which can result in lateral distance B have different values, i.e., not have the same size. 然而血管仍牢固地被夹持住。 However, the vessel was still firmly clamped. 即使夹持在臂部和电极中间的组织,由于热作用和凝结作用以及夹持效应在该点上降低而收缩,也能可靠地消除血管的滑动。 Even tissue clamping arm and the intermediate electrode, action of heat and to reduce coagulation and clamping effect at that point is contracted, the sliding vessels can also be reliably eliminated. 在小刀的随后启动过程中,血管的横向滑动并且之后在不合适点切断血管都能通过该方式进行消除。 In a subsequent startup of the knife, and then the vessel sliding laterally off the blood vessel at an inappropriate point can be eliminated by this embodiment.

[0020] 例如由突起形成的保持部件具有双重功能:保持电极以及改进血管的夹持。 [0020] for example, retaining member formed by the projection has a dual function: as well as improved electrode holder holding vessel.

[0021] 在第一和第二臂部之间优选地设置间隔部件。 [0021] Preferably the spacing member disposed between the first and second arms. 该间隔部件阻止第二臂部接触电极以及由此发生的短路。 The spacer member prevents the second arm portion and a short contact electrode arising therefrom. 此外,该间隔部件阻止在血管上无意施加并由此会压碎血管的过度压カ。 In addition, the spacer members and thereby prevent inadvertent application of excessive pressure will crush ka vessel in the vessel. 该间隔部件优选地由金属突起形成,在其对侧上布置有非金属止动器。 The spacer member is preferably formed from a metal protrusion, is disposed on the opposite side thereof a non-metallic stopper. 金属突起优选地连接至电源,即连接至电极或连接至第二臂部。 Metal protrusion is preferably connected to the power supply, i.e., connected to the electrode or to the second arm. 如果组织处于突起和所布置的接触表面之间,则会阻止发生不期望的故障。 If the tissue is between the projection and the contact surface is arranged, it will prevent undesired malfunction. 如果该突起布置在反相电极附近,尤其是连接至电源,则会导致一定的电流流入所夹持的生物组织,由此就会收缩并且不再阻碍在第二臂部和电极之间设置最小期望距离。 If the projection is arranged in the vicinity of the electrodes reversed phase, in particular to a power supply will result in a constant current flows into the biological tissue sandwiched, thereby shrinks and no longer impede disposed between the second arm and the minimum electrode desired distance. 通过可替代的设计实例,间隔部件可以由非导电材料形成。 , The spacer member may be formed of a non-conductive material through an alternative design example. 这样可以减小臂部之间短路的危险,并且还能扩展凝结区域。 This can reduce the risk of short-circuiting between the arms, and also extended condensation area.

附图说明 BRIEF DESCRIPTION

[0022] 从下面描述、从属权利要求或附图中可以更好地理解本发明有利实施方式的其他细节: [0022] from the following description, the dependent claims, or the accompanying drawings Further details will be better understood advantageous embodiment of the present invention:

[0023] 图I :根据本发明的装置的示意表示。 [0023] FIG. I: a schematic representation of apparatus according to the present invention.

[0024] 图2 :该装置的臂部和小刀的示意侧视图。 [0024] Figure 2: a schematic side view of the arm and the knife of the device.

[0025] 图3 :根据图2的臂部和小刀的部分剖面图。 [0025] FIG 3: a partial sectional view of the arm and the knife 2 according to FIG.

[0026] 图4 :从纵轴方向观察的工具闭合时简化和示意表示的臂部和小刀的垂直剖面表 [0026] Figure 4: a schematic and simplified vertical sectional view showing the table when viewed from the closing tool arm and the longitudinal axis of the knife

/Jn o / Jn o

[0027] 图5 :根据本发明的装置头部的透视图,以及 [0027] Figure 5: a perspective view of the head of the device according to the invention, and

[0028] 图6 :从纵轴方向观察的简化和示意表示的基体和小刀的垂直剖面表示。 [0028] Figure 6: a simplified vertical cross-section and the base body, and a schematic representation of a knife as viewed from the longitudinal axis of FIG.

具体实施方式 Detailed ways

[0029] 图I示出了在操作于人体或动物体时能够例如用于夹持、熔合或切断血管的装置10。 [0029] Figure I shows the apparatus 10 while operating in the human or animal body can be used for holding e.g., fused or off the vessel. 装置10特别用于内窥镜手木。 The endoscope apparatus 10 is particularly for hand wood. 它包括细长轴11,该细长轴11近端保持在外壳12上。 It comprises an elongated shaft 11, the proximal end of the elongate shaft 11 held on the housing 12. 外壳12具有操纵部件,例如手柄13以及驱动元件14。 The housing 12 has an actuating member, such as a handle 13 and a drive member 14. 这些包括例如可枢转手柄部15和/或驱动按钮或杆16,以及其他元件,例如必要时的电气开关。 These include, for example, pivoting and / or 16, and other buttons or lever handle element driving unit 15, such as an electrical switch when necessary. 驱动元件14经由图I中仅通过点划线示意性示出的动カ传输部件17连接至布置在轴11远端上的应用部18。 The drive member 14 only by dot-dash line shown schematically in Figure I, via the movable member 17 is connected to the transmission ka application portion 18 disposed on the distal end of the shaft 11. 该外科装置的应用部或头部18至少包括图2和3中示出的元件,即第一臂部19、第二臂部20和小刀21。 Application or head portion 18 of the surgical device comprises at least 2 and the element 3 are shown, i.e., first arm 19, second arm 20 and the knife 21. 臂部19、20用于夹持血管,其中它们可以朝向彼此移动并牢固地夹持住它们之间的血管。 Arm portions 19, 20 for holding vessels, wherein they can move towards each other and firmly grip the blood vessel therebetween. 小刀21用于切断血管。 A knife 21 for cutting off the blood vessels.

[0030] 在当前实例中,臂部19刚性连接至轴11,而臂部20可以通过驱动手柄部15朝向臂部19或远离臂部19旋转。 [0030] In the present example, the arm 19 is rigidly connected to the shaft 11, the arm 20 and handle portion 15 by the drive arm 19 toward or away from the arm portion 19 rotates. 相反,在驱动按钮16的驱动下,沿轴11的纵向方向推进小刀21,如图2的箭头22所示。 In contrast, in the driving button 16, the knife 21 advancing along the longitudinal direction of the shaft 11, as shown by arrow 222 in FIG.

[0031] 臂部19具有多个部件。 [0031] The arm portion 19 has a plurality of members. 例如包括塑料或陶瓷基体23,从图4中尤其可以看出。 Including, for example, plastic or ceramic matrix 23, in particular, can be seen in FIG. 4. 基体23在其轴侧端刚性连接至轴11,出于此目的它具有如图5所示的肩部24。 Base 23 rigidly connected to the shaft 11 at its shaft-side end, for this purpose it has a shoulder 24, as shown in FIG. 细长基体23从这里发出并延伸离开,其中它首先具有用于小刀21的引导狭槽。 Emitted from the elongate base 23 and extending away from here, where it has a first guide slot 21 for the knife.

[0032] 引导狭槽25沿纵向方向延伸穿过细长圆体23,引导狭槽25具有两个翼26、27,它们以一定距离间隔并且平行相对,以及在它们之间引导小刀21。 [0032] The guide slot 25 extending through the elongated body 23 in the longitudinal direction of the circle, the guide slot 25 having two wings 26 and 27 which are spaced at a distance opposite and parallel, and the guide knife 21 therebetween. 图6对此特别示意。 6 this particular schematically in FIG. 这里小刀21在其中心位置上距离每个翼26、27为工作距离S,所述距离的最大值优选与小刀21的厚度D相等。 Here knife 26, 27 to 21 working distance S from each wing in its central position, the knife is preferably equal to the maximum distance D of a thickness of 21.

[0033] 小刀21包括刀片28,在其上边缘设置有引导带29。 [0033] The knife 21 includes a blade 28, at its upper edge is provided with a guide belt 29. 如图6所示,D定义为引导带29的厚度。 As shown in FIG. 6, D is defined as the thickness of the guide strip 29. 厚度DK是刀片28的厚度。 DK is the thickness of the thickness of the blade 28. 工作距离S优选为不超出5倍于厚度DK的值。 S is the working distance preferably does not exceed 5 times the thickness of the DK value. 在更优选的情形中,厚度DK不超过工作距离S的两倍。 In a more preferred case, no more than twice the thickness DK working distance S. 換言之,小刀21可以在翼26、27之间前后移动最大两倍于S的距离。 In other words, a knife 21 may be moved twice the maximum distance S between the front and rear wings 26, 27. 在理想情形中,厚度DK不大于工作距离S。 In the ideal case, the working distance is no greater than the thickness DK S.

[0034] 如图2所示,小刀21优选具有布置在诸如刀片28上的滑动边缘,其可以沿臂部19的基体滑动并垂直引导小刀21。 [0034] 2, the knife edge 21 is preferably disposed on a slide, such as a blade 28, which can slide along the arm portion 19 of the base 21 and vertical guide knife. 结果如图4和5所示,小刀28邻接切削边缘28c下方的尖端28b可以沿电极33前行或距离电极33很短的距离,而不会磨损。 The results shown in Figures 4 and 5, the bottom 28b of the tip 28 adjacent the cutting edge of the knife 28c can be moved forward electrode 33 or a short distance from the electrode 33, and will not wear.

[0035] 轴承区或铰接区30在笔直延伸中邻接引导狭槽25,在该区中第二臂部枢转地安装在基体23上。 [0035] The hinge region or bearing region 30 extends straight in the guide slot 25 adjacent to, in this region the second arm is pivotally mounted on the base 23. 臂部20连接至动カ传输部件17 (图5中未详细示出),从而可以绕横向布置于基体23上的轴旋转。 Ka movable arm portion 20 is connected to the transmission member 17 (FIG. 5, not shown in detail), can be disposed about a transverse axis on the base body 23 is rotated.

[0036] 引导狭槽25和纵向狭槽31继续穿过臂部20。 [0036] The guide slot 25 and continues through the longitudinal slot 31 of the arm 20. 纵向狭槽31至少向下开ロ,即沿着向下方向朝向基体23。 At least a longitudinal slot 31 open downwardly ro, i.e. the base 23 toward the downward direction. 它的宽度优选至少近似地对应引导狭槽25的宽度。 Its width is preferably at least approximately corresponds to the width of the guide slot 25. 纵向狭槽31的翼52、53是平行的平面。 Wings 52 and 53 longitudinal slot 31 is parallel planes. 通过小刀21,它们相应地限定了针对上述关于工作距离S应用的工作距离尺寸SI。 By a knife 21, which respectively define the SI for the above work on the work of the distance S from the application size.

[0037] 在臂部20下面,基体23具有凹槽状或直通状凹窝32,其中布置有电极33。 [0037] In the following the arm 20, the base 23 has a groove-shaped or straight-shaped recess 32, the electrode 33 disposed therein. 在该设计实例中通过薄圆柱碟形板形成电极33。 Electrode 33 is formed in this example by a thin cylindrical design dish plate. 该电极33在面向臂部19的ー侧上具有弯曲的,优选为凹入的,优选为闭合的平滑表面。 The electrode 33 has a curved, preferably concave on the side facing ー arm portion 19 is preferably a closed smooth surface. 这里电极33基本沿凹窝32的整个长度方向延イ申,而在基体23的前端留下自由区34。 Here electrode 33 substantially along the entire length of the recess 32 Fangxiang Yan イ application, while leaving the front end of the base body 34 consisting of region 23. 用于电极33的保持部件37布置在基体23的上边缘35、36。 An electrode holding member 33 is disposed on an edge 37 of the base 35, 23. 如图4所示,这些部件通过扣合突起38、39形成,所述突起包括电绝缘材料并优选与基体23为一体组件。 4, these members are formed by engaging protrusions 38 and 39, the assembly comprises a projection integrally and preferably electrically insulating material and the matrix 23. 扣合突起38、39形成夹持住电极33上边缘的止动凸耳,。 Engaging protrusions 38 and 39 forms a stop lug gripped the edge of the upper electrode 33. 它们的长度优选略大于电极33的厚度,从而它们稍微突出超过暴露的电极表面。 Preferably a thickness slightly greater than the length thereof electrode 33 so that they slightly protrude over the exposed surface of the electrode.

[0038] 上臂20在其面向电极33的下侧具有遵循电极33形状的电极表面40。 [0038] The upper arm 20 having the lower electrode 33 facing the surface 40 of the electrode 33 follows the shape of the electrode. 如果电极33具有例如圆柱碟形,则电极表面40类似地遵循圆弧,它具有稍微小点的半径。 For example, if electrode 33 has a cylindrical disc, the surface of the electrode 40 similarly to follow a circular arc having a radius slightly smaller. 与该基本形式相独立的是,电极33和电极表面40以凹槽、凸出、绒毛、棱等形式在形状上可以具有局部偏差。 The basic form is independent of the electrode 33 and the electrode surface 40 to the recess, the projection, fluff, and other forms of ribs may have local deviations in shape.

[0039] 在第二臂部20的远端设置延伸至基体23的鼻状突起41,并且在该装置闭合时,支撑于基体23的末端区34。 [0039] provided at the distal end of the second arm 20 extends to nose 23 of the substrate protrusions 41, and when the device is closed, the support region 34 to the end 23 of the base body. 在这种状况下,电极表面40和电极33的内侧之间限定宽度为A的距离间隙。 In this situation, the distance defining a width of the gap A between the inner electrode surface 40 and the electrode 33. 该宽度A优选地至少略大于突起38/39和电极表面40或臂部20的邻接翼42、43之间的距离B。 The distance between 42 and 43 slightly larger than the width of the projection A is preferably at least 38/39 and the electrode surface 40 of the arm 20 adjacent to the wing or B.

[0040] 从图4和5中可以看出,电极33通过电导体44连接至电源。 [0040] As can be seen from FIGS. 4 and 5, the electrode 33 is electrically connected to the power source through a conductor 44. 导体44在此首先延伸穿过轴11进入外壳12并连接至开关(未详细示出),以及通过供给线路45连接至电源装置。 The first conductor 44 extends through the shaft 11 into the housing 12 and is connected to a switch (not shown in detail), and is connected to the power supply device 45 via supply line.

[0041] 类似地,导体(未详细示出)从臂部20延伸到装置。 [0041] Similarly, the conductor (not shown in detail) extends from the arm portion 20 to the apparatus. 导体44例如可以具有设置有绝缘物46等的圆线。 44, for example, may have a conductor with an insulating material 46 such as a round wire. 它在电极33和基体23之间的点处近似中心地连接至电极33。 It is connected to the electrode 33 at a point 23 approximately centrally between the electrode 33 and the substrate. 特别是在铰接区30,导体44在基体23外侧穿过横向开ロ47,并在纵向凹窝49中延伸至达肩部24。 Particularly in the hinge area 30, the conductors 44 extend through a lateral opening 23 in the outer ro substrate 47, and a recess extending in the longitudinal direction of the shoulder portion 24 to the socket 49. 在该点处导体44进入轴11。 At this point the shaft 11 into the conductor 44. 导体44特别地为绝缘银线。 In particular insulated conductor 44 is silver wire. [0042] 所描述的装置按如下操作: [0042] The apparatus described operates as follows:

[0043] 为密封和切断血管,血管夹持于臂部19、20之间。 [0043] The sealing and cutting blood vessels, sandwiched between the arms 19, 20. 手柄部15的驱动促使臂部19、20朝向彼此移动以便夹住血管并且血管壁彼此压靠在一起。 Handle portion 15 causes the drive arm 19, 20 are moved towards each other so as to sandwich the vessel wall and the blood vessel pressed against each other. 这里血管壁挤压在一起,特别是挤压在电极表面40和电极33之间。 Here the vessel wall are pressed together, particularly compressed between the electrode surface 40 and the electrode 33. 此外它们夹持在突起38、39和电极表面40或翼42、43之间。 In addition they are sandwiched between the projections 38, 39 and 42, 43, 40 electrode surfaces or wings. 理想地,突起41定位在基体23的区34上,作为推力轴承并由此阻止血管变形。 Ideally, the projection 41 is positioned in region 34 on the substrate 23, as the thrust bearing and thereby prevent deformation of the blood vessel.

[0044] 在臂部20和电极33之间施加电流或电压,优选为HF电压,开始凝结处理,在该处理中血管壁的细胞打开以及蛋白质释放并变性。 [0044] applying a current or voltage, preferably between the arm 20 and the HF voltage to the electrode 33, the processing starts to condense, in the opening process and vascular wall cells to release proteins and denatured. 夹持在臂部20和电极33之间并彼此压靠的血管壁结合在一起。 Sandwiched between the arms 20 and the electrodes 33 are pressed against the vessel wall and bonded to each other. 它们在该处理中会减小体积。 They will reduce the volume of the process. 独立于血管壁体积的收缩,突起38、39和臂部20之间夹持的血管部分至少充分保持自然状态,由此几乎没有经受任何收缩。 Independent of the volume contraction of the vessel wall, sandwiched between the projections 38 and 39 and the arm portion 20 of the vessel to maintain the natural state at least sufficiently, thereby hardly subjected to any contraction. 它们被可靠地夹持住,因此阻止了血管的横向滑动,这对相对较小血管的密封是特别重要的。 They are securely clamped, thus preventing lateral sliding of the vessel, which sealing of the relatively small vessels is particularly important.

[0045] 如果剩余组织进入鼻部41和区34之间作为推力轴承,这样间隙距离A就稍微大于实际预期的,则狭窄间隙B用作抵制血管横向滑动的防护部件。 [0045] If the remaining tissue into the region between 34 and nose 41 as the thrust bearing, so that it is slightly larger than the gap distance A is actually to be expected, then a narrow gap B is used to resist lateral sliding of the guard vessel member. 而且,鼻部41和电极33 的前端48之间的距离小到使得那里存在的任何组织可以凝结并由此收缩。 Further, the nose 41 and the electrode 4833 between the front end of the small distance such that there exists any tissue may be coagulated and thereby shrink. 这非常有益于在臂部19、20之间可靠地夹持住组织。 This is very beneficial to securely hold tissue between the arms 19, 20.

[0046] 一旦凝结处理足够地超前,医生例如可以通过启动按钮16来驱动小刀。 [0046] Once the coagulation process is sufficiently advanced, for example, a doctor knife may be driven by the start button 16. 现在通过引导狭槽25和纵向狭槽31在中心推进、引导小刀至臂部19、20的自由端。 Now 25 and longitudinal slot 31 is advanced through the central guide slot, the guide knife 19, 20 to the free end of the arm. 这里小刀21大致精确地在图4中指示的中心面M内按虚线延伸,以确保密封血管尾端区域在小刀21的两侧长度相等。 Here the central plane M knife 21 substantially accurately indicated by the broken line in FIG. 4 extends, seal the vessel to ensure equal on both sides of the trailing end region length 21 of the knife. 从而最小化了偏离中心切削的危险,进而最小化非受控流血的危险。 Thereby minimizing the risk of cutting off center, thereby minimizing the risk of uncontrolled bleeding.

[0047] 优选地适于最小侵入手术的装置10 (例如可以通过套管针引入体内)具有两个臂部19、20以及用于夹住血管的中心引导小刀21。 [0047] Preferably the minimally invasive surgical apparatus adapted to 10 (e.g., can be introduced into the body through a trocar) having two arms 19, 20 and a central guide for clamping a blood vessel knife 21. 小刀在至少ー个臂部19、20中的中心引导避免了偏离中心切断凝结组织的弊端。 At least ー knife arm portions 19, 20 in the center of the guide to avoid off-center cut coagulating tissue defects. 而且,小刀21的精确中心引导在其上产生更小的磨损。 Furthermore, the exact center of the guide knife 21 to produce less wear on it. 因此本发明保证小刀21更好切削质量以及更长使用寿命。 Thus, the present invention ensures that the cutting knife 21 better quality and longer service life.

[0048] 一个臂部优选地具有陶瓷基体23,在其上边缘设置向内突出的具有底切形式的突起38、39。 [0048] Preferably, one arm having a ceramic base 23, at its upper edge is provided with inwardly projecting protrusions 38 and 39 form an undercut. 这些电绝缘突起沿中心面M的方向延伸并提供了两个改迸:一方面,便于组装电极33。 These electrical changes provides two extending direction of the protrusions along the central insulation Beng plane M: on the one hand, is easy to assemble the electrode 33. 另ー方面,产生两个组织夹持点。 Another aspect ー create two tissue clamping points. 距离A优选地从突起38、39至引导狭槽31逐渐減少。 The distance A is preferably gradually reduced to the guide protrusions 38 and 39 from the slot 31. 通过本装置,凝结宽度由绝缘突起38、39确定,并由此可靠地再生,这极大地改进了 By this means, the width of coagulation is determined by the insulating protrusions 38 and 39, and thereby reliably reproduced, which greatly improves the

凝结质量。 Coagulation quality.

[0049] 參考标记列表 [0049] Reference Signs List

[0050] 10 装置 [0050] means 10

[0051] 11 轴 [0051] 11 axis

[0052] 12 外壳 [0052] The housing 12

[0053] 13 手柄 [0053] 13 handle

[0054] 14 驱动元件 [0054] The driving element 14

[0055] 15 手柄部件 [0055] The handle member 15

[0056] 16 驱动按钮或杆 [0056] 16 driving button or lever

[0057] 17 动カ传输部件 [0057] The transmission member 17 movable ka

[0058] 18 应用部件,头部 [0058] The application member 18, head portion

[0059] 19 第一臂部 [0059] The first arm 19

[0060] 20 第二臂部[0061] 21 小刀 [0060] The second arm portion 20 [0061] Knife 21

[0062] 22 箭头 [0062] 22 arrow

[0063] 23 基体 [0063] The substrate 23

[0064] 24 肩部 [0064] 24 shoulder

[0065] 25 引导狭槽 [0065] The guide slot 25

[0066] 26,27 槽翼 [0066] Wings 26, 27 groove

[0067] S 25和21之间的间隙 [0067] S 25 and the gap 21 between the

[0068] D 刀21的厚度 The thickness of [0068] D of the blade 21

[0069] DK 刀片28的厚度 Thickness [0069] DK blades 28

[0070] 28 刀片 [0070] Blade 28

[0071] 28a 滑动边缘 [0071] 28a sliding edge

[0072] 28b 尖端 [0072] 28b tip

[0073] 28c 刀刃 [0073] 28c blade

[0074] 29 引导带 [0074] The guide belt 29

[0075] 30 铰接区 [0075] The hinge area 30

[0076] 31 纵向狭槽 [0076] 31 longitudinal slot

[0077] SI 31和21之间的间隙 [0077] The gap between 21 and SI 31

[0078] 32 凹窝 [0078] 32 recess

[0079] 33 电极 [0079] 33 electrode

[0080] 34 基体23的末端区 [0080] 34 end region 23 of the base body

[0081] 35,36 上边缘 [0081] The upper edge 35, 36

[0082] 37 保持装置 [0082] The holding means 37

[0083] 38,39扣合突起 [0083] The engaging protrusions 38, 39

[0084] 40 电极表面 [0084] 40 electrode surface

[0085] 41 突起 [0085] 41 projection

[0086] A 33和40之间的距离宽度 [0086] The distance between A 33 and width 40

[0087] B 38、39和40之间的距离 The distance between the [0087] B 38,39 and 40

[0088] 42,43 臂部20 的翼 [0088] The arm portions 42, 43 of the wings 20

[0089] 44 导体 [0089] 44 conductor

[0090] 45 供给线路 [0090] The supply line 45

[0091] 46 绝缘物 [0091] The insulator 46

[0092] 47 基体23的侧向开ロ [0092] The lateral opening 47 of the body 23 ro

[0093] 48 33 的前端 The front end [0093] 48 33 of

[0094] M 中心面 [0094] M center plane

[0095] 49 纵向凹槽 [0095] 49 longitudinal grooves

[0096] 52,53 31 的狭槽翼。 Wing slots [0096] 52, 53 31.

Claims (12)

1. 一种用于熔合和切削血管的装置(10),其包括: 第一臂部(19),其具有电绝缘基体(23),该电绝缘基体(23)具有凹槽状凹窝(32)和引导狭槽(25),其中基体(23)上设置有保持部件(37、38、39),用于将ー侧弯曲的电极(33)安装在固定位置; 第二臂部(20),其可动地安装在基体(23)上,从而它可以朝向和远离电极(33)运动,其中第二臂部(20)具有纵向狭槽(31);以及小刀(21),其布置在基体(23)的引导狭槽(25)中,从而它可以纵向运动并被布置成突入到纵向狭槽(31)或移动到纵向狭槽(31)中,所述小刀(21)包括彼此牢固连接的引导带(29)和刀片(28),其特征在于所述小刀(21)在引导狭槽(25)中的横向工作距离(S)小于刀片(28)厚度(D)的五倍,以及所述小刀(28)具有笔直并且纵向延伸的滑动边缘(28a),该滑动边缘面向并且接触电极(33 )。 A fusing and cutting apparatus vessel (10), comprising: a first arm portion (19) having an electrically insulating substrate (23), the electrically insulating substrate (23) having a groove-like recess ( 32) and guide slots (25), wherein the base body (23) is provided on the holding member (37,38,39), for ー electrode (33) mounted side bent in a fixed position; the second arm (20 ), which is movably mounted on the base (23), so that it can be toward and away from the electrodes (33) movement, wherein the second arm (20) having a longitudinal slot (31); and a knife (21), which is arranged guide slot in the base body (23) (25), whereby longitudinal movement and it can be arranged to protrude into the longitudinal slot (31) or moved into the longitudinal slots (31), said knife (21) to each other comprising tape guide (29) and blade (28) is firmly connected, characterized in that five times the knife (21) working distance lateral guide slot (25) in the (S) is smaller than the blade (28) thickness (D) of and said knife (28) having a straight edge and a longitudinally extending slide (28a), and the sliding edge facing the contact electrode (33).
2.根据权利要求I所述的装置,其特征在于所述小刀(21)在前侧具有切削边缘(28c),其与小刀(21)的运动方向成一定角度。 2. The apparatus as claimed in claim I, wherein said knife (21) having a cutting edge (28c) on the front side, with a knife (21) at an angle of movement.
3.根据权利要求I所述的装置,其特征在于所述小刀(21)在背对电极(33)的ー侧具有引导带(29),其被布置成在基体(23)的引导狭槽(25)中可纵向运动并突入到第二臂部(20)的纵向狭槽(31)或被布置成移动进入到纵向狭槽(31),以及这确定了小刀(21)在基体(23)和第二臂部(20)中的横向工作距离(S)。 3. The device as claimed in claim I, wherein said knife (21) has a guide strip (29) at the side facing away from ー electrode (33), which guide slot is arranged in the base body (23) longitudinally movable (25) and protrudes into the second arm (20) of the longitudinal slot (31) or arranged to be moved into the longitudinal slot (31), and which determines the knife (21) in the base body (23 ) and a second lateral arm working distance (S) 20) of (.
4.根据权利要求I所述的装置,其特征在于所述第二臂部(20)由固体金属形成。 4. The apparatus according to claim I, characterized in that said second arm (20) is formed from solid metal.
5.根据权利要求I所述的装置,其特征在于所述第二臂部(20)在面向第一臂部(19)的电极(33)的ー侧具有遵循电极(33)形状的形状。 5. The apparatus as claimed in claim I, wherein said second arm (20) has a shape following the shape of the electrodes (33) on the side facing ー first arm (19) of the electrode (33).
6.根据权利要求I所述的装置,其特征在于所述装置(10)的臂部(19)和(20)闭合吋,在电极(33)和第二鼻部(20)之间限定具有宽度(A)的距离间隙。 6. The apparatus as claimed in claim I, wherein the arm portion (19) of the device (10) and (20) closed inches, between the electrodes (33) and a second nose (20) having defined width distance (a) of the gap.
7.根据权利要求I所述的装置,其特征在于所述保持部件(37)形成在凹窝(32)的彼此面对的两个边缘(35、36)上。 7. The apparatus as claimed in claim I, wherein said holding member (37) are formed facing each other at the two edges a recess (32) on the (35, 36).
8.根据权利要求6或7所述的装置,其特征在于所述保持部件(37)由电绝缘突起(38、39)形成,所述突起(38、39)沿第二臂部(20)的方向突出,以及在装置(10)的臂部19和20闭合时,所述突起(38、39)与第二臂部(20)—起限定距离(B),该距离(B)等于或小于距离间隙的宽度(A)。 8. The apparatus of claim 6 or claim 7, wherein said holding member (37) by an electrically insulating projection (38, 39) is formed, said projection (38, 39) along a second arm (20) projection direction, and when the arm means (10) 19 and 20 closed, the projections (38, 39) and the second arm (20) - from a defined distance (B), the distance (B) equal to or It is smaller than the distance of the gap width (a).
9.根据权利要求I所述的装置,其特征在于所述电极(33)通过电导体(44)连接至电源,所述电导体(44)至少部分地布置在基体(23)的外侧上。 9. The apparatus as claimed in claim I, wherein said electrode (33) connected by electrical conductors (44) to the power supply, the electrical conductor (44) at least partially disposed on the outside of the base body (23).
10.根据权利要求I所述的装置,其特征在于所述基体(23)连接至细长轴(11),所述轴(11)从外壳(12)延伸,其中轴(11)具有动カ传输部件(17)用于第二臂部(20)和/或小刀(21)的选择性运动。 10. The apparatus as claimed in claim I, wherein said base body (23) is connected to the elongated shaft (11) extending from the housing (12) of the shaft (11), wherein the shaft (11) having a movable ka transmission means (17) for the second arm (20) and / or a knife (21) selective movement.
11.根据权利要求I所述的装置,其特征在于在第一和/或第二臂部(19、20)上设置间隔部件。 11. The apparatus as claimed in claim I, wherein (19, 20) disposed on the first spacer member and / or the second arm.
12.根据权利要求11所述的装置,其特征在于所述间隔部件是金属导电或电绝缘突起(41)。 12. The apparatus as claimed in claim 11, wherein said spacer member is a conductive metal or an electrically insulating projection (41).
CN2012103832710A 2012-10-10 2012-10-10 Device for fusing and cutting blood vessels CN102860866A (en)

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