CN110013299B - 探针施加器 - Google Patents
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- CN110013299B CN110013299B CN201811493032.4A CN201811493032A CN110013299B CN 110013299 B CN110013299 B CN 110013299B CN 201811493032 A CN201811493032 A CN 201811493032A CN 110013299 B CN110013299 B CN 110013299B
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- A61B1/3132—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes for laparoscopy
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Abstract
本发明涉及探针施加器。具体而言,根据本发明,提供了设置成用于接收柔性探针(11)的探针施加器(10),柔性探针旨在用于内窥镜使用,且可利用探针施加器而变得可用于腹腔镜使用。供应探针(11)的装置的控制经由探针施加器(10)的控制元件(32,33)来发生。优选地,探针(11)经由设在探针施加器(10)上的连接装置(38)供应。
Description
技术领域
本发明的主题是用于柔性探针的腹腔镜使用的施加器。
背景技术
公布US 5314406公开了一种具有细长轴的医疗器械,细长轴的近端保持在具有手柄的壳体上。在壳体的与轴相反的一侧上,提供了插入开口,探针可经由插入开口穿过壳体插入轴中。探针延伸穿过轴,且可在所述轴的远端上从其突出。轴设置成用于从治疗部位抽吸流体,这可通过手柄上的适合的阀控制。壳体的手柄具有用于流体线的连接,以用于清洗和抽吸。探针继而又连接到电力源上。
发明内容
考虑到其,本发明的目的在于提供一种探针施加器,其允许在内窥镜应用外使用柔性探针。
该目的利用根据权利要求1所述的探针施加器实现:
根据本发明的探针施加器包括具有轴的壳体,轴是细长刚性管,其近端连接到壳体上。轴在其两端上开口。轴大致比将滑动穿过轴的探针更硬。轴的刚度优选足够大,使得作用在具有例如200mm到400mm的长度的轴的远端上的0.5N的横向力实现轴的侧向弹性偏转,所述偏转不大于75mm。如果需要,则轴可更硬,使得例如考虑到所述长度和所述力,仅发生6mm或更小的偏转。
在壳体的与轴相反的一侧上,提供了探针插入开口,经由其,柔性探针可滑入壳体中且穿过所述壳体进入轴中。探针已插入其中的壳体然后可借助于设在壳体上的手柄手动地定位和移动,以便将轴(例如,经由小进入开口)插入患者的身体中,以便通过触动探针和移动具有轴的壳体来执行期望的手术程序。为此,用于探针的触动和停用的一个或多个控制元件布置在壳体上,具体是在所述壳体的手柄上。
存在从壳体延伸至插头的线缆,以便将源自控制元件的促动的信号传递至插头或另一连接器。延伸穿过线缆的信号导线可为电线、流体线、波导(例如,如,光纤等)。
此外,探针施加器包括连接装置,其设置成用于连接探针,以便向所述探针提供应操作介质。操作介质可为电力、液体或气态流体、光能等。优选地,连接装置设在插头上,探针施加器经由插头将连接到供应装置上。备选地,还有可能构造与插头分开的连接装置,且例如,以插座布置的形式提供其,插座布置经由柔性线连接到插头上。连接装置还可设在壳体上。
根据本发明的探针施加器允许将内窥镜检查中已知的多个柔性探针用在内窥镜外。例如,用户可在腹腔镜手术中使用探针施加器。这样,内窥镜探针将变得可用于外科学科,如普通外科、内脏手术、妇科、泌尿科以及耳鼻喉(ENT)手术领域。
探针施加器的刚性轴在多达45厘米或更长的长度上使柔性探针稳定。因此,柔性探针可用于腹腔镜检查和小腹腔镜检查,而不需要单独的刚性器械执行相同的功能。
此外,根据本发明的探针施加器使得探针的使用成为可能,特别是以手动促动的方式,这是外科应用中的重要方面。外科医生能够在单手在壳体上的情况下(即,在手柄上,并且借助于设在其上的控制元件)定位、移动和引导,以及触动和停用探针。
轴细而长,同时其直径优选最多5mm,且在一些应用中,最多3mm。轴的长度优选超过至少100mm,此外,优选至少350mm或450mm。轴是刚性的,具体在压缩中是刚性的且是弯曲刚性的,以便能够通过使手柄和壳体以针对性的方式移动来在患者的身体中定位和移动其远端。
在优选实施例中,弯曲装置布置在轴的远端上,所述装置(例如构造为柔性管形区段、波纹管区段等)可从延伸的直线形式转变为弯曲形式。这样,如果弯曲装置能够围绕单个轴线执行枢转移动就足够了。这样,柔性区段围绕弯曲轴线弯曲,所述轴线相对于轴横向地延伸,且并未与所述轴相交。优选地,弯曲装置仅展示出移动的一个自由度,即,枢转运动的一个自由度。轴可具有附加的自由度,即,围绕其纵轴线的旋转。
对于沿各种空间方向的轴的成角端的定向,轴可通过移动壳体来旋转,或备选地,通过使壳体上的轴围绕其纵向方向旋转来旋转。这样,外科医生可朝圆锥的包络移动从轴突出的探针的端部,在此情况下,该圆锥的开口角可通过调整弯曲装置而改变。
此外,探针插入开口可设有用于探针的轴向固定的锁定装置,使得外科医生可使探针向远侧移出轴,或将所述探针缩回到所述轴中,且然后将所述探针固定就位。
附图说明
本发明的有利实施例的附加细节是附图、描述或权利要求的主题。附图示出了本发明的实施例的实例。它们示出了:
图1为具有探针的探针施加器的简化透视图,
图2为没有探针的根据图1的探针施加器的简化透视图,
图3为具有探针的探针施加器的示意性侧立面,
图4为设在器械的轴上的弯曲装置的放大示意图,
图5为探针施加器的插头探针施加器具有可插入插头中的两个不同的探针,以及
图6为插头和为探针而提供的连接装置的改型实施例的示意性侧立面。
零件清单
10 探针施加器
11 探针
12 轴
13 轴12的近端
14 轴容置部
15 壳体
16 轴12的远端
17 内腔
18 探针11的远端
19 轴12的柔性区段
20 轴12的端部区段
21 弯曲轴线
22 轴向屈曲区域
23 轴向刚性区域
24 弯曲装置
25 手柄
26 促动装置
27 杆
28 力传递装置
29 拉力装置
30 线缆
31 插头
32, 33 控制元件
34, 35 线
36, 37 插脚
38 连接装置
39 开口
40 探针插头
41 电触头
42 接触装置
43 插头31的插脚
44-47 夹具
48 锁定装置
49 偏心夹持杆
50 反向轴承
51 插入开口
52 流体连接
53 流体插头插脚
54 流体插头插脚
55 线
具体实施方式
图1示出了设置成用于接收柔性探针(例如,如,探针11)的探针施加器10,以便能够用此探针11执行腹腔镜手术。为了实现其,探针施加器10以腹腔镜器械的方式包括细长轴12,其近端13保持在轴容置部14中或轴容置部14上。优选地,轴容置部14可围绕轴12的纵轴线旋转;然而,其也可为刚性的,即,相对于壳体15非可旋转地构造或布置。
图2示出了没有探针11的探针施加器10。为了更好示出探针施加器10的基本设计,所述施加器又由示意性基础图示为具有探针11。
轴12由细管构成,细管具有优选不超过5mm的直径,并且具有优选大于200mm的长度。轴长度可达到500mm,且在特殊情况下甚至更大。构成轴11的管可为金属或塑料材料,且优选具有一定刚性,使得所述管在经由小开口插入患者的身体中时,所述管可通过使其近端13移动而在身体内定位和移动,使得轴12的远端16采用期望的位置或执行期望的移动。在任何情况下,轴12相比于柔性探针11大致是更硬的,柔性探针11通常提供成用于内窥镜使用,且延伸穿过轴12的沿纵向连续的内腔14,使得所述探针的一端18可突出轴12。
轴12可包括在图4中单独示出的柔性区段19。柔性区段19设置成使轴12的端部成角,所述端部可能是刚性管区段20。因此,轴的远端可从直线(细长)形式转变成弧形形式,其围绕弯曲轴线21弯曲,弯曲轴线21相对于轴2横向地定向,且在所述轴外延伸。
如图4中示意性指出,柔性区段19可在直径上相对的侧上显示出不同的轴向刚度。例如,其可包括面对弯曲轴线21的侧上的可良好压缩的区域22,同时其可具有的特征为相反侧上的纵向可压缩较少的区域23。考虑到该构造,柔性区段19形成弯曲装置24。然而,其还可能以不同方式构造,该方式允许轴的远端从细长形式到成角形式的针对性转换。
为了促动弯曲装置24,在具有手柄25的壳体15中或其上设有促动装置26(例如,杆27的形式),其枢转地支承在壳体15中或壳体上。该杆或任何其它操纵装置可经由包括力传递装置28(例如,以拉力装置29的形式)的适合的齿轮装置来将促动装置26的促动力传递至弯曲装置24。这样,例如,拉力装置29可直接地或经由适合的齿轮装置在近侧连接到杆27上且在远侧连接到端部区段20上,在此情况下,所述拉力装置从壳体15延伸穿过轴12直至轴12的远端16。如果所述拉力装置张紧,则其沿轴向方向压缩区域22,这是为何柔性区段19沿侧向方向弯曲。
此外,经由线缆30,壳体15连接到插头31上,插头31设置成用于将探针施加器10连接到供应装置上。供应装置设置成向探针11供应所需的操作介质,例如,电压和/或液体或气态流体或以及真空。此外,插头31可设置成将控制信号从探针施加器10(具体而言是从设在所述施加器上的控制元件32, 33)传递至供应装置。例如,控制元件32, 33可为电气开关,其开关状态可经由延伸穿过线缆30的线34, 35(图5)输出到插头31上的适合的插脚36,37。例如,开关32可在两条线34, 35之间沿一个流动方向经由二极管准许电流流动,而开关33将在两条线34, 35之间沿相反方向经由另一相反极性的二极管准许电流流动。以此方式,有可能在两个插脚36, 37上辨别开关未促动、一个开关促动还是两个开关促动。其它开关布置是可能的,例如,所有开关可连接到一个共同的参考电位线和连接到一条独立的信号线上。
替代电力线34, 35,还可提供一个或多个其它信号线,例如,光学波导等,在此情况下,至少一个控制元件32和/或33可影响例如一个此光学波导的端部处的反射性质,以便实现信号输送。
插头31包括用于探针11的连接装置38。例如,连接装置38可为设在插头31中的开口39,设在探针11的近端上的探针插头40可插入该开口中。该探针插头设置成向探针11供应其操作介质。例如,如图5中的第一改型中所示,探针插头40包括电触头41,其与设在开口39中的接触插座42或与其它接触装置相关联。该接触插座42电连接到插头31的对应插脚43上。
如可从图1和2推断出,具体而言,探针11可由适合的夹具44到47或由其它适合的装置连接到线缆30上。然后,探针从连接装置38开始延伸穿过壳体15和轴12直到轴12的远端20。如可从图3中推断,锁定装置48可设在壳体15中或壳体上,所述锁定装置可手动地促动,以便选择性地准许或阻挡探针11的轴向移动。例如,锁定装置48可为相反于反向轴承50定位的夹持装置,例如,以偏心夹持杆49的形式。探针11位于反向轴承50与夹持杆49之间,并且可通过促动夹持杆49来适当地固定就位。
迄今所述的探针施加器如下所述地工作:
对于其使用,探针11经由适合的插入开口51(图3)(相反于轴12的近端13定位且在其直线延伸部分中)插入壳体15中且穿过所述壳体进入内腔17中。这样,探针11最初优选前移至一定程度,使得其远端18从端部区段20突出,或在其口部之前不远停止。在此位置,探针11可用锁定装置48锁定就位。在此措施之前或之后,探针插头40插入连接装置38中,且插头31连接到供应装置上。可选地,期望的操作模式在装置上选择。因此,其中插入探针11的探针施加器10准备好用于操作。
轴12的远端16可穿过开口(例如,切口)插入而进入患者,在此情况下,探针施加器10由用户用手柄25保持,且借助于所述手柄定位。如果期望,则用户可借助于促动装置26来弯曲轴12的远端16,以便使探针11的远端18进入期望的角位置。此外,当端部弯曲时,用户可使轴12围绕其纵向端旋转。此外,如果期望,则用户可释放夹持装置48,且进一步使探针11前移或收缩探针11。借助于控制元件32, 33,用户可引起供应装置触动或停用探针11。例如,借助于控制元件32, 33,用户可接通电源或切断电源,或选择且触动以及停用各种模式,例如,电压水平、电压形式(曲线形式、波峰因素)。
连接装置38不限于供应电气探针。例如,所述装置除接触装置32之外或替代接触装置32包括流体连接52,例如,以流体连接器的形式。流体连接52可经由适合的通道连接到流体插头插脚53上,其优选地平行于接触插脚36, 37, 43延伸离插头31。因此,探针11a可设有与流体连接52相关联的流体插头插脚54。除此之外,有可能提供电触头41。在此情况下,控制元件32, 33可设置成独立于彼此地触动或停用探针11a的流体供应和电力供应。
从图6中清楚的是,连接装置38不必直接地设在插头31上。还有可能提供单独的连接器布置,其经由线55连接到插头31上。另一个备选方案在于将连接装置38设在供应装置自身上。除此之外,以上描述类似地适用。
根据本发明,提供了设置成用于接收柔性探针11, 11a的探针施加器10,探针旨在用于内窥镜使用,且可与探针施加器一起成为易用于腹腔镜使用。供应探针11, 11a的装置的控制经由探针施加器10的控制元件32, 33来发生。优选地,探针11, 11a经由设在探针施加器10上的连接装置38供应。
Claims (16)
1.用于柔性探针(11, 11a)的腹腔镜使用的探针施加器(10),包括:
壳体(15),其具有用于相对于患者手动地定位和移动所述探针施加器(10)的手柄(25),
轴(12),其为细长的刚性管,所述刚性管在其近端(13)上连接到设在所述壳体上的轴容置部(14)上,且所述刚性管在其远端(16)上开口,
至少一个控制元件(32, 33),其布置在所述壳体(15)上,以便可手动地接近,
具有线缆(30),其从所述壳体(15)延伸至具有至少一个插头连接器的插头(31),且所述线缆(30)包含将所述控制元件(32)连接到插头触头上的至少一个信号线(34),
探针插入开口(51),其设在所述壳体(15)上,所述开口相反于所述轴容置部(14)定位,以及
连接装置(38),其设置成用于探针(11, 11a)的连接,以便向所述探针供应操作介质;
其中,所述连接装置(38)布置在所述插头(31)上。
2.根据权利要求1所述的探针施加器,其特征在于,所述轴(12)具有的长度超过所述轴(12)的直径的二十倍。
3.根据权利要求2所述的探针施加器,其特征在于,所述长度超过所述轴(12)的直径的五十倍到九十倍。
4.根据权利要求3所述的探针施加器,其特征在于,所述长度小于所述轴(12)的直径的300倍。
5.根据权利要求4所述的探针施加器,其特征在于,所述长度小于所述轴(12)的直径的150倍。
6.根据权利要求1至5中任一项所述的探针施加器,其特征在于,在所述轴(12)的远端(16)上布置了弯曲装置(24),所述弯曲装置(24)连接到布置在所述壳体(15)上的促动装置(26)上。
7.根据权利要求6所述的探针施加器,其特征在于,所述促动装置(26)是布置在所述手柄(25)上的枢转杆(27),所述杆经由力传递装置(28)连接到所述弯曲装置(24)上。
8.根据权利要求1至5中任一项所述的探针施加器,其特征在于,弯曲装置(24)具有柔性区段(19),所述柔性区段(19)可从细长形式转变成弧形形式。
9.根据权利要求1至5中任一项所述的探针施加器,其特征在于,弯曲装置(24)在其远端上具有刚性的直线管区段。
10.根据权利要求1至5中任一项所述的探针施加器,其特征在于,所述轴(12)保持在所述壳体(15)上,以便可围绕轴纵轴线旋转。
11.根据权利要求1至5中任一项所述的探针施加器,其特征在于,在所述探针插入开口(51)上布置了锁定装置(48),以用于将延伸穿过所述探针插入开口(51)的探针(11, 11a)沿轴向固定就位。
12.根据权利要求11所述的探针施加器,其特征在于,所述锁定装置(48)是可手动地促动的夹持装置。
13.根据权利要求1至5中任一项所述的探针施加器,其特征在于,所述信号线(34)是电线,并且所述插头连接器是电插头触头。
14.根据权利要求1至5中任一项所述的探针施加器,其特征在于,所述线缆(30)承载连接装置以用于接收探针(11, 11a)。
15.根据权利要求1至5中任一项所述的探针施加器,其特征在于,所述连接装置(38)包括至少一个流体连接(52)。
16.根据权利要求1至5中任一项所述的探针施加器,其特征在于,所述连接装置(38)包括至少一个电连接件。
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