CN1269457C - 用于显微侵入外科手术的多功能器械 - Google Patents
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Abstract
本发明涉及一种用于显微侵入外科手术的多功能器械，包括一个操作手柄(10)、一个在操作手柄上固定的多腔管(14)、至少两个在管内与管轴线平行的导向通道(16、18、20)以及一些在各导向通道中可移动和可旋转地安装的分别具有一根轴(220、240、260)的外科工具(22、24、26)，在各轴的远端分别设有一个外科工作元件，其中，工具(22、24、26)可在一个静止位置与一个工作位置之间移动，在静止位置，相应的工作元件撤回到管内，而在工作位置，相应的工作元件从管的远端伸出。工具(22、24、26)可电动地移到工作位置和从工作位置移回并且至少一个工具(22、24、26)可在其工作位置电动地旋转。控制装置经由一个电子控制装置实现，以便至少控制外科工具和管的电动的位移运动和旋转运动。
Description
技术领域
本发明涉及一种用于显微侵入外科手术的多功能器械，其包括一个操作手柄、一个在操作手柄上固定的多腔管、至少两个在管内与管轴线平行的导向通道以及一些在各导向通道中可移动和可旋转地安装的分别具有一根轴的外科工具，在各轴的远端分别设有一外科工作元件，其中，各工具可在一个静止位置与一个工作位置之间移动，在静止位置，相应的工作元件撤回到管内，而在工作位置，相应的工作元件从管的远端伸出。
背景技术
在手术进行工作的医学领域(外科、妇科、泌尿科、神经外科等)不断地尝试减少手术上的创伤，亦即由手术本身造成对病人的伤害。减少手术创伤的一个可能性在于使手术的进入路径最小化。
十年前已开始在腹腔内借助于腹腔镜检查实施手术。在这种情况下，除与一个视频链连接的镜组外，还经由多个单独的进入路径将不同的单个工具插入腹腔，它们为实施手术是必需的。在腹腔内的实际手术按原理不变地按照传统的皮肤切口的手术来进行，从而作为原则性区别是省去了借助于切开腹壁的传统的手术入口。
在最小侵入的进入路径中，显著地减小手术过程中和以后机体的紧张反应。因此手术是较少疼痛的，病人可迅速活动，能较早地出院并且可以迅速地再次恢复其活动度和继续工作。
市场上现有的腹腔镜检查的手术器械一般最多组合2个功能。这意味着，典型的手术过程，亦即暴露一结构、封闭它(例如用小夹)、切开结构、暴露另一结构与手术工具的多次更换相联系。测定已得出，在最小侵入的手术中一器械更换从决定更换工具到新工具在手术部位的定位需要约40秒钟。该时间间隔的缩短可以显著地缩短整个手术持续时间。如果在一个器械中实现各种必要的工具功能，则在必要时甚至在手术的大部分时间内可以不要手术护士或手术助手的参加。
由EP 0692224B1已知一种用于开头所述类型的显微侵入的外科手术的多功能器械。那里所示的多功能器械的问题之一在于，必须在手工操作力的帮助下进行手术的工具的选择和管的旋转。因此在工具更换时可能导致多功能器械的扯破。此外，为了这样的更换过程还常常需要第二只手。选定的外科工具的撤回、选择和再向前推进同样必须由外科医生用传感器控制之。
已知的多功能器械的另一问题在于，当相应使用的外科工具借助于弹簧力导回时一反力或反冲量施加到多功能器械上。虽然通过相应的阻尼元件可以减小这种不符合要求的反冲量但在另一方面这样的阻尼元件增加了多功能器械的重量，而后者为了良好的可操作性应该尽可能保持基本上是很轻的。应该补充说明，为了将外科工具移到工作位置外科医生同样必须施加手工操作力，在该工作位所述弹簧被张紧。
发明内容
本发明的目的基本上在于，提供一种用于显微侵入的外科手术的多功能器械，其能够简便而迅速地进行工具更换并且在这方面减轻外科医生的负担，其中同时要避免不期望的副作用如多功能器械的扯破和反冲量。
按照本发明，该目的基本上这样来达到，即提出一种用于显微侵入外科手术的多功能器械，包括一个操作手柄、一个在操作手柄上固定的多腔管、至少两个在管内与管轴线平行的导向通道以及一些在各导向通道中可移动和可旋转地安装的分别具有一根轴的外科工具，在各轴的远端分别设有一个外科工作元件，其中，工具可在一个静止位置与一个工作位置之间移动，在静止位置，相应的工作元件退回到管内，而在工作位置，相应的工作元件从管的远端伸出；各工具可以电动地移到工作位置和从工作位置移回，并且至少一个工具可在其工作位置电动地旋转，以及设有一电子控制装置，用以至少控制电动的位移运动和旋转运动。
在本发明的优选的进一步构成中设定，多腔管可旋转地安装在操作手柄上并且也可电动地旋转，其中借助于电子控制装置可控制旋转运动。
由于外科工具的电动的移出和移进以及多腔管的电动的旋转以选择相应要求的外科工具，通过电机的适当控制实际上可以完全避免外科医生负担的相应的手工运动过程、排除工具更换时多功能器械的扯破以及避免由于复位弹簧产生的反冲量。此外按照本发明的多功能器械能够真正的单手操作。
电子控制的指令输入可以经由在操作手柄上设置的操纵元件如按钮来实现。或者，利用一相应的语言控制装置提供语言的指令输入。在该情况下由控制装置应处理的指令至少应该包括外科工具占有的静止位置或工作位置或外科工具的旋转。当指令输入可选择地经由语言或操纵元件来实现也可能是有利的。
为了电动驱动优选采用电机，例如微型驱动电机，其设置于多功能器械的操作手柄中。在本发明的优选的进一步构成中设定，为各外科工具配置的电机可经由在相应的工具与配置的电机之间接通的连接元件可选择地与相应的待选择的外科工具相连接，其中该选择的连接优选通过工具与配置的电机或配置的连接元件之间的相对运动来实现。当电机固定地设置于手柄中并且基本上通过管的适当的旋转实现选择的连接时，可得到特别简单的结构，其中按照管的角位置不同的外科工具与相应配置的电机相连接以便轴向运动或旋转运动。
优选经由适当的齿轮和小齿轮、蜗轮等实现从驱动电机向外科工具的力传递。为了承受驱动力，按照本发明的另一有利的特征，每一工具的轴的一近端部具有适当的轮齿，其中该轴端部在插入管中的状态下凸出于管的近端。详细地，至少一个外科工具的轴，优选全部外科工具的轴具有第一齿部分用以沿轴向方向移动工具和第二齿部分用以旋转外科工具。
按照本发明的一个有利的进一步构成，至少一个外科工具的轴在其近端具有一连接装置用以嵌接操纵元件以便手工操纵工具。一旦相应选定的外科工具经由连接装置与操纵元件相连接并且借助于配置的电机已移到其工作位置，从此时起其可以由外科医生手工操作；这样的手工操作为这样的外科工具提供，其中触觉的反馈是必要的和值得期望的，例如对剪刀或夹钳涂药器，而例如对卡环涂药器触觉的反馈是不一定需要的并因此也可以提供电动的工作行程。
依此，在本发明的另一有利的构成中设定，至少两个外科工具，例如剪刀和夹钳涂药器具有触觉反馈时的短的工作行程，并且在电动移到其工作位置以后可手工操纵；并且至少一个外科工具，例如具有长的工作行程的卡环涂药器，在电动移到其工作位置以后可手工或电动操纵。
为了使本发明的多功能器械具有尽可能大的应用范围，管优选具有各个不同直径的导向通道，因为例如卡环涂药器比剪刀需要较大的直径。优选管具有至少三个导向通道，特别是两个具有第一直径的导向通道和一个具有第二直径的导向通道，后者大于第一直径，其中第一直径可为约3mm而第二直径可为约5mm。
在本发明的优选的进一步构成中设定，管具有至少一个附加的用作为抽吸通道/或冲洗通道的通道。优选管具有两个附加的通道，其特别邻接于直径较大的导向通道设置并且为了最好的利用供使用的横截面，其具有大致三角形的横截面。相对于管的纵中轴线观察，各导向通道可以合乎目的地设置成使两直径较小的导向通道之间的角间距为90°而在各直径较小的导向通道与直径较大的导向通道之间的角间距分别为135°。
为了导入附加的通道中的流体输入附加的通道或排出附加的通道，按照本发明的另一有利的特征设定，每一附加的通道在管的近端部具有一径向向外延伸的出口，其与在操作手柄上安装的抽吸或冲洗接头相连接。此外设定，在管与操作手柄的在出口/各出口的区域内密封包围管的构件之间设有一沿管圆周方向延伸的空间，其一方面与出口而另一方面与抽吸或冲洗接头接通，其确保即使在管相对于该构件旋转时仍保持附加的通道与抽吸或冲洗接头之间的流体接通。
附图说明
本发明的其他有利的特征由以下的描述得出，其中借助于附图更详细地说明本发明的多个实施例。诸附图中表示半示意的或示意的视图：
图1本发明的多功能器械的局部剖的部分侧视图；
图2按图1的多功能器械的局部剖的前视图；
图3按图1的多功能器械的修改的实施例的部分视图；
图4一局部剖的部分视图，其示出管的驱动装置；
图5一部分视图，其示出操作位置，在该操作位置可移动第一外科工具；
图6一部分视图，其示出操作位置，在该操作位置可旋转第二外科工具；
图7一部分视图，其示出操作位置，在该操作位置可旋转第一外科工具；
图8一部分视图，其示出操作位置，在该操作位置可旋转第三外科工具；
图9一部分视图，其示出操作位置，在该位置可移动第三外科工具；
图10管的近端的径向剖面图。
具体实施方式
本发明的多功能器械包括一个具有壳体12的手枪形弯曲的操作手柄10和一个多腔管14，后者以可拆下方式并经由轴瓦或套筒轴承可旋转地支承在操作手柄10上并具有三个平行于管轴线构成的导向通道16、18、20，各外科工具22、24、26沿纵向方向可移动地并还可旋转地安装于各导向通道中。每一外科工具22、24、26在其图中未示出的远端具有一个手术工具例如一把剪刀、一个夹钳涂药器或一个卡环涂药器，其分别与一轴220、240或260相连接。每一根轴在其近端部具有一个第一切齿部分222、242、262、和一个向远端的方向邻接第一切齿部分的第二切齿部分224、244、264。在插入管14中的处于静止位置的外科工具的情况下，各外科工具的轴以其近端部从管14的近端伸出，从而可使各轴的切齿部分可选择地与驱动元件相啮合，而使相应要求的外科工具22、24、26可从其静止位置移到工作位置，其中在静止位置工作工具在所配置的导向通道被撤回，在工作位置选定的外科工作工具从管14的远端伸出并且在该位置然后可手工或电动地操纵并还可按要求电动地旋转。
管14在其近端具有一直径比其余的管加大的轴承部分28，其可旋转地支承于设置在总体约成手枪形的操作手柄10的远端上的轴承座30中。在轴承座30的近端设有一沿其圆周延伸的轮齿32。一在操作手柄10的壳体12中设置的电机34以一在其输出轴上固定的电机小齿轮36与管14的轴承部分28的轮齿32驱动式相啮合，借此管14可借助于电机34旋转，参见特别是图1和4。
为了移动外科工具22、24，其例如可涉及一把剪刀、一个夹钳涂药器或一个触钩，设有一个在壳体12中固定的电机38，该电机经由一个电机小齿轮40和一个中间小齿轮42与相应的轴220或240的第二切齿部分224或244的径向轮齿驱动式协同操作，参见特别是图1和5。电机38的中间小齿轮42与相应的轴的第二切齿部分这样啮合，即使管14借助于电机34转到相应的角位置。从管或外科工具的一基准位置开始，如其在图5中所示，外科工具由于管按照图6和7的相应的旋转而转入中间小齿轮42的轮齿中。
借助电机38因此可以使与中间小齿轮42处于啮合的外科工具沿轴向方向移动。只要选定的外科工具被移到工作位置，就使其通过管14旋转90°以其在第一切齿部分222或242上的端齿移到与一个电机小齿轮46啮合，该电机小齿轮46固定在一个固定于操作手柄10的壳体12中的电机44的输出轴上。因此借助于电机44可以随意旋转相应选定的外科工具22或24。在外科工具22、24的轴220、240的近端分别设有与轴同心的杆226、246，在其近端成形一个连接球228、248。一个在壳体上可摆动支承的操作摆动杠杆48，其一个杠杆臂伸入壳体12中，在该杠杆臂的末端具有一个容纳口50，其形状匹配于连接球228、248的形状并且可以可嵌入式和可脱开式容纳连接球228、248。在图6和7中所示的位置选定的外科工具22或24向后移动，直到其连接球228、248进入和嵌入操作摆动杠杆48的容纳口50中，从此时起直接手工操作工作工具是可能的，这特别对这样的外科工具是有意义的，其要求触觉的反馈，例如剪刀。
外科工具26，其在其远端例如设有一卡环涂药器，可借助于一个电机52移动，后者固定安装于操作手柄10的壳体12中并且经由一个在其输出轴上固定的电机小齿轮54在管14的相应的角位置时可移到与外科工具26的轴260的第二切齿部分264的径向轮齿驱动式啮合，参见图1和9。另一个在壳体中固定的电机56经由一个在其输出轴上固定的电机小齿轮58在管14的相应的位置时与外科工具26的轴260的第一切齿部分262的端齿处于驱动式啮合并从而可使外科工具26旋转，参见图2和8。外科工具26通过管14的相应的旋转转到按图8和9的工作位置，如以上所述。
按照外科工具22和24，外科工具26在其近端也具有一根杆266，在该杆266的近端设有一连接球268，其可嵌入另一操作摆动杠杆60的容纳口62中，该杠杆60可摆动地支承在壳体12上并且在其伸入壳体12的内部的摆动臂上具有容纳口62。在外科工具26的工作位置连接球268嵌入容纳口62中并从而如同外科工具22和24可直接手工操作外科工具26。
对于不需要组织体质的触觉反馈而作为工作行程只需前移和退回的工具，例如用于设置一个小夹的工具，也可以电动地进行操纵，参见图3，其在这方面示出一可供选择的实施形式。代替连接球268其中设有一个具有径向轮齿的齿杆64，其在外科工具26的工作位置与壳体12中固定的电机66的电机小齿轮68处于驱动式啮合。
在所示的实施例的情况中容纳外科工具22、24的导向通道16、18的直径为3mm，其中外科工具22、24具有大致相同大小的工作行程。容纳外科工具26的导向通道20的直径在该实施例的情况中为5mm并且该外科工具可以比其他的外科工具具有较短的或较长的工作行程。
关于管的中轴线两导向通道16、18的角间距为90°，而导向通道20与导向通道16和导向通道18之间的角间距分别为135°。导向通道16与导向通道20之间以及导向通道18与导向通道20之间存在的空间用于构成其他的通道70、72，它们可特别用作为冲洗和抽吸通道。为了最好的空间利用各通道70构成为大致三角形的横截面，具有相应于邻接壁的各弧形侧表面。
通道70、72沿轴向方向向管的远端开口并且在管14的近端在轴承部分28的区域内各具有一径向出口74、76，其向各一个在轴承座30中构成的抽吸或冲洗连接通道78、80方向延伸，在这两个通道上安装抽吸或冲洗接头82、84。此外在每一径向出口74、76的外端分别邻接一空间86、88，其沿管的圆周方向向出口的两侧延伸一总共例如90°的角区域并且向外是开口的。按这种方式即使在管14相对于操作手柄10旋转时仍保持通道的相应的径向出口与配置的抽吸/冲洗接头的接通。
如以上所述，由塑料构成的管14在操作手柄10上是可拆的并且可利用其轴承部分28沿轴向方向插入操作手柄10的轴承座30中和借助于一锁紧螺母90固定于其操作位置，后者借助于一不能丢失的环锁住。管14操作手柄10上的可拆卸性一方面可使管14更简单的清洁，而另一方面使其可便于从后面配备管14。
多功能器械的操作，至此其不经由操作摆动杠杆48和60来实现，而经由一未示出的电子控制装置来实现，后者可以设置在操作手柄10的外面并可以通过一电缆与其连接。电子控制装置或经由一安装在操作手柄10的壳体12上的按钮电键，其在图2中用标记92表示，或经由一个语言输入控制装置接收控制指令。特别是设有下列控制指令：工具22前进和返回，工具24前进和返回，工具26前进和返回，处于工作位置的工具向右旋转或向左旋转，处于工作位置的工具26的工作行程(参见图3)。
在按图2的实施例的情况中，实际的电子控制装置位于壳体12的内部并由印刷电路板94表示。在全部的实施形式中各个未更详细示出的传感器检测各个工具的位置。这些位置数据在电子控制装置中加以处理并然后根据由印刷电路板或语言输入装置输入的控制指令控制各相应的电机。在语言控制的情况下这在一外部的计算机上进行，其然后可以将相应的指令传送给位于壳体12中的电子控制装置或直接传送给电机。
为了实现一体化，管14必须是绝缘的。由于这个原因，管14已由塑料制成。外科工具22、24中的一个用于合成一体。为一体化所需要的电压的供给通过接触工具22、24的外表面或也通过接触相应的连接球228、248来实现。在壳体12上或在操作摆动杠杆48上实现单极的连接。
按照本发明的多功能器械，因此允许其在管14的内部利用三个不同的外科工具，而不必由外科医生为此从套针中拉出管14。各外科工具经由操作手柄10上适当的操纵元件或经由语言控制装置移到工作位置，必要时将其连接到操作摆动杠杆上以便手工操纵，或者如果要实现电动的工作行程，则电动地操纵。因此为不同的手术步骤所需要的外科工具可在手术部位实现同时和迅速地更换。
本发明的多功能器械能够节省手术时间。对于手术的较长时间内不需要工具装置的护士得到附加的可能的节省，因为只要利用本发明的多功能器械全部的工具功能可供在手术部位例如腹腔内使用，就没有必须更换的工具。
本发明的多功能器械的另一主要优点在于，不同于按现有技术的多功能器械，它可以简便地适应于医学机器人，因为在可预见的时期内最不同的手术如心脏冠状血管手术或对脊柱和关节的手术在日益增长的程度上不直接由外科医生自己，而相反地通过机械手的中间连接(遥控医学一机器人技术)来实施。按照本发明的多功能器械中间连接在机械手与手术部位之间，提高使用可能性，因为在这里单个机械手不再固定于只一个工具上，而可以配备可变的功能。
本发明的多功能器械的另一优点由于这样的情况得出，即不再需要一手术护士或手术助手，其递给各个需要的工具，并且消除可能的传递错误，例如递给错误的工具，其可能妨碍手术过程或危及手术结果。
利用本发明的多功能器械的处理过程简要概括如下：
将以前的手术的可重新使用的工具或工具零件消毒。外科手术前进行要求的使用工具如剪刀、夹钳、小夹等的选择。将选定的各个工具从后面沿相应的导向通道插入从操作手柄中取出的管中。将管安装在操作手柄上并借助于锁紧螺母90固定之。各个工具自动地进入和定位于其在管内的静止位置。在操作手柄上在必要时连接外部的(未消毒的)辅助装置。在内部外科手术上经由壳体上的按钮或经由语言控制装置实现外科工具的选择，其然后自动地移到工作位置并连接到操作摆动杠杆上。如果要求更换工具并且相应的工具通过按钮或语言控制装置来控制，则至此使用过的工具自动回到其静止位置，自动地选出选择的下一工具并且其自动地移到工作位置。随时可使处于工作位置的工具旋转。在手术完成和最后使用的外科工具移到其静止位置以后将管从病人的身体中撤出，从操作手柄上卸下并包括使用过的外科工具在内加以清洁。
对于专家来说产生众多的修改可能性。例如可以将外科工具与手柄中的能源电动、气动或液压地相连接或在外部未消毒的手术区域实现与能源的连接。如果不需要外科工具的旋转则可以省去电动驱动装置。各个工具的电动旋转也可以通过整体旋转管来实现。
附图标记清单
10操作手柄 38电机
12壳体 40电机小齿轮
14管 42中间齿轮
16导向通道 44电机
18导向通道 46电机小齿轮
20导向通道 48操作摆动杠杆
22外科工具 50容纳口
220轴 52电机
222第一切齿部分 54电机小齿轮
224第二切齿部分 56电机
226杆 58电机小齿轮
228连接球 60操作摆动杠杆
24外科工具 62容纳口
240轴 64齿杆
242第一切齿部分 66电机
244第二切齿部分 68电机小齿轮
246杆 70通道
248连接球 72通道
26外科工具 74径向出口
260轴 76径向出口
262第一切齿部分 78连接通道
264第二切齿部分 80连接通道
266杆 82抽吸/冲洗接头
268连接球 84抽吸/冲洗接头
28轴承部分 86空间
30轴承座 88空间
32齿轮 90锁紧螺母
34电机 92按钮电键
36电机小齿轮 94印刷电路板
Claims (28)
1.用于显微侵入外科手术的多功能器械，包括一个操作手柄(10)、一个在操作手柄上固定的多腔管(14)、至少两个在管内与管轴线平行的导向通道(16、18、20)以及一些在各导向通道中可移动和可旋转地安装的分别具有一根轴(220、240、260)的外科工具(22、24、26)，在各轴的远端分别设有一个外科工作元件，其中，工具(22、24、26)可在一个静止位置与一个工作位置之间移动，在静止位置，相应的工作元件退回到管内，而在工作位置，相应的工作元件从管的远端伸出；其特征在于，
工具(22、24、26)可电动地移到工作位置和从工作位置移回；
至少一个工具(22、24、26)可在其工作位置电动地旋转；以及
设有一个电子控制装置，用以至少控制电动的位移运动和旋转运动。
2.按照权利要求1所述的多功能器械，其特征在于，多腔管(14)可旋转地安装在操作手柄(10)上并且可电动地旋转，其中，借助于电子控制装置可控制旋转运动。
3.按照权利要求1或2所述的多功能器械，其特征在于，为了进行电动驱动，在操作手柄(10)内设置电机(34、38、44、52、56、66)。
4.按照权利要求3所述的多功能器械，其特征在于，为各工具配备的电机可经由在相应的工具与所配备的电机之间接通的连接元件(40、42、46、54、58、68)有选择地与相应的待选择的工具(22、24、26)相连接。
5.按照权利要求4所述的多功能器械，其特征在于，通过在工具与所配备的电机或所配备的连接元件之间的相对运动来实现选择连接。
6.按照权利要求5所述的多功能器械，其特征在于，各电机固定设置在操作手柄(10)中并且基本上通过管(14)的旋转实现选择连接。
7.按照权利要求3所述的多功能器械，其特征在于，每一工具(22、24、26)的轴(220、240、260)的一个在插入管(14)中的状态下凸出于管的近端的近端部具有轮齿(222、242、262；224、244、264)，用以嵌接电动的驱动装置。
8.按照权利要求7所述的多功能器械，其特征在于，至少一个工具(16、18、20)的轴(220、240、260)具有一个用以沿轴向方向移动工具的第一齿部分(222、242、262)和一个用以旋转工具的第二齿部分(224、244、264)。
9.按照权利要求7所述的多功能器械，其特征在于，至少一个工具(22、24、26)的轴(220、240、260)在其近端具有一个连接装置(228、248、268)，用以嵌接一个操纵元件(48、6)，以便手工操纵工具。
10.按照权利要求1所述的多功能器械，其特征在于，管(14)具有不同直径的导向通道(16、18、20)。
11.按照权利要求1所述的多功能器械，其特征在于，管(14)具有至少三个导向通道(16、18、20)。
12.按照权利要求10所述的多功能器械，其特征在于，管(14)包括两个具有一个第一直径的导向通道(16、18)和一个具有一个大于第一直径的第二直径的导向通道(20)。
13.按照权利要求12所述的多功能器械，其特征在于，第一直径为3mm+/-0.5mm，而第二直径为5mm+/-0.5mm。
14.按照权利要求12或13所述的多功能器械，其特征在于，相对于管(14)的纵向中轴线观察，两个具有较小直径的导向通道(16、18)之间的角间距为90°，而在各具有较小直径的导向通道(16、18)与具有较大直径的导向通道(20)之间的角间距分别为135°。
15.按照权利要求1所述的多功能器械，其特征在于，管(14)具有至少一个附加的用作抽吸通道或冲洗通道的通道(70、72)。
16.按照权利要求15所述的多功能器械，其特征在于，管(14)具有两个附加的通道(70、72)。
17.按照权利要求12所述的多功能器械，其特征在于，管(14)具有两个附加的用作抽吸通道或冲洗通道的通道(70、72)。
18.按照权利要求17所述的多功能器械，其特征在于，两个附加的通道(70、72)邻接于具有较大直径的导向通道(20)。
19.按照权利要求18所述的多功能器械，其特征在于，两个附加的通道(70、72)各具有一个大致三角形的横截面。
20.按照权利要求15至19之一项所述的多功能器械，其特征在于，每一个附加的通道(70、72)在管(14)的近端部具有一个径向向外延伸的出口(74、76)，该出口与一个抽吸或冲洗接头(82、84)相连接。
21.按照权利要求20所述的多功能器械，其特征在于，在管(14)与操作手柄(10)的在所述出口的区域内密封包围管的构件(30)之间的接触区域中设有一个沿管的圆周方向延伸的空间(86、88)，所述空间一方面与出口(74、76)而另一方面与抽吸或冲洗接头(82、84)接通，并构成为，即使在管(14)相对于构件(30)旋转时仍保持在附加的通道与抽吸或冲洗接头之间的流体接通。
22.按照权利要求1或2所述的多功能器械，其特征在于，为了装上和卸下工具(22、24、26)，管(14)与操作手柄(10)可拆式相连接，特别是通过一种带有锁紧螺母(90)的插塞连接(28、30)来实现。
23.按照权利要求1或2所述的多功能器械，其特征在于，至少两个外科工具(22、24)具有触觉反馈时的短的工作行程并且在电动移到其工作位置以后可进行手工操纵，并且，至少一个外科工具(26)具有长的工作行程，在电动移到其工作位置以后，该外科工具可手工或电动进行操纵。
24.按照权利要求23所述的多功能器械，其特征在于，所述至少两个外科工具(22、24)是剪刀和夹钳涂药器，而所述至少一个外科工具(26)是卡环涂药器。
25.按照权利要求1所述的多功能器械，其特征在于，控制装置的指令输入经由在操作手柄(10)上设置的操纵元件(92)来实现。
26.按照权利要求1所述的多功能器械，其特征在于，控制装置可以实现一语言指令输入。
27.按照权利要求25或26所述的多功能器械，其特征在于，待由控制装置处理的指令至少包括工具(22、24、26)占有的静止位置或工作位置和/或工具的旋转和/或管的旋转。
28.按照权利要求27所述的多功能器械，其特征在于，指令输入有选择地经由语言或操纵元件(92)来实现。
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE10147145A DE10147145C2 (de) | 2001-09-25 | 2001-09-25 | Multifunktionsinstrument für die mikroinvasive Chirurgie |
| DE10147145.9 | 2001-09-25 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1578643A CN1578643A (zh) | 2005-02-09 |
| CN1269457C true CN1269457C (zh) | 2006-08-16 |
Family
ID=7700157
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB028217438A Expired - Lifetime CN1269457C (zh) | 2001-09-25 | 2002-09-24 | 用于显微侵入外科手术的多功能器械 |
Country Status (8)
| Country | Link |
|---|---|
| US (1) | US7252660B2 (zh) |
| EP (1) | EP1434523B1 (zh) |
| JP (1) | JP4286137B2 (zh) |
| CN (1) | CN1269457C (zh) |
| AT (1) | ATE367769T1 (zh) |
| DE (3) | DE10147145C2 (zh) |
| ES (1) | ES2291501T3 (zh) |
| WO (1) | WO2003026511A1 (zh) |
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-
2001
- 2001-09-25 DE DE10147145A patent/DE10147145C2/de not_active Expired - Fee Related
-
2002
- 2002-09-24 CN CNB028217438A patent/CN1269457C/zh not_active Expired - Lifetime
- 2002-09-24 DE DE50210566T patent/DE50210566D1/de not_active Expired - Lifetime
- 2002-09-24 JP JP2003530153A patent/JP4286137B2/ja not_active Expired - Lifetime
- 2002-09-24 WO PCT/DE2002/003581 patent/WO2003026511A1/de active IP Right Grant
- 2002-09-24 US US10/489,868 patent/US7252660B2/en not_active Expired - Lifetime
- 2002-09-24 DE DE10294318T patent/DE10294318D2/de not_active Expired - Fee Related
- 2002-09-24 ES ES02776698T patent/ES2291501T3/es not_active Expired - Lifetime
- 2002-09-24 AT AT02776698T patent/ATE367769T1/de not_active IP Right Cessation
- 2002-09-24 EP EP02776698A patent/EP1434523B1/de not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| ATE367769T1 (de) | 2007-08-15 |
| JP4286137B2 (ja) | 2009-06-24 |
| DE50210566D1 (de) | 2007-09-06 |
| EP1434523B1 (de) | 2007-07-25 |
| WO2003026511A1 (de) | 2003-04-03 |
| DE10147145C2 (de) | 2003-12-18 |
| US20040249366A1 (en) | 2004-12-09 |
| CN1578643A (zh) | 2005-02-09 |
| DE10147145A1 (de) | 2003-08-14 |
| ES2291501T3 (es) | 2008-03-01 |
| DE10294318D2 (de) | 2004-08-12 |
| JP2005502441A (ja) | 2005-01-27 |
| EP1434523A1 (de) | 2004-07-07 |
| US7252660B2 (en) | 2007-08-07 |
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