DE102007026721A1 - Tool i.e. medical gripping tool, for e.g. examining, body part of patient, has two branches provided, where one branch is deformable during movement and is formed of deformable framework and exhibiting flexible flanges - Google Patents

Abstract

The tool has two branches provided, where one branch (1) is deformable during a movement and is formed of a deformable framework. The deformable branch exhibits flexible flanges (2), where a connecting unit (4) e.g. rods, extends between the flexible flanges. The flanges exhibit v-shaped recesses, where the connecting unit lies in the v-shaped recesses, and the thickness of the connecting unit corresponds to a breadth of the recesses. The shape of ends of the connecting unit and the recesses corresponds to one another.

Description

The The invention relates to a tool, in particular a medical Gripping tool with at least two branches for gripping, holding, Editing or examining body parts.

Barrel- and gripping tools for the medicines are generally known in the art. They are usually either big or complex. The gripping tools comprise two connected to a joint Industries that can grab an item, usually by pinching he follows.

Parallel guided gripper tools are not common in medicine. Articulated barrel tools have the disadvantageous property of that when opening the angle between the branches increases, which is a grasping or gripping difficult. Complex, multi-jointed tools are used in surgery not used, because the joints demanded easy cleaning difficult.

In The tool technology outside of medicine become predominantly Pliers shapes used with a joint, such as flat-nose pliers, etc. The missing parallel guidance is partially countered by an adjustability, as you e.g. knows from the water pump pliers ago.

From other areas the FinRay effect is known. He describes a two-layered structure that undergoes force-directed deformations, eg evades the point of attack and bends against it at the ends of the construction. This results in a shape adaptation and point loads are avoided. The effect is known for example for chair backs. The basic construction is eg from the DE 199 16 411 A1 . EP 1 040 999 A2 . EP 1 316 651 A3 . US 2004/0183348 A1 . EP 1 316 651 A2 . EP 1 203 640 A3 . EP 1 203 640 A2 . EP 1 040 999 A3 known.

The Gripping with gripping tools can be in the cases of positive engagement and traction be divided. When form-fitting it is necessary that the affecting bodies and the tool fit well with each other. In all other cases will the traction used. It can also be combinations of both give.

to Time is used in medicine for grasping body parts or aids Tools are used with two industries where the industries have one grooved surface exhibit. The corrugation of the branches should be microscopic Allow positive fit, which is less stress on the tissue. Investigations have shown that, nevertheless, by large, local Force peaks necroses are caused, although the instruments be called atraumatic.

to introduction through tight trocars in the body a tool must be small. As a result, the gripping of large objects is difficult. A gripping of flat objects with largely flat sectors is hardly possible, because the current Gripping tools such as a pair of scissors or pliers when opening a more and more angled shape accept that complicate the grasping.

It is proven by several studies that called atraumatic Forceps cause tissue necrosis. This necrosis can big in the patient Cause problems in the recovery process. The gripping and holding tools available on the market have in recent years, always to meet the needs The doctors adapted, but are always as compromise solutions too see, since no individual adaptation to be manipulated Organs or other body parts given is.

Of the Invention has for its object to provide a gripping tool which overcomes the aforementioned disadvantages and with which the surgical Tasks are particularly well to do without traumatization the current instruments. It is It continues to task the applicability in medicine, specifically in open and minimally invasive surgery. A Application in other areas can be done as well. It should according to the task continue to emerge a tool that is particularly suited to his tasks is adjusted. The gripper tool is to enable various functionalities.

Is solved the task according to the invention through a generic tool, with at least two industries, where at least one of the industries, if applicable, all industries are deformable, in particular during a movement.

hereby results in the possibility that based on the gripping the tool, at least one the industries, preferably in more or even all industries, itself adapt to the shape of the object to be grasped. This can an adaptation and a form fit are made, so that point loads be avoided.

In terms of medicine, atraumatic grasping can be guaranteed even for flat objects. In addition, even strongly curved objects by a tool according to the invention by positive engagement and / or adhesion are tangible in particular without causing tissue injury. This is especially deswe It is possible because with the gripping tool according to the invention as large as possible deflection of an industry and thus a large positive engagement can be achieved even with a small amount of force.

moreover For example, such a tool can be for insertion through narrow accesses to Machining space be made small construction and, e.g. collapsible and be deployed at the site accordingly. It can be provided be that an industry is deformable, without the industry by a hinged Connection to an adjacent branch, but e.g. by having a force essentially in one Direction of longitudinal extension of the gripping tool is generated. In addition, more can be Processing, observation or measuring devices on a gripping tool according to the invention Arrange.

In a preferred embodiment It can be provided that at least one industry from a deformable rod or framework is formed. This can be done this way be that at least one of the branches of a gripping tool, if necessary. also several or all branches two, in particular flexible cheeks comprises, between which are connecting elements, in particular Bars or Sprouts extend.

The Movement of such erfindungemäßen industry goes to the FinRay effect back. It can be such a construction system with individual constructive Elements are achieved that have the special behavior in the system makes it assignable and predictable. By assembling the tool from individual elements can thus the later behavior and the possible uses be determined. So there is the possibility of a construction to design that is tailored to a particular problem such as. a gripping tool for arched structures, not over Force but by means of positive locking works or a tool for flat Structures that make a large-area contact with low surface pressures allowed.

Further particularly preferred embodiments are in the subclaims and will also be described below with reference to the figures described in more detail.

• 1. Die Kräfte, die zur Verformung des Werkzeuges führen, werden über die Wangen eingeleitet. Diese Kräfte 2 und 3 (siehe 12) führen, ohne dass die untere Wange den zu greifenden Gegenstand berührt, zur Verformung.
• 2. Die Kraft, die zur Verformung des Werkzeuges führt, wird vom zu greifenden Gegenstand zum Beispiel als Gegenkraft aus in die innere Wange einer Branche eingeleitet. Diese Kraft 1 (siehe 12) kann also nur beim Vorhandensein eines Gegenstandes im Kontakt mit der Wange ausgeübt werden. Die Kräfte 2 und 3 stellen dann die Reaktionskräfte dar.
• 3. Werden über die für den Fall 2 beschriebenen Kräfte 2 und 3 von außen noch zusätzliche Kräfte aufgebracht in die gleiche Richtung der Kräfte 2 und 3, so lässt sich der Grad der Verformung noch steigern. Dieser Fall stellt somit die Überlagerung der Fälle 1 und 2 dar.

In the tool according to the invention, in particular gripping tool, it is advantageous, the gripping region in the front third of a cheek (see 11 and 12 ). It can be distinguished for the gripping process, two fundamentally different cases, the effects of which can also be superimposed.

• 1. The forces that lead to the deformation of the tool are introduced through the cheeks. These forces 2 and 3 (see 12 ), without the lower cheek touching the object to be gripped, for deformation.
• 2. The force that leads to the deformation of the tool is introduced from the object to be gripped, for example, as a counter force in the inner cheek of an industry. This force 1 (see 12 ) can thus be exercised only in the presence of an object in contact with the cheek. The forces 2 and 3 then represent the reaction forces.
• 3. If additional forces are applied from the outside in the same direction of the forces 2 and 3 via the forces 2 and 3 described for the case 2, the degree of deformation can still be increased. This case thus represents the superposition of cases 1 and 2.

at All gripping tasks of flat objects with uniform thickness (for example intestinal tissue) only by a quasi parallel guidance of the branches of force or Pressure peaks are avoided. According to the invention this can be done by a framework take place, which deflected in the front third parallel to the original axis and thus does not show any pressure peaks on flat objects.

• I. die obere (äußere) Wange ist an ihrem Endpunkt gegen Kippung fixiert und an der Unteren (inneren) wird gezogen, so dass der untere Endpunkt nach links aus der Ruhelage auswandert.
• II. die untere Wange ist an ihrem Endpunkt gegen Kippung fixiert und an der oberen wird geschoben, so dass der obere Endpunkt nach rechts aus der Ruhelage auswandert.

Furthermore, two clamping possibilities of the cheeks (see 12 ) are distinguished:

• I. The upper (outer) cheek is fixed at its end point against tilting and at the lower (inner) is pulled, so that the lower end point migrates to the left from the rest position.
• II. The lower cheek is fixed at its end point against tilting and at the top is pushed, so that the upper end point emigrates to the right from the rest position.

By the simultaneous deformation of the industry emits their peak more as an instrument that has a rigid structure. Especially for long, thin tools, which should be guided by a trocar, for example the case I.

in the The number and arrangement of the sprouts has a special influence on the overall behavior of the structure. The fewer sprouts are used, the more flexible the structure and the easier it is to deflect it.

This leads to, that when used with a predetermined load frame, an optimal number of rungs exists, which on the one hand ensures the necessary stability, on the other hand, a small amount of force for deforming and gripping requirement. For example, can 3 to 7 sprouts in general be beneficial.

Is the instrument for multiple use provided hinged, solid particular one-piece hinges can be used. The use of film hinges lends itself to this, as they open up the possibility of shaping the complete structure as one body, which particularly benefits easy manufacturability.

Becomes a system for different tasks needed can find a kind of plug-in device in which the connecting Elements / rungs are held by the residual stress of the system, and can be used as needed.

In addition to the number of sprouts, the rung orientation also influences the behavior of the construction. If, for example, an instrument is designed for Greiffall 1, it is effective if the sprouts are tilted backwards (see 14 ). If, on the other hand, an instrument is designed for Greiffall 2, it is effective if the sprouts are perpendicular to one of the cheeks, especially the inner cheek (see 12 ). In case 3, a slight tilting of the rungs backwards on an operating handle is too advantageous.

As an advantageous expression of a large deflection of the structure with little use of force for the deformation, the outer cheek, to which the pressure force acts, thicker, and the inner cheek, on which the tensile force acts, are made thinner. Care must be taken to ensure that minimum thicknesses are maintained, as otherwise kinking / breakage of the cheek may occur. ( 12 ).

At Place the massively continuous cheek with the pressure force can this Cheek also be designed as a link chain, thus the deformation work is minimized compared to the holding / or the gripping work.

Prefers becomes a changeable one Rung orientation. This can be done by a plug in between Rungs and cheeks can be achieved. It's also fast change the alignment during the use possible.

Should ensure an immediate adjustment so it is recommended that the connecting elements / sprouts, for example to mount on one / more sledges. The sledges can be in be mounted on the cheek arranged guide rail. Either can by means of pressure or tension mechanism, over the handpiece is operated, a shift of the sprouts can be achieved, or For example, when using multiple carriages, their displacement may be over between them attached expandable elements, e.g. Cushion / bellows etc. happen. The expansion of these elements can be done via fluid introduction with a suitable medium (e.g., liquid or gas).

One Another positive effect when using a sled is a reduction in the height dimension of the system.

Independent with which background (rung alignment / miniaturization) the printing or Traction mechanism or the expandable elements are used, it is also advantageously ensured that the system returns to the ground state as soon as the external force influence eliminated. This can be over for example the use of springs or by using shape memory of the Materials happen.

On the other hand, the own spring stiffness of the material can cause this provision. The above-described temporary miniaturization can be achieved not only by the rung orientation, but also by the rung construction. Here, for example, hinges are used, which can be mounted in the middle of the rungs. These may be provided with a pulling mechanism that can be operated via the handpiece. When force is used, the rungs are buckled, which affects the external dimensions of the overall system (see 3 and 4 ).

Becomes The use of force ended is advantageously guaranteed here be that the sprouts automatically return to their original state align. This is advantageously done via spring properties or shape memory of the material.

These elements, which can be bent over or bent over by a pulling mechanism, can also be used in the cheeks. In doing so, they cause a shortening of a cheek, which alters the orientation of certain shoots and changes the profile of the overall design and thus influences the system behavior (see 5 ).

Next the manipulation of the outer cart longitudinal can These are also designed so that they deform laterally. In this case, you can For example, expandable wedges are used in the expanded Condition cause a lateral kinking of the outer cheeks. The Expansion can also be over here Fluid introduction done with a suitable medium. After emptying The wedges can also be provided here, that the cheeks back in their original orientation align.

The use of spring elements may be useful. The wedge variant can also be used, for example, for steering in a guide catheter / wire (see 9 ). Here, the multi-dimensional steerability through the use be ensured by staggered, at least partially decoupled structures.

An additional alternative for structurally changing the outer cheeks is their equipment with actuators / sensors. These can be movably mounted. These can be extended on site via a pulling mechanism, which prevents, for example, unwanted injury to tissue during insertion of the instrument (see 6 and 7 ).

If a larger contact surface is required, the cheek construction can be equipped with fold-out wings, which are attached to the outer cheeks. The unfolding can be done via the introduction of medium in cavities in the wings (see 10 ).

Independent in which version a gripping tool is finally present, the gripping effectiveness through the use of a structured gripping surface (for example by micro- or nanoparticles).

A applicability is also the use of this technique in connection with deformable, e.g. gel-like lenses or other, pivotable or deformable optical systems. these can at the lens, for example, with the attachment points on the lens edge be attached. Then acts on the construction of a force, so let yourself change the refractive power of the lens with it. Other applications are the deflection or deformation of mirrors.

One Gripping tool according to the invention has the advantage of designing tools using simple structures can be in particular when actuated from a mold into a change another shape and thereby, for example, a barrel task by means of positive locking easier can handle or after the execution unfold or enlarge through a narrow lumen, thereby completing the tasks better to deal with. In another design variant, the instrument behaves like a multi-joint, parallel guided Pliers, although the structure and cleanability much easier is.

The Figures show possible in detail Embodiments of an industry of a gripping tool according to the invention. The other industries can do the same or else be formed differently.

The 1 generally shows a section of a cheek 2 an industry 1 with recesses 3 for receiving connecting elements 4 , The 2 shows a section of an industry 1 with two opposite cheeks 2 between which connecting elements 4 run, for example, in the recesses einliegen or by (film) hinges are connected to these.

3 shows a front area of an industry 1 , where the connecting elements 4 (Rung) in the middle with a tension element 5 are connected. If a tensile force - here to the right - exercised, so buckle the connecting elements 4 at the junction. This causes a deformation that causes the front end to dodge down. It may, like 4 shows, already in a basic position with not buckled elements 4 be provided that the industry already has a comprehensive / encompassing preform. In addition, this design variant in activated form allows a height reduction of the system.

5 shows an embodiment in which a cheek 2 an area 6 is provided to effectively shorten the cheek 2 to cause a pulling force over a tension element 7 on this area 6 is exercised. For this, the area can be designed to be multi-articulated, wherein the tension element can act on a central joint that is connected via levers and a joint to the front and rear part of the cheek. If you pull on the middle joint, it gives way to the inside and thus shortens the distance between the other two joints 8th ,

6 shows an industry with an arranged at the front end retractable actuator or sensor 9 ,

7 shows a gripping tool with three branches 1 , each composed of two cheeks, between which at least in a front region connecting elements 4 extend. Actuators or sensors can be arranged at the top.

8th shows an execution of an industry 1 in which the sprouts 4 with a top end on a sled 10 are fastened, which can slide in a rail not shown here in detail. If the carriage is moved, then the inclination of the rungs and also the deformation of the industry 1 to change.

9 shows an embodiment in which between two sections 2a and 2 B a cheek 2 a fluid-filled wedge-shaped element 11 is arranged. When this is filled, the part moves 2a Following the wedge shape to the left and when emptying back to the left.

10 shows an embodiment with fluid-fillable wings 12 , on the side of a cheek 2 is orders can be. In a fluid filling, the wings fold up, as shown on the right in the figure.

11 visualizes the basic principle of the introduction of force in the cheeks 2 an industry.

In the 12 an industry of a gripping tool according to the invention with two branches is described, each having a lower (inner) and an upper (outer) cheek and these connecting rungs 4 includes. By introducing a tensile force 3 in the lower cheek 2 and a pressing force of force 2 in the upper cheek 2 the industry is deformed 1 in that the tip S bulges downwards. She also does that without gripping an object. The resulting inclinations of the sprouts are in the 13 and 14 shown.

In symmetrical training, a curved object can be partially enclosed after the curvature between the two branches and then easily manipulated. When the industry is pushed by pushing on an object, the force 1 object acts on the lower cheek (see 12 ).

Regarding all versions It should be noted that those mentioned in connection with an execution technical features not only used in the specific execution can be but also in the other versions. All disclosed technical Features of this invention description are essential to the invention be classified and combined with each other or in isolation used.

Claims (42)

Tool, in particular medical gripping tool with at least two branches, in particular for gripping, holding, processing or examining body components, characterized in that at least one of the branches is deformable, in particular during a movement. Tool according to claim 1, characterized that at least one branch of deformable rod or trusses is formed. Tool according to claim 2, characterized that an industry includes two, in particular flexible cheeks, between which extend connecting elements, in particular rods or rungs. Tool according to one of the preceding claims, characterized in that the cheeks have recesses, in particular V-shaped recesses, in which the connecting elements are at the ends, in particular wherein the thickness of an element corresponds to the width of a recess. Tool according to claim 4, characterized that the shape of the ends of the connecting elements and the recesses correspond to each other or at least matched. Tool according to one of the preceding claims 3 to 5, characterized in that the cheeks on the connecting Elements a force directed to the interior between the cheeks exercise, so that the elements are held in the cheeks. Tool according to one of the preceding claims, characterized characterized in that the connecting elements, in particular the Sprouts or bars over film hinges attached to the cheeks. Tool according to one of the preceding claims, characterized characterized in that the connecting elements, in particular the Sprouts are bendable or bendable. Tool according to claim 8, characterized that a buckling or bending of the connecting elements via (film) hinges or a material rejuvenation is given, in particular in one, based on the length middle Area of the connecting elements are arranged. Tool according to one of the preceding claims, characterized in that the hinges or tapered points are provided with an actuating element, in particular a tension element or pressure element are connected to which a buckling and / or a bend is controllable, in particular wherein the connecting elements are controllable in groups. Tool according to claim 10, characterized that the actuating element via a Device is operable in a handle. Tool according to one of the preceding claims 10 or 11, characterized in that the actuating element without operation is automatically reset in a defined position, in particular being a provision a reconstitution of the connecting elements conditional. Tool according to claim 12, characterized in that that a provision by a spring load and / or a shape memory functions of the actuating element and / or cheeks and / or connecting elements. Tool according to one of the preceding claims, characterized in that at least a cheek, in particular an inner cheek of an industry at least one einknickbare and / or bendable region, in particular wherein the region by a (film) hinge and / or a material taper is formed. Tool according to claim 14, characterized that by an actuation of the area, in particular a force acting on it, the effective Length of one Cheek changeable, especially shortened is. Tool according to claim 15, characterized that area is formed by two lever arms which together with a joint joint and at the end with the front and rear remainder of a cheek are articulated. Tool according to claim 16, characterized in that that at the common joint an actuating element, in particular a tension element or pressure element is attached, in particular which is operable from a handle of the tool. Tool according to claim 17, characterized that the joint joint in an operation in the interior between two cheeks of an industry is movable. Tool according to one of the preceding claims, characterized characterized in that the cheeks have actuators and / or sensors, in particular, wherein these movable, in particular herausschiebbar are stored. Tool according to claim 18, characterized that moving over a pulling mechanism or pushing mechanism is effected. Tool according to one of the preceding claims, characterized characterized in that it automatically without an operation in a Reset original position, in particular by means of a spring load or a shape memory alloy. Tool according to one of the preceding claims, characterized characterized in that it has blades. Tool according to one of the preceding claims, characterized characterized in that at least a part of the connecting elements connected to a carriage which is movable on a cheek, in particular in a guide rail is stored, in particular wherein the guide rail on the inside an inner and / or outer cheek an industry is arranged. Tool according to claim 23, characterized that the connecting elements have a force acting on the carriage (train / pressure) in its orientation variable are. Tool according to one of the preceding claims 23 or 24, characterized in that a carriage and / or a cheek is divided into several sections, in particular being between two Sections an expandable, in particular balloon-like element is arranged. Tool according to claim 25, characterized that a fluid can be introduced into an expandable element, in particular whereby the distances the individual sections are mutually changeable. Tool according to one of the preceding claims 25 or 26, characterized in that an outer cheek deflected laterally and / or deformable, in particular by an expandable Element is designed as an expandable wedge into which a fluid can be introduced, in particular, whereby a cheek automatically returns aligned in the original state, after the fluid from a Wedge was removed. Tool according to one of the preceding claims 25 to 27, characterized in that a cheek by a plurality of individual controllable wedges, in different directions, is deflected. Tool according to one of the preceding claims, characterized characterized in that at least one of the cheeks at least one foldable wings in particular which has cavities and in particular Made of silicone. Tool according to claim 29, characterized that one wing can be unfolded by a fluid inlet, in particular being a wing after a Fluidausleitung again automatically applies to cheek Tool according to one of the preceding claims, characterized characterized in that the connecting elements, in particular sprouts or bars or the cheeks of at least one branch on an optical element, in particular a deformable lens or a mirror attached are. Tool according to claim 31, characterized that by means of a force on the elements an optical Property of the optical element, in particular the refractive power the lens changeable is. Tool according to one of the preceding claims, characterized in that the Bran chen have a gripping layer which is coated with micro- or nanoparticles, which prevent slippage during gripping even at low gripping force. Tool according to claim 33, characterized that the particles are aligned in a preferred direction. Tool according to one of the preceding claims, characterized characterized in that there are three to seven connecting elements / rung having. Tool according to one of the preceding claims, characterized characterized in that the gripping surface formed by the front third of an industry. Tool according to one of the preceding claims, characterized characterized in that the connecting elements / rungs in the direction tilted to the handle. Tool according to one of the preceding claims, characterized characterized in that the cheek on which a compressive force acts, thicker is designed as the other cheek. Tool according to one of the preceding claims, characterized characterized in that the connecting elements / rungs are vertical are arranged to one of the cheeks of an industry. Tool according to one of the preceding claims, characterized characterized in that the distance of the connecting elements / Sprout distance increased starting from the tip. Tool according to one of the preceding claims, characterized characterized in that an outer cheek an industry is fixed on a tool shank and a force in particular a tensile force or a compressive force on the inner cheek via an actuating element transferable in or on the tool shank is. Tool according to one of the preceding claims, characterized characterized in that an outer cheek is designed as a link chain.