DE102008036420A1 - Tissue cylinders cutting and removing apparatus for e.g. laparascopic for treatment of myomas of patient, has drive accommodated by housing, where drive is brought in mutual engagement with driving device by coupling device - Google Patents

Abstract

The apparatus has two cutting devices (12, 12') provided with a set of hollow cylindrical bases (14, 14'), where a set of cutting elements (20, 20') surround a set of distal openings (18, 18'). The cutting devices are arranged inside each other and are rotated relative to one another. A drive (30) is accommodated by a housing (32), where the drive is brought in mutual engagement with a driving device (22) by a coupling device for rotating the base of one of the cutting devices about a longitudinal axis of respective base.

Description

The The invention relates to a device for cutting and removal tissue cylinders made of a tissue that is within a body or Joint cavity and / or in or on a wall portion thereof and their use.

Such devices are well known. Accordingly, such devices, with the simultaneous use of a trocar and a trocar sleeve, for example in the medical field of gynecology, serve to remove tissue from a uterus, a uterus as a whole or to treat fibroids, etc. From US Pat EP 0 522 125 B1 For example, such a device is known. Such devices are also used in medicine in numerous and sometimes diverse different fields of use, such as abdominal surgery, stomach and gall bladder removal or appendix removal. However, in practice such devices have proven to be in part relatively disadvantageous. Thus, such devices all only have a cutting device with a hollow cylindrical body, a distal opening at a distal end of the body and a cutting element which surrounds the distal opening. The hollow cylindrical body with the cutting element is rotated to cut or punch out the tissue cylinder. Due to such a rotation of the hollow cylindrical base body, however, at the same time the tissue from which the tissue cylinder is to be cut out or punched out, deformed or sometimes even rotated in self-rotation. In order to be able to make a targeted intervention on the tissue, therefore, additional medical instruments, such as grasping instruments, such as a claw-tiller, are required in order to deform or fix the tissue accordingly. Along with this, the handling of such devices is overall complicated, not very gentle and time-consuming for the patient.

Of the Invention is therefore based on the object, a device for Cutting and removing tissue cylinders from a tissue for To provide, with which the above disadvantages which are structurally particularly simple, is compact and stable and at the same time a simple and quick removal of a cut or punched out Tissue cylinder from the operating area allows a Extremely light, gentle and, above all, time-saving handling ensures as well as a significantly improved and increased Ensures patient safety, and a beneficial To provide use of this device.

These Task is in device-technical terms to surprising simple manner solved by the features of claim 1.

Therefore can be due to the embodiment of the invention Apparatus for cutting and removing tissue cylinders from a Tissue that is located within a body or joint cavity and / or in or on a wall portion thereof, at least two, in particular two, cutting devices, each with a hollow cylindrical Main body, a distal opening at a distal End of the main body and one the distal opening surrounding cutting element, which are arranged inside each other and to each other are relatively rotatable, and one of a housing recorded gear that via a coupling device with at least one drive device for rotating the respective Basic body of the at least two cutting devices can be brought around the longitudinal axes in mutual operative engagement is, includes, a simple, compact and stable design throughout Reach device. Furthermore, the inventive Device, which can also be referred to as morcellator, the essential Advantage that the device when cutting or punching a tissue cylinder no additional instrument, in particular a gripping instrument such as a claw dicer or the like, for Deforming or holding the tissue during the operative Intervention requires. Due to the configuration of the invention Device with at least two, in particular two, such cutting elements is rather a deformation or self-rotation of the tissue, from which a tissue cylinder to be morcellated is cut out or punched out, excluded. Not least of all as a result but also by the very simple coupling or decoupling the at least one drive device to or from the transmission, results in a very light, very gentle and above all time-saving handling of the device as a whole. After all can be with the device according to the invention a achieve significantly improved and increased patient safety.

Further advantageous details of the invention Devices are described in claims 2 to 51.

So it is within the scope of the invention that the inner cutter from the adjacent outer cutter the at least two cutting devices according to claim 2 coaxial is included.

Conveniently, the inner cutter is thereby from the adjacent outer cutter of the at least two cutting edge Facilities according to claim 3 recorded with little play.

alternative is the inner cutter from the adjacent outer Cutting device of the at least two cutting devices according to claim 4 recorded with a larger game, at least a centering and / or guide element between the basic bodies the inner cutter and the adjacent outer Cutting device is arranged / are. Through this centering and / or guide element thus becomes a coaxial alignment the adjacent base body of the cutting devices reached.

Farther it is within the scope of the invention that the at least two cutting devices after Claim 5 by the at least one drive means to each other can be driven in the opposite direction and / or in synchronism. From pronounced Of great importance in this context is above all the inventive embodiment of an opposing Drive the at least two cutting devices through the at least a drive device to each other. Due to a drive in the Counterflow namely can be additionally Achieve that tissue from which the tissue cylinder is cut out or punched out, no deformation or even self-rotation is subjected by applying the cutting device. By Rotation of the at least two, in particular two, cutting devices relative to each other, the cut when cutting or punching out of Tissue cylinder forces acting on the tissue and Moments largely against each other.

To this purpose is the gear received from the housing according to claim 6 in an advantageous manner between the at least two Cutting devices and the at least one drive device interposed.

In Further embodiment of the invention, the transmission includes accordingly the measures of claim 7, a driven gear, the the at least one drive device is assigned, and two, with the drive gear meshing with an output gear, each associated with one of the at least two cutting devices are.

Prefers are the output gear and the two drive gears of the transmission according to claim 8 designed as bevel gears.

to constructive simplification of the invention Device serve the features of claim 9. Then stand the two drive gears, each one of at least associated with two cutting devices, with the output gear, which is associated with the at least one drive device, in simultaneous intervention. The axes of rotation of the two drive gears fall together. The axes of rotation of the two drive gears in contrast to the axis of rotation of the output gear each offset by ± 90 °. With a such training is achieved in a simple manner that the at least two cutting devices are mutually driven in opposite directions. The drive can also only by a single drive device respectively.

Of Furthermore, it is provided according to the invention that the output gear according to claim 10 advantageously on the Housing of the transmission is rotatably supported. By such a configuration is a very simple Construction achieved.

In In this context, the driven gear comprises according to claim 11 preferably a disk-shaped carrier element, that of an annular stop on the housing the transmission is rotatably guided, wherein the underside the carrier element and the inner wall of the housing of the transmission and the outer circumference of the carrier element and the inner circumference of the annular stop on the housing of the transmission with each other without play or with little play in mutual Standing in contact. The output gear and the carrier element are preferably formed integrally or in one piece. The carrier element can therefore also as a rear extension of the output gear be designed.

To Claim 12 is the output gear or, if present, the carrier element with the at least one drive device via a pin-shaped transmission element with a square, rectangular, square, hexagonal or otherwise polygonal, elliptical, trapezoid, parallelogram-like or semicircular profile rotationally fixed connected.

The Drive gears can claim 13 each comprise a disc-shaped stop element, wherein the Bottom of the stop element and the inner wall of the housing of the transmission with each other without play or with little play in mutual contact stand. The drive gear / drive gears and the associated stop element are each preferably integrally or formed in one piece. The stop element (s) can / can Consequently, as a back extension of the respective Drive gear be configured.

Furthermore, it is within the scope of the invention that the drive gears according to claim 14 each of drive bushings, each one of the we at least two cutting devices are assigned, are included. By such a two-part design, it is possible to choose different material for the drive gears and the drive bushes according to the particular stress.

Conveniently, are the drive gears according to claim 15 respectively the drive bushes via a threaded connection or latching or snap connection or attached by gluing.

Corresponding The measures according to claim 16 protrude the drive bushings advantageously through an opening of the housing of the transmission and are upon rotation of the cutting devices supported on an inner periphery of the opening and guided.

According to the invention provided according to claim 17, that the drive bushes and the respectively associated Cutting devices each at the proximal end and / or on the proximal end facing the region of the body the cutting devices together by means of bonding insoluble or via a threaded connection or latching or snap connection are detachably connected.

to Simplification of construction and assembly of the device according to The invention relates to the drive bushes according to claim 18 a distance sleeve spaced from each other.

Farther it is within the scope of the invention that the at least one drive device according to claim 19 by means of a, in particular electronic, control and / or control device is controllable and / or controllable, in such a way that the at least two cutting devices by the drive means each interval driven in opposite drive direction are. This ensures that two each to each other adjacent cutting devices in any way in a right-left rotation and / or reversible and also in any way in a left-right rotation are drivable.

In In this context, it is advantageous if the time intervals for driving the at least two cutting devices in the opposite drive direction according to claim 20 by the, in particular electronic, control and / or control device are arbitrarily adjustable and / or presettable.

From Of particular interest are the constructive measures of claim 21. Accordingly, the at least one drive device rotatably with the transmission via a coupling device connectable. The coupling device is in its constructive Training particularly easy to handle by the respective user.

To For this purpose, the coupling device according to claim 22 is used as plug-in and latching or snap device is formed. Such a plug and Latching or snap device is particularly advantageous because during the surgical intervention, a simple and fast connection of the at least two cutting devices and the drive device with the gearbox or a subsequent separation of the connection is possible, and possibly even with only one hand of the user.

there it is particularly advantageous that the coupling device after Claim 23 a integrally formed on the housing of the transmission, approximately pot-shaped receiving element for receiving a in Shape and dimension adapted coupling element of at least comprises a drive device, wherein receiving element of the Ge housing of the Gear and coupling element of the drive device to each other can be arranged against rotation. That way you can the device according to the invention simple, fast and assemble in a few steps with a drive device and bring it into effect. In this context, the measures of claim 24 decidedly appropriate. Therefore has the approximately pot-shaped receiving element, the on or is integrally formed with the housing of the transmission, a essentially quadrangular, hexagonal or otherwise polygonal base and is the coupling element the at least one drive device essentially as a quadrangular or hexagonal nut or otherwise polygonal nut educated.

By The structural design according to claim 25 is also a simple Assembly and disassembly, for example, to connect a more powerful Drive device or a drive device with largely fully charged battery or accumulator. such that the device according to the invention and the drive means by the user himself with only one hand to assemble. Accordingly, the coupling device a substantially U-shaped bracket, the end arranged, facing locking projections comprises which recesses of the receiving element pass through and in corresponding recesses or undercuts engage the coupling element for mutual latching.

The features of claim 26, wherein the latching projections of the substantially U-shaped Bü Gels have beveled contact surfaces, which support an actuation of the substantially U-shaped bracket from a Ineingriffstellung in a disengaged position of the locking projections from the recesses or -interchanges, also serve a simplified assembly and disassembly of inventive device and drive means.

In Advantageously, the recesses or -interior cuts are the coupling element according to claim 27 as substantially at the Outer circumference of the coupling element in the transitional or corner of each adjacent straight outer surfaces arranged grooves formed. The production of the recesses or -interferences is particularly simple and inexpensive, especially if the coupling element anyway equal to a usual square, hexagonal or otherwise polygonal screw formed is.

The same applies to the measures of claim 28 that namely the substantially U-shaped bracket held in grooves on the outer circumference of the receiving element and by means of the grooves from an engagement position of the latching projections in the recesses or undercuts of the coupling element in a disengaged position of the locking projections from the recesses or undercuts of the coupling element, and vice versa, is guided.

Of Furthermore, it is provided according to the invention that the substantially U-shaped bracket according to claim 29 in a Ineingriffstellung the locking projections in the Locking recesses or -intermediations of the coupling element spring loaded and in a disengaged position of the Locking projections from the recesses or undercuts the coupling element is spring-loaded. This also makes the Handling of the device according to the invention in the coupling or decoupling of the drive device considerably simplified.

About that In addition, it is within the scope of the invention that the inner / innermost the at least two cutting devices according to claim 30 with a sealing device for closing and releasing a proximal opening is provided at the proximal end of the base body.

In Advantageously, the sealing device according to the features of claim 31 a two-part and substantially cup-shaped trained housing with a body at the bottom attached housing element and one on the housing element fastenable lid or cap-shaped closure element on.

The constructive measures of claim 32 are used throughout Advantageously, a simple, fast and reliable as well as above all cost-effective production and assembly. Thereafter, the housing element and the closure element the housing via a snap or snap connection or a threaded connection with each other solvable or unsolvable connected. The structural design, a detachable or a permanent connection between the housing element and Provide closure element of the housing, depends essentially according to the mode of use and determination of the invention Device, d. H. whether the device for single or multiple use should be provided. This in turn, as well as vice versa, affects significantly on the overall design of the device or the selection the materials from which the individual components of the invention Device consist of.

is the device - as provided herein - for example only for one-time use, so will After use completely disposed of, that can Housing element and the closure element of the housing according to claim 33, preferably with an intermediate arrangement of an adhesive, in particular a silicone adhesive, or by means of ultrasonic welding be inextricably linked with each other.

For the multiple use, the housing element and the Closing element of the housing, which then certainly too are formed of metal, by means of, for example, a thread screwed together.

To Claim 34 are the housing element and the closure element the housing via at least one locking projection or the like locking lug on the housing element and at least egg NEN further locking projection or the like locking lug on the closure element, which work together and can be brought into mutual engagement, connected with each other. A kinematic reversal of that, at least a locking projection or the like locking lug on the closure element and the at least one latching recess or the like on the housing element to provide is also possible. Instead of the at least a further latching projection may also at least one latching recess or the like provided with the at least one latching projection interacts.

For a single use, the device according to the invention in this context is advantageously designed according to the features of claim 35. Accordingly, is / are the at least one locking projection or the like latch nose on the housing element or on the closure element and the at least one further latching projection or the like latching lug on the closure element or on the housing element formed such that the housing element and the closure element of the housing either one hand after Ineingriffbringung of the at least one latching projection or the like latching lug and the at least one further latching projection or the like locking lug are permanently connected to each other or on the other hand after subsequent disengagement from the at least one latching projection or like latching lug and the at least one further latching projection or like latching lug are not connected to each other. In the latter embodiment would be conceivable, for example, to provide one of the two locking projections or the like locking lugs with a predetermined breaking point, so that this locking projection or the like locking lug upon application of a certain tensile force from the housing element or from the closure element. Instead of the at least one further latching projection may also be provided at least one latching recess or the like, which cooperates with the at least one latching projection.

From The constructive ones are still very important Measures of claim 36, wherein the sealing device comprises two sealing elements, which in the housing on the Longitudinal axis of the main body of the cutting device are arranged adjacent to each other and cooperate with each other.

It is provided according to the invention that one of the two sealing elements of the sealing device according to claim 37 is substantially cone, truncated cone, pot, hat or the like-shaped, a slot opening in a plane opposite to a through the base of the Said sealing element spanned plane is arranged offset in the direction of the distal end of the base body of the cutting device, comprises and has a radially outwardly extending peripheral portion in the plane defined by the base of the sealing element for fixing in the housing. Thus, one of the two sealing elements is forced and held in its closed position due to its shape and arrangement in the housing in the opposite direction to the action of an artificially constructed overpressure within a body or joint cavity, for example by CO ₂ insufflation. In this case, the sealing element is pressed against another instrument or its shaft, for example a gripping or other cutting instrument, in particular a claw dipper or a myoma drill, on the outside with complete sealing. Accordingly, it is ensured that the overpressure which is required for operating, ie cutting out or punching out a tissue cylinder from a tissue and subsequently removing the cut-out or punched-out tissue cylinder from the surgical area, is maintained in any case. Thus, escape of gas, such as CO ₂ or the like, is excluded from the body or joint cavity of the operating area and thus counteracts obstruction of the Aushülsungsvorganges or traumatization of the surrounding tissue during the excavation.

Especially it is within the scope of the invention that the one of the two sealing elements after Claim 38 has at least two sealing lips, for closing and releasing the slot opening in mutual operative engagement stand.

About that In addition, another one of the two sealing members of the sealing device formed according to claim 39 disc-shaped and has a central, approximately circular recess through which a another instrument, in particular a gripping or other cutting instrument, preferably a clawed geiger or a Myombohrer, durchführbar is on.

The central, approximately circular recess of the other of the two Sealing elements according to claim 40, preferably with an inner diameter formed, which is less than or equal to an outer diameter the further instrument is.

Of Furthermore, it is within the scope of the invention that the other of the two Seal elements according to structural design Claim 41 in the housing on the longitudinal axis of the body of the cutting device between the proximal End of the main body and one of the two sealing elements, especially the one through the base of one of the two Sealing elements spanned plane adjacent, is arranged. In this way, a mutual interaction of the two Sealing elements achieved, whereby the seal in addition can be improved.

to Improvement of the sealing effect is / are at least one, in particular the two, sealing element (s) of the sealing device according to claim 42 made of flexible plastic, in particular silicone, educated.

Of particular interest are the features of claim 43. Thereafter, the cutting elements of the at least two cutting devices which surround the distal opening are chamfered substantially bevelled, conical or oblique the distal opening facing away from the outside and / or facing the distal opening formed inwardly extending.

In In this context, the cutting elements of the at least two Cutting devices according to claim 44 advantageously a very sharp, continuous or continuous or discontinuous Smooth, serrated or toothed on a rotary motion of the basic body an exact cut in tissue without too much trauma to the remaining tissue becomes. This allows the fabric to be shelled out without that surrounding tissue is deformed in the process.

To Claim 45 are the cutting elements of at least two cutting devices the foremost edge of the distal opening preferably with equipped with a serrated edge. In this embodiment of the invention arise several, distributed over the circumference circular arc sections with axially receding troughs and axial prominent wave crests. For example, at four Shaft projections and four intermediate, easy axially guided back in the peripheral surface Wave troughs arc sections approximately in the range of 40 arise up to 45 °. The serration can be circumferential or continuously, d. H. over the entire circumference of distal opening, be present. Conveniently, can the sharpening zone in the transition area between the wave trough and the wave projection particularly sharp be, so first an axial fixation of the tissue and only then by the rotational movement of the body the morcellation of tissue cylinders or tissue tubes is carried out. If necessary, the serration can be used but also discontinuous in the manner of a flaky Arrangement provided around the shell periphery at the distal opening be.

The same applies to the alternative embodiment of the invention according to Claim 46. Accordingly, the cutting elements of we least two cutting devices with the tooth grinding over the circumference distributed teeth with axially receding tooth roots and axially protruding tooth tips. Dependent on of the desired use is a circulating or Continuous or discontinuous tooth grinding conceivable.

To the Punching or hemming tissue can be the rotational movement to the body according to claim 47 via a Motor, electric, with battery, pneumatic or hydraulic is drivable, be applied.

In Particularly advantageously, the housing can / the gearbox in whole or in part, in particular the housing element and / or the housing cover, and / or the centering and / or guide element and / or the output gear and / or the carrier element and / or the drive gear and / or the / the Stop element / s and / or the drive bushes and / or the spacer bushing and / or the coupling device wholly or partly and / or the Receiving element and / or the substantially U-shaped Bracket and / or the sealing device and / or the housing element and / or the closure element of the housing according to claim 48 made of plastic, in particular polyoxymethylene, polyester, polyphenylene sulfone, ABS, acrylic, polycarbonate, tetrafluoroethylene or Impax, thermosetting Elastomers, with or without glass fiber reinforcement, of one Combination be formed from this. The inventive Device is particularly lightweight and can be pronounced produce economically.

alternative It is also within the scope of the invention that the basic body the at least two cutting devices, the housing of the Gearboxes wholly or partly, in particular the housing element and / or the housing cover, and / or the centering and / or Guide element and / or the output gear and / or the Carrier element and / or the drive gears and / or the stop element (s) and / or the drive bushes and / or the spacer bush and / or the coupling device wholly or partly and / or the receiving element and / or the substantially U-shaped Bracket and / or the sealing device and / or the housing element and / or the closure element of the housing according to claim 49 Metal, in particular (stainless) steel, stainless steel, aluminum, Brass, zinc, gunmetal alloys or an alloy thereof formed is / are.

The Device can thus be thermally and / or altogether chemically sterilize and readily for multiple use reuse.

Of particular interest are further the constructive measures of claim 50. Accordingly, the transmission, which is arranged between the at least two cutting devices and the drive device, formed with the individual components in the form of a modular system and assembled. The gearbox and thus the entire device can be assembled in this way similar to the construction of the surgeon or the operator. On the one hand, additional installation costs can thus be saved by the manufacturer. On the other hand, the device according to the invention can thereby be disassembled simply and quickly as well as reliably, for instance for the purpose of disinfection or the like and then reassemble when reused.

In In this connection, the features of claim 51 are of great Advantage, according to which the housing of the transmission or the housing element and the housing cover, the output gear, the carrier element, the drive wheel (s), the stopper (s), the spacer and the at least two cutting devices formed with the drive bushes in the form of a kit and can be assembled.

These Task is finally still in use With respect to the features of claim 52.

Therefore may include a device for cutting and removing tissue cylinders from a tissue that is inside a body or joint cavity and / or in or on a wall portion thereof, for example one of an organic cavity of a human body at least partially absorbed and / or surrounded, organic body, preferably of embryos, fibroids, tumors, ulcers and Carcinomas are used. The invention is particularly suitable Device for laparoscopic, thoracoscopic or athroscopic and the like minimally invasive surgical interventions. Without being presented in detail, it is equally possible with the aid of the inventive device inorganic Bodies, such as biliary and bladder stones or the like, located within a body or joint cavity and / or in or on a wall portion thereof, in the form of such Cut out and remove body cylinders.

The inventive device is due to a Extremely cost-effective manufacturability according to claim 53 for single use with a subsequent professional Disposal or destruction particularly suitable.

Further Features, advantages and details of the invention will become apparent the following description of a preferred embodiment of Invention and with reference to the drawings. Hereby show:

1 a front perspective view of an embodiment of an inventive device for cutting and removing tissue cylinders from a tissue, in the assembled state,

2 an exploded perspective view of the embodiment of the inventive device according to the 1 .

3A to 3E a side view, a bottom view, a plan view, a rear view and a front view of the embodiment of the inventive device according to the 1 and 2 .

3F a cross-sectional view through the embodiment of the inventive device according to the 1 and 2 along the line IIIF-IIIF in the 3E .

3G a broken cross-sectional view through the embodiment of the device according to the invention according to section IIIG in the 3F in an enlarged view,

3H a cross-sectional view through the embodiment of the inventive device according to the 1 and 2 along the line IIIH-IIIH in the 3A in an enlarged view,

3I a cross-sectional view through the embodiment of the inventive device according to the 1 and 2 along the line IIII-IIII in the 3A in an enlarged view,

3J a broken, schematic perspective side view of cutting elements of the embodiment of the inventive device according to section IIIJ in the 1 in an enlarged view,

3K a broken, schematic perspective side view of cutting elements of another embodiment of the inventive device according to the 3J .

4A to 4C a front perspective view, a side view and a plan view of the embodiment of the inventive device according to the 1 . 3A and 3C , without housing cover of the gearbox,

5A to 5D 3 is a front perspective view, a front view, a top view and a side view of an embodiment of a U-shaped bracket of the device according to the invention, in an enlarged view,

6A to 6C a plan view, a side view and a cross-sectional view through an embodiment of a lid or cap-shaped closure element of the housing of the invention according trained device along the line VIC-VIC in the 6A .

7A an exploded, perspective view of an embodiment of a coupling element of the inventively constructed device as part of a drive device,

7B a perspective view of the embodiment of the coupling element of the inventive device as part of a drive device according to the 7A in assembled condition and enlarged view, and

7C to 7G a side view, a plan view, a bottom view and cross-sectional views through the embodiment of the coupling element of the inventively constructed device as part of a drive device according to the 7A and 7B along the lines VIIF-VIIF and VIIG-VIIG in the 7C ,

The device according to the invention 10 is intended for cutting and removing tissue cylinders from a tissue located within a body or joint cavity and / or in a wall portion thereof. In the following description of an embodiment of the device according to the invention 10 are corresponding to each other, the same components each provided with identical reference numerals.

The device 10 According to the invention is in the broadest sense for operating, especially removing, an organic tissue, preferably fibroids, tumors, ulcers, carcinomas, etc., or an inorganic body, such as gallbladder and bladder stones or the like agglomerations of a body or Joint cavity or an organic cavity of a human or animal body and / or in or on a wall portion thereof are at least partially received and / or surrounded.

The device according to the invention is particularly well suited 10 as a result of their extremely cost-effective production for single use, albeit also with appropriate design of the device 10 or the selection of their materials as well a multiple use is readily possible.

In the 1 to 4C is a preferred embodiment of such a device 10 represented according to the invention.

The device 10 includes at least two cutting devices 12 . 12 ' each with a hollow cylindrical body 14 . 14 ' , At the distal end 16 . 16 ' of the basic body 14 . 14 ' each has a distal opening 18 . 18 ' , The distal opening 18 . 18 ' is each of a cutting element 20 . 20 ' surround.

In the in the 1 to 4C shown device are two such cutting devices 12 . 12 ' provided, which corresponds to a particularly advantageous realization of the invention. However, without being shown in detail, three or even more cutting devices can basically also be used 12 . 12 ' be provided.

The two cutting devices 12 and 12 ' are arranged inside each other. In that regard, the inner cutting element 20 from the outer cutting element 20 added. Furthermore, the two cutting elements 20 . 20 ' formed relative to each other relatively rotatable.

The inner cutter 12 is thus from the adjacent outer cutter 12 ' the two cutting devices 12 . 12 ' recorded coaxially. Between the inner cutting device 12 and the adjacent outer cutter 12 ' is preferably only a small game available. Consequently, the outer diameter of the main body 14 the cutting device 12 slightly smaller than the inner diameter of the body 14 ' the cutting device 12 ' , and vice versa. The game between the inner cutter 12 and the adjacent outer cutter 12 ' should be selected such that the cutting devices 12 . 12 ' rotate smoothly relative to each other, but at the same time allow an exact guidance to each other or each other. In addition, a passage of blood, body fluid or gas etc. between the outer diameter of the body should 14 the cutting device 12 and the inner diameter of the main body 14 ' the cutting device 12 ' be possible or largely prevented.

Alternatively, it would be possible, without being shown in detail, that the inner cutter 12 from the adjacent outer cutter 12 ' also recorded with a bigger game. In such an embodiment, however, one or more centering and / or guiding elements (not shown) is / are between the basic bodies 14 . 14 ' the inner cutter 12 from the adjacent outer cutter 12 ' arranged. This / s centering and / or guide element / s are intended in particular to tilt and / or become sluggish during the relative rotation of the inner cutter 12 opposite the adjacent outer cutter 12 ' and prevent the passage of blood, body fluid or gas, etc.

At least one drive device 22 displaces the respective basic body 14 . 14 ' the two cutting devices 12 . 12 ' around their respective longitudinal axis 24 . 24 ' in rotation. In the present embodiment of the device 10 is only such a drive device 22 provided (shown schematically). The drive device 22 can be at a proximal end 26 . 26 ' one of the main body 14 . 14 ' be arranged. Alternatively or as shown in the present embodiment, the drive means is 22 also at an area 28 . 28 ' of the basic body 14 arranged, which the proximal end 26 . 26 ' only facing and / or adjacent. The drive device 22 is designed as a motor which is, for example, electrically driven by battery, pneumatically or hydraulically.

In a particularly advantageous manner, the two cutting devices 12 . 12 ' by the drive device 22 each other driven in opposite directions. In this way, it is additionally possible to achieve in a particularly simple and thus also cost-effective manner that the tissue (not shown) from which the corresponding tissue cylinder is to be cut out and / or punched out, during the surgical procedure by means of the device according to the invention 10 within the body or joint cavity and / or in or on the wall portion thereof is neither deformed nor spent in self-rotation. By the opposite rotation of the two cutting devices 12 . 12 ' in any case, those through the appropriate cutting elements 20 . 20 ' lifted forces acting on the tissue and / or possible moments against each other. The consequence of this is that the tissue is undergoing surgery through the device 10 undeformed or remains in a particular position without proper movement according to the invention.

Without being shown in detail, the drive device 22 be controlled and / or regulated by means of a, in particular electronic, control and / or regulating device (not shown), so that the two cutting devices 12 . 12 ' by the drive device 22 can each be driven at intervals in the opposite direction of drive. The, about oscillating or the like changing, change the drive direction of the two cutting devices 12 . 12 ' is independent of their relative rotation to each other. In other words, a drive of the two cutting devices 12 . 12 ' take place in the opposite direction of drive, without their relative drive is canceled each other in the opposite direction and / or in synchronism. This ensures that two mutually adjacent cutting devices 12 . 12 ' in any way in a right-left rotation and / or reversible and also in any way in a left-right rotation can be driven.

It is particularly advantageous if the time intervals for driving the two cutting devices 12 . 12 ' in the opposite drive direction by the, in particular electronic, control and / or regulating device are arbitrarily adjustable and / or presettable. In this context, the time intervals can be selected to be the same or different lengths, can be adapted exactly to the individually encountered operating area or formed stochastically, etc.

To drive the two cutting devices 12 . 12 ' by the drive device 22 to achieve each other in the opposite direction and / or in synchronism, is between the two cutting devices 12 . 12 ' and the drive device 22 a gearbox 30 interposed in an enclosure 32 is housed.

The housing 32 consists of a housing element 34 and a housing cover 36 , which all 1 to 3H is removable. The housing element 34 and the housing cover 36 are connected to each other via a circumferential spring-groove connection 38 in the range of mutually associated housing edges or edges 40 of housing element 34 and housing cover 36 centered and composed. In addition, stiffening ribs 42 on the inner walls 44 of housing element 34 and housing cover 36 molded, which also cooperate with each other or can be brought into mutual / n active intervention or conditioning. The stiffening ribs 42 serve at the same time a centering during assembly and assembly of the device according to the invention 10 ,

For example, on the inner walls 44 of the housing element 34 according to the 2 and 4A to 4C four pairs of parallel stiffening ribs 42 arranged, which in each case in shape and dimension correspondingly formed, but laterally offset pairs or individual stiffening ribs 42 of the housing cover 36 pick up like a rail. To this end, the four pairs of stiffening ribs protrude 42 of the housing element 34 as in the 2 and 4A to 4C represented, over the housing edges or edges 40 of the housing element 34 go out to the case lid 36 extend in and at the stiffening ribs 42 set.

The gear 30 includes an output gear to drive in reverse 46 , which is the drive device 22 assigned. In addition, the gearbox points 30 two drive gears 48 . 50 on that with the output gear 46 in operative engagement and in each case one of the two cutting devices 12 . 12 ' assigned.

The output gear 46 and the two drive gears 48 . 50 of the transmission 30 are at the in the 1 to 4C illustrated embodiment of the device according to the invention 10 each formed as bevel gears.

In the in the 1 to 4C shown embodiment of the device 10 stand the two drive gears 48 respectively. 50 , each one of the two cutting devices 12 respectively. 12 ' are associated with the output gear 46 , that of the drive device 22 is assigned, in simultaneous active intervention. In the present embodiment, the axes of rotation fall 52 . 52 ' the two drive gears 48 . 50 together. The axes of rotation 52 . 52 ' the two drive wheels 48 . 50 are also identical to the longitudinal axes 24 . 24 ' the main body 14 . 14 ' , In contrast, the axes of rotation 52 . 52 ' the two drive gears 48 . 50 opposite the axis of rotation 54 of the output gear 46 once offset by + 90 ° and once by -90 °. By such a structural configuration is a simultaneous, uniform, but also opposite rotation of the two drive gears 48 . 50 according to the arrows 56 . 56 ' by rotation of the output gear 46 according to arrow 58 reached. Turns the output gear 46 in contrast to the arrow 58 opposite direction also reverses the direction of rotation of the two drive gears 48 . 50 according to the arrows 56 . 56 ' around (not shown).

As in particular from the 2 . 3F . 3G and 3H shows, is the output gear 46 in the illustrated embodiment further integral with an approximately disc-shaped support member 60 educated. The carrier element 60 is therefore as a rear extension of the output gear 42 designed. Regardless, the output gear can 46 and the carrier element 60 be readily formed as separate components, which are then connected to each other by means of suitable fasteners releasably or permanently. The two-part structural design of output gear 46 and carrier element 60 allows the use of different materials with different properties. So can the output gear 60 made of polyoxymethylene (POM) and the carrier element 60 be formed from polyphenylene sulfone (PPSU).

In the in the 2 . 3F . 3G and 3H shown embodiment of the device according to the invention 10 is the carrier element 60 on the housing element 34 of the housing 32 from the transmission 30 rotatably supported. In particular, the disk-shaped carrier element 60 from an annular stop 62 on the inner wall 44 of the housing element 34 rotatably guided. Here are the bottom 64 of the carrier element 60 and the inner wall 44 or inside of the housing 32 of the transmission 30 as well as the outer circumference 66 of the carrier element 60 and the inner circumference 68 of the annular stop 62 on the housing 32 of the transmission 30 play-free or with little play in mutual contact. Alternatively, the carrier element 60 also in a round recess or the like (material) recess (not shown) may be introduced.

The carrier element 60 is still with a centrally located recess 70 provided in which a pin-shaped transmission element 71 the drive device 22 ( 7A . 7B ) rotatably engaged. The centrally arranged recess 70 and the transmission element 71 are formed corresponding to each other. So can the transmission element 71 for example, be equipped with a rectangular, square, hexagonal or otherwise polygonal, elliptical, trapezoidal, parallelogram or semicircular profile in cross section.

In a similar way, the two drive gears 48 . 50 formed and each substantially annular stop elements 72 . 72 ' include, which are explained in more detail below. The drive gear / drive gears 48 . 50 and the associated stop element 72 . 72 ' are each preferably formed integrally or in one piece. The stop element (s) 72 . 72 ' can / can therefore be configured as a rear extension of the respective drive gear. A two-piece design of drive gear / drive gears 48 . 50 and stop elements 72 . 72 ' is however also possible.

Preferably, there is / consist of the driven gear 46 with the carrier element 60 and / or the two drive gears 48 . 50 with the substantially annular stop elements 72 . 72 ' , For example, the output gear 46 in the present embodiment of the device 10 from polyphenylene sulfone (PPSU). Polyphenylene sulfone is known to occur when high forces and / or moments occur from the drive device 22 over the transmission element 71 on the carrier element 60 act, far more resistant and wear-resistant than some other plastic.

The two drive gears 48 . 50 are each from drive sockets 74 . 74 ' received, which in each case one of the two cutting devices 12 . 12 ' assigned.

According to the 2 are the two drive gears 48 . 50 in the illustrated device 10 each at the drive sockets 74 . 74 ' attached via a threaded connection. To secure, for example, screws 76 , especially Ma Screws with a hexagon socket, provided in a corresponding threaded hole in the stop elements 72 . 72 ' the two drive gears 48 . 50 intervene and are counterable. Alternatively or cumulatively, it is conceivable, the drive gears 48 . 50 by means of pins or bolts (not shown) or with the interposition of an adhesive, preferably a silicone adhesive, or by means of ultrasonic welding.

The drive sockets 74 . 74 ' extend, as in the 3F and 3G is clearly visible, even about an opening 78 . 78 ' through the housing 32 of the transmission 30 therethrough. Upon rotation of the cutting devices 12 . 12 ' are the drive sockets 74 . 74 ' on the inner circumference 80 . 80 ' the respective opening 78 . 78 ' supported and from the inner circumference 80 . 80 ' the respective opening 78 . 78 ' guided.

The drive sockets 74 . 74 ' and the respective associated cutting devices 12 . 12 ' in turn are each at the proximal end 26 . 26 ' and / or at the proximal end 26 . 26 ' facing area 28 . 28 ' of the basic body 14 . 14 ' the Schneidide directions 12 . 12 ' each other by means of bonding insoluble or releasably connected via a threaded connection or latching or snap connection.

About a spacer 82 are the drive sockets 74 . 74 ' spaced apart, such that the underside 84 . 84 ' of the respective stop element 72 . 72 ' the drive bushes 74 . 74 ' with an inside annular area 86 . 86 ' of the housing element 34 and the housing cover 36 around the respective opening 78 . 78 ' is supported around backlash-free or with little play. The assembly consisting of the two drive sockets 74 . 74 ' and the spacer bushing arranged therebetween 82 are thus in the housing 32 in the axial direction on the longitudinal axes 24 . 24 ' stored without clearance or with little play stock.

The drive device 22 is with the gearbox 30 via a coupling device 88 rotatably connected. The coupling device 88 is designed as a plug and latch or snap device.

The coupling device 88 includes a receiving element 90 that of a receptacle of a coupling element 92 the drive device 22 serves. receiving element 90 and coupling element 92 are matched in shape and dimensions. The receiving element 90 is on the case 32 of the transmission 30 integrally formed and formed approximately pot-shaped.

receiving element 90 of the housing 32 of the transmission 30 and coupling element 92 the drive device 22 are mutually twistable can be arranged. For this purpose, the receiving element 90 a substantially quadrangular, hexagonal or otherwise polygonal base 94 on. The coupling element 92 the drive device 22 Accordingly, it is essentially designed as a square or hexagonal nut or otherwise polygonal nut.

In the embodiment of the device shown 10 is the base area 94 of the receiving element 90 , like from the 1 to 4C and best of all 3I emerges, hexagonal shaped. As the 7A to 7G show is the coupling element 92 the drive device 22 in adaptation to it as a hexagonal nut 96 educated. The coupling element 92 is part of a head element of the drive device 22 , in the context of the device according to the invention 10 should not be discussed in detail.

The coupling device 88 has a substantially U-shaped bracket 98 on, with latching projections 100 is provided. The locking projections 100 are at the two parallel legs 102 of the substantially U-shaped bracket 100 arranged, and opposite each other, approximately at the end and facing each other. The locking projections 100 pass through recesses or through holes 104 of the receiving element 90 and engage in corresponding, groove-shaped recesses or undercuts 106 of the coupling element 92 for mutual locking.

The essentially U-shaped bracket 98 is over its thigh 102 in diametrically opposed grooves 108 of the receiving element 90 led and held. The grooves 108 are on the outer circumference 110 of the receiving element 98 and in a plane perpendicular to the longitudinal axis 112 of the receiving element 90 arranged. The essentially U-shaped bracket 98 gets in the grooves 108 held and by means of the grooves 108 from an engagement position of the latching projections 100 in the recesses or undercuts 106 of the coupling element 92 (please refer 3I ) in a disengaged position of the latching projections 100 from the recesses or undercuts 106 of the coupling element 92 (not shown), and vice versa, slidably guided. In the present embodiment, the longitudinal axis falls 112 with the rotation axis 54 of the output gear together.

Furthermore, the substantially U-shaped bracket 98 in the Ineingriffstellung the locking projections 100 in the recesses or undercuts 106 of the coupling element 92 feather raw loads and in the disengaged position of the locking projections 100 from the recesses or undercuts 106 of the coupling element 92 spring-loaded, ie biased by a spring force. The spring force is created by bending or spreading of the two legs 102 . 102 ' of the temple 98 away from each other.

Further structural details of the substantially U-shaped bracket 98 arise from the 5A to 5D , Accordingly, the locking projections 100 of the substantially U-shaped bracket 98 beveled contact surfaces 114 on. The beveled contact surfaces 114 support an actuation of the substantially U-shaped bracket 98 from the Ineingriffstellung in the disengaged position of the locking projections 100 from the recesses or undercuts 106 in the direction of the arrow 116 , By pressurizing the printing surface 118 or the like push button is the substantially U-shaped bracket 98 in the direction of the arrow 116 opposite the receiving element 90 of the housing 32 relatively shifted. The beveled contact surfaces 114 , which act as a ramp, simplify the relative displacement and the associated bending or spreading of the receiving element 90 according to double arrow 117 additionally.

Referring again to the 7A to 7G are the recesses or undercuts 106 of the coupling element 92 formed as grooves which are substantially on the outer periphery 120 of the coupling element 92 in the transition or corner area 122 each adjacent straight outer surfaces 124 are arranged.

The U-shaped bracket 98 is in the Ineingriffstellung or closed position of the coupling device 88 over the locking projections 100 with the recesses 106 of the coupling element 92 engaged. The locking projections 100 protrude through the recesses 104 of the receiving element 90 therethrough. The respective cutting device 12 . 12 ' or the drive device 22 are thus rotationally fixed to the gearbox 30 tethered.

In the disengaged position or open position of the coupling device 88 however, which by pressing the U-shaped bracket 98 against the force of the strap 98 is reached, the hanger becomes 98 with its thighs 102 according to double arrow 117 pressed apart or spread. The locking projections 100 come as a result of the recesses 104 and the recesses 106 out of engagement. The drive device 22 can therefore be easily from the transmission 30 separate.

In the execution of the device 10 according to the invention, in the 1 to 4C is shown, is the drive bush 74 that of the inner cutter 12 the two cutting devices 12 . 12 ' is assigned as a sealing device 126 educated.

The sealing device 126 serves to close and release a proximal opening 128 that is at the proximal end 26 of the basic body 14 located. The sealing device 126 includes a housing 130 and at least one in the housing 130 absorbable sealing element 132 . 132 ' , Like from the 1 to 4C can be seen are in the illustrated embodiment of the device according to the invention 10 a total of two sealing elements 132 . 132 ' intended. Without being shown in detail, it is readily conceivable, only a single sealing element, for example as an integral component of the two sealing elements shown 132 . 132 ' , or also more than two such sealing elements 132 . 132 ' provided.

The housing 130 is made of a housing element 134 and a closure element 136 educated.

The housing element 134 goes into the drive socket 74 above. The housing element 134 is therefore with the drive socket 74 integrally formed or connected to this sealed otherwise. The housing element 134 is substantially cup-shaped, takes the at least one sealing element 132 . 132 ' on and is on the body 14 permanently attached. The at least one sealing element 132 . 132 ' extends at least in part in a chamber 138 that of the housing element 134 of the housing 130 enclosed and thus formed.

The closure element 136 is designed lid or cap-shaped. The closure element 136 is with a central, approximately circular designed hole 140 or the like recess provided. Through the hole 140 is another instrument (not shown), in particular a gripping or other cutting instrument, preferably a Krallengeifer or a Myombohrer, durchführbar, namely on the bore 140 through the proximal opening 128 of the basic body 14 , through the sealing device 126 at the proximal end 26 of the basic body 14 , through the main body 14 even to the distal end 16 of the basic body 14 , through the distal opening 18 finally to the tissue (cylinder) to be removed in the operating area.

The closure element 136 is in turn on the housing element 134 fixable. To this Purpose can the housing element 134 and the closure element 136 of the housing 130 via a latching or snap connection 142 or threaded connection, either solvable or unsolvable. The structural design of a detachable or a non-detachable connection between the housing element 134 and closure element 136 depends on the use and destination of the device 10 in the form of a single or multiple use, the formation of the device 10 or the selection of materials from which the individual components of the device according to the invention 10 exist, the wishes of the users, etc.

In this case, the housing element 134 and the closure element 136 via at least one latching projection 144 or the like locking lug on the housing element 134 or on the closure element 136 and at least one further locking projection 146 on the closure element 136 or on the housing element 134 connected with each other. The two locking projections 144 . 146 or similar latching lugs cooperate and can be brought into mutual engagement.

Preferably, the at least one locking projection can / can 144 or the like latching lug and / or the at least one further latching projection 146 or the like locking lug be formed in this context such that the housing element 134 and the closure element 136 of the housing 130 are inextricably linked after engaging each other or unbinding after subsequent disengagement with each other. For example, one or both of the locking projections can 144 . 146 or the like locking lug / n be provided with a predetermined breaking point to the device 10 To permanently damage after a disengagement and thus make it useless for reuse. In a single use of the device 10 are the housing element 134 and the closure element 136 via the catch or snap connection 142 or threaded connection, optionally with the interposition of an adhesive, preferably a silicone adhesive, or by means of ultrasonic welding, inextricably connected to each other. In this way, a thermal or chemical sterilization de device 10 and any further or further use of the device 10 locked out.

The sealing device 126 includes, as already mentioned, in the execution of 1 to 4C two sealing elements 132 . 132 ' in the case 130 on the longitudinal axis 24 of the basic body 14 the cutting device 12 are arranged adjacent to each other and cooperate with each other.

One 132 the two sealing elements 132 . 132 ' the sealing device 126 is substantially cone, truncated cone, pot, hat or the like shaped. The sealing element 132 includes a slot opening 148 that in a plane 150 (perpendicular to the plane of the page), which face one through the base 152 of the sealing element 36 spanned level 154 (perpendicular to the leaf plane) towards the distal end 16 of the basic body 14 is arranged offset. The sealing element 132 Therefore, it extends with the substantially conical, truncated, pot, hat or the like-shaped part or section in the direction of the distal end 16 of the basic body 14 and sticks out in the chamber 138 of the housing 130 , In addition, the sealing element 132 a radially outwardly extending peripheral portion 156 on that in by the base area 152 of the sealing element 132 spanned level 154 lies and a fixation in the housing 130 serves.

The sealing element 132 has at least two sealing lips 158 . 158 ' on, for closing and releasing the slot opening 148 in mutual operative engagement. Due to the shape and arrangement of the two sealing lips 158 . 158 ' of the sealing element 36 in the case 130 in the opposite direction to the effect of an artificially constructed overpressure within a body or joint cavity, for example by CO ₂ insufflation, the sealing lips nestle 158 . 158 ' to another instrument (not shown), for example a gripping or other cutting instrument, in particular a claw or a Myombohrer, on the outside, with complete sealing. In this way, there is a kind of wedging of the sealing lips 158 . 158 ' instead of. The sealing lips 158 . 158 ' are pressed against the other instrument and remain in this position until the overpressure is canceled controlled. This ensures that the overpressure which is necessary for operating, ie cutting out or punching out a tissue cylinder from a tissue and during the subsequent removal of the cut-out or punched-out tissue cylinder from the operating area, is permanently maintained. An escape of gas, such as CO ₂ or the like, from the body or joint cavity of the operating area is effectively prevented.

Another 132 ' the two sealing elements 132 . 132 ' the log device 126 is disc-shaped and has a central, approximately circular recess 160 Mistake. Through the recess 160 of the sealing element 132 ' is the already mentioned, further instrument (not shown), in particular a gripping or other cutting instrument, preferably a claw-dipper or a myoboid drill, can be passed. The central, approximately circular recess 160 is with an In nendurchmesser, which is smaller than or equal to an outer diameter of the other instrument provided.

Like from the 3G it can be seen that is the other sealing element 132 ' in the case 130 on the longitudinal axis 24 of the basic body 14 between the proximal end 26 of the basic body 14 and the one sealing element 132 arranged. In particular, the other sealing element 132 ' the level 154 passing through the footprint 152 of a sealing element 132 is spanned, (immediately) adjacent assigned.

The two sealing elements 132 . 132 ' the sealing device 126 are also fixable to each other by means of a positive connection. So has the other sealing element 132 ' a pointed protrusion 162 on which the one sealing element 132 is facing and in this in the region of the peripheral portion 156 engages or acts on this. Alternatively, the projection 162 from a correspondingly formed recess 164 of a sealing element 132 be included. head Start 162 and / or r recess 164 can be designed continuously or discontinuously circular circumferential.

According to the 1 . 2 and 3J respectively. 3K are the cutting elements 20 . 20 ' the cutting devices 12 . 12 ' substantially chamfered, conical, conical or oblique from the distal opening 18 . 18 ' facing away from the outside and / or to the distal opening 18 facing inwardly extending trained. In the execution of the device 10 is the cutting element 20 the cutting device 12 substantially chamfered, conical, conical or oblique to the distal opening 18 facing inward ver running trained. In contrast, the cutting element 20 ' the cutting device 12 ' substantially chamfered, conical, conical or oblique from the distal opening 18 ' arranged facing away from the outside. Without being shown in detail, are any other structural configurations or arrangements of the cutting elements 20 . 20 ' to each other equally possible.

In this case, the cutting elements 20 . 20 ' each have a circumferential or discontinuous serrated edge, smooth grinding or tooth grinding. In the execution of the device 10 , especially from the 1 . 2 and 3J shows are both cutting elements 20 . 20 ' the two cutting devices 12 . 12 ' designed, for example, in the serration, which has distributed over the circumference arc sections with axially receding troughs and axially protruding wave crests. Without being shown in detail, in this regard, any other combinations are feasible. So could the cutting elements 20 . 20 ' , as in 3K is shown to be provided with a tooth grinding, which has circumferentially distributed teeth with axially receding tooth surfaces and axially protruding tooth tips.

The at least one, in particular the two, sealing element / s 132 . 132 ' the sealing device 126 is / are made of flexible plastic, in particular made of silicone.

The housing 32 of the transmission 30 in whole or in part, in particular the housing element 34 and / or the housing cover 36 , and / or the centering and / or guide element and / or the output gear 46 and / or the carrier element 60 and / or the drive gear (s) 48 . 50 and / or the stop element (s) 72 . 72 ' and / or the drive jacks 74 . 74 ' and / or the spacer sleeve 82 and / or the coupling device 88 wholly or partly and / or the receiving element 90 and / or the substantially U-shaped bracket 98 and / or the sealing device 126 and / or the housing element 134 and / or the closure element 136 of the housing 130 is / are made of plastic, in particular Polyoximethy len (POM), polyester, polyphenylene sulfone (PPSU), ABS, acrylic, polycarbonate, tetrafluoroethylene or Impax, thermosetting elastomers, with or without glass fiber reinforcement, or a combination thereof.

Instead, the housing can / can 32 of the transmission 30 in whole or in part, in particular the housing element 34 and / or the housing cover 36 , and / or the centering and / or guide element and / or the output gear 46 and / or the carrier element 60 and / or the drive gear (s) 48 . 50 and / or the stop element (s) 72 . 72 ' and / or the drive jacks 74 . 74 ' and / or the spacer sleeve 82 and / or the coupling device 88 wholly or partly and / or the receiving element 90 and / or the substantially U-shaped bracket 98 and / or the sealing device 126 and / or the housing element 134 and / or the closure element 136 of the housing 130 alternatively and / or cumulatively made of metal, in particular (non-rusting) steel, stainless steel, aluminum, brass, zinc, gunmetal alloys or an alloy thereof. In contrast, the main body 14 . 14 ' the cutting devices 12 . 12 ' preferably as a rule made of metal, in particular (non-rusting) steel, stainless steel, aluminum, brass, zinc, gunmetal alloys or an alloy thereof.

Without being shown in detail, the transmission can 30 that between the at least two cutting devices 12 . 12 ' and the drive device 22 is arranged, with its individual Components in the form of a modular box is designed and assembled. The gear 30 and thus the entire device 10 can be assembled in this way like a box by the surgeon or the operator. On the one hand, additional installation costs can thus be saved by the manufacturer. On the other hand, the device according to the invention can thereby be disassembled simply and quickly and reliably in the case of multiple use, for purposes such as disinfection or the like, and then reassembled for reuse. The advantage here is that the housing 32 of the transmission 30 or the Ge housing element 34 and the housing cover 36 , the output gear 46 , the carrier element 60 , the or the drive gears 48 . 50 , the stop element (s) 72 . 72 ' , the distance bush 82 and the at least two cutting devices 12 . 12 ' with the drive sockets 74 . 74 ' designed and can be assembled in the form of a kit.

The invention is not limited to the illustrated embodiments of the device 10 according to the 1 to 7G limited. Accordingly, it is readily possible, the at least two cutting devices 12 . 12 ' to the illustrated embodiment of the device according to the invention 10 not or not exclusively in the opposite direction, but alternatively or cumulatively in synchronism to drive, if an operative intervention would require such a rectified drive. Without being shown in detail, in this case would be well known per se, additional design precautions in terms of the transmission 30 , Circuit options for the transmission 30 etc. provided. Furthermore, instead of a snap or snap connection 142 also a threaded connection (not shown in detail) for mutual attachment of housing element 134 and closure element 136 be provided.

10

contraption

12 12 '

cutter

14 14 '

body

16 16 '

distal End of the body

18 18 '

Distal opening of the basic body

20 20 '

cutting element

22

driving means

24 24 '

longitudinal axis of the basic body

26 26 '

proximal End of the body

28 28 '

Area of the main body, facing the proximal end

30

transmission

32

casing

34

housing element

36

housing cover

38

Tongue and groove

40

casing edges or margins

42

stiffening ribs

44

interior walls of housing element and housing cover

46

output gear

48

drive gear

50

drive gear

52 52 '

axis of rotation of the drive gear

54

axis of rotation of the output gear

56 56 '

arrows

58

arrow

60

support element

62

annular attack

64

bottom of the carrier element

66

outer periphery of the carrier element

68

inner circumference of the annular stop

70

center arranged recess

71

transmission element

72 72 '

stop element

74 74 '

Drive socket / n

76

screw

77

threaded holes

78 78 '

openings of the housing

80 80 '

inner circumference the openings

82

Distanzbuchse

84 84 '

bottom the stop elements

86 86 '

annular Area of housing element / cover

88

coupling device

90

receiving element the housing of the gearbox

92

coupling member the drive device

94

Floor space

96

Hexagonal nut

98

U-shaped hanger

100

latching projections

102

leg of U-shaped bracket

104

recesses or through holes

106

recesses

108

groove of the receiving element

110

outer periphery of the receiving element

112

longitudinal axis of the receiving element

114

beveled contact surfaces

116

arrow

117

double arrow

118

print area or push button

120

outer periphery of the coupling element

122

Transition area of the coupling element

124

Just Outside surfaces of the coupling element

126

seal means

128

Proximal opening of the basic body

130

casing the sealing device

132 132 '

sealing elements the sealing device

134

housing element of the housing

136

Cover- or cap-shaped closure element of the housing

138

chamber of the housing

140

drilling or recess of the closure element

142

latching or snap or threaded connection

144

catch projection

146

catch projection

148

slot opening of a sealing element

150

level

152

Floor space of a sealing element

154

level

156

peripheral portion of a sealing element

158 158 '

sealing lips of a sealing element

160

recess of the other sealing element

162

head Start

164

Recess.

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• - EP 0522125 B1 [0002]

Claims (53)

Device for cutting and removing tissue cylinders from a tissue located within a body cavity or joint cavity and / or in a wall area thereof, the at least two, in particular two, cutting devices ( 12 . 12 ' ) each having a hollow cylindrical basic body ( 14 . 14 ' ), a distal opening ( 18 . 18 ' ) at a distal end ( 16 . 16 ' ) of the basic body ( 14 . 14 ' ) and one the distal opening ( 18 . 18 ' ) surrounding cutting element ( 20 . 20 ' ), which are arranged one inside the other and relatively rotatable relative to each other, and one of a housing ( 32 ) received gear ( 30 ), which via a coupling device ( 88 ) with at least one drive device ( 22 ) for rotating the respective base body ( 14 . 14 ' ) of the at least two cutting devices ( 12 . 12 ' ) about their longitudinal axes ( 24 . 24 ' ) can be brought into mutual operative engagement includes. Apparatus according to claim 1, characterized in that the inner cutting device ( 12 ) from the adjacent outer cutter ( 12 ' ) of the at least two cutting devices ( 12 . 12 ' ) is received coaxially. Apparatus according to claim 1 or 2, characterized in that the inner cutting device ( 12 ) from the adjacent outer cutter ( 12 ' ) of the at least two cutting devices ( 12 . 12 ' ) is recorded with little play. Device according to one of claims 1 to 3, characterized in that the inner cutting device ( 12 ) from the adjacent outer cutter ( 12 ' ) of the at least two cutting devices ( 12 . 12 ' ) is received with a larger clearance, wherein at least one centering and / or guide element between the basic bodies ( 14 . 14 ' ) of the inner cutter ( 12 ) and the adjacent outer cutting device ( 12 ' ) is / are arranged. Device according to one of claims 1 to 4, characterized in that the at least two cutting devices ( 12 . 12 ' ) by the at least one drive device ( 22 ) are mutually driven in the opposite direction and / or in synchronism. Device according to one of claims 1 to 5, characterized in that the of the housing ( 32 ) received gear ( 30 ) between the at least two cutting devices ( 12 . 12 ' ) and the at least one drive device ( 22 ) is interposed. Device according to one of claims 1 to 6, characterized in that the transmission ( 30 ) an output gear ( 46 ), the at least one drive device ( 22 ), and two, with an output gear ( 46 ) in meshing drive gears ( 48 . 50 ), each one of the at least two cutting devices ( 12 . 12 ' ). Device according to one of claims 1 to 7, characterized in that the output gear ( 46 ) and the drive gears ( 48 . 50 ) of the transmission ( 30 ) are formed as bevel gears. Device according to one of claims 1 to 8, characterized in that the drive gears ( 48 . 50 ), each one of the at least two cutting devices ( 12 . 12 ' ) are associated with the output gear ( 46 ), the at least one drive device ( 22 ) are in simultaneous operative engagement, wherein the axes of rotation ( 52 . 52 ' ) of the drive gears ( 48 . 50 ) and the axes of rotation ( 52 . 52 ' ) of the drive gears ( 48 . 50 ) with respect to the axis of rotation ( 54 ) of the output gear ( 46 ) are each offset by ± 90 °. Device according to one of claims 1 to 9, characterized in that the output gear ( 46 ) on the housing ( 32 ) of the transmission ( 30 ) is rotatably supported. Device according to one of claims 1 to 10, characterized in that the output gear ( 46 ) a disc-shaped carrier element ( 60 ), which by an annular stop ( 62 ) on the housing ( 32 ) of the transmission ( 30 ) is rotatably guided, wherein the underside ( 64 ) of the carrier element ( 60 ) and the inner wall ( 44 ) of the housing ( 32 ) of the transmission ( 30 ) as well as the outer circumference ( 66 ) of the carrier element ( 60 ) and the inner circumference ( 68 ) of the annular stop ( 62 ) on the housing ( 32 ) of the transmission ( 30 ) are in mutual contact with each other without play or with little play. Device according to one of claims 1 to 11, characterized in that the output gear ( 46 ), in particular the carrier element ( 60 ), with the at least one drive device ( 22 ) via a pin-shaped transmission element ( 71 ) is rotatably connected with a rectangular, square, hexagonal or otherwise polygonal, elliptical, trapezoidal, parallelogram or semicircular profile in cross-section. Device according to one of claims 1 to 12, characterized in that the drive gears ( 48 . 50 ) in each case a disk-shaped stop element ( 72 . 72 ' ), the underside ( 84 . 84 ' ) of the stop element ( 72 . 72 ' ) and the inner wall ( 44 ) of the housing ( 32 ) of the transmission ( 30 ) with each other without play or with little play in ge to be in contact with each other. Device according to one of claims 1 to 13, characterized in that the drive gears ( 48 . 50 ) each of drive bushes ( 74 . 74 ' ), each one of the at least two cutting devices ( 12 . 12 ' ) are assigned. Device according to one of claims 1 to 14, characterized in that the drive gears ( 48 . 50 ) on each of the drive sockets ( 74 . 74 ' ) are attached via latching or snap connection or a threaded connection or by gluing. Device according to one of claims 1 to 15, characterized in that the drive bushes ( 74 . 74 ' ) through an opening ( 78 . 78 ' ) of the housing ( 32 ) of the transmission ( 30 ) and upon rotation of the cutting devices ( 12 . 12 ' ) to / from an inner circumference ( 80 . 80 ' ) of the opening ( 78 . 78 ' ) are supported and guided. Device according to one of claims 1 to 16, characterized in that the drive bushes ( 74 . 74 ' ) and the respective associated cutting devices ( 12 . 12 ' ) each at the proximal end ( 26 . 26 ' ) and / or at the proximal end ( 26 . 26 ' ) facing area ( 28 . 28 ' ) of the basic body ( 14 . 14 ' ) of the cutting devices ( 12 . 12 ' ) are non-detachably connected to one another by means of adhesive bonding or are detachably connected via a threaded connection or latching or snap connection. Device according to one of claims 1 to 17, characterized in that the drive bushes ( 74 . 74 ' ) via a spacer bush ( 82 ) are spaced from each other. Device according to one of claims 1 to 18, characterized in that the at least one drive device ( 22 ) is controllable and / or controllable by means of a, in particular electronic, control and / or regulating device, such that the at least two cutting devices ( 12 . 12 ' ) by the at least one drive device ( 22 ) are each driven at intervals in the opposite direction of drive. Device according to one of claims 1 to 19, characterized in that the time intervals for driving the at least two cutting devices ( 12 . 12 ' ) in the opposite direction of drive through the, in particular electronic, control and / or regulating device are arbitrarily adjustable and / or presettable. Device according to one of claims 1 to 20, characterized in that the at least one drive device ( 22 ) with the gearbox ( 30 ) via the coupling device ( 88 ) is rotatably connected. Device according to one of claims 1 to 21, characterized in that the coupling device ( 88 ) is designed as a plug-in, latching or snap-in device. Device according to one of claims 1 to 22, characterized in that the coupling device ( 88 ) on the housing ( 32 ) of the transmission ( 30 ) integrally formed, approximately cup-shaped receiving element ( 90 ) for receiving a shape and dimension adapted coupling element ( 92 ) of the at least one drive device ( 22 ), wherein receiving element ( 90 ) of the housing ( 32 ) of the transmission ( 30 ) and coupling element ( 92 ) of the drive device ( 22 ) can be arranged against rotation against each other. Device according to one of claims 1 to 23, characterized in that the on or with the housing ( 32 ) of the transmission ( 30 ) integrally formed, approximately cup-shaped receiving element ( 90 ) has a substantially quadrangular, hexagonal or otherwise polygonal base surface and the coupling element ( 92 ) of the at least one drive device ( 22 ) essentially as a square or hexagonal nut ( 96 ) ( 100 ) or otherwise polygonal nut is formed. Device according to one of claims 1 to 24, characterized in that the coupling device ( 88 ) a substantially U-shaped bracket ( 98 ), the end arranged, facing locking projections ( 100 ), which recesses ( 104 ) of the receiving element ( 90 ) and in corresponding recesses or intersections ( 106 ) of the coupling element ( 92 ) intervene for mutual locking. Device according to one of claims 1 to 25, characterized in that the latching projections ( 100 ) of the substantially U-shaped bracket ( 98 ) beveled contact surfaces ( 114 ), which an actuation of the substantially U-shaped bracket ( 98 ) from an Ineingriffstellung in a disengaged position of the locking projections ( 100 ) from the recesses or intersections ( 106 ) support. Device according to one of claims 1 to 26, characterized in that the latching recesses or undercuts ( 106 ) of the coupling element ( 92 ) as substantially on the outer periphery ( 110 ) of the coupling element ( 92 ) in the transition area ( 122 ) of each other be adjacent straight outer surfaces ( 124 ) arranged grooves are formed. Device according to one of claims 1 to 27, characterized in that the substantially U-shaped bracket ( 98 ) in grooves ( 108 ) on the outer circumference ( 110 ) of the receiving element ( 90 ) and by means of the grooves ( 108 ) from an engagement position of the latching projections ( 100 ) in the recesses or undercuts ( 106 ) of the coupling element ( 92 ) in a disengaged position of the latching projections ( 100 ) from the recesses or intersections ( 106 ) of the coupling element ( 92 ), and vice versa. Device according to one of claims 1 to 28, characterized in that the substantially U-shaped bracket ( 98 ) in an engagement position of the latching projections ( 100 ) in the recesses or undercuts ( 106 ) of the coupling element ( 92 ) spring loaded and in a disengaged position of the locking projections ( 100 ) from the recesses or intersections ( 106 ) of the coupling element ( 92 ) is spring loaded. Device according to one of claims 1 to 29, characterized in that the inner / innermost of the at least two cutting devices ( 12 . 12 ' ) with a sealing device ( 126 ) for closing and releasing a proximal opening ( 128 ) at the proximal end ( 26 ) of the basic body ( 14 ) is provided. Device according to one of claims 1 to 30, characterized in that the sealing device ( 126 ) a two-part substantially pot-shaped housing ( 130 ) with one on the base body ( 14 ) mounted housing element ( 134 ) and one on the housing element ( 134 ) fastenable lid or cap-shaped closure element ( 136 ) having. Device according to one of claims 1 to 31, characterized in that the housing element ( 134 ) and the closure element ( 136 ) of the housing ( 92 ) via a latching or snap connection ( 142 ) or a threaded connection are detachably or permanently connected to each other. Device according to one of claims 1 to 32, characterized in that the housing element ( 134 ) and the closure element ( 136 ) of the housing ( 92 ) with the interposition of an adhesive, preferably a silicone adhesive, or by means of ultrasonic welding are non-detachably connected to each other. Device according to one of claims 1 to 33, characterized in that the housing element ( 134 ) and the closure element ( 136 ) of the housing ( 92 ) via at least one locking projection ( 144 ) or the like locking lug on the housing element ( 134 ) or on the closure element ( 136 ) and housing element ( 134 ) or on the closure element ( 136 ) and at least one further locking projection ( 146 ) or the like latching lug or at least one latching recess or the like on the closure element ( 136 ) or on the housing element ( 134 ), which cooperate and are engageable with each other. Device according to one of claims 1 to 34, characterized in that the at least one latching projection ( 144 ) or the like locking lug on the housing element ( 134 ) or on the closure element ( 136 ) and the at least one further locking projection ( 146 ) or the like latching lug or the at least one latching recess or the like on the closure element (FIG. 136 ) or on the housing element ( 134 ) is / are formed such that the housing element ( 134 ) and the closure element ( 136 ) of the housing ( 92 ) after engagement of the at least one latching projection ( 144 ) or the like locking lug and the at least one further latching projection ( 146 ) or the like latching lug or the at least one latching recess are connected to each other inseparably or after subsequent disengagement from the at least one latching projection ( 144 ) or the like locking lug and the at least one further latching projection ( 146 ) or the like latching lug or the at least one latching recess are unverbindverbind together. Device according to one of claims 1 to 35, characterized in that the sealing device ( 126 ) two sealing elements ( 132 . 132 ), which in the housing ( 92 ) on the longitudinal axis ( 24 ) of the basic body ( 14 ) of the cutting device ( 12 ) are arranged adjacent to each other and cooperate with each other. Device according to one of claims 1 to 36, characterized in that a ( 94 ) two sealing elements ( 132 . 132 ' ) of the sealing device ( 126 ) is substantially conical, truncated, pot, hat or the like ausgebil det, a slot opening ( 148 ), which are in one level ( 150 ), which in relation to one through the base area ( 152 ) of the sealing element ( 132 ) level ( 154 ) towards the distal end ( 16 ) of the basic body ( 14 ) of the cutting device ( 12 ) is arranged offset, comprises and a radially outwardly extending peripheral portion ( 156 ) in the area ( 152 ) of the sealing element ( 132 ) level ( 150 ) for fixing in the housing ( 130 ) having. Device according to one of claims 1 to 37, characterized in that the one ( 132 ) two sealing elements ( 132 . 132 ' ) at least two sealing lips ( 158 . 158 ' ) for closing and releasing the slot opening (FIG. 148 ) are in mutual operative engagement. Device according to one of claims 1 to 38, characterized in that another ( 132 ' ) of the two sealing elements ( 132 . 132 ' ) of the sealing device ( 126 ) disc-shaped and a central, approximately circular recess ( 160 ), through which a further instrument, in particular a gripping or other cutting instrument, preferably a claw or a Myombohrer, can be passed, has. Device according to one of claims 1 to 39, characterized in that the central, approximately circular recess ( 160 ) of the other ( 132 ' ) of the two sealing elements ( 132 . 132 ' ) has an inner diameter which is smaller than or equal to an outer diameter of the further instrument has. Device according to one of claims 1 to 40, characterized in that the other ( 132 ' ) of the two sealing elements ( 132 . 132 ' ) in the housing ( 92 ) on the longitudinal axis ( 24 ) of the basic body ( 14 ) of the cutting device ( 12 ) between the proximal end ( 26 ) of the basic body ( 14 ) and the one ( 132 ) of the two sealing elements ( 132 . 132 ' ), in particular by the base area ( 152 ) of the one ( 132 ) of the two sealing elements ( 132 . 132 ' ) level ( 1154 ) is arranged adjacent. Device according to one of claims 1 to 41, characterized in that the at least one, in particular the two, sealing element / s ( 132 . 132 ' ) of the sealing device ( 126 ) is made of flexible plastic, in particular silicone, is / are. Device according to one of claims 1 to 42, characterized in that the cutting elements ( 20 . 20 ' ) of the at least two cutting devices ( 12 . 12 ' ) substantially chamfered, conically, conically or obliquely from the distal opening (FIG. 18 . 18 ' ) facing away from the outside and / or to the distal opening ( 18 . 18 ' ) facing inwardly extending. Device according to one of claims 1 to 43, characterized in that the cutting elements ( 20 . 20 ' ) of the at least two cutting devices ( 12 . 12 ' ) have a circumferential or discontinuous smoothing, serrated or toothed grinding. Device according to one of claims 1 to 44, characterized in that the cutting elements ( 20 . 20 ' ) of the at least two cutting devices ( 12 . 12 ' ) with the serration on the circumference distributed circular arc sections having axially receding troughs and axially protruding wave crests. Device according to one of claims 1 to 45, characterized in that the cutting elements ( 20 . 20 ' ) of the at least two cutting devices ( 12 . 12 ' ) with the tooth grinding over the circumference distributed teeth with axially receding tooth surfaces and axially protruding tooth tips. Device according to one of claims 1 to 46, characterized in that the at least one drive device ( 22 ) is designed as a motor which is electrically, with battery, pneumatically or hydraulically driven. Device according to one of claims 1 to 47, characterized in that the housing ( 32 ) of the transmission ( 30 ) in whole or in part, in particular the housing element ( 34 ) and / or the housing cover ( 36 ), and / or the centering and / or guide element and / or the output gear ( 46 ) and / or the carrier element ( 60 ) and / or the drive gear (s) ( 48 . 50 ) and / or the stop element (s) ( 72 . 72 ' ) and / or the drive jacks ( 74 . 74 ' ) and / or the spacer bushing ( 82 ) and / or the coupling device ( 88 ) in whole or in part and / or the receiving element ( 90 ) and / or the substantially U-shaped bracket ( 98 ) and / or the sealing device ( 126 ) and / or the housing element ( 134 ) and / or the closure element ( 136 ) of the housing ( 130 ) made of plastic, in particular polyoxymethylene (POM), polyester, polyphenylene sulfone (PPSU), ABS, acrylic, polycarbonate, tetrafluoroethylene or Impax, thermosetting elastomers, with or without glass fiber reinforcement, or a combination thereof is / are formed. Device according to one of claims 1 to 48, characterized in that the basic body ( 14 . 14 ' ) of the at least two cutting devices ( 12 . 12 ' ) and / or the housing ( 32 ) of the transmission ( 30 ) in whole or in part, in particular the housing element ( 34 ) and / or the housing cover ( 36 ), and / or the centering and / or guide element and / or the output gear ( 46 ) and / or the carrier element ( 60 ) and / or the drive gear (s) ( 48 . 50 ) and / or the stop element (s) ( 72 . 72 ' ) and / or the drive jacks ( 74 . 74 ' ) and / or the spacer bushing ( 82 ) and / or the coupling device ( 88 ) in whole or in part and / or the receiving element ( 90 ) and / or the substantially U-shaped bracket ( 98 ) and / or the sealing device ( 126 ) and / or the housing element ( 134 ) and / or the closure element ( 136 ) of the housing ( 130 ) made of metal, in particular (stainless) steel, stainless steel, aluminum, brass, zinc, gunmetal alloys or an alloy thereof is / are formed. Device according to one of claims 1 to 49, characterized in that between the at least two cutting devices ( 12 . 12 ' ) and the at least one drive device ( 22 ) arranged gear ( 30 ) is formed and assembled with its individual components in the form of a kit. Device according to one of claims 1 to 50, characterized in that the housing ( 32 ) of the transmission ( 30 ) or the housing element ( 34 ) or the housing cover ( 36 ), the output gear ( 46 ), the carrier element ( 60 ), the drive gear or the drive gears ( 48 . 50 ), the stop element (s) ( 72 . 72 ' ), the spacer bush ( 82 ) and the at least two cutting devices ( 12 . 12 ' ) with the drive bushes ( 74 . 74 ' ) are designed and assembled in the form of a kit. Use of a device according to one of the preceding Claims to laparoscopic, thoracoscopic or athroscopic and minimally invasive surgical interventions. Use of a device according to one of the preceding Claims for single use.