DE102009025008A1 - Medical needle holder for e.g. intracorporal suturing of wound, during endoscopic operations, has actuating lever arranged at proximal end of shaft and provided for moving stopper between pivoting and swivel out positions - Google Patents

Abstract

The holder has a handle (6) arranged at a proximal end of a shaft (2) for opening and closing of a jaw (4). A strand stopper (10) is arranged in an area of a distal end of the shaft in a proximal direction at a distance from the jaw. The stopper is movable between a pivoting position and a swivel out position, in which the stopper protrudes over an outer circumference of the shaft. An actuating lever (22) is arranged at the proximal end of the shaft and provided for moving the stopper between the pivoting and the swivel out positions. The stopper is designed in form of a pin.

Description

The The invention relates to a medical needle holder.

Medical needle holders are used for intracorporeal suturing or intracorporeal knotting during endoscopic operations. Such a needle holder is for example off DE 202 15 569 U1 known. For knotting, it is necessary to loop the thread around the needle holder. To prevent slippage of the thread is off DE 202 15 569 U1 a needle holder is known, which has a spring eye for fixing the thread or the thread loop. To then pull the loop from the needle holder, it is necessary to take the thread with another gripping member and pull out of this spring eyelet, which requires a certain force to pull out the thread from the spring eyelet.

in the In view of this prior art, it is an object of the invention to provide a medical needle holder through which the intracorporeal knot formation is facilitated over the known prior art.

These Task is by a medical needle holder with the in the claim 1 specified characteristics solved. Preferred embodiments emerge from the dependent claims, the following Description and the attached figures.

As the known medical needle holder also has the invention Needle holder on a shaft, at the distal end of a mouth with at least a movable jaw part is formed. This is the jaw part designed to take a needle or a thread suitable is. At the proximal end of the shaft is in a known manner a handle arranged, which for opening and closing the mouth serves. This is a suitable transfer mechanism arranged in the shaft, which indicates the movement of the handle on or several movable jaws of the mouth transmits.

According to the invention now in the region of the distal end of the shaft an additional arranged movable projection. This mobile tab is spaced from the distal end of the shaft in the proximal direction, d. H. seen from the distal end proximal side of the movable Maulteiles located. The movable projection is between one pivoted position and a pivoted position movable. In the pivoted position, the projection lies within the Outer circumference of the shaft. Preferably closes he is flush with the adjoining outer circumference Shank parts off. In the swung-out position stands the projection in the radial direction with respect to the longitudinal axis of the shaft via the outer circumference of the shaft before. At the proximal end of the Shank is arranged an actuating element, by means of which the movable projection between its pivoted and its swung-out position is movable. In the actuator it can be an additional handle. actuator and movable projection are about a suitable mechanism coupled with each other in their movement, so by movement of the Actuating the movable projection to be moved can.

By this embodiment of the invention is the Intracorporeal node formation with the needle holder significantly simplified. The Fa denstopper serving movable projection comes after the Sew the wound to use. After sewing The wound may initially be held by the needle holder Needle from one additionally into the body cavity imported gripping element are taken. Of the as a thread stopper protrusion is swung in his, d. H. moved radially projecting position. Now the thread can be behind, d. H. one or more times around the proximal end of the thread stopper Shaft of the needle holder are wound around. Subsequently the thread or the thread end is then with the jaw part of the needle holder gripped and by actuation of the actuator moved the movable projection in its pivoted position. Then it can then around the shaft of the needle holder wound thread are stripped in the distal direction or the Needle holder with the mouth through the formed loop in the proximal Direction be pulled. Sc becomes a loop or a first half of the node formed. To form a complete Node, this process can then be repeated.

By the movable thread stopper in the form of the movable projection Thus, the stripping of the thread is greatly facilitated by the shaft, because no major forces applied to the thread need to be in order to release it from a spring clamp, as required in the prior art.

The Actuator is preferably as a pivotable lever educated. The lever can be pivoted between two positions be, with a position of the pivoted position of the movable Projection and the other position of the swung-out position associated with the movable projection.

Furthermore, it is preferred that the actuating element in the region of the handle is so order is that it is operable with the thumb of a hand gripping the hand. For example, a lever may be arranged so that it can be pressed or pivoted with the thumb. In this way it is possible that the actuating element and thus the movable projection is moved without having to embrace the instrument. Thus, the actuator can be operated in the normal working position of the hand.

Of the movable projection is preferably formed as a pin, which in the pivoted position parallel to the longitudinal axis the shank and in its swung-out position transversely, preferably extends at right angles to the longitudinal axis of the shaft. To the pin is preferably pivotally mounted on a longitudinal end and can have one with the actuator connected mechanics about the bearing point at an angle of preferably be pivoted substantially 90 °. So extends in the pivoted state, the longitudinal axis of the pin parallel to the instrument's longitudinal axis, so the pen within the outer periphery of the shaft is located. In swung out State, the pin then extends radially outward. The pivotable pin is preferably articulated so that in the pivoted Condition of the bearing point at the proximal end of the pin is located. So is a simple, but safe stripping of Thread over the pivoted pin possible.

Prefers a movable actuating rod is arranged in the shaft, which with the movable projection and the actuating element coupled is that by movement of the actuating element is moved. The operating rod is actuated the actuating element preferably in the axial direction, d. H. moved parallel to the instrument's longitudinal axis. To the Pivoting the movable projection may be the actuating rod be hinged at a pivot point on the projection, which in the longitudinal direction the projection of the bearing or pivot point spaced is. Accordingly, the actuating element in the form of a Levers in a similar manner to the operating rod be articulated.

According to one Another preferred embodiment is the actuating rod designed as a tube. This allows a good longitudinal guidance inside the shaft and at the same time a good Bespülbarkeit reach the body cavity.

to Movement of a movable jaw part of the mouth may be in the shaft a movable actuating rod can be arranged over which the jaw part is motion-coupled with the handle. Also this actuating rod preferably moves in the longitudinal direction of the shaft. Further preferred is also this actuating rod designed as a tube. So both operating rods, d. H. the operating rod for the movable Tab and the operating rod for the mobile Jaw part are arranged in each other in the shaft.

Further it is preferred that the movable projection in the proximal direction behind the swing mechanism of the jaw part, d. H. behind the turn or pivot axes of the movable jaw part is arranged. So Ensures that the thread is proximal to the moving or swiveling parts of the jaw part are wound around the shaft can and does not affect the jaw part in its mobility is then, as described above, take the thread to be able to.

following the invention will be described by way of example with reference to the attached Figures described. In these shows:

1 an overall view of the needle holder according to the invention,

2 the section A according to 1 .

3 a section accordingly 2 with mouth open, and

4 a section according to 2 and 3 with closed jaw part and swiveled in thread stopper.

The needle holder according to the invention has a shaft extending in the direction of the instrument longitudinal axis X. 2 on. At the distal end of the shaft is a mouth 4 educated. In the example shown, this consists of a movable jaw part 4a and a fixed jaw part 4b , To open and close the mouth 4 by movement of the movable jaw part 4a is at the proximal end of the shaft 2 a handle 6 with a fixed handle part 6a and a movable handle part 6b educated. By pressure on the movable handle part 6b becomes the movable jaw part 4a so swung that the mouth 4 is opened. The movement is handled by the handle 6 on the jaw part 4a through an actuating rod 8th , which is movable parallel to the longitudinal axis X, transmitted.

According to the invention, the instrument shown has a movable thread stopper 10 in the form of a movable projection. The thread stopper 10 is pin-shaped and a pivot point 12 swiveling on the shaft 2 stored. The pivot point 12 is proximally spaced to the distal end of the mouth 4 and the swivel axis 14 of the movable jaw part 4a arranged. The pivot point 12 is so far from the pivot axis 14 spaced, that the distance is greater than the length of the thread stopper 10 is so that it also in the pivoted state described below fully proximal side of the mouth 4 is located. Here is the thread stopper 10 hinged at its proximal end, so that a thread when stripping not between shaft 2 and thread stopper 10 can slip.

The thread stopper 10 indicates one of the pivot point 12 spaced articulation point 16 on. This is about a lever 18 an actuating rod 20 hinged. The lever extends 18 essentially in the distal extension of the actuating rod 20 and serves to the radial offset of the articulation point 16 when pivoting the thread stopper 10 around the pivot point 12 compensate. The operating rod 20 is displaceable in the direction of the instrument axis X.

In the in 1 and 2 shown state is the operating rod 20 withdrawn on the proximal side and the thread stopper 10 is in the radial direction with respect to the instrument longitudinal axis X substantially at an angle of 90 ° to the instrument longitudinal axis X to the outside over the outer circumference of the shaft 2 in front. In this position, the thread stopper 10 to hold back a thread. The thread is for knotting while the proximal side, ie at the mouth 4 opposite side of the thread stopper 10 around the shaft 2 wound.

For stripping the thread, the thread stopper 10 in the in 4 shown pivoted position to be moved. This is the operating rod 10 displaced distally, whereby also the lever 18 is moved distally so that the articulation point 16 is moved distally and the thread stopper 10 around the pivot point 12 is pivoted at an angle of substantially 90 ° so that the longitudinal axis Y of the thread stopper 10 extends parallel to the instrument longitudinal axis X and the thread stopper 10 within the outer circumference of the shaft 2 is located. In this position, one around the shaft 2 formed loop in the distal direction of the shaft 2 be stripped off.

The pivoting movement of the thread stopper 10 is achieved by pivoting the actuating element in the form of an actuating lever 22 effected at the proximal end of the instrument. The operating lever 22 is arranged so that it with the thumb of the handle 6 holding hand can be moved. In this case, the operating lever 22 be pivoted between two positions. The operating rod 20 is at the proximal end with the lever 22 connected by pivoting the lever between the two positions described above, ie the in 2 and 3 shown proximal position and the in 4 shown distal position can be moved.

As in 3 can be seen, is the thread stopper 10 regardless of the mouth 4 mobile, ie the mouth 4 can be used with the thread stopper pivoted in and out 10 be opened and closed.

2

shaft

4

mouth

4a

portable jaw

4b

fixed jaw

6

handle

6a

fixed Handle part

6b

portable Handle part

8th

actuating rod

10

thread stopper

12

pivot point

14

swivel axis

16

articulation point

18

lever

20

actuating rod

22

actuating lever

X

instrument longitudinal axis

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

• - DE 20215569 U1 [0002, 0002]

Claims (8)

Medical needle holder with a shaft ( 2 ), one at the distal end of the shaft ( 2 ) trained mouth ( 4 ), which is designed to grip a needle or a thread, and one at the proximal end of the shaft ( 2 ) arranged handle ( 6 ) for opening and closing the mouth ( 4 ), characterized in that in the region of the distal end of the shaft ( 2 ) in the proximal direction spaced from the mouth ( 4 ) a mobile projection ( 10 ) which is disposed between a pivoted position in which within the outer periphery of the shaft ( 2 ), and a swung-out position in which the projection ( 10 ) over the outer circumference of the shaft ( 2 ) is movable, wherein at the proximal end of the shaft ( 2 ) an actuating element ( 22 ) is arranged, by means of which the movable projection ( 10 ) is movable between its pivoted and its swung-out position. Medical needle holder according to claim 1, characterized in that the actuating element ( 22 ) is designed as a pivotable lever. Medical needle holder according to claim 1 or 2, characterized in that the actuating element ( 22 ) in the region of the handle ( 6 ) is arranged such that it with the thumb of a handle ( 6 ) is gripping hand operable. Medical needle holder according to one of the preceding claims, characterized in that the movable Before jump ( 10 ) is formed as a pin, which in the pivoted position parallel to the longitudinal axis (X) of the shaft ( 2 ) and in its swung-out position transversely, preferably at right angles to the longitudinal axis (X) of the shank ( 2 ). Medical needle holder according to one of the preceding claims, characterized in that in the shaft ( 2 ) a movable actuating rod ( 20 ) arranged in such a way with the movable projection and the actuating element ( 22 ) is coupled, that by movement of the actuating element ( 22 ) the lead ( 10 ) is moved. Medical needle holder according to claim 5, characterized in that the actuating rod ( 20 ) is designed as a tube. Medical needle holder according to one of the preceding claims, characterized in that in the shaft ( 2 ) a movable actuating rod ( 8th ), in particular a movable actuating tube is arranged, via which a movable jaw part of the mouth ( 4 ) with the handle ( 6 ) is motion coupled. Medical needle holder according to one of the preceding claims, characterized in that the movable projection ( 10 ) in the proximal direction behind the pivoting mechanism ( 14 ) of the mouth ( 4 ) is arranged.