DE102021120171A1 - Surgical instrument for removing soft tissue, cartilage and/or bone material - Google Patents

Abstract

The invention relates to a surgical instrument for removing cartilage tissue and/or bone material, comprising a hollow-cylindrical shaft (2) with a hollow area (20) and with a connection (9) for a drive at a proximal end (22), a blade tip (3 ) at a distal end (21) of the shank (2), and a hollow outer tube (8) in which the hollow-cylindrical shank (2) is arranged, the blade tip (3) having a dome-shaped, blade-free, distal end (4). , wherein the blade tip (3) has a multiplicity of openings (5) which are separated from one another by a multiplicity of webs (6), with a cutting edge ( 7) is formed, and wherein a soft tissue opening (82) is provided in the outer tube (8) at a distal end of the outer tube, through which soft tissue can be sucked.

Description

The present invention relates to a rotatable surgical instrument for removing soft tissue, cartilage tissue and/or bone material.

Various configurations of rotatable surgical instruments are known from the prior art. To remove cartilage tissue or bone material, hereinafter referred to as solid tissue, milling cutters are usually used, in contrast to soft tissue, which have a milling cutter head with a large number of cutting edges at a distal end. The milling cutter can be spherical or elongated and is arranged on a hollow shank. An opening is then provided in the direction of the proximal end of the surgical instrument, which opening provides a connection with the hollow shaft. Such an instrument is, for example, from DE 697 32 580 T2 known. Through the use of such a surgical instrument, however, the solid tissue to be removed is cut off in the smallest pieces, so that in extreme cases a tissue pulp is formed in which a large number of the cells have died. By transporting the cut-off solid tissue in the grooves of such milling cutters in the direction of the opening to the hollow shaft, the cut-off solid tissue is further broken up. Since, for example, cartilage tissue that has been cut off in this way is to be cultivated after removal or is to be injected directly into a patient at another location, a high proportion of dead tissue is bad for the desired reproduction using the removed solid tissue. There are also situations during operations in which soft tissue is also to be removed.

It is therefore the object of the present invention to provide a surgical instrument for removing soft tissue, cartilage tissue and/or bone material which, with a simple structure and simple, cost-effective manufacturability, enables different types of tissue to be removed without changing the surgical instrument.

This object is achieved by a surgical instrument having the features of claim 1. The dependent claims show preferred developments of the invention.

In contrast, the surgical instrument for removing soft tissue, cartilage tissue and/or bone material with the features of claim 1 has the advantage that different types of tissue, in particular soft tissue and harder tissue such as cartilage tissue and/or bone material, can be removed with a single surgical instrument . As a result, there is no need to change the surgical instrument, which in the prior art has always been specialized in removing soft tissue or harder tissue such as cartilage tissue or bone tissue or the like. According to the invention, a wide variety of types of tissue can be removed with a single surgical instrument. As a result, operation times can be significantly reduced and the burden on a patient can be significantly reduced. Furthermore, a large number of living cells can also be removed from cartilage tissue and/or bone material in a safe and simple manner. The surgical instrument according to the invention also makes it possible for larger material fragments to be removed from the harder tissue. This ensures that there are enough living cells in the removed tissue. Furthermore, the surgical instrument runs particularly quietly and with little vibration. When removing soft or hard tissue, this ensures that other areas surrounding the removal site are not damaged by the cutting edges of the surgical instrument. Another great advantage of the surgical instrument according to the invention is that it is possible for the material severed from the soft tissue, cartilage tissue and/or bone to be completely removed from the removal area. This is achieved in particular in that the surgical instrument has a blade tip with a dome-shaped, blade-free end at the distal end of a shaft. The shank is designed as a hollow cylinder with a hollow area and has a connection for a drive, in particular a motor drive, on a proximal end, which is opposite the distal end of the shank. Severed, harder material can be completely sucked into the hollow area of the shank through a large number of openings which are formed in the blade tip and are separated from one another by webs. Softer material that has been separated off can be sucked in through a soft tissue opening at a distal end of the outer tube in an outer tube of the surgical instrument in which the hollow-cylindrical shaft is arranged. Thus, when removing harder material, it can be ensured that soft tissue, which can possibly also be severed during the process of separating the harder material, can also be suctioned off. The soft tissue passes through the soft tissue opening at the distal end of the outer tube and the large number of openings in the blade tip into the hollow inner area of the shaft and can there to the proximal be aspirated at the end of the surgical instrument. Each of the openings in the tip of the cutting edge has a cutting edge on at least one edge of the opening formed by the webs, preferably on two opposite edges of the opening. The cutting edges at the openings therefore do not reach as far as an outermost distal area of the surgical instrument, which is formed by the dome-shaped, cutting-free end. However, the cutting edges reach close to the actual distal end of the instrument, so that the cutting edges reach almost to the extreme distal end of the cutting edge tip, but a dome-shaped, cutting-edge-free distal end is nevertheless formed.

According to a further preferred embodiment of the invention, the surgical instrument also comprises an outer tube which has an open, beveled distal end at which the blade tip is at least partially exposed. The slanted end of the outer tube thus surrounds the blade tip only in a partial area, preferably a quarter of the circumference of the blade tip, so that particularly good protection of the surrounding tissue is ensured when the outer tube is positioned at the corresponding point during tissue removal.

More preferably, the soft tissue opening is formed in the outer tube at the beveled distal end of the outer tube. This allows severed soft tissue to be sucked through the soft tissue opening at the distal end of the surgical instrument and sucked through the openings in the blade tip into the hollow interior of the shank.

The beveled distal end has a first length L1 along a central axis X-X of the surgical instrument and the soft tissue opening has a second length L2 along the central axis X-X. The second length L2 is in a range of 0.3×L1≦L2≦0.7×L1. Thus, an expansion of the soft tissue opening in the direction of the central axis X-X is less than an axial expansion of the beveled end of the outer tube. As a result, the soft tissue opening is arranged in the region of the surgical instrument in which the tip of the cutting edge is also located and in which harder tissue in particular is removed during tissue removal. Thus, the harder tissue removed by the blade tip as well as the soft tissue can be removed by the surgical instrument at the same time and removed through the hollow-cylindrical shaft.

The soft tissue opening is preferably rectangular. The rectangular soft tissue opening is preferably arranged in such a way that the long side of the rectangle lies in the direction of the central axis X-X of the surgical instrument.

In order to enable a particularly safe removal of soft tissue, the soft tissue opening preferably has beveled edge areas.

More preferably, the soft tissue opening is in a half of the beveled distal end of the outer tube that is closer to the distal end of the surgical instrument.

The outer tube particularly preferably has exactly one single soft tissue opening.

A completely circumferential cutting edge is preferably formed at the edge of each opening of the cutting edge tip.

More preferably, the openings of the blade tip widen in the direction of the central axis X-X of the surgical instrument. This further improves the suction process of the separated material.

According to a further preferred embodiment of the invention, each opening of the blade tip has a first and a second linear blade section and an arcuate, distal blade section. The arcuate distal blade portion is located near the dome-shaped end and connects the two linear blade portions together. The two straight blade sections thus form the sides of the opening, so that the surgical instrument can be operated both in a clockwise rotation and in a counterclockwise rotation.

Preferably, each blade tip opening has a base portion directed toward the proximal end of the surgical instrument and first and second arcuate proximal blade regions. The first and second proximal blade area connects the straight blade sections to the base section. Thus, the opening has a cutting edge at each edge area, so that a completely uninterrupted circumferential cutting edge is formed at each opening.

More preferably, all of the openings are geometrically identical and all the webs are geometrically identical. In this way, in particular, very cost-effective manufacturability can be ensured.

According to a further preferred embodiment of the invention, the webs have a first Width B1 in the circumferential direction, which is smaller than a second width B2 of the openings in the circumferential direction. This makes it possible for a large area of the blade tip to be formed by the openings, so that all of the severed material can be safely transported into the hollow area of the shank.

The distal, dome-shaped end of the blade tip is particularly preferably designed in the shape of a part of a sphere.

For particularly smooth running, the surgical instrument preferably has exactly four openings and exactly four webs between the openings. More preferably, the surgical instrument is designed symmetrically to a central axis.

The exactly four webs are preferably arranged in such a way that they form a cross when the tip of the surgical instrument is viewed from above. The webs arranged in the shape of a cross merge particularly preferably without an edge directly into the distal, dome-shaped end of the blade tip. More preferably, the webs merge continuously into the hollow-cylindrical shaft of the surgical instrument without an edge. This makes it particularly easy to handle the surgical instrument. The direct transition of the webs both into the dome-shaped end of the blade tip and into the hollow-cylindrical shaft also enables the surgical instrument to be advanced particularly reliably to the point at which the material is then to be removed. There is practically no damage to the tissue or the like up to the point where the material is removed.

• 1 eine schematische, perspektivische Ansicht eines chirurgischen Instruments gemäß einem ersten bevorzugten Ausführungsbeispiel der Erfindung,
• 2 eine schematische, vergrößerte Seitenansicht einer Schneidenspitze des chirurgischen Instruments von 1,
• 3 eine schematische, vergrößerte Ansicht eines distalen Endes eines Außenrohrs des chirurgischen Instruments,
• 4 eine schematische, vergrößerte Ansicht des in 3 gezeigten Außenrohrs, welches um 180° gedreht ist,
• 5 eine schematische, perspektivische Ansicht aus Ansicht der Schneidenspitze des chirurgischen Instruments von 1, und
• 6 eine perspektivische Schnittansicht durch die Schneidenspitze des chirurgischen Instruments von 1.

A preferred embodiment of the invention will be described in detail below with reference to the accompanying drawings. In the drawing is:

• 1 a schematic, perspective view of a surgical instrument according to a first preferred embodiment of the invention,
• 2 a schematic, enlarged side view of a cutting tip of the surgical instrument of FIG 1 ,
• 3 a schematic, enlarged view of a distal end of an outer tube of the surgical instrument,
• 4 a schematic, enlarged view of the in 3 shown outer tube, which is rotated by 180°,
• 5 FIG. 12 is a schematic perspective view from the cutting tip of the surgical instrument of FIG 1 , and
• 6 a perspective sectional view through the cutting tip of the surgical instrument of FIG 1 .

In the following, with reference to the 1 until 6 a surgical instrument 1 according to a first preferred embodiment of the invention is described in detail.

The surgical instrument 1 comprises a shaft 2 with a blade tip 3.

Like in particular 6 As can be seen, the shaft 2 is designed as a hollow cylinder and has a hollow area 20 . The blade tip 3 is arranged at a distal end 21 of the shank. A connection 9 for a drive is provided at a proximal end 22 of the shaft.

The surgical instrument 1 also includes a hollow outer tube 8 in which the shaft 2 is arranged. How out 2 As can be seen, the outer tube 8 has an inclined opening in the form of an open, beveled distal end 80 at the distal end. The blade tip 3 then protrudes from this beveled distal end 80 . The outer tube 8 is not driven and therefore does not rotate with the blade tip 3, but can be rotated manually.

The cutting tip 3 is in detail from the 2 , 5 and 6 apparent. The blade tip 3 here has exactly four openings 5 and four webs 6 . How out 3 As can be seen, the four webs 6 are arranged as a cross in a plan view of a dome-shaped, blade-free, distal end 4 of the blade tip. The blade tip 3 is designed symmetrically to a central axis XX of the surgical instrument.

Like in particular 2 As can be seen, the openings 5 along the circumference of the blade tip 3 occupy a larger area than the webs 6.

The openings 5 have a first straight cutting edge section 71 and a second straight cutting edge section 72 . The first and second straight blade portions 71, 72 are located opposite each other at each opening 5 and are parallel to the central axis XX. How out 3 As can be seen, the first and second linear blade portions 71, 72 are connected to one another by an arcuate distal blade portion 70. FIG. Furthermore, each opening has a Base portion 73 which is connected to the first and second linear blade portions 71, 72 via first and second arcuate proximal blade portions 74, 75, respectively.

Thus, each opening 5 has a completely circumferential cutting edge 7 at its edge. The cutting edge 7 has no interruptions whatsoever and the surgical instrument 1 is therefore suitable both for left-hand rotation and for right-hand rotation. Material can be removed from cartilage or bone in both directions of rotation.

How to proceed in particular 6 As can be seen, the openings 5 increase in the direction of the central axis XX. This makes it easier to receive the removed material in the hollow area 20 of the shank 2 . In 6 the inflow of removed material is indicated by the arrows 10 .

Like in particular 2 As can be seen, in the position of the shank 2 in the area of the beveled distal end 80, which protects the blade tip 3 like a tongue, material can also be accommodated in the openings 5 and thus in the hollow area 20. The tongue 81 formed by the beveled distal end 80 protects the surrounding tissue at the removal site, which is not intended to be removed.

The relatively large openings 5 therefore result in a relatively large spacing, in particular for the straight cutting edge sections 71, 72, which ensures that relatively large pieces can be separated from the material to be removed. This results in a significantly higher probability that living cells of the material to be removed will also be removed with the separated larger pieces. In particular with the surgical instruments used in the prior art, there is a risk that the material to be removed will be removed in a mushy form, with the material then being almost exclusively dead and/or destroyed cells. As a result, the further use of the removed material is significantly restricted. With the invention, on the other hand, the material to be removed can also be removed in larger pieces with a high proportion of undestroyed and living cells, so that further use of the removed material is significantly improved. In particular, the removed material can, for example, be directly reintroduced at a point on the body where the material is needed. Due to the high number of living cells, regrowth of cartilage tissue, for example, is then significantly improved. Alternatively, the material removed with a high proportion of living cells can also be cultivated outside of the body and then later used at the required location in the body.

In this way, harder material such as cartilage tissue and/or bone material can be safely removed using the blade tip 3 with the openings 5 . In order to also remove softer material at the same time, the outer tube 8 also has a soft tissue opening 82 at the beveled distal end 80 . The soft tissue opening 82 is in detail from the 3 and 4 apparent.

As in 3 and 4 As shown, the soft tissue opening 82 is generally rectangular with one longer side of the rectangle oriented toward the central axis XX. The beveled distal end 80 of the outer tube 8 has a first length L1 in the direction of the center axis XX, and the soft tissue opening 82 has a second length L2 in the direction of the center axis XX. In this exemplary embodiment, the second length L2 is half the first length L1.

The soft tissue opening 82 has four beveled edge regions 83 on the side facing the outside of the outer tube 8 .

How to proceed in particular 4 As can be seen, the soft tissue opening 82 is located as close to the beveled distal end 80 of the outer tube 8 as possible. A width B1 of the soft tissue opening corresponds to approximately 1/4 of a circumferential length of the outer tube 8.

Thus, using the surgical instrument 1 according to the invention, harder material can be simultaneously fed through the blade tip 3 and soft tissue, which may be loosely located on the outer circumference of the surgical instrument, through the soft tissue opening 82 and then through the openings 5 in the blade tip 3 into the hollow shaft 2 of the surgical Instrument 1 are sucked.

This means that soft tissue can also be suctioned off when harder tissue is being removed, which is not possible in the prior art. In the prior art, a second surgical instrument has always had to be used in order to also be able to completely remove soft tissue.

By rotating the surgical instrument 1 once through 360° at the operation site, the soft tissue opening 82 thus comes into contact with all tissue areas adjoining the surgical instrument at the distal end and can loose tissue there, which, in addition to soft tissue, can also contain small material splinters, for example can be of harder tissue, safely aspirate. It should be noted that during this suction process, the blade tip can also be retracted somewhat into the outer tube 8, so that the beveled distal end 80 of the outer tube 8 is exposed and free tissue can be safely sucked in.

Reference List

1

surgical instrument

2

shaft

3

blade tip

4

dome-shaped, cutting-free end

5

openings

6

webs

7

cutting edge

8th

outer tube

9

Connection for drive

10

Flow direction of the separated material

20

hollow area

21

distal end of the shaft

22

proximal end of the shaft

70

arcuate distal cutting portion

71

first straight cutting section

72

second straight cutting section

73

base section

74

first arcuate proximal blade portion

75

second arcuate proximal blade area

80

beveled distal end

81

Tongue

82

soft tissue opening

83

beveled edge area

B1

Width of the soft tissue opening

L1

first length of blade opening

L2

second length of soft tissue opening

X-X

central axis

QUOTES INCLUDED IN DESCRIPTION

This list of documents cited by the applicant was generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Patent Literature Cited

• DE 69732580 T2 [0002]

Claims (12)

Surgical instrument for removing soft tissue, cartilage tissue and/or bone material, comprising: - a hollow-cylindrical shaft (2) with a hollow area (20) and with a connection (9) for a drive at a proximal end (22), - a blade tip (3) at a distal end (21) of the shank (2), and - a hollow outer tube (8) in which the hollow-cylindrical shaft (2) is arranged, - wherein the blade tip (3) has a dome-shaped, blade-free, distal end (4), - the blade tip (3) having a multiplicity of openings (5) which are separated from one another by a multiplicity of webs (6), - A cutting edge (7) being formed at each opening (5) on at least one edge formed by the webs (6), and - A soft tissue opening (82) being provided in the outer tube (8) at a distal end of the outer tube, through which soft tissue can be sucked. instrument after claim 1 wherein the outer tube (8) has an open, beveled distal end (80), wherein the blade tip (3) is at least partially exposed at the beveled distal end (80). instrument after claim 2 wherein the soft tissue opening (82) is formed in the outer tube (8) at the beveled distal end (80) of the outer tube. instrument after claim 2 or 3 , wherein the beveled distal end (80) has a first length L1 in the direction of a central axis (XX) of the surgical instrument and the soft tissue opening (82) has a second length L2 in the direction of the central axis (XX), the second length L2 in one range of 0.3 x L1 ≤ L2 ≤ 0.7 x L1 and in particular L2 = 0.5 x L1. Instrument according to one of the preceding claims, wherein the soft tissue opening (82) is rectangular. Instrument according to one of the preceding claims, wherein the soft tissue opening (82) has beveled edge regions (83). An instrument according to any one of the preceding claims, wherein the soft tissue opening (82) is located in a distal end half of the beveled end (80) of the outer tube (8). Instrument according to one of the preceding claims, wherein a complete circumferential cutting edge (7) is arranged at the edge of each opening (5) of the cutting tip (3) and/or wherein the openings (5) extend in the direction of a central axis (X-X) of the surgical instrument expand. Instrument according to one of the preceding claims, wherein each opening (5) of the cutting tip (3) has a first straight cutting section (71) on a first web and a second straight cutting section (72) on a second web and an arcuate distal cutting section (70), connecting the two linear blade portions (71, 72) and each opening (5) has a base portion (73) directed towards the proximal end (22) of the instrument, a first arcuate proximal blade portion (74) and a second arcuate proximal blade portion (75), the first and second arcuate proximal blade portions (74, 75) connecting the first and second linear blade portions (71, 72) to the base portion (73). Instrument according to one of the preceding claims, wherein the openings (5) of the blade tip (3) are each geometrically identical and wherein the webs (6) are each geometrically identical, and/or wherein the webs (6) have a first width in the circumferential direction have, which is smaller than a second width of the openings (5) in the circumferential direction. Instrument according to one of the preceding claims, in which the distal end (21) of the blade tip (3) is designed in the shape of a part of a sphere. Instrument according to one of the preceding claims, wherein the blade tip (3) has exactly four openings and exactly four webs and the webs (6) are arranged in a cross shape and merge directly into the distal end of the blade tip (3) and/or the webs (6 ) merge continuously into the hollow-cylindrical shaft (2).

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