DE19700113A1 - Device for lifting organ parts for feeding through surgical engagement device into rectal region of human body - Google Patents

Abstract

The device has a proximal handle section (6) connected with a shaft section (7) whose central region runs approximately in the longitudinal direction towards the handle part. A distal region (8) of the shaft section runs approximately perpendicular to the central region, is spoon-shaped and is connected with the central region via a joint region. The handle part (6) can be angled approximately perpendicular to the central region of the shaft section, where the central region has a hinge element with a securing sleeve (10) which can be slid over it. The sleeve has a stop element (11) which fixes the handle relative to the shaft section in an angled position by projecting into an opening in the shaft section.

Description

The invention relates to a device for Raising organ parts for implementation surgical intervention in the rectal area of the human body in the manner of hooking parks with a proximal part of the handle, which is connected to a shaft cut is connected, the proximal area in runs approximately in the longitudinal direction to the handle part and one distal region which is approximately perpendicular to the proximal area runs, spoon-shaped is and over a curved transition area with this  is integrally connected.

To perform surgical procedures in the rectal area of the human body, it is necessary for the surgeon to treat the person to be treated End of intestine within the human body cavity largely exposed in the for the Surgical measures require freedom of movement to ensure the section of the intestine to be treated. In addition to known spreading and stretching devices, the one to widen and hold the abdominal wall in one provided open state, the so-called hooks related to parks, which is known as Instrument in surgery for lifting the bladder is used and with the help of a largely free access to the section of the intestine to be treated on Intestinal exit area can be made possible.

The operation of the known hook after parks will be explained in more detail with reference to FIG. 1.

In Fig. 1 a partial representation of the rectal end region of the human body is shown in longitudinal sectional view. The rectal exit 1, to which the end region of the large intestine 2 connects intracorporeally, is partially enclosed below by the coccyx 3 and above by the bone part with the name Symphyse 3 '. In order to expose the colon area 2 to be treated, a work sector S, which is delimited by the dashed lines, must be created. For this purpose, the bladder 4 resting on the intestinal area must be raised in particular. To lift the bladder 4 of the hook (1 in Fig. With a continuous black trace Pictured LLT) is used by Parks 5, the match proximally disposed handle part 6 has and which is connected to a shaft section 7. The shaft section 7 merges into a distal region 8 , which is arranged approximately perpendicular to the central shaft section 7 . The distal region 8 is preferably in the shape of a spoon or in the manner of a shoehorn, so that the bladder 4 can be easily grasped by the distal region 8 formed in this way and raised with the aid of the hook to parks in the manner shown in FIG. 1.

In order to space the bladder 4 in a controlled manner from the rectal area 2 , the operator of the hook after parking has to carefully consider three force components acting on the bladder via the grip part 6 . The bladder 4 is spaced largely vertically from the rectal region 2 by the force F3. Due to the additional action of force via the force component F2, the bladder 4 is brought against the symphysis 3 in order to use the spatial area already present below the symphysis 3 . Furthermore, the distal tip of the hook is to be raised to the park, in particular to create an operating room at the immediate rectal exit, so that the bladder 4 is also spaced from the intestinal area at the rectal exit via the force F1.

In particular for the targeted application of forces F1 and F2 it is for the operator of the hook after park extremely difficult, especially on and in human Body has no mechanical counter bearing to The forces F1 and F2 are closed by a lever effect produce. The operator is rather asked to position the hook for parks in a free position  and sometimes over long periods of time, even a Hour can exceed.

The force components F1, F2 and F3 acting on the bladder 4 via the distal region of the hook after parking are to be generated by the operator on the handle part 6 . Here, however, there is additionally the difficulty that the force F1, which is required to lift the distal tip of the distal region 8 , has to be generated on the grip part 6 in different directions relative to the direction of the force F1 in the region of the bladder 4 . If the force F1, which has to act largely vertically on the bladder 4 upwards, is to be generated, the operator has to incline the grip part 6 to the right (see FIG. 1). Especially in the case of long-lasting operations, the rethinking process of this kind can lead to incorrect operation due to the different directions of force in the event of concentration weaknesses and physical weakness in the operator, which can have a lasting effect on the operation.

The invention is therefore based on the object Device for lifting organ parts for the Performing rectal surgery Area of the human body in the manner of the hook of parks with a proximal handle part that with a Shank section is connected, the proximal Area approximately in the longitudinal direction to the handle part runs, and has a distal region that runs approximately perpendicular to the proximal area, is spoon-like and curved Transition area is integrally connected to this, to further develop such that the operability  should be simplified considerably, so that Misalignments and operating errors that occur during the course from long-term operations due to Weakness of concentration, loss of strength or the like adjust the operator, can be avoided.

The solution of the invention is specified in claim 1. The invention advantageously further features are Subject of the subclaims.

The invention is based on the idea of developing the known hook for parks in such a way that there are no differences in direction between the forces to be exerted on the handle part of the hook relative to the forces to be exerted on the organ part 4 to be spaced at the distal region.

According to the invention is a device for lifting Organ parts for performing surgical Interventions in the rectal area of the human Hook-type body of parks with one proximal handle part that with a shaft section is connected, whose central area is approximately in Longitudinal direction from the handle part and a distal Area that is approximately perpendicular to proximal area runs, spoon-shaped and with a curved transition area is connected in one piece, designed such that the handle part within the central area of the Shaft section approximately perpendicular to this is bendable. In addition to the vertical bendability of the handle part relative to the central area of the The shaft section is also the device According to the invention in that the  Handle part and the distal area almost parallel run.

The invention is based on the following figures without one limitation of the general inventive concept closer described. Show it:

Fig. 1 longitudinal section through rectal human area with hooks of parks and modification according to the invention as well

Fig. 2 hinge element.

The hook for parks already described in connection with FIG. 1 is modified according to the invention in such a way that in the area of the central shaft section 7 the handle part 6 can be bent approximately vertically at a fixed predetermined location 9 (see dashed line illustration of the angled handle part). By the measure according to the invention it can be achieved that for the metered and controlled exertion of the desired forces F1, F2 and F3, which act on the bladder 4 , are also exerted on the handle part 6 by the operator in the same direction. In particular, to raise the distal tip, the force F1 is in the same way to testify on the handle part.

In addition, the modification according to the invention allows a more energy-saving operation of the instrument, especially a mechanical counter bearing in the invention Instrument that is shaped like a U, not  seems more necessary.

In principle, the device according to the invention can unchangeably assume the shape indicated in FIG. 1 in an angled position (see dashed lines) and be made of a completely rigid material. However, if you want to increase the ease of use, especially when inserting the hook into the intracorporeal area, a device must be provided on the shaft area with which the grip part and at least a part of the middle shaft area can be angled to the rest of the shaft area. On the one hand, this can be achieved by means of a material which is resistant to bending and which permits plastic bending at the corresponding point several times.

However, a hinge element is preferred to be provided that allows a clear angle.

A corresponding hinge element is shown in FIG. 2 in the angled state and in the extended state. A hinge element 9 is shown in the central area of the instrument, which enables two areas to be folded down against one another. A securing sleeve 10 is attached to the upper area of the foldable proximal area and can be pushed over the hinge element. A stop element 11 is provided on the securing sleeve, which in the angled state limits the maximum angular range in which the grip part can be angled relative to the shaft section. Spacers 12 ensure that the securing sleeve 10 cannot be spaced too far from the hinge element 9 . The stop element 11 is preferably formed as a pin and protrudes in the angled state into a bore 13 provided in the lower shaft area. In this way, both shaft areas can be firmly fixed against each other. Alternatively, the stop member may be fork-shaped in the direction of the angled shaft portion 11, so that the impact element 11 to both sides engages around the proximal portion.

In the stretched state, see FIG. 2b for this purpose, the securing sleeve 10 serves to avoid an undesired kinking of the two shaft sections against one another.

Claims (8)

1. Device for lifting organ parts for performing surgical interventions in the rectal region of the human body in the manner of hooking parks with a proximal handle part, which is connected to a shaft portion, the middle Be extends approximately in the longitudinal direction to the handle part and one Distal region which extends approximately perpendicular to the central region, is spoon-like and is integrally connected to it via a curved transition region, characterized in that the grip part within the central region of the shaft section can be bent approximately perpendicularly to this. 2. Device according to claim 1, characterized in that in the central area Hinge element is provided. 3. Device according to claim 2, characterized in that the hinge element by means of a locking sleeve over the hinge element can be pushed, against unintentional bending, can be secured. 4. The device according to claim 3, characterized in that the sleeve with an impact element is connected, which in angled Position the handle part relative to the shaft section fixed.   5. The device according to claim 1, characterized in that the stop element in angled position in an opening within the middle shaft portion protrudes. 6. The device according to claim 1, characterized in that in the central area bendable section is provided in which the Ab angle of the grip part to the shaft section. 7. Device according to one of claims 1 to 6, characterized in that the handle part in abge angled condition roughly parallel to the spoon-like trained distal area. 8. Device for lifting organ parts for the Performing rectal surgery Area of the human body in the manner of the hook of parks with a proximal handle part that with a Shank section is connected, the proximal and has a distal region, the distal Area approximately perpendicular to the proximal area runs and is spoon-like and over one curved transition area with the proximal area is connected in one piece, characterized in that the handle part and the distal area run approximately parallel.