DE2065742A1 - AIR CLAMPING DEVICE FOR CLAMPING THE SKIN - Google Patents
AIR CLAMPING DEVICE FOR CLAMPING THE SKINInfo
- Publication number
- DE2065742A1 DE2065742A1 DE2065742*A DE2065742A DE2065742A1 DE 2065742 A1 DE2065742 A1 DE 2065742A1 DE 2065742 A DE2065742 A DE 2065742A DE 2065742 A1 DE2065742 A1 DE 2065742A1
- Authority
- DE
- Germany
- Prior art keywords
- piston
- cartridge
- pressurized gas
- inlet opening
- plunger
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
- A61B17/0684—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil having a forming anvil staying above the tissue during stapling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00544—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated pneumatically
- A61B2017/00548—Gas cartridges therefor
Description
25 213 G/fr25 213 G / fr
18. Februar 197618th February 1976
United States Surgical Corporation, Baltimore/USAUnited States Surgical Corporation, Baltimore / USA
Druckgasbetätigte Vorrichtung zum Klammern aer hautPressurized gas operated device for stapling aer skin
Die Erfindung betrifft ein chirurgisches Instrument zum Anbringen von sterilisierten Klammern an der aufgetrennten haut eines Patienten oder zum Verbinden von Gewebe- M scnnitten. Die Verwendung von sterilisierten Klammern für medizinische Zwecke nimmt ständig und schnell zu. Bekannte Vorrichtungen zum Anbringen von sterilisierten Klammern werden über pistolenartige Handgriffe über von der Hand zu betätigende hebel durch tiandkraft angebracht. Bisher war es jedoch im allgemeinen für den Chirurgen oder seinen Assistenten schwierig, aufeinanderfolgende Klammern gleichmäßig so einzubringen, daß die eingebrach-The invention relates to a surgical instrument for applying clips to sterilized the separated skin of a patient or for connecting scnnitten M of tissue. The use of sterilized staples for medical purposes is increasing rapidly and steadily. Known devices for attaching sterilized clips are attached by means of pistol-like handles by means of hand-operated levers. In the past, however, it has generally been difficult for the surgeon or his assistant to insert successive staples evenly so that the inserted staples
- 2 60 9826/0346 ORIGINAL INSPECTED- 2 60 9826/0346 ORIGINAL INSPECTED
ten Klammern eine einheitliche Form aufwiesen. Die Uneinheitlichkeit des Einbringens und Verformens der Klammern war vor allem darauf zurückzuführen, daß der Chirurg nicht imstande war, aas von ihm bediente Instrument mit einer konstanten Kraft zu betätigen. Ein weiterer Grunci besteht darin, daß die Hand des Chirurgen nach eiern Einbringen zahlreicher Klammern ermüdet, so daß aie Klammern noch uneinneitlicher eingebracht und verformt werden.th brackets had a uniform shape. The inconsistency the introduction and deformation of the clamps was mainly due to the fact that the The surgeon was unable to operate the instrument he was operating with a constant force. Another Grunci is that the surgeon's hand gets tired after inserting numerous staples, so that all brackets are inserted and deformed even more unevenly.
Aufgabe der vorliegenden Erfinüung ist es daher, eine Vorrichtung zum Anbringen medizinischer Klammern zu schaffen, mit der sich Klammern einheitlich und gleichmäßig einbringen lassen.The object of the present invention is therefore to provide a device for attaching medical clips create, with which brackets can be inserted uniformly and evenly.
Erfindungsgemäß wird diese Aufgabe dadurch gelöst, daß der die Klammern ausstoßende unet verformende Stößel von einer druckgasgetriebenen Betätigungseinrichtung bewegt wird. Mit der erfindungsgemäßen Vorrichtung lassen sich alle Klammern gleichmäßig setzen. Der Chirurg oder sein Assistent können nicht ermüden, weil die Funktion der druckgasbetätigten Einrichtung durch eine kleine Bewegung eines Hebels oder Auslösers ausgelöst werden kann. Im Betrieb wird die Funktion der druckgasbetätigten Klammerauswerfeinrichtung durch die Bedienungsperson ausgelöst, worauf die Einrichtung den Klammervorgang durchführt und in kürzester Zeit und mit maximalem Wirkungsgrad in ihren Ausgangszustand zurückkehrt, worauf sie erneut betätigt werden kann. Die Antriebseinrichtung ist im Aufbau einfach und enthält nur wenige sich bewegende Teile, arbeitet zyklisch und hat eineAccording to the invention this object is achieved in that the clamps ejecting and deforming plunger of a compressed gas operated actuator is moved. With the device according to the invention can put all brackets evenly. The surgeon or his assistant cannot tire because of the function of the Pressurized gas actuated device can be triggered by a small movement of a lever or trigger. In operation, the function of the pressurized gas-operated staple ejector is performed by the operator triggered, whereupon the device carries out the clamping process and in the shortest possible time and with a maximum Efficiency returns to its original state, whereupon it can be operated again. The drive device is simple in structure and contains only a few moving parts, works cyclically and has a
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sehr lange Gebrauchsdauer. Die Gaspatrone läßt sich nach Gebrauch austauschen.very long service life. The gas cartridge can be exchanged after use.
Bei der Verwendung von druckgasbetätigten Einrichtungen ist es üblich, die die Patrone aufnehmende Einrichtung mit einem Stift zu versehen, der eine Dichtung der Gaspatrone durchsticht. Es hat sich jedoch gezeigt, daß ein derartiger Stift schnell abgenutzt wird, so daß die druckgasbetätigte Einrichtung nur eine kurze Gebrauchsdauer hat. When using pressurized gas actuated devices, it is common to use the device receiving the cartridge to be provided with a pin that pierces a seal of the gas cartridge. However, it has been shown that such a pin wears out quickly, so that the pressurized gas operated device has only a short useful life.
In weiterer Ausgestaltung der Erfindung wird daher eine Gaspatrone verwendet, die selbst mit einem Durchsteckmechanismus versehen ist. Man kann daher eine sterilisierte und mit einem Durchstechmechanismus versehene Gaspatrone und eine sterilisierte, gefüllte Klammernpatrone zusammen verpacken. Auf diese Weise wird das Nachladen des Instruments sehr erleichtert.In a further embodiment of the invention, therefore, a gas cartridge is used which itself has a push-through mechanism is provided. One can therefore get a sterilized one with a piercing mechanism Pack the gas cartridge and a sterilized, filled staple cartridge together. That way it becomes Reloading the instrument is very easy.
Ein Ausführungsbeispiel der Erfindung wird nachstehend anhand der Zeichnung näher erläutert. In der Zeichnung zeigtAn embodiment of the invention is explained in more detail below with reference to the drawing. In the drawing shows
Fig. 1 in einer Seitenansicht, teilweise im Schnitt, eine erfindungsgemäße Vorrichtung zum Klammern der Haut,Fig. 1 in a side view, partially in section, a device according to the invention to cling the skin,
Fig. 2 zeigt die Vorrichtung nach Fig. 1 mit betriebsbereit eingesetzter Patrone in größerem Maßstab in einer teilweise geschnittenen Seitenansicht,FIG. 2 shows the device according to FIG. 1 with the cartridge inserted and ready for operation on a larger scale in a partially sectioned side view,
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Fig. 3 zeigt die erfindungsgemäß verwendete Patrone in einer Draufsicht,Fig. 3 shows that used according to the invention Cartridge in a plan view,
Fig. 4 zeigt in einer Untersicht die in Fig.3 aargestellte Patrone,Fig. 4 shows a bottom view of the cartridge shown in Fig. 3,
Fig. 5 zeigt in größerem Maßstab den hinteren Teil der in Fig.3 gezeigten Patrone, wobei ein Teil des Deckels entfernt ist,Fig. 5 shows on a larger scale the rear part of the cartridge shown in Fig. 3, with part of the lid removed,
Fig. 6 zeigt einen Querschnitt nach der Linie 6-6 in Fig. 5,Fig. 6 shows a cross section along the line 6-6 in Fig. 5,
Fig. 7 einen Querschnitt nach der Linie 7-7 in Fig. 6,7 shows a cross section along the line 7-7 in FIG. 6,
Fig. 8 in größerem Maßstab den Vorderteil der Patrone gemäß Fig. 3 bei teilweise abgenommenem Deckel,Fig. 8 on a larger scale the front part of the cartridge according to FIG. 3 at partially removed cover,
Fig. 9 einen Querschnitt nach der Linie 9-9 in Fig. 8,FIG. 9 shows a cross section along the line 9-9 in FIG. 8,
Fig. 10 einen Querschnitt nach der Linie 10-10 in Fig. 8,Fig. 10 is a cross section along the line 10-10 in Fig. 8,
Fig. 11 in einer Vorderansicht die Patrone gemäß Fig. 3,11 shows the cartridge according to FIG. 3 in a front view,
Fig. 12 in einer Draufsicht den Stößel der erfindungsgemäßen Vorrichtung und12 shows the plunger of the invention in a plan view Device and
609826/0348609826/0348
-J —-J -
Fig. 13 aen Stößel gemäß Fig. 12 in einer Seitenansicht.FIG. 13 aen tappet according to FIG. 12 in a side view.
Die Figuren 14 bis 17 erläutern die aufeinanderfolgenden Phasen der Verformung einer Klammer während eines Klammervorganges,Figures 14 to 17 explain the successive phases of the deformation of a Clamp during a clamp process,
Die Figuren 18 bis 22 erläutern aufeinanderfolgende Phasen der Verformung einer Klammer in aer Haut eines Patienten,FIGS. 18 to 22 explain successive phases of the deformation of a bracket in a patient's skin,
Fig. 23 zeigt einen Querschnitt durch den druckgasbetätigten Antriebsmechanismus des erfinuungsgemäßen Instruments,23 shows a cross section through the pressurized gas actuated drive mechanism of the instrument according to the invention,
Die Figuren 24 bis 2ö zeigen aufeinanderfolgende Phasen des Auswerfens und Verformens einer Klammer mit Hilfe der druckgasbetätigten Antriebseinrichtung nach Fig.23,FIGS. 24 to 20 show successive phases of ejection and deformation a clamp with the aid of the pressurized gas actuated drive device according to Fig. 23,
Fig. 29 zeigt in einer Vorderansicht das Gehäuse der in Fig. 1 aargestellten Vorrichtung zum Klammern der haut, M 29 shows in a front view the housing of the device for clamping the skin, M shown in FIG
Fig. 30 zeigt das Getriebegehäuse in einer Draufsicht, Fig. 30 shows the gear housing in a plan view,
Fig. 31 einen Querschnitt nach aer Linie 31-31 in Fig. 30,31 shows a cross section along line 31-31 in FIG. 30,
Fig. 32 eine Seitenansicht des Getriebes gemäß Fig. 31,32 shows a side view of the transmission according to FIG. 31,
— 6 —- 6 -
609826/0 346609826/0 346
Fig. 33 in einem Querschnitt nach der Linie33 in a cross section along the line
33-33 in Fig. 30 das Getriebe in einer Rückzugs- oder Bereitschaftsstellung,33-33 in Fig. 30 the transmission in a retracted or standby position,
Fig. 34 in einer der Fig. 33 ähnlichen Darstellung das Getriebe in der Klammerauswerfstellung, FIG. 34 shows the gear mechanism in the clamp ejection position in a representation similar to FIG. 33,
Fig. 35 in einer den Figuren 33 und 34 ähnlichen Darstellung die sich bewegenden Teile des Getriebes bei der Rückkehr aus der Stellung gemäß Fig. 34 in die Stellung gemäß Fig. 33,35 shows the moving parts in a representation similar to FIGS. 33 and 34 of the transmission when returning from the position according to FIG. 34 to the position according to FIG. 33,
Fig. 36 in einer Seitenansicht eine zweite Ausführungsform aes Gehäuses einer erfindungsgemäßen Vorrichtung zum Klammern der riaut,36 shows a side view of a second embodiment of a housing of one according to the invention Device for stapling the riaut,
Fig. 37 einen Schnitt nach der Linie 37-37 in Fig. 36 bei abgenommener Gaspatrone,37 shows a section along line 37-37 in FIG. 36 with the gas cartridge removed,
Fig. 38 einen Schnitt nach der Linie 38-38 in Fig. 36 und38 shows a section along the line 38-38 in FIG. 36 and FIG
Fig. 39 schaubildlich und mit auseinandergezogenen Teilen die Gaspatrone und den Durchstechmechanismus gemäß den Figuren 36 bis 38.39 shows, in perspective and with parts exploded, the gas cartridge and the piercing mechanism according to FIGS. 36 to 38.
In Figur 1 ist die erfindungsgemäße Vorrichtung zumIn Figure 1, the inventive device is for
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Klammern der Haut mit 10 bezeichnet. Die Vorrichtung besitzt eine wegwerfbare Klammernpatrone 12 una ein Gehäuse 14. Dieses hat einen handgriff 16, den der Chirurg im Gebrauch des Instruments erfaßt und der die .druckgasbetätigte Antriebseinrichtung 17 enthält. Der Vorderteil des Gehäuses 14 bildet eine Halterung für die Patrone 12. Zwischen dem handgriff 16 und der Patronenhalterung 18 befindet sich ein Getriebeaufnahmeteil 19, in dem das Getriebe enthalten ist, das zum Synchronisieren eier Bewegungen der Llemente der erfindungsgemäßen Vorrichtung zum Klammern der baut dient.Clamps of the skin are designated by 10. The device has a disposable staple cartridge 12 and a housing 14. This has a handle 16 that the Detected surgeon in the use of the instrument and the .druckgasbetätigte drive device 17 contains. Of the Front part of the housing 14 forms a holder for the cartridge 12. Between the handle 16 and the Cartridge holder 18 is a gear receiving part 19 in which the gear is contained, which is used for Synchronize eier movements of the elements of the invention Device for stapling the building is used.
Figur 1 zeigt die Patrone 12 während ihres Einsetzens in die Patronenhalterung 18. Man erkennt, daß die Halterung 18 einen Hohlraum 20 besitzt, der so bemessen ist, daß die Patrone 12 schräg eingesetzt werden kann. In der Halterung 18 ist eine halbzylindrische Nocke 22 drehbar gelagert.FIG. 1 shows the cartridge 12 as it is being inserted into the cartridge holder 18. It can be seen that the holder 18 has a cavity 20 which is dimensioned so that the cartridge 12 can be inserted at an angle. In the Holder 18 is a semi-cylindrical cam 22 rotatably mounted.
ßexm Einsetzen oder Herausnehmen der Patrone 12 in das bzw. aus dem Gehäuse 14 befindet sich die tfocke 22 in der in Figur 1 gezeigten Stellung. Zum Verriegeln der Patrone 12 in dem Gehäuse 14 wird die Hocke 22 um 180° in die in Figur 2 gezeigte Stellung gedreht, in der sie mit ihrer Klemmfläche 23 fest an der Unterseite der Patrone 12 angreift. In einer mit dem Gehäuse 14 horizontal fluchtenden Stellung wird die Patrone 12 von zwei aufwärtsgerichteten Flanschen 24 der Deckplatte der Patrone 12 gehalten. Die Flansche 24 greifen in zwei Vertiefungen 26 ein, die in dem Bereich 18 des Gehäuses 14 ausgebildet sind. When the cartridge 12 is inserted or removed from the housing 14, the jib 22 is in the position shown in FIG. To lock the cartridge 12 in the housing 14, the crook 22 is rotated 180 ° into the position shown in FIG. In a position horizontally aligned with the housing 14, the cartridge 12 is held by two upwardly directed flanges 24 of the cover plate of the cartridge 12. The flanges 24 engage in two recesses 26 which are formed in the area 18 of the housing 14.
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Wie am besten aus den Figuren 6 und 11 hervorgeht, erstrecken sicn die beiden im Abstand voneinander angeoraneten Flansche 2 4 von dem hinteren Ende des Patronenaeckels aufwärts. Die· Flansche 24 sind in einem solchen Abstand voneinander angeoranet, daß sich ein Antriebsglied 2 8 (Fig.2) zwischen ihnen hin- und herbewegen kann.As best seen in Figures 6 and 11, extend sicn the two spaced apart flanges 2 4 from the rear end of the cartridge cover upwards. The flanges 24 are arranged at such a distance from one another that a drive member 2 8 (Fig.2) can move back and forth between them.
Gemäß Figur 1 hat das Antriebsglied 2 8 einen langgestreckten, mittleren Bereich 29. An dem vorderen Ende aes Antriebsgliedes ist dieses mit einem Fortsatz 30 zum Angriff an dem Stößel versehen. Der mittlere Teil des Antriebsgliedes 28 besitzt eine Schrägfläche 32, die an einem verscniebbaren Kolben 34 angreifen kann, aer von einer Feder 35 aufwärts belastet ist.According to Figure 1, the drive member 28 has an elongated, central region 29. At the front end Aes drive member this is provided with an extension 30 for attack on the plunger. The middle part of the drive member 28 has an inclined surface 32 which can act on a piston 34 which can be displaced, aer is loaded upwards by a spring 35.
Figur 1 zeigt das Antriebsglied 28 in seiner hinteren Stellung, in aer es ein einsetzen oder Herausnehmen der Patrone 12 gestattet. Dabei wird der Kolben 34 durch die Kraft der Belastungsfeder 35 in seiner oberen Stellung gehalten. Wenn während eines Klammervorganges das Antriebsglied 28 vorwärtsbewegt wird, wirkt die Fläche 32 auf den Kolben 34, so daß dieser gegen die Kraft der Belastungsfeder 35 abwärtsgedrückt wird. Die Funktionen dieser Elemente sind nachstehend ausführlicher beschrieben. Figure 1 shows the drive member 28 in its rear position, in aer it an insert or remove the Cartridge 12 permitted. The piston 34 is in its upper position by the force of the loading spring 35 held. If the drive member 28 is moved forward during a stapling operation, the surface acts 32 on the piston 34, so that it is pressed down against the force of the loading spring 35. The functions these elements are described in more detail below.
Nachstehend werden anhand der Figuren 3 bis 13 die Ausbildung und Wirkungsweise der Patrone 12 beschrieben. Diese besitzt einen Körper 36, der von einer Deckelplatte 38 verschlossen werden kann. Der Körper 36 be- The training is shown below with reference to FIGS. 3 to 13 and operation of the cartridge 12 is described. This has a body 36 which can be closed by a cover plate 38. The body 36 loads
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sitzt zwei Ausricntfortsätze 40, uie gemäß Figuren 4 und 5 in je eine Vertiefung 42 eier Deckeiplatte 3ü eingreifen. In aem Körper 36 aer Patrone 12 sina zwei zylindrische Vertiefungen 44 ausgebildet (Fig. 7), aie sich im wesentlichen über aie ganze j^änge des Körpers 36 erstrecken und zum naltern von zwei drehbar gelagerten Schrauben 46 dienen.two alignment extensions 40 are seated, as shown in FIG. 4 and 5 each engage in a recess 42 egg cover plate 3ü. In a body 36 of the cartridge 12 there are two cylindrical depressions 44 are formed (FIG. 7), which extend essentially over the entire length of the body 36 extend and serve to age two rotatably mounted screws 46.
Wie am besten aus den Figuren 7 und ύ hervorgeht, sindAs can best be seen from Figures 7 and ύ , are
in dem Körper 36 der Patrone 12 ferner zwei Vertiefun- ä in the body 36 of the cartridge 12 further comprises two depressions ä
gen 48 vorgesehen, die von Leisten 4 9 und Seitenwänuen 51 begrenzt sind. Die Leisten 49 und die Wände 51 aienen zum Führen von menreren Klammern 50.gen 48 provided that of strips 4 9 and Seitenwänuen 51 are limited. The strips 49 and the walls 51 serve to guide several clamps 50.
Aus den Figuren 6 und 7 erkennt man, daß die Leisten 49 una die Seitenwände 51 uie Klammern 50 über einen beträchtlichen Teil der Länge der Patrone auf einem Niveau unterhalb des Außenumfanges der Schrauben 46 führen. Dies wird dadurch ermöglicht, aaß die Scnrauben 46 mit Gewinaen 52 zum Führen und Vorschieben der Klammern 50 längs der Leisten 49 und zwischen den Wänaen 51 versehen sind.It can be seen from FIGS. 6 and 7 that the strips 49 and the side walls 51 and brackets 50 over a considerable distance Guide part of the length of the cartridge at a level below the outer circumference of the screws 46. This is made possible by the fact that the screws 46 have threads 52 for guiding and advancing the clamps 50 along the strips 49 and between the walls 51 are provided.
hin die Klammern 50 abdeckender, plattenförmiger Stößel 54 ist in einer nut 56 aer Leckelplatte 38 verschiebbar. Der Stößel 54 wird von der Oberseite der Schrauben 46 und der Unterseite uer Deckelplatte 3Ö geführt unu hält außer während eines VorschubVorganges jede Klammer 50 an die Leisten 49 an. Beim Vorschubvorgang wird die vorderste Klemme von dem sie bedeckenden Stößel 54 weg vorgeschoben.The plate-shaped plunger 54 covering the clamps 50 can be displaced in a groove 56 of the leakage plate 38. The plunger 54 is guided and held by the top of the screws 46 and the bottom of the cover plate 30 except during a feed process, each clamp 50 on the strips 49. During the advancement process, the foremost clamp is moved away from the plunger 54 that covers it advanced.
- 10 -- 10 -
B 0 9 8 2 ί / ι · 'iL 6B 0 9 8 2 ί / ι · 'iL 6
Jede Schraube 46 ist an ihrem hinteren Ende mit einem gewindelosen Fortsatz 58 versehen, der in einer zylindrischen Vertiefung 59 aes Körpers 36 drehbar gelagert ist und außen einen flachen Portsatz 60 besitzt (Fig. 5 und 6) .Each screw 46 is at its rear end with a threadless extension 58 is provided which is rotatably mounted in a cylindrical recess 59 aes body 36 and has a flat set of ports 60 on the outside (FIGS. 5 and 6).
Die Ausbildung des Stößels 54 ist in den Figuren 12 und 13 dargestellt. Der Stößel 54 besteht aus einer flachen Platte, auf der zwei aufwärtsgerichtete Führungsvorsprünge 66 zentriert sina, die in Nuten 67 in der Oberseite der Deckelplatte 38 gleiten können. Der hintere Teil des Stößels 54 besitzt eine Ausnehmung 68, in die der Fortsatz 30 des anhand aer Figur 1 beschriebenen Antriebsgliedes 28 eingreifen kann. Der Fortsatz 30 erstreckt sich durch einen Schlitz 69 der Deckelplatte in das Loch 68. Der Vorderteil des Stößels 54 ist U-förmig mit zwei Schenkeln 70 ausgebildet. Diese sind gemäß Figur 8, 9, 12 und 13 V-förmig, damit sie die Klammern 50 beim Ausbringen derselben einwandfrei führen können. Aus einem nachstehend erläuterten Grund besitzt jeder Schenkel 70 eine Schrägfläche 72.The design of the plunger 54 is shown in FIGS. The plunger 54 consists of a flat one Plate on which two upwardly directed guide projections 66 are centered, which are in grooves 67 in the top the cover plate 38 can slide. The rear part of the plunger 54 has a recess 68 into which the extension 30 of the drive member 28 described with reference to aer FIG. 1 can intervene. The appendix 30 extends through a slot 69 of the cover plate into the hole 68. The front part of the plunger 54 is U-shaped with two legs 70. These are according to Figure 8, 9, 12 and 13 V-shaped so that they Brackets 50 can lead properly when deploying the same. For a reason explained below each leg 70 has an inclined surface 72.
Gemäß den Figuren 1,3,9 und 11 steht vom vorderen Ende der Deckelplatte 38 ein Amboß 62 vor, der einen Fortsatz der Oberseite der Deckelplatte 38 bildet und in die Ebene des Stößels 54 hineingewölbt ist. Der Amboß 62 ist mit Klammerauswerffedern 64 versehen, die nach dem Klammervorgang die Klammer aus dem Bereich des Ambosses 62 wegdrücken. Während des Klammervorgangs bewegt der Stößel 54 die Federn 64 aus der Ebene heraus, in der die Klammern verformt werden. Beim Beginn desAccording to Figures 1, 3, 9 and 11 is from the front end the cover plate 38 an anvil 62 before, which forms an extension of the top of the cover plate 38 and in the plane of the plunger 54 is curved into it. The anvil 62 is provided with staple ejector springs 64, which after During the stapling process, push the staple away from the area of the anvil 62. During the stapling process the plunger 54 moves the springs 64 out of the plane in which the clips are deformed. At the beginning of the
- 11 -- 11 -
609826/0346609826/0346
Rückzuges des Stößels werden die Federn freigegeben. Nach dem Rückzug des Stößels 54 aus dem Bereich des Ambosses drücken die Federn 64 die soeben gebildete Klammer 60 aus der Ebene des Stößels heraus.Retraction of the plunger releases the springs. After the plunger 54 has withdrawn from the area of the On the anvil, the springs 64 push the clip 60 that has just been formed out of the plane of the ram.
Wie am besten aus der Figur 3 hervorgeht, genügt aer Abstand zwischen den Schenkeln 70 des Stößels 54 zur bequemen Aufnahme des Ambosses. Gemäß Figur 17 ist der Abstand zwischen den Schenkeln 70 gleich der Breite des Ambosses 62 zuzüglich dem doppelten Durchmesser einerAs can best be seen from FIG. 3, aer is sufficient Distance between the legs 70 of the plunger 54 for convenient reception of the anvil. According to Figure 17 is the Distance between the legs 70 equal to the width of the anvil 62 plus twice the diameter of a
Klammer 50 und einer kleinen Zugabe, damit eine zügige ™Clip 50 and a small allowance for a quick ™
Bewegung gewährleistet ist.Movement is guaranteed.
Man kann die Patronen 12 in der nachstehend beschriebenen Weise füllen und einsetzen. Zunächst setzt man die Schrauben 46 in ihre zylindrischen Vertiefungen 44 ein. Dann setzt man die Klammern 50 zwischen den Seitenwänden 59 des Körpers 36 ein. Die Schrauben sollen sich in der in Figur 5 gezeigten Stellung befinden, in der die flachen Fortsätze vertikel angeordnet sind und miteinander fluchten. Nun wird der Stößel 54 über den Klammern 50 eingesetzt und die Deckelplatte 38 eingesetzt. Die vorderste Klammer soll jetzt so angeordnet sein, daß JjThe cartridges 12 can be filled and inserted in the manner described below. First you set the Screws 46 into their cylindrical recesses 44. Then place the clamps 50 between the side walls 59 of the body 36 a. The screws should be in the position shown in Figure 5, in which the flat projections are arranged vertically and are aligned with one another. Now the plunger 54 is over the brackets 50 inserted and the cover plate 38 inserted. The foremost bracket should now be arranged so that Jj
der Stößel 54 alle Klammern 50 bedeckt. Danach kann die Patrone in das Instrument eingesetzt werden.the plunger 54 covers all of the clamps 50. The cartridge can then be inserted into the instrument.
Die Schrauben 46 haben solche Gewinde, daß bei einer Drehung der Schrauben 60 mittels der Fortsätze 60 um 360° jede Klammer um eine Klammernteilung bewegt wird. Die Klammernteilung kann als die Strecke definiert werden, über welche die zweite Klammer aus ihrer Bereit-The screws 46 have such a thread that when the screws 60 are rotated by means of the extensions 60 to 360 ° each bracket is moved by one bracket division. The bracket division can be defined as the distance via which the second bracket from its readiness
- 12 -- 12 -
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Schaftsstellung in eine Stellung zum Auswerfen bewegt werden muß. In Figur 8 und 9 ist die Klaminernteilung mit "a" bezeichnet.Shaft position moved to a position for ejection must become. In FIGS. 8 and 9, the staple division is designated by "a".
Nun sei anhand der Figuren 8 und 9 die Anordnung der vordersten Klammer 50 beschrieben, die zunächst um eine Klammernteilung von der Stellung entfernt ist, aus der sie ausgeworfen werden kann. Der Stößel 54 ist in seiner hinteren Stellung, in der er alle Klammern in den Gewinden 52 der Schrauben 46 festhält.The arrangement of the foremost clamp 50 will now be described with reference to FIGS Staple division is removed from the position from which it can be ejected. The plunger 54 is in his rear position in which he holds all the clamps in the threads 52 of the screws 46.
Wie aus der Figur 9 hervorgeht, endet jede Leiste 49 in einer Schrägfläche 74, die dazu dient, die Spitze der vordersten Klammer 50 aufwärts und in die Ebene des Stößels 54 zu führen, während .dieser vorgeschoben wird. Gleichzeitig mit der Wirkung der Fläche 74 hebt der vorderste Teil jeder Schraube 46 den Steg der ersten Klammer 50 in die Ebene des Stößels 54. Dies geht am besten aus der Figur 10 hervor, die den vordersten Teil der Schraube 46 zeigt. Die Drehrichtung der Schraube 46 ist durch den Pfeil 75 angedeutet. Man erkennt, daß die Gewindetiefe bei 76 mit Ausnahme des vordersten Teils gleich der gleichbleibenden Gewindetiefe an anderen Stellen des Gewindes ist. Bei 78 hat das Gewinde die Tiefe Null. Der bei 7& auf der Schraube gleitende Steg einer Klammer befindet sich daher in der Ebene des Stößels 54.As can be seen from Figure 9, each strip 49 ends in an inclined surface 74, which serves to the tip of the foremost clamp 50 upwards and into the plane of the plunger 54 while .dieser is advanced. Simultaneously with the action of the surface 74, the foremost part of each screw 46 lifts the web of the first Clamp 50 in the plane of the plunger 54. This can best be seen in Figure 10, the foremost part the screw 46 shows. The direction of rotation of the screw 46 is indicated by the arrow 75. You can see that the Thread depth at 76, with the exception of the foremost part, is the same as the constant thread depth on others Make the thread is. At 78 the thread has zero depth. The bar sliding on the screw at 7 & a clamp is therefore located in the plane of the plunger 54.
Nachstehend wird das Auswerfen und Führen der Klammern beschrieben. Wenn das Antriebsglied 28 den Stößel 54 vorschiebt, wird der Kolben 34 von der Schrägfläche 32 desThe following describes how to eject and guide the staples. When the drive member 28 advances the plunger 54, the piston 34 from the inclined surface 32 of the
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Antriebsgliedes 2S heruntergedrückt, so daß eine Klammer in die Auswerfstellung gelangt, ehe der Stößel den Berührungsbereich erreicht. Wenn sich die Klammer in der richtigen Stellung befindet, erreicht der Stößel 54 den Berührungsbereich und drückt er die erste Klammer (siehe Figur 8 und 9) aus der Patrone 12 gegen den Amboß 62. Wenn aer Stößel 54 seine vorderste Stellung erreicht, wird er von dem Antriebsglied 23 (Fig. 1 una 2) in der entgegengesetzten Richtung bewegt. In einem Zeitpunkt während des Rückzuges des Stößels 54 gibt die Schrägfläche 32 des Antriebsgliedes 23 aen Kolben 34 frei, so " daß dieser und das Getriebe in die Bereitschaftsstellung für den nächsten Klammervorgang gelangen können. Das Getriebe erteilt den ßeiden Schrauben 46 während des Vorschubes des Stößels 54 etwas mehr als eine Umdrehung. Dies wird nachstehend bescnrieben.Drive member 2S depressed so that a bracket reaches the ejection position before the plunger reaches the contact area achieved. When the clamp is in the correct position, the plunger 54 reaches the Contact area and he presses the first clip (see FIGS. 8 and 9) out of the cartridge 12 against the anvil 62. When aer plunger 54 reaches its foremost position, it is of the drive member 23 (Fig. 1 and 2) in the moves in the opposite direction. At a point in time during the retraction of the plunger 54 there is the inclined surface 32 of the drive member 23 aen piston 34 free, so that it and the transmission are in the ready position for the next stapling process. The transmission gives the two screws 46 during the advance of the plunger 54 a little more than one revolution. This is described below.
Nachstehend wird aas Zusammenwirken des Stößels 54, der Klammern 50, der Leiste 49 mit ihrer Schrägfläche 74 und der eine abnehmende Gewindetiefe besitzenden Schrauben 46 erläutert, hin nachstehend beschriebenes Getriebe erteilt jeder Schraube 46 während des Vorwärtshubes des Stößels 54 etwas mehr als eine Umdrehung, so daß M Aas the interaction of the plunger 54, the clamps 50, the bar 49 with its inclined surface 74 and the screw 46, which has a decreasing thread depth, will be explained that M
jede Klammer, mit Ausnahme der ersten, um etwas mehr als eine Klammernteilung vorgeschoben wird. Die vorderste Klammer bewegt sich nur um eine Klammernteilung in eine Bereitscnaftsstellung, weil am vorderen Unde jeder Schraube 6 4 kein Gewinde vorhanden ist. Wenn sich die Schrauben 46 drehen und die Klammern vorschieben, wirken gleichzeitig die Leiste 74 una das flacher werdende Gewinde der Schrauben 46 auf ciie vorderste Klammer 50 ein.each bracket, with the exception of the first, is advanced by a little more than one bracket division. The foremost Bracket only moves one bracket division into a ready position, because everyone at the front end Screw 6 4 is not threaded. When the screws 46 rotate and advance the brackets, they take effect At the same time, the strip 74 and the thread of the screws 46, which is becoming flatter, fit onto the foremost bracket 50.
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Dadurch wird die erste Klammer aus ihrer Stellung unterhalb des Stößels 54 in üie Ebene des Stößels gehoben, wobei diese Klammer ständig parallel zu der Ebene des Stößels bleibt. Dieser Vorgang wird durchgeführt, während sich der Stößel vorwärtsbewegt, aber ehe er den berührungsbereich erreicht. Wenn sich die erste Klammer in der Auswerfstellung befindet, wird sie von dem Stößel 54 berührt.As a result, the first clamp is lifted from its position below the plunger 54 in the level of the plunger, this bracket always remains parallel to the plane of the ram. This process is carried out while the ram moves forward but before it reaches the contact area. When the first bracket is in the eject position, it is released by the plunger 54 touched.
Die erfindungsgemäß verwendete, wegwerfbare Patrone kann jede beliebige Anzahl von Klammern enthalten. In dem vorliegenden Ausfunrungsbeispiel enthält sie 25 Klammern. Für einen einzigen Jähvorgang kann mehr als eine Patrone erforderlich sein. Der Chirurg muß dann wissen, wieviel Klammern in seiner wegwerfbaren Patrone noch enthalten sind. Die Erfindung schafft eine Einrichtung zur Anzeige der Anzahl der noch vorhandenen Klammern.The disposable cartridge used in the present invention can contain any number of brackets. In the present exemplary embodiment, it contains 25 brackets. More than one cartridge may be required for a single cut. The surgeon must then know how much Staples are still included in its disposable cartridge. The invention provides a device for display the number of brackets still present.
Aus den Figuren 4 bis 7 geht hervor, daß der Körper unter jeder zylindrischen Vertiefung 44 eine kleine rechteckige Vertiefung 80 besitzt. Die Vertiefungen erstrecken sich im wesentlichen über die ganze Länge des Körpers 36 und stenen mit den Vertiefungen 44 in Verbindung. Auf seiner Unterseite ist der Körper 36 von 25 verjüngten Bohrungen 82 durchsetzt. Gemäß Figur 7 stehen die Vertiefungen 44 mit den Bohrungen 82 über mehrere zylindrische Bohrungen 84 in Verbindung, deren Durchmesser kleiner ist als der kleinste Durchmesser der verjüngten Bohrungen 82.From Figures 4 to 7 it can be seen that the body under each cylindrical recess 44 has a small one rectangular recess 80 has. The depressions extend essentially over the entire length of the body 36 and stenen with the recesses 44 in connection. On its underside is the body 36 of 25 tapered bores 82 penetrated. According to FIG. 7, the depressions 44 with the bores 82 protrude a plurality of cylindrical bores 84 in connection, the diameter of which is smaller than the smallest diameter of the tapered bores 82.
In den Vertiefungen 80 sind zwei rechteckige KlötzeIn the wells 80 are two rectangular blocks
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und 88 verschiebbar gelagert. Jeder Klotz 86 ist mit einem zylindrischen Fortsatz 90 versehen, der in dem Gewinde 52 einer Schraube 46 gleitet.and 88 slidably mounted. Each block 86 is provided with a cylindrical extension 90 which is in the Thread 52 of a screw 46 slides.
Gemäß Figur 4 sind die verjüngten Bohrungen 82 über die Länge der Patrone 12 versetzt und fluchten die in den Vertiefungen 80 verschiebbaren Klötze 86 und 88 miteinander. Infolge des Fluchtens der Klötze 86 und 88 und der versetzten Anordnung der Bohrungen 82 ist jeweils nur ein Klotz durch eine Bohrung hindurch sichtbar. i According to FIG. 4, the tapered bores 82 are offset over the length of the cartridge 12 and the blocks 86 and 88 which can be displaced in the depressions 80 are aligned with one another. As a result of the alignment of the blocks 86 and 88 and the offset arrangement of the bores 82, only one block is visible through a bore. i
Im Betrieb fluchten die Klötze 86 und 88 gemäß Figur mit der hintersten Bohrung 82, welche mit der Nummer "25" versehen ist und anzeigt, daß sich 25 Klammern in der Patrone befinden. Der Klotz 88 ist zunächst durch diese Bohrung hindurch sichtbar. Bis nach dem Auswerfen einer Klammer aus der Patrone ist jede Schraube 46 umIn operation, the blocks 86 and 88 are aligned with the rearmost bore 82, which is numbered "25" indicates that there are 25 staples in the cartridge. The block 88 is initially through visible through this hole. Until after a staple is ejected from the cartridge, each screw is 46 µm
3öQ° gedreht worden. Da die Vorsprünge 90 der Klötze und 88 in die Gewinde 52 der Schrauben 46 eingreifen, bewegen sich die Klötze über eine Klammernteilung. Die Abstände zwischen den Bohrungen 82 betragen je eine Klammernteilung. Infolgedessen ist der Klotz 86 durch3oQ ° has been rotated. Since the projections 90 of the blocks and 88 engage the threads 52 of the screws 46, the blocks move over a bracket pitch. the The distances between the bores 82 are each a bracket division. As a result, the block 86 is through
die mit der Nummer "24" versehenen Bohrungen 82 sieht- ™the bores 82 provided with the number “24” can be seen- ™
bar. Diese Versetzung der sichtbaren Klötze geht weiter, bis der Klotz 88 durch die mit der Nummer "1" versehene Bohrung 82 fluchtet und anzeigt, daß noch eine Klammer vorhanden ist. Nach dem Auswerfen der letzten Klammer deckt der Körper 36 beide Klötze 86 und 88 ab. Der Chirurg erhält daher ständig eine Anzeige, wie viele Klammern in seinem Instrument noch enthalten sind.bar. This displacement of the visible blocks continues until block 88 is replaced by the number "1" Bore 82 is aligned, indicating that a bracket is still in place. After ejecting the last clip the body 36 covers both blocks 86 and 88. The surgeon therefore constantly receives an indication of how many Brackets are still included in his instrument.
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Anhand der Figuren 14 bis 17 sei nun das Zusammenwirken des Stößels 54, einer Klammer 50 und des Ambosses 62 erläutert. In jeder dieser vier Figuren ist gezeigt, daß sich der Stößel 54" in der Pfeilrichtung in der Zeichnung nach links bewegt.The interaction of the ram 54, a clamp 50 and the anvil 62 is now based on FIGS. 14 to 17 explained. In each of these four figures it is shown that the plunger 54 "is in the direction of the arrow in the Drawing moved to the left.
Fig. 14 zeigt die Relativstellung des Stößels 54 und der Klammer 50 beim Auftreffen, wobei sich der Stößel in deren Berührungsbereich befindet. Das heißt, daß die Schrauben bereits zum Vorschieben der Klammern 50 gedreht worden sind.14 shows the relative position of the plunger 54 and the clamp 50 when they strike, the plunger being in whose contact area is located. This means that the screws have already been turned to advance the clamps 50 have been.
Aus der in Figur 14 gezeigten Stellung bewegt sich der Stößel 54 vorwärts, bis die Klammer 50 den Amboß 62 berührt. Dabei wird die Klammer von der V-förmigen Fläche des Stößelschenkels 70 berührt. Der Stößel 54 wird nach links geschoben. Infolge der Schrägflächen 72 der Schenkel 70 kann die Klammer 50 leicht um den Amboß herum gebogen werden. Mach einem geringen Vorschub des Stößels 54 hat die Klammer die in Figur 16 gezeigte Form angenommen, wobei sie immer noch von den V-förmigen Stößelschenkeln geführt wird. Die Schrägfläche gestattet das Ausüben einer Biegekraft auf die Klammer 50 an von dem Amboß 62 entfernten Stellen, so daß zum Einleiten des Biegens' eine geringe Kraft genügt.From the position shown in FIG. 14, the ram 54 moves forward until the clamp 50 contacts the anvil 62. The clamp is touched by the V-shaped surface of the tappet leg 70. The plunger 54 is after pushed left. As a result of the inclined surfaces 72 of the legs 70, the clip 50 can easily around the anvil be bent around. With a slight advance of the plunger 54, the clamp has that shown in FIG Assumed shape, still guided by the V-shaped tappet legs. The sloping surface is permitted exerting a bending force on the bracket 50 at locations remote from the anvil 62 so as to initiate bending 'a small force is sufficient.
Wenn sich die Klammer in der in Figur 16 gezeigten Stellung befindet, wird der Angriffspunkt der Biegekraft von dem äußeren in den inneren Teil der Schrägfläche verlagert. Infolge der zunehmenden Massenkräfte kann der Biegevorgang jedoch leicht fortgesetzt werden. DerWhen the clamp is in the position shown in Figure 16, it becomes the point of application of the bending force shifted from the outer to the inner part of the inclined surface. As a result of increasing mass forces can however, the bending process can easily be continued. Of the
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Stößel wird bis in die in Figur 17 gezeigte Stellung vorgeschoben, in der aie Klammer 50 im wesentlichen rechteckig ist und mit inren Spitzen angreift.The plunger is advanced into the position shown in FIG. 17, in which the clamp 50 is essentially is rectangular and attacks with inner tips.
Anhand der Figuren 13 ois 22 wird jetzt aie Verformung der Klammer in Bezug auf aie haut erläutert. Die Außenhaut 92 des Patienten ist an einem einschnitt 94 geteilt. Ls ist die Aufgabe aer erfinaungsgemäßen Vorrichtung zum Klammern der Haut, die beiden Teile eier riaut 92 fest miteinander zu verbinden una zwar derart, daß aie Teile sauber und zuverlässig festgelegt bleiDen, damit aie ™A deformation is now based on FIGS. 13 to 22 the bracket explained in relation to aie skin. The outer skin 92 of the patient is divided at an incision 94. Ls is the task of the inventive device for Clamps the skin, the two parts riating 92 firmly to be connected with each other in such a way that all parts stay clean and reliably fixed, so that aie ™
heilung erleichtert wiru.healing is made easier.
Gemäß Figur 18 wira das Vorderende aer Vorrichtung zum Klammern aer haut über dem einschnitt 94 gegen die Haut des Patienten gedrückt. In der richtigen Stellung der Vorrichtung ist der Amboß 62 gegenüber aem einschnitt 94 zentriert. Das Antriebsgliea 28 wira jetzt betätigt und erteilt dem Stößel 54 einen Vorwärtshub. Gleichzeitig werden die Klammern 50 vorwärtsbewegt. Wenn der Stößel 54 den Berührungsbereich erreicnt, ist die vorderste Klammer für das Auswerfen bereit. Gemäß Figur 18 berührt aer Stößel aie erste Klammer 50; wirft sie aus der A According to FIG. 18, the front end of the device for stapling the skin is pressed over the incision 94 against the patient's skin. In the correct position of the device, the anvil 62 is centered with respect to aem incision 94. The drive element 28 is now actuated and gives the plunger 54 a forward stroke. At the same time, the clamps 50 are moved forward. When the plunger 54 reaches the contact area, the foremost clip is ready to be ejected. According to FIG. 18, the plunger touches the first clamp 50; throws them out of the A
Patrone aus und schiebt sie gegen den Amboß 62 (Fig.19). Figur 19 zeigt, wie die Klammer in die haut des Patienten eindringt.Cartridge and pushes it against the anvil 62 (Fig. 19). Figure 19 shows how the clip penetrates the patient's skin.
Figur 20 zeigt, wie aie Klammer beginnt, die haut 92 umzulegen. In dieser Stellung wird die Klammer in aer vorstehend anhana der Figur 16 gezeigten Weise verformt.Figure 20 shows how the clip begins to fold over the skin 92. In this position the clamp is in aer deformed manner shown above in anhana of FIG.
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Die Klammer wird aann vollständig um den Amboß 62 herumgebogen und nimmt die in Figur 17 gezeigte Form an. Die entsprechende Stellung der Klammer in Bezug auf die naut ist in Figur 21 gezeigt.The staple is then bent completely around the anvil 62 and assumes the shape shown in FIG. The corresponding position of the bracket in relation to the naut is shown in FIG.
Während aes Vorschubes des Stößels 54 bewegen die Schenkel 70 die Federn 64 aus der Klammerebene heraus. Wenn nach dem Klamniervorgang der Rückzug des Stößels in seine Ruhestellung beginnt, werfen die dem Amboß 62 zugeordneten Federn 64 die Klammer 50 von dem Amboß aus. Jetzt kann sich die haut 92 unter dem Einfluß des unter der haut befindlichen Gewebes zu dem Steg der Klammer hin ausdehnen. Dies ist in Figur 22 gezeigt.While the plunger 54 is advancing, the legs 70 move the springs 64 out of the plane of the clamps. When the retraction of the plunger into its rest position begins after the Klamniervorgang, throw the anvil 62 associated with it Spring 64 the clip 50 from the anvil. Now the skin 92 can move under the influence of the under of the skin-located tissue to the web of the clip to expand. This is shown in FIG.
Da während eines Klammervorgangs die Vorrichtung 10 zum Klammern der Haut den Patienten nur mit ihrem relativ kleinen Vorderteil berührt, kann die erfindungsgemäße Klammervorrichtung senr vielseitig verwendet werden. Man kann sie zum Klammern der Außenhaut oder eines inneren Organs verwenden. Dies war bisher nicht möglich.Since during a stapling process, the device 10 for stapling the skin the patient only with their relative touches the small front part, the clamping device according to the invention can be used in a variety of ways. They can be used to clamp the outer skin or an internal organ. So far this has not been possible.
Für die Ausbildung der Antriebseinrichtung für den Stößel gibt es zahlreiche Möglichkeiten. Der Antrieb kann von hand oder durch Federn erfolgen. Die Lrfindung sieht vor, daß der Stößel mit hilfe eines Druckgases betätigt wird. Insbesondere ist erfindungsgemäß vorgesehen, den Stößel durch die Wirkung einer Kohlendioxidladung anzutreiben, die unter Druck in einem kleinen, wegwerfbaren Behälter angeordnet ist.There are numerous possibilities for the design of the drive device for the plunger. The drive can be done by hand or by springs. The discovery provides that the plunger is actuated with the aid of a pressurized gas. In particular, it is provided according to the invention to drive the plunger by the action of a carbon dioxide charge, which under pressure in a small, disposable container is arranged.
Anhand der Figuren 2 3 bis 28 sei nun die druckgasbe-Based on the figures 2 3 to 28, the pressurized gas
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tätigte Antriebseinricntung der erfinaungsgeiaäßen Vorrichtung beschrieben.actuated drive mechanism of the device according to the invention described.
Gemäß Figur 23 hat die Antriebseinrichtung folgenae Ausbildung. Die Antriebseinricntung 100 besitzt eine Gaseintrittsöffnung 102, einen Ventilkolben 104, zwei Dichtmembranen 106 und 108, einen Durchlaß 110 von der einen Seite des Ventilkolbens 104 zur anderen, einen Kolben 112, der mit hilfe einer sich abwälzenden Membran 115 gegenüber der Wandung 114 einer Kolbenkammer 134 abgedichtet ist, und eine Feder 117, die den Kolben 112 f elastisch aufwärtszubewegen trachtet. An aem Kolben 112 ist eine Kolbenstange 116 befestigt, die eine Kerbe 11ö besitzt. Der oberste Teil 120 der Kolbenstange 116 übt unter der Wirxung der Feaer 117 eine Aufwärtskraft auf den Ventilkolben 104 aus. Line an der Mündung der Gaseintrittsöffnung 102 vorhandene Dichtung 122 verhindert einen Austritt von Gas durch die Eintrittsöffnung 102, wenn der Ventilkolben 104 an der Dichtung 122 angreift. Es sind eine Druckentlastungsöffnung 122 und eine Abströmöffnung 126 vorgesehen, die mit einer Abströmkammer 130 in Verbindung stehen. Eine Eintrittskammer 132 steht mit der Eintrittsöffnung 102 in Verbindung. m According to FIG. 23, the drive device has the following design. The drive device 100 has a gas inlet opening 102, a valve piston 104, two sealing membranes 106 and 108, a passage 110 from one side of the valve piston 104 to the other, a piston 112, which with the help of a rolling membrane 115 against the wall 114 of a piston chamber 134 is sealed, and a spring 117, which seeks to move the piston 112 f elastically upward. A piston rod 116, which has a notch 11ö, is attached to aem piston 112. The uppermost part 120 of the piston rod 116 exerts an upward force on the valve piston 104 under the action of the fibers 117. The seal 122 present at the mouth of the gas inlet opening 102 prevents gas from escaping through the inlet opening 102 when the valve piston 104 engages the seal 122. A pressure relief opening 122 and an outflow opening 126 are provided, which are in communication with an outflow chamber 130. An entry chamber 132 is in communication with the entry opening 102. m
Anhand der Figuren 24 bis 28 sei nun die Wirkungsweise der Antriebseinrichtung 100 erläutert. Es wurde schon erwähnt, daß die Feder 117 trachtet, den Ventilkolben 104 gegen die Dichtung 122 zu bewegen,so daß kein Druckgas in die Eintiittskammer 132 gelangen kann. Der auf die Oberseite des Ventilkolbens 104 wirkende Druck ist kleiner als die von der Feder 117 ausgeübte Kraft,The mode of operation of the drive device 100 will now be explained with reference to FIGS. It was fine mentions that the spring 117 tends to move the valve piston 104 against the seal 122 so that no Pressurized gas can get into the inlet chamber 132. Of the The pressure acting on the top of the valve piston 104 is less than the force exerted by the spring 117,
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weil bei an der Dichtung 122 anliegendem Ventilkolben 104 aer Druck in aer .tintrittsöffnung auf eine kleine Fläche wirkt.because when the valve piston 104 is in contact with the seal 122, the pressure in the aer Area works.
Figur 24 zeigt einen Abzug 136, der um eine Schwenkachse 138 verschwenkbar ist. Das Vorderende des Abzuges 136 greift in die Kerbe 118 der Kolbenstange 116 ein. Nach dem Drücken des Abzuges 136 wird daher die von der Feder 117 ausgeübte Kraft überwunden und der Ventilkolben 104 durch aas Druckgas von der Dichtung 122 und der Eintrittsöffnung 102 weg abwärtsgedrückt. Wenn der Ventilkolben 104 den Boden der Abströmkammer 130 erreicht, dichtet er die Abströmöffnung 126 gegenüber dem in der Eintrittsöffnung 102 herrschenden Druckgas ab. Das Druckgas strömt aann aurch die Eintrittsöffnung in die Eintrittskamiuer 132 und weiter durch den Durchlaß 110 in den Kolbenraum 134. Der von dem Gas ausgeübte Druck bewegt den Kolben 112 abwärts in die in Figur gezeigte Stellung.Figure 24 shows a trigger 136 which is about a pivot axis 138 is pivotable. The front end of the trigger 136 engages the notch 118 of the piston rod 116. After the trigger 136 is pressed, the force exerted by the spring 117 is overcome and the valve piston 104 is pushed downwardly away from the seal 122 and the inlet opening 102 by aas pressurized gas. If the Valve piston 104 reaches the bottom of the outflow chamber 130, it seals the outflow opening 126 with respect to the pressurized gas prevailing in the inlet opening 102. The pressurized gas then flows through the inlet opening into the inlet chamber 132 and further through the passage 110 into piston chamber 134. The pressure exerted by the gas moves piston 112 downward into the position shown in FIG position shown.
Zunächst ist der Druck in der Kolbenkammer 134 infolge der Drosselung in dem Durchlaß 110 niedriger als der Druck in der Eintrittsöffnung 132. Der Druck in der Kolbenkammer 134 steigt jedoch schnell an, bis er den Druck in der Eintrittskammer 132 überwindet. Der Druck in der Kolbenkammer überwindet den Druck in der Eintrittskammer, weil der Druck in der Kolbenkammer auf eine größere Fläche (die Unterseite des Ventilkolbens 104) wirkt als der Eintrittskammerdruck, der auf die Oberseite der Membran 106 wirkt.First, the pressure in the piston chamber 134 is a result the restriction in the passage 110 is lower than the pressure in the inlet port 132. The pressure in the However, piston chamber 134 rises rapidly until it overcomes the pressure in entry chamber 132. The pressure in the piston chamber overcomes the pressure in the entry chamber because the pressure in the piston chamber increases a larger area (the underside of the valve piston 104) acts as the inlet chamber pressure applied to the Upper side of the membrane 106 acts.
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Infolge der vorstehend angegebenen Flächendifferenz bewegt der Druck in der Kolbenkammer 134 den Ventilkolben 104 aufwärts bis in Berührung mit der Dichtung 122, so daß die Eintrittsöffnung wieder abgedicntet wird. Dies ist in Figur 26 gezeigt. In diesem Zeitpunkt ist der Druck in der Kolbenkammer aem Verhältnis zwischen den Flächen der oberen und der unteren Dichtmembran 106 bzw. 108 direkt proportional. Die in uem System vorhandenen Drücke trachten daher, sich auszugleichen.Moved as a result of the area difference specified above the pressure in piston chamber 134 upwardly valve piston 104 into contact with seal 122, so that the inlet opening is sealed again. This is shown in FIG. At this point in time is the Pressure in the piston chamber aem ratio between the areas of the upper and lower sealing membrane 106 and 108 directly proportional. The pressures existing in the system therefore try to equalize each other.
Das in der Kolbenkammer 134 vorhandene Gas kann jetzt durch die verengte Abströmöffnung 126 ins Freie gelangen. Gleichzeitig drückt die Feder 117 aen Kolben 112 aufwärts, so daß an der unteren Dichtung 108 ein Gegendruck aufrechterhalten und der Ventilkolben 104 an die Dicntung 122 angehalten wirct. Dieser Vorgang wird fortgesetzt, bis der obere Teil 120 aer Kolbenstange 116 den Ventilkolben 104 berührt. Wenn diese Berührung hergestellt ist, hält die Feuer 117 den Ventilkolben 104 an die Dichtung 122 an. Eine Zwischenstellung ist in Figur 27 und die Endstellung in Figur 28 gezeigt. Wenn das System die in Figur 2ö gezeigte Stellung erreicht hat, ist es für die nächste Auslösung bereit. In der in Figur 28 gezeigten Stellung werden bis auf die Eintrittsöffnung 102 alle Bereiche der Einrichtung unter atmosphärischem Druck gehalten. Die Kerbe 121 der Kolbenstange 120 ermöglicht trotz der Berührung zwischen der Kolbenstange 120 und der öffnung 110 eine Verbindung zwischen der Kammer 132 und der Abströmöffnung 126.The gas present in the piston chamber 134 can now pass through the narrowed outflow opening 126 into the open. At the same time, the spring 117 pushes a piston 112 upwards, so that a counterpressure is maintained at the lower seal 108 and the valve piston 104 to the seal 122 is stopped. This process continues until the upper part 120 of the piston rod 116 contacts the valve piston 104. When that touch is made is, the fire 117 holds the valve piston 104 to the seal 122. An intermediate position is shown in FIG 27 and the end position shown in FIG. When the system has reached the position shown in Figure 2ö, it is ready for the next trigger. In the position shown in FIG. 28, with the exception of the inlet opening 102, all areas of the device are exposed to atmospheric conditions Pressure held. The notch 121 of the piston rod 120 allows despite the contact between the Piston rod 120 and opening 110 establish a connection between chamber 132 and outflow opening 126.
Die mit der Druckentlastungskammer 128 in VerbindungThe with the pressure relief chamber 128 in connection
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stehende Druckentlastungsöffnung 124 gewährleistet eine leichte Bewegung äes Ventilkolbens und des Antriebskolbens, so daß ein Druckanstrieg zwischen den Membranen 106 und 108 verhindert wird.standing pressure relief opening 124 ensures a slight movement of the valve piston and the drive piston, so that a pressure increase between the diaphragms 106 and 108 is prevented.
Jetzt seien anhand der Figuren 2 und 29-35 die Ausbildung und Wirkungsweise des Getriebes erläutert. Gemäß Figur 2 ist der hintere Teil des Antriebsgliedes 28 mit einem Joch 150 versehen, an dem das vordere Ende der Kolbenstange 116 angreifen kann. Nach dem Auslösen der Antriebseinrichtung 17 werden die Kolbenstange 116, das Antriebsglied 2b und der Stößel 54 vorgeschoben, so daß eine Klammer gegen den Amboß 62 rechteckig verformt wird.The design and mode of operation of the transmission will now be explained with reference to FIGS. 2 and 29-35. According to Figure 2, the rear part of the drive member 28 is provided with a yoke 150 on which the front end the piston rod 116 can attack. After triggering the drive device 17, the piston rod 116, the drive member 2b and the plunger 54 are advanced so that a clamp against the anvil 62 is deformed rectangularly will.
Beim Vorschub des Antriebsgliedes 28 bewegt sich die mit ihm einstückige Schrägfläche 32 vorwärts und greift diese Fläche an dem Kolben 34 an,der gegen den Druck seiner Belastungsfeder 35 abwärtsbewegt wird.When the drive member 28 is advanced, the inclined surface 32, which is integral with it, moves forward and engages this surface on the piston 34, which is moved downward against the pressure of its loading spring 35.
Wie am besten aus der Fig. 2 hervorgeht, ist der Kolben 34 in seiner Vorderfläche mit einer Kerbe 152 versehen, die einen Flansch 154 aufnimmt, der an dem unteren Rand der Rückseite einer dreieckigen Tragplatte 156 vorgesehen ist. Wenn daher beim Vorschub des Antriebsgliedes 28 die Schrägfläche 32 an dem Kolben 34 angreift, bewirkt die Kerbe 152 des Kolbens 34, daß sich die dreieckige Tragplatte 156 infolge der Wechselwirkung zwischen der Kerbe 152 und dem Flansch 154 abwärtsbewegt. Aus der Fig. 34 geht hervor, daß sich der Flansch 154 ein beträchtliches Stück über die drei-As best seen in Fig. 2, the piston 34 is provided with a notch 152 in its front surface, which receives a flange 154 provided on the lower edge of the rear of a triangular support plate 156 is. If, therefore, when the drive member 28 is advanced, the inclined surface 32 engages the piston 34, the notch 152 of the piston 34 causes the triangular support plate 156 to move as a result of the interaction moved downward between notch 152 and flange 154. From Fig. 34 it can be seen that the Flange 154 a considerable distance over the three
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eckige Tragplatte 156 erstreckt, die bei 157 schwenkbar gelagert ist. Diese Anordnung ist auch in Fig. 35 gezeigt, in der ferner zwei in dem Kolben 34 montierte Zapfen 161 und 163 erkennbar sind, die einen Verschleiß des Flansches 154 der dreieckigen Tragplatte 156 verhindern. angular support plate 156 extends which is pivotable at 157 is stored. This arrangement is also shown in FIG. 35, in which two further mounted in the piston 34 Pins 161 and 163 can be seen, which prevent wear of the flange 154 of the triangular support plate 156.
Fig. 2 und 33 zeigen, welche Relativstellung der Kolben 34 und die dreieckige Tragplatte 156 einnehmen, wenn das Antriebsglied 28 das Tastglied 34 nicht berührt. Fig. 34 zeigt, welche Relativstellung diese .Elemente einnehmen, wenn der Kolben 34 während des Klammervorganges an der Schrägfläche 32 des Antriebsgliedes 28 angreift. Bei einem Vergleich der Figuren 33 und 34 erkennt man sofort, daß bei einer Abwärtsbewegung des Kolbens 34 die Tragplatte 156 im Gegensinn des Uhrzeigers um ihre Schwenkacnse 157 verschwenkt wird.Fig. 2 and 33 show the relative position of the piston 34 and the triangular support plate 156 assume when the drive member 28 does not touch the feeler member 34. 34 shows the relative position of these elements take when the piston 34 during the clamping process on the inclined surface 32 of the drive member 28 attacks. When comparing FIGS. 33 and 34, it can be seen immediately that with a downward movement of the Piston 34 the support plate 156 is pivoted counterclockwise about its pivot axis 157.
Aus der Fig. 33 erkennt man ferner, daß mit Hilfe eines Schwenkzapfens 160 eine Klinke 158 auf der dreieckigen Tragplatte 156 schwenkbar gelagert ist. Die Vorderfläche der Klinke 158 kann an der Fläche eines Sperrzahnrades 159 angreifen, das sechs Zähne besitzt. Man erkennt, daß die Klinke 158 in ihrer Ruhestellung nicht in die Zähne des SperrZahnrades 159 eingreift. Die Klinke 158 wird durch einen Zapfen 162 blockiert, der auf der Rückfläche der Klinke montiert ist und ein Loch 164 in der Tragplatte 156 durchsetzt. Eine zweite Klinke 168 ist schwenkbar auf einem Zapfen 170 gelagert, der an dem Gehäuse des Getriebes befestigt ist. Die Klinke 168 ist daher unabhängig von der Tragplatte 156From Fig. 33 it can also be seen that with the help of a pivot pin 160 a pawl 158 on the triangular Support plate 156 is pivotably mounted. The front surface of the pawl 158 can be on the surface of a ratchet wheel 159 attack, which has six teeth. It can be seen that the pawl 158 is not in its rest position engages in the teeth of the locking gear 159. the Pawl 158 is blocked by a pin 162 mounted on the rear surface of the pawl and a hole 164 penetrated in the support plate 156. A second pawl 168 is pivotably mounted on a pin 170, which is attached to the housing of the transmission. The pawl 168 is therefore independent of the support plate 156
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und der Klinke 158. .tine Feder 166 trachtet, die Klinken 158 und 168 gegen das Sperrzahnrad 159 zu bewegen. Die Feder 166 kann durch zwei nicht gezeigte Zugfedern ersetzt werden, die auf den Schwenkzapfen der Klinken bzw. 168 montiert sind. Die Klinke 168 dient als Anschlag zur Begrenzung der Drehung des Sperrzahnrades 159.and the pawl 158. A spring 166 seeks the pawls 158 and 168 to move against the ratchet 159. The spring 166 can be replaced by two tension springs, not shown mounted on the trunnions of the pawls or 168. The pawl 168 serves as a stop to limit the rotation of the ratchet gear 159.
Der Unterteil der Tragplatte 156 ist mit einem Fortsatz versehen, der einen Zapfen 172 trägt. Dieser erstreckt sich so weit vorwärts, daß er in eine Vertiefung einer kleeblatt-förmigen Nockenscheibe 174 eingreift. Auf diese Weise werden die Teile des Getriebes im Bereitschaftszustand des Instruments formschlüssig festgelegt.The lower part of the support plate 156 has an extension provided, which carries a pin 172. This extends so far forward that it is in a recess of a Shamrock-shaped cam 174 engages. In this way the parts of the transmission are in the ready state of the instrument fixed positively.
Gemäß Fig. 32 ist ein Hauptzahnrad 176 auf der Welle montiert, die auch das Sperrzahnrad 159 und die Nockenscheibe 174 trägt. Diese Elemente sind miteinander drehfest verbunden. Fig. 31 zeigt,daß das Hauptzahnrad 176 mit zwei Ritzeln 180 kämmt. Das Übersetzungsverhältnis., zwischen dem Kauptzahnrad 176 und den Ritzeln 180 ist 6:1.32, a main gear 176 is mounted on the shaft, which is also the ratchet gear 159 and the cam plate 174 carries. These elements are non-rotatably connected to one another. Fig. 31 shows that the main gear 176 combs with two pinions 180. The gear ratio., between main gear 176 and pinions 180 is 6: 1.
Wenn daher das Sperrzahnrad 159 um eine Zahnteilung verdreht wird, macht jedes Ritzel 180 eine vollständige Umdrehung.Therefore, when the ratchet 159 is rotated one pitch, each pinion 180 makes one complete Revolution.
Jedes Ritzel 180 ist auf einer Welle 181 montiert, die an ihrem einen Ende einen Schlitz 183 hat* Diese Schlitze nehmen je einen der Fortsätze 60 auf, die mit den Schrauben 46 einstückig sind. Bei jeder Umdrehung des Ritzels werden daher die Klammern um eine Klammernteilung vorwärtsbewegt.Each pinion 180 is mounted on a shaft 181 which has a slot 183 at one end * These slots each receive one of the extensions 60 that are connected to the Screws 46 are integral. With each revolution of the pinion, the brackets are therefore one bracket pitch moved forward.
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Anhand der Figuren 33 bis 35 sei jetzt die Wirkungsweise aes Getriebes beschrieben. Vor aem Auslösen aer Vorrichtung zum Klammern der haut (Fig. 33) befinaet sich das Antriebsglied 23 in seiner hinteren Stellung. Der Kolben 34 mit der Kerbe 152 befindet sich unter der Wirkung der Feder 35 in seiner oberen Stellung, so daß die Tragplatte 156 so weit wie möglich im Uhrzeigersinn verschwenkt ist und die Klinke 168 an einem Zahn aes Sperrzahnrades 159 angreift. Der Antriebsteil der Klinke 158 ist im Abstand von dem ihm nächstliegenden Zahn des Sperrzahnrades 159 angeordnet, so daß die Platte 156 % The mode of operation of a transmission will now be described with reference to FIGS. 33 to 35. Before releasing the device for clamping the skin (Fig. 33), the drive member 23 is in its rear position. The piston 34 with the notch 152 is in its upper position under the action of the spring 35, so that the support plate 156 is pivoted clockwise as far as possible and the pawl 168 engages a tooth of a ratchet wheel 159. The drive part of the pawl 158 is arranged at a distance from the tooth of the ratchet wheel 159 closest to it, so that the plate 156 %
etwas Spiel hat, ene sich das Sperrzahnrad 159 dreht. Infolge dieses Spiels kann der Zapfen 172 aus der Vertiefung der Nockenscheibe 174 austreten.has some play when the ratchet wheel 159 is turning. As a result of this play, the pin 172 can emerge from the recess in the cam disk 174.
Wenn sich während eines Klanunervorganges das Antriebsglied 28 vorwärtsbewegt, bewegt es den Kolben 34 gegen axe Kraft der Feder 35 abwärts. Dadurch wird die Tragplatte 156 im Gegensinn des Uhrzeigers um ihren Schwenkzapfen 157 gedreht, wobei die Klinke 158 aas Sperrzahnrad 159 dreht.When the drive member 28 moves forward during a Klanun process, it moves the piston 34 against ax force of the spring 35 downwards. This causes the support plate 156 to rotate counterclockwise about its pivot pin 157 rotated, wherein the pawl 158 aas ratchet wheel 159 rotates.
Fig. 34 zeigt, welche Stellung die Elemente des Getrie- m FIG., 34 shows what position the elements of the gearbox m
bes einnehmen, wenn die Klinke 158 das Sperrzahnrad 159 so weit wie möglich verdreht hat. Dieser größte Winkel ist größer als der zum Vorschub jeder Klammer um eine Klammernteilung erforderliche Winkel, d.h., daß die Zahnräder zu weit verdreht werden.take bes when the pawl 158 has rotated the ratchet wheel 159 as far as possible. That biggest corner is greater than the angle required to advance each staple one staple division, i.e. the The gears are twisted too far.
Fig. 35 zeigt die Zahnräder nach der zu weitgehenden Verdrehung, wobei sich jedoch das Antriebsglied 2835 shows the gearwheels after the excessive rotation, but the drive member 28
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bereits etwas rückwärtsbewegt hat und der Kolben 34 daher etwas aufwärtsbewegt worden ist.has already moved somewhat backwards and the piston 34 has therefore been moved somewhat upwards.
Nachstehend wird die Wirkungsweise des Getriebes beschrieben. Fig. 33 zeigt die Zahnräder im Ruhestand, während das Antriebsglied 28 zurückgezogen ist und auf seine Betätigung wartet. Der Zapfen 172 greift in eine Vertiefung der Nockenscheibe 174 ein, so daß das Sperrzahnrad 159, das Hauptzahnrad 176 und die Ritzel 180 blockiert sind. In dieser Stellung fluchten die Schlitze 183 (Fig. 29 und 30), so daß eine Klammerpatrone leicht eingesetzt oder herausgenommen werden kann.The operation of the transmission is described below. 33 shows the gears in retirement, while the drive member 28 is withdrawn and awaiting actuation. The pin 172 engages in a Recess of the cam 174 so that the ratchet gear 159, the main gear 176 and the pinion 180 are blocked. In this position, the slots 183 (Figs. 29 and 30) are aligned so that a staple cartridge can easily can be inserted or removed.
Beim Auslösen der Antriebseinrichtung wird das Antriebsglied vorgescnoben und bewegt seine Schrägfläche 32 den Kolben 34 abwärts, so daß er die Platte 156 im Gegensinn des Uhrzeigers verschwenkt.When the drive device is triggered, the drive member is snubbed and moves its inclined surface 32 Piston 34 downwards so that it pivots plate 156 counterclockwise.
Während der ersten Bewegungsphase bewegt sich kein Zahnrad. Infolge des Spiels zwischen der Klinke 158 und dem nächstliegenden Zahn des Sperrzahnrades 159 kann sich der Zapfen 172 aus der Vertiefung in der Nockenscheibe 174 heraustreten, ehe sich ein Zahnrad dreht. Es versteht sich, daß dies notwendig ist. Die Klinke 158 greift dann an einem Zahn des Sperrzahnrades 174 an und dreht das Sperrzahnrad, das Hauptzahnrad 176 und die Ritzel 180 in die in Fig. 34 gezeigte Stellung.No gear wheel moves during the first phase of movement. As a result of the play between the pawl 158 and the The closest tooth of the ratchet wheel 159 can be the pin 172 from the recess in the cam disk 174 step out before a gear turns. It goes without saying that this is necessary. The pawl 158 engages then engages a tooth of ratchet gear 174 and rotates the ratchet gear, main gear 176, and pinions 180 into the position shown in FIG.
In der in Fig. 34 gezeigten Stellung sind die Zahnräder zu weit fortgeschaltet worden, d.h., sie sind weiter verdreht worden, als es für eine Bewegung der KlammernIn the position shown in Fig. 34, the gears have been indexed too far, i.e., they are further been twisted as it was for movement of the brackets
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um eine Klammernteilung erforderlich ist. Dadurch ist gewährleistet, daß die den Ritzeln 180 zugeordneten Schlitze 183 so fluchten, daß eine Patrone eingesetzt oder herausgenommen werden kann.around a bracket division is required. This is ensures that the slots 183 associated with the pinions 180 are aligned so that a cartridge is inserted or can be removed.
Nach dem Klammervorgang bewegt sich das Antriebsglied rückwärts, so daß der Kolben 34 auf der Schrägfläche aufwärtsgleitet. Infolgedessen werden die Platte 156 und mit ihr der Zapfen 172 in die in Fig. 35 gezeigte Stellung bewegt. Aus dieser Stellung bewegt die Feder 35 * den Zapfen 172 gegen die Oberfläche der Nockenscheibe 174. Da sich diese Nockenscheibe in der Anschlagstellung befindet, wird sie von dem Zapfen 172 im Uhrzeigersinn verdreht, bis sich das Getriebe in der in Fig. 33 gezeigten Bereitschaftsstellung für den nächsten Klammervorgang befindet.After the clamping process, the drive member moves backwards so that the piston 34 slides upwards on the inclined surface. As a result, the plate 156 and with it the pin 172 are moved into the position shown in FIG. From this position, the spring 35 * moves the pin 172 against the surface of the cam disk 174. Since this cam disk is in the stop position, it is rotated clockwise by the pin 172 until the gear is in the ready position for shown in FIG the next stapling process is located.
Anhand der Fig. 36 wird jetzt eine zweite Ausführungsform des Gehäuses der erfindungsgemäßen Vorrichtung zum Klammern der Haut beschrieben. Das Gehäuse 200 besitzt einen Teil 202, der zur Halterung der Patrone 12 dient, die mit der vorstehend beschriebenen Patrone 12 übereinstimmt. Eine Nocke 204 ist vorgesehen, die der in ^ Fig. 2 gezeigten Nocke 22 ähnelt. Das Gehäuse 200 besitzt einen Griff 206 und einen Abzug 208. Der Gehäuseteil 210 nimmt eine Antriebseinrichtung auf, die mit der anhand der Figuren 23-28 beschriebenen übereinstimmt. 36, a second embodiment of the housing of the device according to the invention will now be used Staples of the skin described. The housing 200 has a part 202 which is used to hold the cartridge 12, which corresponds to the cartridge 12 described above. A cam 204 is provided which is similar to that shown in ^ Fig. 2 is similar to cam 22 shown. The housing 200 has a handle 206 and a trigger 208. The housing part 210 accommodates a drive device which corresponds to that described with reference to FIGS. 23-28.
Der Griff 206 ist am Ende mit einem Gewinde versehen, in das ein Stöpsel 214 eingeschraubt ist. In dem Hand-The handle 206 is threaded at the end, into which a plug 214 is screwed. In the hand
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griff 206 ist eine Patrone 216 angeordnet, die mit einem Druckgas, z.B. Kohlendioxid, gefüllt ist. Die Ladung dieser Patrone wird der Antriebseinrichtung 210 über einen Kanal 218 zugeführt, der in einer Kammer 220 endet, die der Gaseintrittsöffnung 202 in Fig. 23 entspricht.handle 206 is a cartridge 216 arranged with a Compressed gas, e.g. carbon dioxide, is filled. The charge of this cartridge is transferred to the drive device 210 a channel 218 which ends in a chamber 220 which corresponds to the gas inlet opening 202 in FIG. 23.
Der Abzug 208 ähnelt der in Fig. 24 gezeigten Abzugseinrichtung 136. Beim Drücken des Abzuges 208 bewegt sich daher die Kolbenstange der Abtriebseinrichtung etwas, so daß der Arbeitshub eingeleitet wird, der zum Vorschieben und Verformen einer Klammer erforderlich ist.The trigger 208 is similar to the trigger device 136 shown in FIG. 24. Moved when the trigger 208 is pressed therefore the piston rod of the output device something, so that the working stroke is initiated, which for Advancing and deforming a bracket is required.
Beim Gebrauch des Instruments 200 legt der Chirurg die vier Finger einer Hand um den Griff 206, während der Daumen derselben Hand an dem Abzug 208 angreift. Der Amboß der Klammerpatrone 12 wird gegen den zu klammernden Bereich des Körpers gedrückt und dann der Abzug betätigt.In using the instrument 200, the surgeon wraps the four fingers of one hand around the handle 206 while the Thumb of the same hand engages the trigger 208. The anvil of the staple cartridge 12 is against the one to be clamped Area of the body and then pulled the trigger.
Jetzt wird der Arbeitshub eingeleitet und die Klammer verformt, worauf das Instrument aus dem geklammerten Bereich entfernt und in den nächsten Bereich- gebracht wird, in den eine Klammer eingebracht werden soll. Dieses Arbeitsspiel wird so oft wiederholt, bis der Einschnitt vollständig vernäht ist.Now the working stroke is initiated and the clamp is deformed, whereupon the instrument moves out of the clamped Area removed and moved to the next area where a staple is to be inserted. This work cycle is repeated until the incision is completely sewn.
Fig. 37 zeigt einen Querschnitt in der Richtung der Pfeile 37-37 in Fig. 36 gesehen. Man erkennt, daß der Kanal 218 mit der vordersten Bohrung in dem Griff 206 an einer exzentrisch angeordneten Stelle in Verbindung steht, damit der Gaskanal nicht durch einen Teil derFIG. 37 shows a cross section in the direction of arrows 37-37 in FIG. 36. You can see that the Channel 218 communicates with the foremost bore in handle 206 at an eccentrically located location stands so that the gas duct does not go through part of the
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Gaspatrone oder des Mechanismus zum Durchstechen der Patrone verlegt wird.Gas cartridge or cartridge piercing mechanism is misplaced.
Gemäß Fig. 36 und 37 besitzt der Griff 206 eine Bohrung 222 zur Aufnahme der Gaspatrone 216 und eine Eohrung zur Aufnahme des nachstehend beschriebenen Mechanismus zum Durchstechen der Patrone. Die Bohrungen 222 und 224 sind "durch eine Schrägwanaung miteinander verbunden.36 and 37, the handle 206 has a bore 222 for receiving the gas cartridge 216 and a bore for receiving the mechanism described below to pierce the cartridge. The bores 222 and 224 are "connected to one another by an inclined curve.
Es wurde vorstehend bereits erläutert, daß bei den bekannten druckgasbetätigten Antriebseinrichtungen der die ύ Gaspatrone durchstechende Stift sich schnell abnutzt. Ferner wurde vorstehend angegeben, daß es beabsichtigt ist, eine gefüllte und sterilisierte Klammernpatrone mit einer gefüllten und sterilisierten Druckgaspatrone zusammenzupacken. Um die vorstehend angegebenen iM'achteile zu vermeiden, ist auf einer Gaspatrone ein einfach aufgebauter, billiger Durchstechmechanismus angebracht, der geeignet ist, den Verscnluß der Gaspatrone zu zerstören, wenn diese in dem Griff 206 des Instruments 200 angeordnet und mit Hilfe des Stöpsels 204 festgeschraubt wird.It has already been explained above that in the known drive devices actuated by compressed gas, the pin piercing the gas cartridge wears out quickly. Furthermore, it was indicated above that it is intended to pack a filled and sterilized staple cartridge together with a filled and sterilized pressurized gas cartridge. In order to avoid the disadvantages mentioned above, a simply constructed, inexpensive piercing mechanism is attached to a gas cartridge, which is suitable for destroying the seal of the gas cartridge when it is arranged in the handle 206 of the instrument 200 and screwed tight with the aid of the plug 204 will.
Anhand der Figuren 3o und 39 sei jetzt der neuartige ™Based on FIGS. 3o and 39, let us now consider the novel ™
Mechanismus zum Durchstechen der Patrone beschrieben.Mechanism for piercing the cartridge described.
Mit 216 ist eine Flasche bezeichnet, die ein Druckgas enthält. Die Mündung der Flasche 216 ist mit einem üblichen Verschluß 226 versehen. Über der Mündung der Flasche 216 ist eine Kappe 228 angeordnet, die durch einen O-Ring 230 gegen die Flasche 216 abgedichtet ist.With a bottle is designated 216, which contains a compressed gas. The mouth of the bottle 216 is with a usual lock 226 provided. A cap 228 is placed over the mouth of the bottle 216 and extends through an O-ring 230 is sealed against the bottle 216.
Wenn die Flasche gebrauchsfertig verpackt ist, befindetWhen the bottle is packed ready for use, it is located
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sich ein Stift 232 zwischen einem einwärtsgerichteten Flansch 234 der Kappe 228 und dem Verschluß 226 der Flasche 216. Der Stift 232 hat einen Hauptteil 236, eine Spitze 238 und einen Endteil 240.A pin 232 is located between an inwardly facing flange 234 of the cap 228 and the closure 226 of FIG Bottle 216. The pen 232 has a main portion 236, a tip 238, and an end portion 240.
Quer über den Endteil 240 erstreckt sich ein Schlitz 2 42. Ein Kanal 246 erstreckt sich von dem Ende des Stifts 2 33 zu dem Ende des Schlitzes 242.A slot 242 extends across the end portion 240. A channel 246 extends from the end of the Pin 2 33 to the end of slot 242.
Aus den Figuren 36 und 3S geht nervor, daß beim einschrauben des Stöpseis 214 in den Griff 206 die Flasche 216 zu dem Grund 244 der Bohrung 224 hin bewegt wird, bis der Teil 240 an dem Grund 244 angreift und die Spitze 238 des Stiftes 232 den Verschluß 226 der Flasche 216 durchsticht. Jetzt tritt Gas aus der Flasche 216 cmrch den Kanal 246 unu den Schlitz 242 in die Bohrung 224.From FIGS. 36 and 3S it can be seen that when screwing in of the stopper 214 in the handle 206, the bottle 216 is moved towards the bottom 244 of the bore 224, until the portion 240 engages the base 244 and the tip 238 of the pin 232 engages the closure 226 of the bottle 216 punctures. Gas now comes out of the bottle 216 Run channel 246 and slot 242 into the bore 224.
Die Kappe 228 hat einen dünnen, biegsamen Fortsatz 248, der satt an der Wandung der Bohrung 224 anliegt. Das in die Bohrung 224 eintretende Druckgas gelangt in den Bereich zwischen dem Körper der Kappe 228 und dem Fortsatz 248, so daß der Fortsatz 248 gegen die Wandung der Bohrung 224 gedrückt und eine Rückströmung von Gas in den Griff 206 verhindert wird.The cap 228 has a thin, flexible extension 248, which rests snugly against the wall of the bore 224. The pressurized gas entering bore 224 enters the area between the body of the cap 228 and the extension 248 so that the extension 248 against the wall of the bore 224 and a back flow of gas into the handle 206 is prevented.
Vorstehend wurden Ausführungsbeispiele der Erfindung beschrieben, die jedoch im Rahmen des Erfindungsgedankens abgeändert werden können, so daß die Erfindung nicht auf diese Ausführungsbeispiele eingeschränkt ist.Exemplary embodiments of the invention have been described above, but within the scope of the inventive concept can be modified so that the invention is not limited to these embodiments.
03826/034603826/0346
Claims (1)
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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US85282269A | 1969-08-25 | 1969-08-25 |
Publications (1)
Publication Number | Publication Date |
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DE2065742A1 true DE2065742A1 (en) | 1976-06-24 |
Family
ID=25314300
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE2065742*A Pending DE2065742A1 (en) | 1969-08-25 | 1970-08-25 | AIR CLAMPING DEVICE FOR CLAMPING THE SKIN |
Country Status (8)
Country | Link |
---|---|
US (2) | US3643851A (en) |
JP (2) | JPS4842438B1 (en) |
CA (3) | CA953997A (en) |
DE (1) | DE2065742A1 (en) |
FR (1) | FR2059173A5 (en) |
GB (1) | GB1328841A (en) |
SE (2) | SE373496B (en) |
SU (1) | SU419001A3 (en) |
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-
1969
- 1969-08-25 US US852822A patent/US3643851A/en not_active Expired - Lifetime
-
1970
- 1970-08-21 CA CA091,312A patent/CA953997A/en not_active Expired
- 1970-08-24 SE SE7011485A patent/SE373496B/en unknown
- 1970-08-24 FR FR7030969A patent/FR2059173A5/fr not_active Expired
- 1970-08-24 SE SE7406757A patent/SE395219B/en unknown
- 1970-08-25 SU SU1481582A patent/SU419001A3/ru active
- 1970-08-25 GB GB4087170A patent/GB1328841A/en not_active Expired
- 1970-08-25 JP JP45073919A patent/JPS4842438B1/ja active Pending
- 1970-08-25 DE DE2065742*A patent/DE2065742A1/en active Pending
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1971
- 1971-03-17 US US00125077A patent/US3815476A/en not_active Expired - Lifetime
- 1971-12-14 CA CA130104A patent/CA938182A/en not_active Expired
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1973
- 1973-04-24 CA CA169,305A patent/CA953999A/en not_active Expired
- 1973-06-06 JP JP48063701A patent/JPS5016103B1/ja active Pending
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JPS5016103B1 (en) | 1975-06-10 |
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DE2042158B2 (en) | 1975-10-02 |
CA953997A (en) | 1974-09-03 |
JPS4842438B1 (en) | 1973-12-12 |
US3815476A (en) | 1974-06-11 |
SU419001A3 (en) | 1974-03-05 |
SE395219B (en) | 1977-08-08 |
CA953999A (en) | 1974-09-03 |
SE373496B (en) | 1975-02-10 |
FR2059173A5 (en) | 1971-05-28 |
US3643851A (en) | 1972-02-22 |
DE2042158A1 (en) | 1971-03-11 |
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