DE2109604B2 - SURGICAL CLAMPING DEVICE FOR CLAMPING BONE TISSUE - Google Patents

Description

15 ^[ r laiidgrüi ι
iiieni Kop!

body with g

_K:; . The one die with milling out:: -cn the k! Aninierfüßchen attached hi 'zero of the SU'tzkörpers is a clamp' i-ev.T.dezaplcn and one unmoved. uiv.eiLchiacht. That as a hollow housing: 'anm ^ ruehäuse takes a bump'. ci aiii, regarding the Klam ::! hr / rhewesilich is. Am Klamme - ■ - -Ibaies Kiaiiimeriiiai: a /:

K:

ι ;, rn belestigi. in the the

Vv .mi τι ' ¹ ' .. ■■> · di, γ ('i -.' ·
de !: / :: - :: : ... .:. ~ (. ..Ui dv.i; ■ esp : ( ^; ■ ■ lläl.seil:. Ρ, Ulli! ! ι .-. se i rm .: Clammy d - ■ e: .i / m ι by Is;: ·>. Kianin.e ent; L'.i / in ι the. Hi. i -el Dir. L. . ¹ II :: ■ M ..: the Κ! .ι Lliüi L: -111.ig. Di ·. Κ I. -T-TIi the kilo \ u i.gewel ile the Mia-ur

45

5 °

55

60

! The invention relates to a surgical stapler for K .immerverbinden of bone tissues, TLAs a Stützkorper with a jaw and hefestigte it] template strand with cutouts of animals for bending brackets, an i-in guides of the support ^body: nes same back and herbewecliches Klammeruc-> ! ·: .ILiciis of the stapler. 'e :: i: - ·. dall the support hoe. ii: e: '..! eii Knoeheiileil succeeded :. :.: ·. ·. . ;;: de- mother of Klamm, -hieb; thereby the Klamn ..

.'ur die forward. ',Everyone:'. s ^: egg; with Mainz ..

■ ;;. !! ^; M 1 ..-! -, SUlCKe ZW iscllCIl

m.i.! ei 'Matiize fcs'.iieklemm'.

veb: de 'Surgeon the Stö! .'- e

: ■ ', /. ■. de! then the gorges

iz.η! ', er.iiis ^ u'iss.

pierce with their l'iil ..:

ν and bend as v.

:; eii hit the die, ah. ·. you.eh them to connecteiidei; Knoclienhrueh '. _; : ■ te- ·! unite with each other.

When suturing the bone fractions with d. : n he known staplers, both clamps bend, lüßeheii in mcichem Mai .'- e from. where the ma! '. .:. Abbiemiiisi in each case the strength of the binders to be ν: ', Cooking batches should correspond. In the \.:· binding of oil fractions differently Build strength! but that the weaker Knocli ... hriichleil du'ehskchende Klamnieriüßchen one, r ..- dem Ossicles protruding and the w ^.!, E The fabric of the next environment-damaging sheets.

When ^v of Knoehenbruchteile Getting Connected dutch the known stapler can diverge these and are movable against each other, as ml'ulüc read Aulbaus of the components of the device is not guaranteed that the Klamnieriüßchen at their Ahbiesien to the die in d..s zusammenzunähende Knochensiewehe from behind stab again. In addition, with the known stapling device, an effective connection of bone bridge parts with a complicated shape, such as for example in the case of the lower jaw, is not possible.

The object of the present invention is for the whole round. To create a stapling device for connecting bone tissue diTch staples with the Bone fractures Ie of the same and different strengths and of a complicated shape, safe and firm can be connected, with the clamp feet on the back of the puncture site in the bone tissue forcibly prick it again so that the staple seam is ulatt and the knot

Clienbruchtcüc can be reliably set without that -i can break away from each other or never are movable.

This issue is applied to the introduction mentioned device solved in that the liacke on two against each other in Fänesrichuint: bev , resembled, at different distances from Klammeri;: ag:! /. 'm adjustable jaw parts composed i-l and dab the die from two accordingly <! eii parts attached to the hoe.

The milled-out areas preferably have Malri-Mi. which serve to bend the staple feet. in the ZtMic of the first time. Disagreeing with the K k.ininerfüßchen a Fj vveitei unu on.

It is also useful that the parts of the Matrij : i are removable and its connected to the bone tissue ir. surfaces coming into contact with the f. hene in contact with ti: bone tissue t clamp; magazines are inclined. This makes s: ..-: ge'ste! '. T. that these powers are possible- ·! ''.I; on - ■> I- -eieiiigewebe- attached. Thereby -ollieii the milling out - .. Lien tier matrices a different from the hoder.miltc'tci! , ii Ramlkaiiien have a widening shape.

\ iii / iiLisweiSe have the extrusuiiüen in the I äii '_> v suffered the l-oini of a circular arc, whose R.idius 2f> 1.!, -', ens is equal to half of the bracket. \ Ii ¹ ATTENTION the Helesiinunt takes place; tier parts tier, "' 1, are secured by silence, animals are connected to the I- ./body via a leather strip.

The die can be fitted with a corner at the end of the supporting J -.- located projection with liner Ausfräsimg l'i; - only one l-ül.'iclien tier bracket to be provided. Da-K ' can for better ixiering of the matrices come into contact with the bone tissue I must be attached to the same thorns.

\ n each matrix part can also contain at least '. \ -r cutouts must be attached so that the brackets inside the Klammei seams with different;.: ir. Abslaiitl and changeable angles! between the brackets can lie.

The structure of the stapler according to the invention allows. Bone fragments of the same and different strengths as well as those with more complicated ones Shape reads to connect with each other, with the little tips of the brackets when turning penetrate back into the bone tissue. This gives the clamp seam a smooth shape, thereby preventing injuries to the adjacent soft tissue.

are changeable and combinable, can be according to the design Stapler for various operations on the collarbone, ribs and on intricately shaped bones, like your heart: eggs. be used.

Using the Ai; ^ shown in the drawing Management examples, the invention is explained in more detail below. Fs shows

F i g. 1 in the same representation a surgical one Stapler for connecting bone tissues.

F i g. 2 the stapler of FIG. I in plan view.

Fig. 3 the section IH-III of F ig. 2.

F i g. 4 the mutual arrangement of the matrix / s and the staple magazine: ·. with the staples in the stapler before stitching the knot tissue.

1 i g. :> a. 5 b. 5 c. : "■ d im '. ^S e the sehn · .: N. - \ i! .T! ■' i ti. 3 bei versclredeneii Ai'sfüh;ιΐΓ.'ΛΐΐΊ'ίκ.ιι tici matrix.

I "i g. <I an AusliihruiiLisbeispici der AusiraMiiigcn

at the die.

1 i g. 7 the section \ 1I - \ 'II of the 1 1 g. <\ I 1 g. S an illustration of a staple connection with the stapling device .- 'usgcfüll 1 th.

F i t!. '■ * another AiMühruii'jsbeispiei tiei die and

Fig. 10 embodiments of m.i tlem Klammeigeräi executed Klammcniäliien.

The surgical stapler for Klammerve: - binthmii of bone tissue contains a support body 1 (Ii g. 1 ) with a jaw. The jaw beMehl of two parts, a mobile icMchen- 2 and IL-3 Backenleil u (F i g. 2).

The movable cheek part! 2 '., Ann -i regarding ties read see the two parts of the guide (in tier / eiclinuη 1; not indicated) ties support body 1 back and forth move here.

■ 1 "I'm the movable jaw part 2 of the seat body 1 in the invention-g. to adjust to moderate Kiammeriierrat, is an with I :. winds of zapieii 4 (Fig. 1) provided, aiii one Müller 5 atilgeschraubt will.

4i 'in the support body! is also an open catch groove (not indicated) worked out. in this clamp housing ft Hines ties support body 1 back and forth is housed producible.

A hand grill 7 is attached to the support body 1. 5'- the staple magazine 8. the grooves 9 for staples possesses, is attached to the clamp housing ft mil with the aid of a leaf spring IO mil Gleiteinsie'ler II, which is mounted on the clamp housing ft and in a recess of the Klanimermagaziiis 8 with her Ilakcii-

By engaging with the clip end according to the invention.

The staple sutures applied by the device become the parts of the bones If held firmly in place, let them neither detach from one another nor move one another can. This considerably speeds up the healing process after the operation.

Depending on the width of the bone fragments to be connected the device according to the invention enables various types of clamps. namely, finkle seams. Zvveiklammeniamen with changeable The clip housing is designed hollow and in the interior of which accommodates a sleeve 12.

The plunger 12 has a Knp.stempel 13. which is used to pull the clips out of your magazineS serves, the latter sitting on the copy stamp of the ram) 2.

The staple magazine 8 is vein outside with projections 14. which cooperate with edge flanks 15 in the support grains 1, and

Opening lft

chem distance between the brackets as well as two 65 (Fig. 2) for visual control after the presence of staple seams with staples at an angle to each other in the staple magazine S and observation

elastic brackets.

Since the matrices are removable, fitted against one another from the fracture zone.

The rear part of the clamp housing ft has a

Left-hand thread section. to dom a mother 17 is screwed on. The nut 17 interacts with a groove 18 in the socket 1 and is / ur reciprocating adjustment of the clamp housing 6 provided with all of the components arranged on this with respect to the support body 1.

In the rear part of the clamp housing 6 is a rod 19 (Fig. 1) to see the hand crank 20, which is used for Adjusting the plunger 12 to the on the jaw of the

In order to be able to hold on better, the mandrels 32 are carried out on the contact surface of the die. When sewing the ribs and the collarbone together, it is expedient to use the matrix IY, on which at least four outcrops (Fig. 9) have been worked out.

The last-mentioned embodiment of the die IY enables the production of different types of seams (Fig. 10a, 10b, 10c), in which both the number and

different feet of one and the same bracket determined.

During the turning, the clamping feet press against the cutouts 24 (FIG. 3). These

ordered and held on it by leaf spring 10 and edge flanks 15 of the support body 1.

The fixed jaw part 3 of the support body 1

of the support body 1 and are held there by pins 26.

The pin 26 is retained in the jaw by a resilient strip 27.

The surfaces 29 of the parts 22 which come into contact with the bone tissue 28 (FIG. 4). 23 the die 21 can be designed both perpendicular to the longitudinal axis of the support body and at an angle.

Support body 1 attached die 21 to serve. This »° also the intermediate distance and angular position of the die 21 consists of two parts 22 and 23 brackets can be changed.
(Fig. 2). each of which corresponds to the action of the stapler for joining

movable 2 and immovable cheek part 3 which runs through staples of bone tissue like Support body 1 is attached. follows.

Each part of the die 21 is ready to be bent

movable cheek part 2 of the support body 1 in the stapler of the present shape of broken bones correspondingly selected combinations of the parts 22 and 23 of the die 21 attached.

Ausfräsuneen 24 expand to the zone of their 20 Das with the necessary number of brackets initial contact with the staple feet- charged magazine 8 is recognized on the stapler, in order to be able to absorb them every time.

The parts 22 and 23 of the die 21 are detachable and are attached to the jaw parts 2 and 3
of the support body 1 by means of projections 25 (Fig. 1) ² 5 is fastened under the one of the knobs to be sewn together. which are guided into corresponding slots in the jaw and in this position through

Clamping between the die 21 and the Klarnrncrrnasazin 8 held. This will be the Clamp housing 6 with the plunger 12 and attached to it! Staple magazine 8 by turning the nut 17 in the direction of the jaw d; s Stülzkkörcrs 1 advanced.

Another fragment is then attached to the bone fragment retained in the stapler

as a result of which a tight connection of the file of die 35 is brought up and after they have been compared 21 on bone tissue 28 can be achieved. the staple magazine 8 through the part 22 (Fig. 2)

In this case, the parts of the die 21 can be the same as the die 21 on the movable jaw part 2 can be selected and set in the stapler. is mounted. pushed up. The adjustment of the beso that practically every shape of the cheek part 2, which is movable with the bone, is made by twisting on Mutweb surfaces coming into contact, as accomplished by 40 ter5. The application in Klammergc-F ig. 5. 5 a. 5 b. 5 "c. 5d. 5 c illustrates, designed advises of two mutually adjustable jaw parts

LCN of a movable and fixed 2 3 is a possibility, so that the broken bone parts of different thickness in the stapler face the parts of the die 1 \ played off "5 and retain
After the broken bone has been established, their milled-out must be audible

parts in the stapler is on the rear part de: Klammergehäuses6 a hand crank20 (Fig. 1) screwed, which when unscrewing the bumps

Circular arc shape. those with a radius (Fig. 7) 50 12 in the direction of the die 21 through their rod 1 « and is laid out with a tendon, the length of which adjusts the.

Half of the width of the bracket is not exceeded. As a result, the tappet Y pushes in its forward gear.

it is achieved that after piercing the knot under action on the back parts of the in chen tissue 28 by staples the little foot ends staple magazine 8 located staples these ii of the clamp 31 when it is bent, the direction of the bone to be sewn together is essential Bone tissue 28 (FIG. 8) on the back, which is located between the die 21 and the chen. Staple magazine 8 are in front.

The number of millings in the die 21 can prick the staples during their movement

be different, depending on how many staples are to be applied to the longitudinal staple grooves 9 of the staple magazine 8 as bone tissue to be connected ⁶ ° bone tissue with the tips of their feet through un <. If, for example, the jawbone bends, it is sewn together into the milled recesses in the die 2. in this way the die with the milled-out parts is pressed off.

Sung only used for one bracket (Fig. 6). In the tips of the feet of the clamps 31 (Fig. 8

In this case, the die 21 is expediently with advancing during its turning after the Wiedei jump, like this F i g. 1 shows, for the purpose of more convenient 65 exit from the milled recesses of the die into the Knc Introduce the jaw of the stapler under the tissue from the back Pine made. Forming the staple seam around the die in relation to the knotty shape.

For this purpose 2 sheets of drawings

will. Such a possibility allows one and the same stapler when suturing broken bones different surface shapes to be used.

from the center of the floor to the edge edges like the cutouts 30 in FIG. 6 expand.

In the longitudinal section, the cutout 30 has a

Claims (7)

Patent claims: 1. Surgical staple joint / around staple connection of bone tissue, which has a support body with a jaw and attached matrix with milled recesses for bending the staples, a clip housing reciprocating in guides of the support body along the same with a clip magazine and one in the clip housing in its longitudinal direction - and contains adjustable ram, thereby geke η η ζ. calibrated. that the jaw is composed of two mutually longitudinally movable jaw parts (2, 3) that can be adjusted at different distances from the clamp magazines /., n (8) and that the die (21) consists of two correspondingly on the jaw parts (2.3) helestigien Ί .ilen (22. 2Y, - viewed. 2. Stapling device according to claim 1, characterized in that the cutouts (24) eggs Matrices (21) an extension in eier / one des initial contact with the clamp exhibit. 3. Stapling device according to claim 1, characterized in that the parts (22, 23) of the Mali: / s (2!) Are designed to be removable and their surface η ( ¹ X)) coming into contact with the bone tissue (28) with the level of the staple magazine (K) in contact with the bone tissue are gencim. 4. Stapling device according to c; iiem of claims I. Iv. 4. characterized in that the Ausläsung (3 (1) has the shape of an arc of a circle, the length of which is at most pale half Width of the bracket is. 5. Stapling device according to one of the preceding claims, characterized in that dal.i the attachment of the parts (22. 23) of the dies (21) on the support jaw by means of on the surfaces dei Matrices (21) of the heel facing projections (25) takes place, the projections in corresponding Slots in the jaw surfaces of the support body (1) engage and pins (26) are secured, the ends of which are connected to the support body (1) via a resilient strip (27) stand. . (■> stapler according to one of claims 1 to (\ characterized in that the die (21) located on the one find the pick projection having a cut-out for only a Füßclv: n of the bracket has. 7. stapling device according to claim Ci, characterized characterized in that on the surfaces (29) coming into contact with the bone tissue Matrices (21) mandrels (32) are provided. o. Stapling device according to one of Claims 1 to 5, characterized in that on each part the die (2Γ) at least four millings are machined. lvii.se with a staple magazine and a Kkniimc'-ehänsc in the longitudinal direction hm- u I, r \ ersvMiiaren plunger complies. . \ us NS (lorkin. AM I schesclewn-New surgical instruments and Cieiate, lJMisik-s; · Tch ^r a.:i;:e MLDGlS. Moscow. IW.! ein'c'himm ^ h ^ stapling device for connecting · . ruev. known by brackets.. Lä d e ^: ivii stud / body it oil fire longitudinal groove and lu i '.. part-