DE2166983C3 - Surgical instrument for laying around staples to tie off tubular organic structures - Google Patents
Surgical instrument for laying around staples to tie off tubular organic structuresInfo
- Publication number
- DE2166983C3 DE2166983C3 DE2166983A DE2166983A DE2166983C3 DE 2166983 C3 DE2166983 C3 DE 2166983C3 DE 2166983 A DE2166983 A DE 2166983A DE 2166983 A DE2166983 A DE 2166983A DE 2166983 C3 DE2166983 C3 DE 2166983C3
- Authority
- DE
- Germany
- Prior art keywords
- instrument
- spring
- cartridge
- tube
- staples
- 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.)
- Expired
Links
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T29/00—Metal working
- Y10T29/53—Means to assemble or disassemble
- Y10T29/53709—Overedge assembling means
- Y10T29/53783—Clip applier
Description
Die Erfindung betrifft ein chirurgisches Instrument zum Herumlegen von Klammern zum Abbinden rohrförmiger organischer Gebilde sowie zu deren Vernähen und Durchtrennen mit einem Handgriff versehenen Schaft und einer die Klammern enthaltenden Patrone sowie mit einem die Klammern ausstoßenden Stößel und mit einem am Handgriff schwenkbar gelagerten Abzugshebel, der über Antriebsmittel mit dem Stößel in Antriebsverbindung steht und eine zwischen dem Abzugshebel und den weiteren Antriebsmitteln angeordnete, schwenkbar gelagerte Nockenscheibe beaufschlagt, die eine Steuerkurve mit unterschiedlichen Steigungen aufweist, nach Patent 21 20 447.The invention relates to a surgical instrument for wrapping around braces for tying tubular organic structures and for their sewing and cutting with a handle provided shaft and a cartridge containing the clips as well as with a plunger ejecting the clips and with a pivotable on the handle mounted trigger lever, which is in drive connection with the ram via drive means and a Pivotably mounted cam disk arranged between the trigger lever and the further drive means, which has a control cam with different gradients, according to patent 21 20 447.
Das Instrument nach dem Hauptpatent läßt sich während der unterschiedlichen Arbeitsvorgänge des Ausstoßens, Abklemmens und Trennens mit im wesentlichen gleicher Betätigungskraft handhaben.The instrument according to the main patent can be used during the different operations of the Handle ejecting, pinching and separating with essentially the same operating force.
Aufgabe der vorlegenden Erfindung ist es, das Instrument nach dem Hauptpatent dadurch weiter zu verbessern, daß sich mit diesem unabhängig von der aufgewendeten Handkraft die zum Ausstoßen der Klammern aus der Klammerpatrone und zu deren Verformen benötigten Kräfte nacheinander mit der richtigen Größe aufbringen lassen.The object of the present invention is to further develop the instrument according to the main patent improve that with this regardless of the manual force used to eject the Staples from the staple cartridge and forces needed to deform them one after the other with the apply the correct size.
Diese Aufgabe wird bei dein chirurgischen Instrument nach dem Hauptpatent gelöst durch drei selbständige Anschlußglieder, die relativ zu dem Gehäuse und relativ zueinander beweglich gelagert sind, der Steuerung je eines Arbeitsschritts des Instruments dienen und von denen ds?: erste über Hebel und Gestänge mit dem Abzugshebel in Antriebsverbindung steht, das zweite über Federn seine Antriebsbewegung von dem ersten ableitet und das dritte Anschlußglied nach Freigabe durch das zweite von einer Feder angetrieben ist, wobei die Härte der Federn so aufeinander abgestimmt ist, daß die Anschlußglieder nacheinander mit den zum Ausstoßen der Klammern aus der Klammernpatrone und zu deren Verformen benötigten Kräften bewegt werden. Während die von dem Abzugshebel vurschwenkte Nockenscheibe aufgrund der unterschiedlichen Steigungen ihrer Steuerkurve bewirkt, daß der Chirurg bei der Handhabung des Instruments nicht deutlich spürt, daß er zum Ausstoßen der Klammern aus der Klammernpätrone und zu deren Verformen unterschiedliche Kräfte aufbringen muß, stellt die erfindungsgemäße Kuppelung der Anschlußglieder durch Federn sicher, daß das Ausstoßen der Klammern aus der Klammernpatrone und deren Verformen nacheinander mit den richtigen Kräften erfolgt.According to the main patent, this task is solved by three in your surgical instrument independent connecting members which are mounted so as to be movable relative to the housing and relative to one another are used to control one work step of the instrument and of which ds ?: first via lever and the linkage is in drive connection with the trigger, the second derives its drive movement from the first via springs and the third connecting member after being released by the second from a spring is driven, the hardness of the springs being coordinated so that the connecting members one after the other with those for ejecting the staples from the staple cartridge and for deforming them required forces are moved. While the cam disk pivoted forward by the trigger lever causes the surgeon to handle the Instruments does not feel clearly that he is about to eject the staples from the staple cartridge and to their Deforming must apply different forces, the coupling of the connecting members according to the invention by springs ensures that the ejection of the Staples from the staple cartridge and their deformation one after the other with the correct forces he follows.
Zweckmäßigerweise ist das erste Anschlußglied mit einer zentralen, sich im wesentlichen Über die Länge des Instruments erstreckenden Stange verbunden, die mit dem Antriebshebel in Antriebsverbindung steht. Das zweite Anschlußglied kann mit einem auf der zentralen Stange verschieblichen Rohr verbunden sein, während das dritte Anschlußglied vorzugsweise aus einem auf diesem Rohr verschieblichen Ring besteht.Appropriately, the first connecting member with a central, extending substantially over the length of the Instruments extending rod connected, which is in drive connection with the drive lever. That The second connecting member can be connected to a tube that is slidable on the central rod, while the third connecting member preferably consists of a ring displaceable on this tube.
Das Rohr kann mit einem hinteren Bund versehen sein, gegen den sich einerseits eine zwischen diesem undThe tube can be provided with a rear collar against which on the one hand one between this and
einer am hinteren Ende der zentralen Stange befestigten Scheibe eingespannte und diese umgebende Feder und andererseits eine das Rohr umgebende und zwischen seiner Führung im Instrument und dem Bund eingespannte Feder abstützen.a disc clamped at the rear end of the central rod and surrounding it and on the other hand a tube surrounding the tube and between its guide in the instrument and the collar Support the clamped spring.
Weitere vorteilhafte Ausgestaltungen der Erfindung sind in den Unteransprüchen näher beschrieben worden.Further advantageous refinements of the invention are described in more detail in the subclaims.
Ein Ausfuhrungsbeispiel der Erfindung wird nachstehend anhand der Zeichnung näher erläutert In dieser zeigtAn exemplary embodiment of the invention is explained in more detail below with reference to the drawing shows
F i g. 1 eine teilweise geschnittene Seitenansicht des chirurgischen Instruments mit strichpunktiert angedeuteter, angekuppelter Klaminernpatrone,F i g. 1 is a partially sectioned side view of the surgical instrument with dash-dotted lines, coupled staple cartridge,
Fig. 2 eine Seitenansicht des Vorderteils des Instruments nach Fig. 1 in der Stellung, welche dessen Teile einnehmen, wenn sich der Abzugshebel in der in F i g. 1 mit 2 bezeichneten Stellung befindet,Fig. 2 is a side view of the front part of the instrument of FIG. 1 in the position which its Occupy parts when the trigger is in the position shown in FIG. 1 is in the position marked 2,
F i g. 3 eine der F i g. 2 entsprechende Darstellung des Instruments, in der Stellung, welche dessen Teile einnehmen, wenn sich der Driicker in der in Fig.! mit 3 bezeichneten Stellung befindet,F i g. 3 one of the F i g. 2 corresponding representation of the instrument, in the position which its parts when the trigger is in the position shown in Fig.! with 3 designated position is located,
F i g. 4 eine der F i g. 2 entsprechende Darstellung des Instruments in der Stellung, welche dessen Teile einnehmen, wenn sich der Drücker in der in F i g. 1 mit 4 bezeichneten Stellung befindet.F i g. 4 one of the F i g. 2 corresponding representation of the instrument in the position which its parts take when the pusher is in the position shown in FIG. 1 with 4 designated position is located.
Das chirurgische Instrument, an das sich eine Klammernpatrone ankuppeln läßt, dient dazu, schlauchförmige organische Gebilde nacheinander anzubinden, zu nähen und zu zerteilen. Die an das Instrument ankuppelbare Patrone besitzt ein Gehäuse, das auf zwei ortsfesten Führungen verschiebbar ist, zwei Stößel und eine Messerklinge. Wenn sich das schlauchförmige organische Gebilde zwischen dem Patronengehäuse und den ortsfesten Ambossen befindet, wird in der aus drei Schritten bestehenden Arbeitsfolge der Patrone deren Gehäuse vorwärtsbewegt, bis das Gehäuse an den ortsfesten Ambossen angreift und die Backen der Patrone das schlauchförmige Gebilde vollkommen umschließen. Danach werden durch Betätigung der Stößel zwei Klammern aus dem Gehäuse ausgeworfen und um das schlauchförmige organische Gebilde herum verformt. Nach dem Verformen der Klammern bewegt sich die Messerklinge vorwärts, wodurch das schlauchförmige Gebilde an einer zwischen den Klammern liegenden Stelle zerteilt wird. Zur Duichführung dieser drei Schritte mittels der Patrone sind drei voneinander unterscheidbare Kräfte erforderlich. Zunächst muß das Patronengehäuse gegenüber den ortsfesten Führungen und Ambossen vorwärts bewegt werden. Wenn das Gehäuse an den Ambossen angreift, müssen die Stößel vorgeschoben werden, so daß sie ein Klammernpaar werfen und verformen. Nach dem Verformen der Klammern muß die Messerklinge vorgeschoben werden, wobei sich die Stößel an ihrem vorderen Totpunkt befinden. Die Maßnahmen, die zur Erfüllung der an das Instrument geseilten Forderungen dienen, gehen aus der folgenden Beschreibung näher hervor.The surgical instrument to which a staple cartridge can be coupled is used to make tubular Tying, sewing and dividing organic structures one after the other. The ones on the instrument attachable cartridge has a housing that is slidable on two fixed guides, two plungers and a knife blade. When the tubular organic structure is between the cartridge housing and the stationary anvils is located in the three-step sequence of the cartridge whose housing is moved forward until the housing engages the stationary anvils and the jaws of the Cartridge completely enclose the tubular structure. Then by pressing the Plunger two staples ejected from the housing and around the tubular organic structure deformed. After deforming the staples, the knife blade moves forward, creating the tubular Structure is divided at a point lying between the brackets. To guide this three steps by means of the cartridge three distinct forces are required. First of all, it must Cartridge housing are moved forward relative to the stationary guides and anvils. If that Housing engages the anvils, the ram must be advanced so that they have a pair of clamps throw and deform. After deforming the clamps, the knife blade must be advanced with the tappets at their front dead center. The measures required to meet the requirements of the Serving instrument roped claims, will emerge from the following description in more detail.
Mit dem Instrument IO ist eine Patrone 12 gekuppelt, wie dies in Fig.] strichpunktiert angedeutet ist. Das Instrument 10 besitzt ein Gehäuse 12, das mit einem ortsfesten Handgriff 16 versehen ist, ferner einen um einen Zapfen 20 schwenkbar gelagerten Abzugshebel 18, ein laufartiges Teil 22 und ein Kopfstück 24. Vordem Kopfstück 24 des Instruments 10 befinden sich drei Anschlußglieder 26, 28 und 30, die bei aufgesetzter Patrone 12 deren Mener, Stößeln und Gehäuse zugeordnet sind. Das vorderste Anschlußglied 26 ist einstückig mit einer Stange 32, das sich von dem Anschlußglied 26 zu dem hinteren Teil des laufartigen Gehäuses 22 erstreckt Auf dem Ende der Stange 32 ist eine Scheibe 34 angeordnet, deren Funktion nachstehend noch beschrieben wird. Das Anschlußglied 28 ist einstückig mit einem Rohr 36, das sich von dem Anschlußglied 28 nach hinten erstreckt und an seinem Ende einen Bund 38 aufweist Das Anschlußglied 30 hat die Form eines mit einer Umfangsnut versehenen Ringes, der das Rohr 36 umgibt und auf diesem längsverschieblich angeordnet istA cartridge 12 is coupled to the instrument IO, as is indicated by dash-dotted lines in FIG. That Instrument 10 has a housing 12 which is provided with a stationary handle 16, furthermore a a pin 20 pivotably mounted trigger lever 18, a barrel-like part 22 and a head piece 24. Before Head piece 24 of the instrument 10 are three connecting members 26, 28 and 30, which when attached Cartridge 12 their mener, plungers and housing assigned. The foremost connection member 26 is integral with a rod 32 extending from the Connection member 26 extends to the rear of the barrel-like housing 22 on the end of the rod 32 is a disk 34 is arranged, the function of which will be described below. The connecting member 28 is integral with a tube 36 extending rearwardly from the connecting member 28 and on its End has a collar 38. The connecting member 30 has the shape of a one provided with a circumferential groove Ring which surrounds the tube 36 and is arranged on this in a longitudinally displaceable manner
Damit das Instrument 10 die Klammernpatrone 12 in drei Schritten betätigen kann, sind die Bewegungen der drei Anschlußglieder 26, 28 und 30 von den Funktionen der Patrone 12 und von dem Zusammenwirken von drei Federn abhängig. Eine erste Feder 40 umgibt das Rohr 36 und ist zwische dem mit diesem verbundenen Bund 38 und der Innenfläche 42 der in dem Kopfstück 24 befindlichen Führung eingespannt Infolgedessen trachtet die Feder 40 das Anschlußglied 28 -:, dem Kopfstück 24 des Instruments 10 hin zu bewegen. Fine Feder 44 umgibt das Rohr 36 und ist zwischen dem Anschlußglied 30 und der vorderen Stirnfläche 46 der Führung in dem Kopfstück 24 eingespannt. Infolgedessen trachtei die Feder 44 das Anschlußglied 30 von dem Kopfstück 24 wegzudrücken. Die dritte Feder 48 ist im hinteren Teil des Gehäuses angeordnet und zwischen der auf der Stange 32 befestigten Scheibe 34 und dem mit dem Rohr 36 verbundenen Bund 38 eingespannt, so daß die Feder 48 trachtet, die Anschlußglieder 26 und 28 in Anlage aneinander zu halten. Vorzugsweise sind die Federn 40 und 44 Schraubenfedern und die Feder 48 ist eine Tellerfeder. Im Hinblick auf die von den Federn auszuführenden Funktionen müssen die nachstehend angegebenen Beziehungen zwischen den Federkräften vorhanden sein. Die Feder 44 übt die schwächste Federkraft aus, die in dem vorliegenden Beispiel 1,81 kp beträgt. Die von der Feder 40 ausgeübte Federkraft hat einen mittleren Wert, der in dem vorliegenden Beispiel 3,63 kp beträgt. Die Feder 48 kann eine Kraft von etwa 27 k|■· ausüben.So that the instrument 10 can operate the staple cartridge 12 in three steps, the movements are the three connectors 26, 28 and 30 from the functions of the cartridge 12 and from the cooperation of three Feathers dependent. A first spring 40 surrounds the tube 36 and is between the collar 38 connected to it and the inner surface 42 of the guide located in the head piece 24 tends to be clamped as a result the spring 40 the connecting member 28 -: to move the head piece 24 of the instrument 10 towards. Fine spring 44 surrounds the tube 36 and is between the connecting member 30 and the front end face 46 of the guide in the Head piece 24 clamped. As a result, the spring 44 urges the connector 30 from the head piece 24 to push away. The third spring 48 is arranged in the rear part of the housing and between the on the Rod 32 fixed disc 34 and the collar 38 connected to the tube 36 clamped so that the spring 48 seeks to keep the connecting members 26 and 28 in abutment against one another. Preferably the springs are 40 and 44 coil springs and the spring 48 is a plate spring. In terms of the feathers The functions to be performed must have the following relationships between the spring forces to be available. The spring 44 exerts the weakest spring force, which in the present example is 1.81 kp amounts to. The spring force exerted by the spring 40 has an average value, that in the present example 3.63 kp. The spring 48 can exert a force of approximately 27 kΩ.
Es wurde schon darauf hingewiesen, daß die Betätigung der Klammernpatrone und daher auch des Instruments 10 in drei Schritten erfolgt. Iniolge der verschiedenen Funktionen der Elemente der Patrone sind zur Durchführung der einzelnen Funktionen unterschiedliche Kräfte erforderlich. So genügt zum Bewegen des Patronengehäuses zu den ortsfesten Ambossen eine relativ schwache Kraft. Dagegen sind zur Verformung der Klammern relativ starke Kräfte erforderlich. Für den Vorschub des Messers genügt wieder eine schwache Kraft. Es muß ferner gewährleistet sein, daß die drei Arbeitsschritte der Klammernpatrone in der richtigen Reihenfolge durchgeführt werden. Aus diesem Grunde sind die von den Federr 40,44 und 48 ausgeübten Kräfte nicht konstant.It has already been pointed out that the operation of the staple cartridge and therefore also of the Instruments 10 takes place in three steps. Iniolge of the various functions of the elements of the cartridge Different forces are required to carry out the individual functions. So is enough for Moving the cartridge case to the stationary anvils is a relatively weak force. Against are relatively strong forces are required to deform the brackets. Suffice it to feed the knife again a weak force. It must also be ensured that the three working steps of the staple cartridge be done in the correct order. For this reason, those of Federr 40,44 and 48 forces exerted not constant.
Für die bei aufgesetzter Patrone durchzuführenden drei Arbeitsschritte des Instruments sind verschiedene Betätigungskräfte r /forderlich. Ohne besondere Maßnahmen müßte daher die Betätigungsnerson bei der Betätigung des Instruments verschieden große Widerstände überwinden. Um dies zu vermeiden, ist das chirurgische Instrument mit einer verstellbaren Nokkenscheibe versehen, die dem Abzugshebel 18 zugeordnet und so ausgebildet ist, daß der Chirurg die drei Arbeitsschritte der Patrone durch Ausübung einer relativ gleichmäßigen Betätigungskraft durchführen kann.The three working steps of the instrument to be carried out with the cartridge in place are different Actuating forces r / required. Without special measures, the operator would therefore have to Operate the instrument to overcome various resistances. To avoid this, this is Surgical instrument is provided with an adjustable cam disk which is assigned to the trigger 18 and is arranged so that the surgeon can perform the three operations of the cartridge by performing a can perform relatively uniform actuation force.
Aus Fik-1 ist ersichtlich, daß der Abzugshebel 18From Fig-1 it can be seen that the trigger 18
einen hebelartigen Fortsatz SO besitzt, der sich zum Gehäuse 14 hin erstreckt. An dun Ende de„ Hebels 50 ist ein Anschlag in Form einer auf diesem drehbar gelagerten Rolle 52 vorgesehen. Diese Rolle 52 kann sich längs der Steuerkurve 54 abwälzen, die auf einem Zapfen 58 schwenkbar gelagert ist. Der nicht dargestellte obere Teil der Steuerkurve 56 nimmt einen Fortsatz mit, der der auf der Stange 32 befestigten Scheibe 34 zugeordnet ist. Diese Teile sind in dem Hauptpatent näher beschrieben worden. Infolge der Wechselwirkung der Federn 40 und 48 wird auf die Nockenscheibe 56 eine Kraft ausgeübt, die sie im Uhrzeigersinn um den Zapfen 58 zu bewegen trachtet.has a lever-like extension SO, which is to Housing 14 extends out. At the end of the "lever 50 a stop in the form of a roller 52 rotatably mounted on this is provided. This role 52 can roll along the control cam 54, which on a Pin 58 is pivotably mounted. The upper part of the cam 56, not shown, has an extension with which is assigned to the disk 34 fastened on the rod 32. These parts are in the main patent has been described in more detail. As a result of the interaction the springs 40 and 48 is exerted on the cam plate 56, a force that they clockwise around the Pin 58 seeks to move.
Wenn der Abzugshebel 18 in Richtung des Pfeils 60 bewegt wird, schwenkt der mit dem Abzugshebel 18 einstückige Hebelarm 50 um den Zapfen 20, so daß sich die Rolle 52 längs der Steuerkurve 54 der Nockenschei-When the trigger 18 is moved in the direction of arrow 60, it pivots with the trigger 18 one-piece lever arm 50 around the pin 20 so that the roller 52 moves along the cam 54 of the cam disc
1· si! « al~ _.J1 si! « Al ~ _.J
Ulli UCIIUlli UCII
verschwenkt wird. Diese Bewegung erfolgt gegen den von den Federn 40 und 48 ständig ausgeübten Widerstand. Man erkennt aus Fig. I, daß die Rolle 52 an dem unteren Teil der Nockenscheibe 56 angreift, wenn sich der Abzugshebel 18 in der Stellung 1 befindet. Dann bewegt sich die Rolle 52 längs der Steuerkurve 54 vorwärts, bis sich der Abzugshebel 18 in seiner Endstellung 4 befindet, in welcher die Rolle 52 an dem oberen Teil der Nockenscheibe 56 angreift.is pivoted. This movement occurs against that constantly exerted by springs 40 and 48 Resistance. It can be seen from Fig. I that the roller 52 to engages the lower part of the cam 56 when the trigger 18 is in position 1. then the roller 52 moves along the cam 54 forwards until the trigger 18 is in its End position 4 is in which the roller 52 engages the upper part of the cam disk 56.
Aus F i g. 1 ist ersichtlich, daß die Steuerkurve 54 der Nockenscheibe 56 drei Bereiche besitzt. Diese ermöglichen eine Betätigung des Instruments 10 in der Weise, daß auf den Abzugshebel 18 eine relativ gleichmäßige Betätigungskraft ausgeübt und diese in die verschieden starken Kräfte übersetzt wird, die zur Durchführung der drei Arbeitsschritte der Patrone 12 erforderlich sind, ohne daß diese drei Arbeitsschritte dem Chirurgen bewußt werden. Die Abstände zwischen den Bereichen sind daher so gewählt, daß sie den gewünschten Hüben der Anschlußgiieder 26, 28, 30 entsprechen. Die Form und die Steilheit der Bereiche der Steuerkurve sind ferner so gewählt, daß sie infolge der Hebelwirkung der aus dem Handgriff und der Nockenscheibe sowie den Antriebsstangen bestehenden Anordnung bei der Ausübung einer gleichmäßigen Kraft auf den Abzugshebel 18 die i:n die Patrone 12 abgegebenen Kräfte verändert werden.From Fig. 1 it can be seen that the cam 54 of the cam disk 56 has three areas. These enable an actuation of the instrument 10 in such a way that on the trigger 18 a relatively uniform Actuating force exerted and this is translated into the different strengths of the forces required to carry out the three operations of the cartridge 12 are required without these three operations to the surgeon be aware. The distances between the areas are therefore chosen so that they achieve the desired strokes the connecting members 26, 28, 30 correspond. The shape and steepness of the areas of the control curve are also chosen so that they as a result of the leverage of the handle and the cam disk and the Drive rods existing arrangement when exerting an even force on the trigger 18 the forces delivered to the cartridge 12 can be changed.
Die Wirkungsweise des Instruments 10 ist folgende: Wenn sich der Abzugshebel 18 in der Stellung 1 befindet, ist das Anschlußglied 38 in seiner hintersten Stellung in dem Gehäuse und das Instrument 10 entspannt. Wenn der Abzugshebel 18 durch eine auf ihn ausgeübte Kraft in die Stellung 2 verschwenkt wird, bewegt sich die auf der Stange 32 befestigte und mit dem oberen Bereich der Nockenscheibe 56 verbundene Scheibe 34 zu dem Kopfstück 24 des Instruments 10 hin. Da die Feder 48 zwischen der Scheibe 34 und dem Bund 38 eine relativ starke Kraft von 27 kp ausübt, bewegt sich der Bund 38 mit der Scheibe 34 in die Stellung 2, so daß die Feder zusammengedrückt wird. Gleichzeitig bewegt sich das Anschlußglied 30 zusammen mit den Anschlußgliedern 26 und 28 von dem Kopfstück 24 weg, weil die Feder 44 das Anschlußglied 30 von dem Kopfstück 24 des Instruments 10 wegzubewegen trachtet Infolgedessen bewegen sich das Patronengehäuse, die Stößel und das Messer gemeinsam von dem Kopfstück 24 weg.The operation of the instrument 10 is as follows: When the trigger 18 is in position 1 is located, the connecting member 38 is in its rearmost position in the housing and the instrument 10 relaxed. When the trigger 18 is pivoted into position 2 by a force exerted on it, moves the attached to the rod 32 and with The disk 34 connected to the upper region of the cam disk 56 towards the head piece 24 of the instrument 10. Since the spring 48 between the disc 34 and the collar 38 exerts a relatively strong force of 27 kp, moves the collar 38 with the disk 34 in position 2, so that the spring is compressed. Simultaneously the connecting member 30 moves together with the connecting members 26 and 28 away from the head piece 24, because the spring 44 moves the connecting member 30 away from the head piece 24 of the instrument 10 As a result, the cartridge housing, the plunger and the knife move together from the Head piece 24 away.
Wie in dem Hauptpatent 21 20 447 beschrieben ist, werden die Führungen und Ambosse der Patrone an dem Kopfstück 24 des Instruments 10 durch einen Zapfen 62 befestigt, der mit den Führungen und den Ambossen einstückig ist und passend in eine Nut 64 in dem Kopfstück eingreift und durch eine mit dem Daumen betätigbare Sperreinrichtung 66 darin festgelegt ist. Wenn die Führungen und Ambosse gegenüber dem Instrument 10 festgelegt sind und sich das Patronengehäuse 12, die Stößel und das Messer von dem Kopfstück 24 weg bewegen, umschließt das Patronengehäuse 12 die ortsfesten Ambosse. In F i g. ! ist mit 2 die Stellung bezeichnet, in wddici das Patronengehäuse die Ambosse gerade berührt. Wenn das Gehäuse der Patrone 12 mit den ortsfesten Ambossen in Berührung gelangt, k^nn üich das Anschlußglied 30 nicht weiterbewegen. Die fortgesetzte Verschwenkung des Abzugshebels 18 in Richtung des Pfeils 60 bewirkt dann eine gemeinsame Bewegung der Anschlußglieder 26 und 28 von dem jetzt festgelegt·.:. AnSCrmiSgiicu 30 weg. in diesem Äibeiissuiiiiii wird der Abzugshebel 18 in die in Fig. 1 mit 3 bezeichnete Stellung bewegt, wobei die Anschlußglieder die aus dieser Figur ersichtlichen Stellungen einnehmen.As described in the main patent 21 20 447, the guides and anvils of the cartridge are attached attached to the head piece 24 of the instrument 10 by a pin 62, which with the guides and the The anvil is in one piece and fits snugly into a groove 64 in the head piece and through one with the Thumb actuated locking device 66 is set therein. When facing the guides and anvils the instrument 10 are fixed and the cartridge housing 12, the plunger and the knife of Move the head piece 24 away, the cartridge housing 12 encloses the stationary anvils. In Fig. ! is marked with 2 the position, in wddici that Cartridge housing just touches the anvils. If the housing of the cartridge 12 with the stationary If anvils come into contact, I can do that Do not move connecting member 30 any further. The continued pivoting of the trigger 18 in the direction of the Arrow 60 then causes a common movement of the connecting members 26 and 28 of the now set ·.:. AnSCrmiSgiicu 30 away. in this Äibeiissuiiiiii the Trigger lever 18 is moved into the position designated in Fig. 1 with 3, the connecting members from positions shown in this figure.
In die mit 3 bezeichnete Stellung bewegen sich die Elemente folgendermaßen: Es wurde schon erwähnt, daß sich nach der Berührung mit den ortsfesten Ambossen das Gehäuse 12 der Patrone relativ zu den Ambossen nicht mehr bewegen kann. Infolgedessen kann au,;h keine Relativbewegung zwischen dem Kopfstück 24 des Instruments 10 und dem Anschlußglied 30 mehr erfolgen. Beim Weiterverschwenken des Abzugshebels 18 wird auf die Scheibe 3-1 eine Kraft in Richtung des Kopfstücks 24 ties Instruments 10 ausgeübt, so daß sich die Anschlußglieder 26 und 28 unter Überwindung der Kraft der Feder 40 weiterbewegen. Zwischen diesen Anschlußgliedern findet dabei keine Bewegung statt, weil zum Zusammendrücken der starken Druckfeder 48 eine Kraft von 27 kp erforderlich ist. Infolgedessen wird die Feder 48 nicht weiter zusammengedrückt, während die Feder (3,63 kp) zusammengedrückt wird. Wenn sich das Instrument in der Stellung 3 befindet, haben sich das dem Anschlußglied 26 zugeordnete Messer und die dem Anschlußglied 28 zugeordneten Stößel zu den ortsfesten Ambossen der Patrone 12 hin bewegt und die Stößel haben das Biegen der ausgestoßenen Klammern vollständig durchgeführt. Die Stößel befinden sich jetzt an ihrem vorderen Totpunkt. Sie haben die Klammern ganz zusammengedrückt und greifen effektiv an den ortsfesten Ambossen an. Infolgedessen sind die beiden Anschlußglieder 28 und 30 ganz ausgefahren. Beim Weiterverschwenken des Schwenkgriffs 18 in Richtung des Pfeils 60 «ird daher gegen den Widerstand der Feder 48 von 27 kp der Sattel 26 von dem Sattel 28 wegbewegt. In der Endstellung 4 ist das Messer ganz ausgefahren und es hat das bereits abgebundene, schlauchförmige organische Gebilde zerteilt. F i g. 4 zeigt diese Endstellung der Anschlußglieder. Unter der Wirkung der auf den Abzugshebel 18 ausgeübten Kräfte werden daher unter Steuerung durch die für die Betätigung der Elemente der Klammernpatrone erforderlichen Kräfte die Bewegungen der Anschlußglieder in der richtigen Reihenfolge durchgeführt Infolge der vorstehend angegebenen Ausbildung der Steuerkurve 54 der Nockenscheibe 56 werden die unterschiedlichen Kräfte der drei Federn und die drei Arbeitsschritte der Patrone dem Chirurgen nicht bewußt, so daß mit Hilfe des Instruments 10 ein Chirurg drei verschiedene chirurgische Maßnahmen automatisch, leicht und bequem in kürzester Zeit durchführen kann.In the position marked 3, the elements move as follows: It has already been mentioned that after contact with the stationary anvils, the housing 12 of the cartridge relative to the Anvils can no longer move. Consequently can au,; h no relative movement between the Head piece 24 of the instrument 10 and the connecting member 30 take place more. When swiveling the The trigger lever 18 exerts a force on the disc 3-1 in the direction of the head piece 24 ties the instrument 10 exercised, so that the connecting members 26 and 28 move on overcoming the force of the spring 40. There is no movement between these connecting members because of the compression of the strong compression spring 48 a force of 27 kp is required. As a result, the spring 48 stops moving compressed while the spring (3.63 kp) is compressed. If the instrument is in the Position 3 is the knife assigned to the connecting member 26 and that of the connecting member 28 associated plunger is moved towards the stationary anvils of the cartridge 12 and the plungers have the bending of the ejected staples is carried out completely. The tappets are now at their front Dead center. You have squeezed the clamps all the way together and are effectively gripping the stationary anvils at. As a result, the two connecting members 28 and 30 are fully extended. When swiveling further of the swivel handle 18 in the direction of the arrow 60 "is therefore against the resistance of the spring 48 of 27 kp Saddle 26 moved away from saddle 28. In the end position 4, the knife is fully extended and it has the already set, tubular organic Structure divided. F i g. 4 shows this end position of the connecting members. Under the effect of on the Forces exerted on the trigger 18 are therefore under the control of those responsible for actuating the elements the staple cartridge forces the movements of the connecting links in the correct order carried out as a result of the above-mentioned design of the control cam 54 of the cam disk 56 The different forces of the three springs and the three working steps of the cartridge are presented to the surgeon not consciously, so that with the aid of the instrument 10 a surgeon can perform three different surgical measures can be carried out automatically, easily and conveniently in the shortest possible time.
Hierzu 1 Blatt Zeichnungen1 sheet of drawings
Claims (9)
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US8045070A | 1970-10-13 | 1970-10-13 |
Publications (3)
Publication Number | Publication Date |
---|---|
DE2166983A1 DE2166983A1 (en) | 1977-04-21 |
DE2166983B2 DE2166983B2 (en) | 1979-01-18 |
DE2166983C3 true DE2166983C3 (en) | 1979-09-06 |
Family
ID=22157464
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE2166983A Expired DE2166983C3 (en) | 1970-10-13 | 1971-10-11 | Surgical instrument for laying around staples to tie off tubular organic structures |
Country Status (4)
Country | Link |
---|---|
US (1) | US3740994A (en) |
JP (1) | JPS554409B1 (en) |
CA (1) | CA976445A (en) |
DE (1) | DE2166983C3 (en) |
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US11937816B2 (en) | 2021-10-28 | 2024-03-26 | Cilag Gmbh International | Electrical lead arrangements for surgical instruments |
-
1970
- 1970-10-13 US US00080450A patent/US3740994A/en not_active Expired - Lifetime
-
1971
- 1971-10-11 DE DE2166983A patent/DE2166983C3/en not_active Expired
- 1971-10-12 CA CA124,899A patent/CA976445A/en not_active Expired
- 1971-10-13 JP JP8022271A patent/JPS554409B1/ja active Pending
Also Published As
Publication number | Publication date |
---|---|
JPS554409B1 (en) | 1980-01-30 |
DE2166983B2 (en) | 1979-01-18 |
US3740994A (en) | 1973-06-26 |
CA976445A (en) | 1975-10-21 |
DE2166983A1 (en) | 1977-04-21 |
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Legal Events
Date | Code | Title | Description |
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C3 | Grant after two publication steps (3rd publication) |