DE68914002T2 - Pneumatisches Verbindungselement für ein chirurgisches Klammerinstrument. - Google Patents

Pneumatisches Verbindungselement für ein chirurgisches Klammerinstrument.

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DE68914002T2
DE68914002T2 DE68914002T DE68914002T DE68914002T2 DE 68914002 T2 DE68914002 T2 DE 68914002T2 DE 68914002 T DE68914002 T DE 68914002T DE 68914002 T DE68914002 T DE 68914002T DE 68914002 T2 DE68914002 T2 DE 68914002T2
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pneumatic
surgical stapling
stapling instrument
parts
instrument according
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DE68914002D1 (de
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Jess Deniega
Jack Pedlick
Bela Vincze
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Ethicon Inc
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Ethicon Inc
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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
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • 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
    • 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
    • A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
    • 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
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2905—Details of shaft flexible
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgical Instruments (AREA)
  • Materials For Medical Uses (AREA)
  • Saccharide Compounds (AREA)
  • Valve Device For Special Equipments (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)
  • Portable Nailing Machines And Staplers (AREA)
  • Agricultural Chemicals And Associated Chemicals (AREA)
  • Gripping Jigs, Holding Jigs, And Positioning Jigs (AREA)
  • External Artificial Organs (AREA)
  • Control Of Fluid Pressure (AREA)
  • Quick-Acting Or Multi-Walled Pipe Joints (AREA)
  • Prostheses (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Steroid Compounds (AREA)

Description

  • Die Erfindung betrifft chirurgische Klammergeräte zur Implantation von mechanischen, chirurgischen Befestigungselementen in das Gewebe eines Patienten und insbesondere chirurgische Klammergeräte, die mit Druckgas angetrieben werden.
  • Chirurgische Klammergeräte, die chirurgische Befestigungseinrichtungen unter Nutzung der Kraft von Druckgas implantieren, sind im Stand der Technik bekannt und in den U.S.-Patenten 3,837,555; 3,836,116; 3,815,476; 3,717,294; 3,662,939; 3,643,851; 3,618,842; 3,613,507; 4,407,432; 4,439,028 und 4,331,277 unter anderem beschrieben. Bei den in diesen Patenten gezeigten Instrumenten ist ein Zylinder mit Druckgas im Handgriff des Instruments enthalten. Gas aus dem Zylinder wird zu einer Antriebseinheit auf der Rückseite des Handgriffs geführt, wo das Druckgas auf das proximale Ende einer mechanischen Hebelanordnung aufgebracht wird. Die mechanische Hebelanordnung ist mit einer Klammerpatrone am distalen Ende des Instruments verbunden. Wenn der Auslöser auf dem Handgriff eingedrückt wird, betätigt Druckgas die mechanische Hebelanordnung, um eine Klammer aus der distal angeordneten Patrone zu implantieren.
  • Sämtliche der in den vorgenannten Patenten gezeigten Instrumente geben bei jeder Betätigung des Instruments eine einzelne Klammer aus. Es wäre für ein pneumatisches Klammergerät wünschenswert, bei jeder Betätigung des Instruments mehrere Klammern auszugeben, so, wie es durch das lineare Klammergerät, das im U.S.-Patent 4,527,724 gezeigt ist, ausgeführt wird. Das Instrument dieser Erfindung ist in der Lage, zwei Reihen von Klammern bei jeder Betätigung des Instruments zu implantieren. Die chirurgischen Klammerinstrumente der vorgenannten Patente sind sämtlich starr ausgebildet, wodurch die Verwendung des Instruments auf eine einzelne Konfiguration beschränkt wird. Es wäre für den Benutzer wünschenswert, in der Lage zu sein, die verschiedenen Bereiche des Klammerinstruments gegeneinander zu rotieren und zu verschwenken, wie es beispielsweise im U.S.-Patent 4,728,020 gezeigt ist. Bei dem in diesem Patent gezeigten Instrument ist die Befestigungselement- Applikationsanordnung, oder Klammerkopf, in der Lage, etwa um 180º zu jeder Seite der Achse der Schaftanordnung des Instruments zu schwenken, und der Klammerkopf ist ebenso in der Lage, über einen Bogen von näherungsweise 300º um die Achse des Schafts zu rotieren. Eine derartige Rotation ermöglicht eine Handhabung des Instruments, die die chirurgische Verwendung vereinfacht und den Zugriff zu schwierigen chirurgischen Stellen ermöglicht.
  • Wenn eine Anpassung eines pneumatisch betriebenen, linearen Klammerinstruments für ein derartiges Schwenken und Drehen durchgeführt wird, muß auf die Art und Weise geachtet werden, in der die Kraft des Druckgases an den Klammerkopf ausgegeben wird. Es ist vorzuziehen, daß das Druckgas unmittelbar zum Klammerkopf ausgegeben wird, um die Vielzahl von Teilen und die Komplexität von jeder zwischengeschalteten, mechanischen Hebelanordnung zu eliminieren. Hierdurch werden die Dreh- und Schwenkverbindungen des Instruments kompliziert, welche dann zu der gewünschten Bewegung fähig sein müssen, obgleich die Unversehrtheit des Gasausgabesystems aufrechterhalten wird. Insbesondere ist es wünschenswert, getrennte Druckgasquellen an den Klammerkopf auszugeben: eine, um den Klammerkopf gegen das zu klammernde Gewebe zu klemmen, und eine zweite, um die Einrichtung zum Treiben der Klammer durch das Gewebe zu betätigen. Somit ist es für die bewegbaren Verbindungen im Instrument wünschenswert, daß sie den gewünschten Bewegungsbereich aufweisen und dieses in einer Art und Weise tun, die die Unversertheit der zwei Gasausgabeleitungen bewahrt.
  • In Übereinstimmung mit den Prinzipien der vorliegenden Erfindung ist ein pneumatisch betätigtes Klammerinstrument vorgesehen, das zumindest eine Verbindungseinrichtung aufweist, die eine Drehung um eine gegebene Achse ermöglicht.
  • Ein derartiges Klammergerät ist in Anspruch 1 definiert.
  • In den Zeichnungen ist bzw. sind:
  • Fig. 1 eine perspektivische Ansicht eines chirurgischen Klammergeräts unter Verwendung der Verbindungseinrichtungen der vorliegenden Erfindung;
  • Fig. 2 eine Darstellung des Schafts und des Klammerkopfs eines chirurgischen Klammergeräts unter Verwendung der Verbindungseinrichtungen der vorliegenden Erfindung; und
  • Fig. 3a, 3b und 4a bis 4c Darstellungen von Drehverbindungseinrichtungen der vorliegenden Erfindung mit Schnelltrenn-Verbindungsstücken zum Anschluß verschiedener modularer Komponenten eines chirurgischen Klammergeräts.
  • Fig. 1 zeigt ein pneumatisch betätigtes chirurgisches Klammergerät der vorliegenden Erfindung. Das Klammergerät weist drei Hauptkomponenten auf: einen Handgriffteil 10, einen Schaftteil 108 und einen Klammerkopf 110. Die drei Komponenten sind an ihren Verbindungsstellen durch pneumatische SchnelltrennVerbindungsstücke verbunden, die ein Trennen der Komponenten und Auswechseln mit Schaften und Klammerköpfen anderer Konfigurationen ermöglichen. An den Verbindungsstellen 20 und 22 sind darüberhinaus pneumatische, drehbare Verbindungseinrichtungen der vorliegenden Erfindung angeordnet. Die drehbaren Verbindungseinrichtungen ermöglichen eine freie Drehung der Hauptkomponenten des Klammergeräts gegeneinander, wie durch die Pfeile 24 und 26 dargestellt. Insbesondere der Schaft 108 kann frei vollständig um seine Achse an der Verbindungsstelle 20, wie durch den Pfeil 24 angezeigt, rotieren. Der Klammerkopf 110 kann frei um mehr als 200º um eine Achse rotieren, die normal zur Achse des Schafts 108 ist, wie durch den Pfeil 26 angezeigt.
  • Ein Zylinder mit Druckgas ist in den unteren Teil 12 des Handgriffs 10 durch Entfernen der Kappe 16 und Einsetzen des Zylinders in den Handgriff eingesetzt. Wenn der Zylinder einmal eingesetzt worden ist und die Kappe 16 festgezogen worden ist, wird Gas aus dem Zylinder ausgegeben und strömt zu einem Druckregler im Handgriff. Die Ausgabe von Gas aus dem Zylinder macht das Klammergerät abschußbereit und bewirkt, daß ein Knopf 25 sich um ein kleines Stück aus der Rückseite des Handgriffs herausbewegt, wodurch dem Benutzer angezeigt wird, daß das Klammegerät unter Druck steht.
  • Die erste Stufe bei einem Klammervorgang besteht darin, das zu klammernde Gewebe zwischen den Backen des Klammerkopfs 110 zu klemmen. Das Gewebe wird zwischen den Backen angeordnet, und ein Schieber 74, der sich aus der Rückseite des Klammergeräts erstreckt, wird eingedrückt. Wenn der Schieber nach vorn gedrückt wird, kann Druckgas durch eine erste Gasleitung zum Klammerkopf strömen, um das Gewebe zwischen den Backen des Klammerkopfs zu klemmen. Sobald der Schieber 74 losgelassen wird, gleitet er in seine dargestellte, ausgefahrene Position durch Federkraft zurück. Die Position des hinteren Teils des Klammerkopfs nach dem Klemmen ist bei 110' in Phantomlinien in Fig. 1 dargestellt.
  • Die Klammern in einer Patrone 112 können dann durch das geklemmte Gewebe durch Eindrücken des Auslösers 84 des Handgriffs getrieben werden. Bevor der Auslöser eingedrückt werden kann, muß jedoch eine Auslösesicherung 78 in ihrem Schlitz 80 von der in Fig. 1 dargestellten Position nach oben geschoben und in eine vordere Ausnehmung 82 des Schlitzes 80 geschwenkt werden. Dieser Sicherungsmechanismus verhindert ein unbeabsichtigtes Plazieren der Klammern, bevor der Benutzer bereit ist, dies zu tun. Nachdem die Auslösesicherung 78 nach oben bewegt und nach vorn geschwenkt worden ist, kann der Auslöser eingedrückt werden, um die Klammern ins Gewebe zu implantieren, entweder durch Umlegen der Klammerschenkel gegen einen Amboß 114 im Klammerkopf 110 oder durch Verriegeln der Klammerschenkel durch verbindende Klammeraufnahmen, die anstelle des Ambosses angeordnet sind. Wenn der Auslöser eingedrückt wird, schwenkt die Auslösesicherung zurück in ihre mehr vertikale Position und gleitet im Schlitz 80 durch Federkraft nach unten.
  • Fig. 2 ist eine teilweise Querschnittsdarstellung des Schafts 108 und des Klammerkopfs 110. Der Klammerkopf weist eine Backe 200 auf, die eine Vielzahl von Klammern 202 in einem bewegbaren Klemm- und Klammermechanismus trägt. Gegenüberliegend der Backe 200 ist eine stationäre Gegenbacke 204 angeordnet. Die oberfläche der stationären Backe, die dem Klammermechanismus gegenüberliegt, weist einen Amboß auf, der die Schenkel der metallischen Klammern, die das Gewebe zwischen den Backen durchdringen, umlegt oder umbiegt. Alternativ trägt, wenn die Klammern aus absorbierbaren Polymermaterialien geformt sind, die stationäre Backe eine Patrone mit Aufnahmen, die mit den Schenkeln der polymeren Klammern zusammenpassen und diese halten. Derartige polymere Klammern und Aufnahmen sind in der EP-A-315465, einem Artikel 54 (3) EPÜ-Dokument beschrieben.
  • Die Klammern 202 sind in Taschen angeordnet, die in einer Klammerpatrone 112 an der Backe 200 ausgebildet sind, wobei die Schenkel der Klammern gegen die stationäre Backe 204 gerichtet sind. Hinter der Klammerpatrone 112 ist ein Klammerschieber 210. Der Klammerschieber weist Finger 212 auf, die gegen die Kronen der einzelnen Klammern in der Klammerpatrone gerichtet sind. Hinter dem Klammerschieber 210 ist ein Antriebskolben 214. Der Antriebskolben ist im Innern eines Klemmkolbens 220 angeordnet und ist durch zwei Umfangs-O-Ringe 216 und 218 darin pneumatisch abgedichtet. Der Klemmkolben 220 ist im Innern eines Kolbengehäuses 230 angeordnet. Der Klemmkolben 220 ist im Innern des Kolbengehäuses durch zwei Umfangs-O-Ringe 222 und 224 pneumatisch abgedichtet. Zwischen den letztgenannten zwei O-Ringen sind Anschlüsse 226 und 228, die durch den Klemmkolben führen. Diese Anschlüsse sind symmetrisch angeordnet, so daß der Klemmkolben in das Kolbengehäuse mit jedem Ende am Boden eingesetzt werden kann.
  • Auf der Rückseite des Kolbengehäuses ist ein Kanal 232 angeordnet. Dieser Kanal ist über ein pneumatisches Rohrleitungssegment 34 mit einer rechtwinkligen Verbindungseinrichtung 150 verbunden. Zur Vorderseite des Kolbengehäuses hin ist ein zweiter Kanal 236 vorgesehen. Dieser Kanal ist über ein Rohrleitungssegment 36 an das Verbindungsstück 150 angeschlossen.
  • Unten links vom Klammerkopf 110 ist das Schaftteil 108 des Klammergeräts. Der Schaft 108 weist zwei pneumatische Rohrleitungssegmente 30 und 32 auf. Die Rohrleitung im Schaftteil ist mit Schnelltrenn- Verbindungsstücken der beiden Einlaßanschlüsse der rechtwinkligen Verbindungseinrichtung 150 (von denen einer bei 54 dargestellt ist) durch Schnelltrenn-Verbindungsstücke, von denen eins bei 106 dargestellt ist, verbunden. Am hinteren Endpunkt des Schafts 108, der zur Verbindung mit dem Handgriff 10 dient, ist eine parallele pneumatische Verbindungseinrichtung 120 vorgesehen. Die pneumatische Verbindungseinrichtung 120 ist mittels pneumatischer Schnappverbindungsstücke, von denen eins bei 43 dargestellt ist, an den Handgriff abnehmbar angeschlossen. Die pneumatische Rohrleitung 30, 32 ist an zwei Auslaßanschlüsse 206 der Verbindungseinrichtung 120 angeschlossen.
  • Wenn zu klammerndes Gewebe zwischen den Backen 200 und 204 angeordnet ist, und es gewünscht wird, das Gewebe zwischen den Backen zu klemmen, wird der Schieber 72 eingedrückt und Druckgas strömt aus dem Handgriff und in die Verbindungseinrichtung 120. Das Druckgas wird durch das Rohrleitungssegment 30 im Schaftteil 108 und durch einen Kanal des rechtwinkligen Verbindungsstücks 150 gefördert. Das Druckgas gelangt durch das Rohrleitungssegment 34 und den Kanal 232 zur Rückseite des Klemmkolbens 220. Dort wird das Gas in den Grenzbereich 240 zwischen dem Klemmkolben und dem Kolbengehäuse gezwungen, wo es expandiert und den Klemmkolben gegen die stationäre Backe nach vorn drückt. Wenn der Klemmkolben sich bewegt, trägt er den Antriebskolben, den Klammerschieber und die Klammerpatrone mit sich. Hierdurch wird das Gewebe zwischen der Klammerpatrone und der stationären Backe 204 geklemmt. Der Klemmkolben 220 ist nun in einer Position im Gehäuse 230, so daß der vordere Kanal 236 dem Anschluß 228 des Klemmkolbens gegenüberliegt.
  • Bei zwischen den Backen sicher geklemmtem Gewebe bewegt der Benutzer die Auslösesicherung, dreht sie und zieht den Auslöser, um die Klammern zu implantieren. Druckgas strömt durch die Verbindungseinrichtung 120, die pneumatische Rohrleitung 32, die Verbindungseinrichtung 150 und das Rohrleitungssegment 36 zum Kanal 236. Das Druckgas strömt dann durch den Anschluß 228 in Klemmkolben und in den Raum 242 an der Rückseite des Antriebskolbens. Das in diesem Raum expandierende Gas drückt den Antriebskolben 214 nach vorn gegen die Rückseite des Klammerschiebers 210, wodurch auf den Schieber und seine Finger ein gleichmäßiger Druck aufgebracht wird. Die Finger treiben dann die Klammern aus den Taschen der Klammerpatrone durch das Gewebe und gegen den Amboß oder in die Aufnahmen der stationären Backe. Wenn der Auslöser losgelassen wird, wird das Druckgas zum Antriebskolben und zum Klemmkolben durch den Handgriff entlüftet, wodurch die Backe 200 vom geklammerten Gewebe freigegeben wird.
  • Die Anordnung von Fig. 2 ist detaillierter in der EP-A-324636 beschrieben.
  • Das im Handgriffteil 10 erzeugte Druckgas wird zum Klemm- und Klammermechanismus im Klammerkopf 110 durch die pneumatischen Rohrleitungen 30 und 32 und die Verbindungsstellen 20 und 22, die den Handgriffteil des Klammergeräts mit dem Klammerkopf durch einen austauschbaren Schaftteil 108, wie in den Fig. 1 und 2 dargestellt, verbinden, geführt. Das Schaftteil ist mit dem Handgriffteil und dem Klammerkopf durch Schnelltrenn-Schnappverriegelungs-Verbin-dungsstücke verbunden, ähnlich denen, die an vielen pneumatischen Instrumenten zu finden sind, und durch die drehbaren Verbindungseinrichtungen 120 und 150. Die drehbaren Zwei-Kanal-Verbindungseinrichtungen ermöglichen, daß der Klammerkopf und der Schaftteil gegenüber dem Handgriffteil verdreht werden, während die Unversertheit der Druckgasleitungen erhalten wird.
  • Die parallele Verbindungseinrichtung 120 an der Verbindungsstelle 20 des Handgriffs und des Schafts ist in Fig. 3a perspektivisch und in Fig. 3b im Querschnitt dargestellt. Die parallele Verbindungseinrichtung 120 von Fig. 3b weist eine Formhälfte 122 mit Einlaßanschlüssen 124 und 126 auf. An den Einlaßanschlüssen sind Schnelltrenn-Verbindungsstückbuchsen 43 und 46 befestigt. Der Anschluß 124 führt zu einem Kanal 127 im Zentrum der Verbindungseinrichtung, und der Anschluß 126 führt zu einem Kanal 129, der zum Zentrum der Verbindungseinrichtung versetzt ist. Der Kanal 129 durchschneidet einen kreisförmigen Kanal 130, der in einer Ebene normal zur Ebene der Fig. 3b angeordnet ist. Eine Querschnittsansicht, die durch gegenüberliegende Seiten eines kreisförmigen Kanals 130 geführt ist, ist in Fig. 3b dargestellt.
  • Die parallele Verbindungseinrichtung 120 weist eine zweite Formhälfte 132 mit Auslaßanschlüssen 134 und 136 auf, die mit Kanälen 127 und 131 verbunden sind. An diesen Auslaßanschlüssen sind Schnelltrenn-Verbindungsstückstecker 34 und 36 befestigt. Die beiden Hälften 122 und 132 werden durch eine Rohrverschraubung 140 zusammengehalten. An der Grenzfläche der beiden Hälften sind zwei O-Ringe 142 und 144 vorgesehen, die im Querschnitt dargestellt sind. Die Rohrverschraubung ist fest genug gezogen, um die Vollständigkeit der O-Ring abgedichteten pneumatischen Kanäle aufrechtzuerhalten, jedoch ausreichend lose über die Grenzfläche, um eine Relativbewegung der beiden Hälften zu ermöglichen. Der kleinere O-Ring 142 dichtet den zentrischen Kanal 127 im Innern des O-Rings ab und trennt den Zentrumskanal von dem äußeren kreisförmigen Kanal 130. Der größere O-Ring 144 dichtet den äußeren Durchmesser des kreisförmigen Kanals 130 ab.
  • Wenn die beiden Hälften der parallelen Verbindungseinrichtung bei Drehung der Teile des Klammergeräts gedreht werden, rotieren die Formhälften der Verbindungseinrichtung um den Zentrumskanal 127, der den Einlaßanschluß 124 mit dem Auslaßanschluß 134 verbindet. Obwohl die Kanäle 131 und 129 in Fig. 3b fluchtend miteinander dargestellt sind, tritt diese Ausrichtung nicht länger auf, wenn die Hälften der Verbindungseinrichtung gedreht werden. Stattdessen drehen die Kanäle 131 und 129 um das Zentrum der Verbindungseinrichtung im Bogen des kreisförmigen Kanals 130, an den sie angeschlossen sind. Somit umfaßt der pneumatische Verbindungsweg vom Einlaßanschluß 126 zum Auslaßanschluß 136 den Kanal 129, die Bogenabschnitte des kreisförmigen Kanals 130 und den Kanal 131. Die Verbindungseinrichtung ermöglicht hierdurch eine Relativdrehung der Teile des Klammergeräts, während die Trennung und Unversehrtheit der pneumatischen Leitungen aufrechterhalten wird.
  • Wie zu erkennen ist, weisen die Schnelltrenn-Verbindungsstückbuchsen 43 und 46 jeweils ein aufgeweitetes, äußeres Ende 44 und 47 auf, die passende Verbindungsstückstecker erfassen. Die befestigten Enden der Verbindungsstücke 43 und 46 sind im Durchmesser wie bei 45 und 49 dargestellt, verengt, um abdichtend mit den zusammenpassenden Verbindungsstücken in Eingriff zu sein. Die Verbindungsstückstecker 34 und 36 weisen dieselbe Konfiguration auf, wobei ihre aufgeweiteten Enden 33 und 38 an den jeweiligen Anschlüssen 134 und 136 befestigt sind. Die verengten Durchmesserbereiche der Verbindungsstückstecker sind im Eingriff mit O-Dichtringen 35 und 37. Wenn die Verbindungsstückbuchsen und die Verbindungsstückstecker im Eingriff sind, wird durch die Kompression der O-Ringe 35 und 37 innerhalb der verengten Durchmesserbereiche 45 und 49 der Verbindungsstückbuchsen eine pneumatische Abdichtung erzielt. Die Verbindungsstücke erhalten somit eine sichere pneumatische Abdichtung aufrecht, obgleich sie einfach verbunden und getrennt werden können, wenn verschiedene Teile des Klammergerät-Systems gegeneinander ausgetauscht werden. Die Verbindungsstücke sind zum Eingriff ineinander geeignet, wie bei 54 und 106 in Fig. 2 dargestellt, und können ebenso unmittelbar an Rohrleitungssegmente, wie bei 206 in Fig. 2 dargestellt, angeschlossen werden, wenn eine Trennung nicht erforderlich ist.
  • Eine rechtwinklige Verbindungseinrichtung 150, sowie die, die an der Verbindungsstelle 22 des Schaftteils und des Klammerkopfs in Fig. 2 verwendet wird, ist in Fig. 4a perspektivisch und in den Fig. 4b und 4c im Querschnitt dargestellt. Wie die parallele Verbindungseinrichtung 120 weist die rechtwinklige Verbindungseinrichtung 150 Einlaßanschlüsse 152 und 154 auf, die Schnelltrenn-Verbindungsstücke 52 und 54 aufnehmen, und Auslaßanschlüsse 162 und 164, die Schnelltrenn-Verbindungsstücke 62 und 64 enthalten. Ein zentraler Kanal 156 verbindet den Einlaßanschluß 152 mit einem Auslaßanschluß 162, und ein kreisförmiger Kanal 158 verbindet den Einlaßanschluß 154 mit dem Auslaßanschluß 164 über Kanäle 166 15 und 168. Dasselbe drehbare Konzept wird angewendet, wobei die Kanäle 166 und 168 um den zentralen Kanal 156 im Bogen des kreisförmigen Kanals 158 schwenken.

Claims (12)

1. Chirurgisches Klammerinstrument mit einem Handgriffteil (10), einem Schaftteil (108) und einem Klammerkopf (110), wobei der Klammerkopf (110) drehbar mit einem Ende des Schaftteils (108) verbunden ist, wobei das andere Ende des Schaftteils (108) drehbar mit dem Handgriffteil (10) verbunden ist, dadurch gekennzeichnet,
daß das Schaftteil (108) über drehbare pneumatische Verbindungseinrichtungen (120, 150) mit den anderen Teilen verbunden ist, das Klammerinstrument eine Pneumatikleitung (32) aufweist, die einen Auslösemechanismus (84) mit einem Antriebsmechanismus verbindet, und eine Pneumatikleitung (30), die einen Schieber (14) mit einem Klemmmechanismus (220) verbindet, mittels des Schaftteils (108), wobei die Pneumatikleitungen (30, 32) das Schaftteil (108) durchqueren und an mindestens einer der pneumatischen Verbindungseinrichtungen (120) befestigt sind, wobei die zumindest eine der pneumatischen Verbindungseinrichtungen pneumatische Verbindungsgänge (124, 126) aufweist, die dadurch hindurchgehen, wobei jeder Verbindungsgang mit einem Schnelltrenn-Verbindungsstück (43, 46) versehen ist.
2. Chirurgisches Klammerinstrument nach Anspruch 1, bei dem die andere der pneumatischen Verbindungseinrichtungen (150) pneumatische Verbindungsgänge (156, 158) aufweist, die dahindurchgehen, wobei jeder Verbindungsgang mit einem Schnelltrenn-Verbindungsstück (52, 54) versehen ist,
wobei das Schaftteil (108) aus der Verbindung mit dem Schieber und dem Auslösemechanismus sowie dem Klemmmechanismus und dem Antriebsmechanismus gelöst werden kann.
3. Chirurgisches Klammerinstrument nach Anspruch 1 oder Anspruch 2, bei dem zumindest eine pneumatische Verbindungseinrichtung (120; 150) aufweist:
zwei Paßteile (127, 132), wobei jedes Paßteil eine Vielzahl von pneumatischen Leitungsbereichen (127, 129, 130; 131) aufweist, wobei ein Paßteil gegenüber dem zweiten Paßteil um eine für beide Paßteile übereinstimmende Achse drehbar ist;
wobei jeder Pneumatikleitungsbereich eines Teils (122) mit einem Pneumatikleitungsbereich des zweiten Paßteils (132) korrespondiert, derart, daß, wenn die Paßteile der Verbindungseinrichtung miteinander gepaart sind, Fluid durch eine Vielzahl von komplettierten Pneumatikleitungen strömen kann, von denen jede zwei Leitungsbereiche umfaßt, unabhängig von der Drehorientierung eines Paßteils (122) gegenüber dem anderen Paßteil (132).
4. Chirurgisches Klammerinstrument nach Anspruch 3, bei dem jede der komplettierten Pneumatikleitungen der Verbindungseinrichtung gegenüber der Umgebung abgedichtet ist, um eine kontinuierliche Fluidströmung durch die Verbindungseinrichtung zu ermöglichen.
5. Chirurgisches Klammerinstrument nach Anspruch 3 oder Anspruch 4, bei dem die Pneumatikleitungsbereiche (127, 129; 131) im wesentlichen parallel zur Achse der Paßteile der Verbindungseinrichtung sind.
6. Chirurgisches Klammerinstrument nach Anspruch 3 oder 4, bei dem die Pneumatikleitungsbereiche (152, 154) eines Teils im wesentlichen rechtwinklig zu den Pneumatikleitungsbereichen (168) des anderen Teils sind.
7. Chirurgisches Klammerinstrument nach einem der Ansprüche 3 bis 6, bei dem eine komplettierte Leitung der Verbindungseinrichtung koinzident mit der genannten übereinstimmenden Achse ist, und ein Bereich der zweiten komplettierten Leitung radial um die übereinstimmende Achse herumgeführt ist.
8. Chirurgisches Klammerinstrumet nach einem der Ansprüche 3 bis 7, bei dem nach der Paarung von beiden Teilen der Verbindungseinrichtung Fluid durch eine komplettierte Pneumatikleitung mittels eines passenden Verbindungsgangs an der Schnitt stelle der Teile strömen kann;
wobei der passende Verbindungsgang eine ringförmige Öffnung (130) aufweist, die konzentrisch zur Rotationsachse der Paßteile ist, derart, daß ein Pneumatikleitungsbereich von einem Paßteil in Fluidverbindung mit einem korrespondierenden Pneumatikleitungsbereich mittels des passenden Verbindungsgangs (130) ist.
9. Chirurgisches Klammerinstrument nach Anspruch 8, bei dem jede der komplettierten Pneumatikleitungen der Verbindungseinrichtung gegenüber der Umgebung abgedichtet ist, um eine kontinuierliche Fluidströmung durch die Verbindungseinrichtung zu schaffen.
10. Chirurgisches Klammerinstrument nach Anspruch 9, bei dem diejenigen Bereiche des Fluidweges, die durch die Pneumatikleitungsbereiche gebildet sind, im wesentlichen parallel zur übereinstimmenden Achse sind.
11. Chirurgisches Klammerinstrument nach Anspruch 10, bei dem Fluid in die Verbindungseinrichtung durch eines der Paßteile im wesentlichen rechtwinklig zur übereinstimmenden Achse des anderen Paßteils eintritt.
12. Chirurgisches Klammerinstrument nach Anspruch 8, bei dem zwei komplettierte Fluidleitungen durch die gepaarten Teile ausgebildet sind, derart, daß eine komplettierte Leitung entlang der übereinstimmenden Achse führt, und die zweite komplettierte Leitung radial um die übereinstimmende Achse herumführt, derart, daß nach der Paarung die zweite komplettierte Pneumatikleitung einen kreisförmigen Verbindungsgang (130) an der Schnittstelle der Teile aufweist, wobei der Verbindungsgang innerhalb der gepaarten Teile gegenüber der einen komplettierten Leitung abgedichtet ist.
DE68914002T 1988-01-15 1989-01-13 Pneumatisches Verbindungselement für ein chirurgisches Klammerinstrument. Expired - Lifetime DE68914002T2 (de)

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DE68914002T Expired - Lifetime DE68914002T2 (de) 1988-01-15 1989-01-13 Pneumatisches Verbindungselement für ein chirurgisches Klammerinstrument.
DE68914003T Expired - Lifetime DE68914003T2 (de) 1988-01-15 1989-01-13 Kopf eines chirurgischen Klammerinstrumentes mit pneumatischem Antrieb.

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ATE103158T1 (de) 1994-04-15
JP2601537B2 (ja) 1997-04-16
GR1000771B (el) 1992-12-30
JPH01308541A (ja) 1989-12-13
CA1306652C (en) 1992-08-25
AU2849689A (en) 1989-07-20
US4951861A (en) 1990-08-28
BR8900177A (pt) 1989-09-12
ZA8998B (en) 1990-09-26
PT89451A (pt) 1989-10-04
GR1000772B (el) 1992-12-30
PT89458A (pt) 1989-10-04
PT89450A (pt) 1989-10-04
AU614014B2 (en) 1991-08-15
GR1000770B (el) 1992-12-30
GR1000773B (el) 1992-12-30
EP0324635A1 (de) 1989-07-19
DE68914004T2 (de) 1994-07-28
CA1306650C (en) 1992-08-25
US5018657A (en) 1991-05-28
JP2601536B2 (ja) 1997-04-16
ZA8959B (en) 1990-09-26
CA1325572C (en) 1993-12-28
AU2849589A (en) 1989-07-20
ZA8960B (en) 1990-09-26
ES2050223T3 (es) 1994-05-16
US4964559A (en) 1990-10-23
ZA8994B (en) 1990-09-26
JPH01250238A (ja) 1989-10-05
BR8900170A (pt) 1989-09-12
US4938408A (en) 1990-07-03
DE68914003T2 (de) 1994-07-28
EP0324635B1 (de) 1994-03-23
AU2849389A (en) 1989-07-20
EP0324636B1 (de) 1994-03-23
DE68914003D1 (de) 1994-04-28
ES2050224T3 (es) 1994-05-16
BR8900168A (pt) 1989-09-12
CA1306651C (en) 1992-08-25
JPH01317429A (ja) 1989-12-22
DE68914004D1 (de) 1994-04-28
GB8800909D0 (en) 1988-02-17
PT89450B (pt) 1993-12-31
JPH01288248A (ja) 1989-11-20
BR8900176A (pt) 1989-09-12
DE68914002D1 (de) 1994-04-28
ES2050222T3 (es) 1994-05-16
ATE103159T1 (de) 1994-04-15
JP2601534B2 (ja) 1997-04-16
PT89452B (pt) 1994-01-31
EP0324636A1 (de) 1989-07-19
AU2849789A (en) 1989-07-20
PT89451B (pt) 1994-10-31
JP2601535B2 (ja) 1997-04-16
AU614015B2 (en) 1991-08-15
AU613444B2 (en) 1991-08-01
AU614572B2 (en) 1991-09-05
PT89452A (pt) 1989-10-04

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