DE9318814U1 - Surgical tubular shaft instrument - Google Patents

Description

HOEGER, STELLREC.Mt..&* RAf^TNBR.

PATENT ATTORNEYS UHLANDSTRASSE 14 c ■ D 7000 STUTTGART 1

A 51 596 u Applicant: Aesculap AG

u-219 Am Aesculap-Platz

30 November 1993 D-78532 Tuttlingen

SURGICAL TUBULAR SHAFT INSTRUMENT

The invention relates to a surgical tubular shaft instrument with two handle branches connected to one another in an articulated manner, with a tube held on one handle branch, a tool mounted at the end of the tube, a rod-shaped actuating element for the tool mounted longitudinally displaceably in the tube, which is connected in an articulated manner to the other handle branch via a cylindrical or spherical end, and with a detachable connection between the tube and actuating element on the one hand and the two handle branches on the other.

With tubular shaft instruments of this type, which can be used in a wide variety of ways, it is important to be able to disassemble the instrument as completely as possible for the purpose of exchanging tools and for cleaning.

Instruments of this type are known in which the handle branches can be connected to the tube and to the actuating element via threaded connections. Making and releasing the connection takes a relatively long time, since fine threads must usually be used, which require a large number of turns.

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In addition, it is difficult to connect the concentric parts simultaneously in this way, since two different connections have to be made.

It is the object of the invention to design a generic instrument in such a way that the establishment and release of the connection between the tube and the actuating element on the one hand and the handle branches on the other hand is facilitated.

This object is achieved according to the invention in a surgical instrument of the type described at the outset in that the tube can be inserted into a tubular receptacle on one handle branch and can be axially secured therein by at least one radially movable locking body which, in an end position, forms a positive connection with the tube, and in that a retaining element is mounted on the other handle branch which, in an end position, partially encompasses the cylindrical or spherical end of the actuating element and can be moved into another end position in which the cylindrical or spherical end can be removed from the other handle branch in the longitudinal direction of the actuating element.

Separate, movable locking elements are used for both the tube and the actuating element, which can be moved or rotated by a movement between a closed position and an open position, so that the release and connection are very simple. In particular, these processes can be carried out very quickly.

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It is advantageous if the locking body is a ball, i.e. if a so-called ball lock is used to secure the pipe in the holder.

It can be provided that the radial movement of the locking body is limited by a stop on the outside of the locking body and that the stop can be moved relative to the locking body in such a way that the locking body can be moved radially outwards by different distances. In particular, the stop can be formed by a sleeve that can be moved axially on the tubular holder. To release the tube from the holder, it is therefore sufficient to move this sleeve on the tubular holder into an end position, then the locking body can release the tube in the radial direction.

It is advantageous if the sleeve is spring-loaded and moved into the end position in which the displacement path of the locking body is most restricted. This means that the spring always moves the sleeve into the locking position, and only against the force of this spring is it possible to release the axial fixation of the tube in the holder.

In the preferred embodiment, it is provided that the sleeve forms a stop for an outer tube mounted axially displaceably on the tube, which in the advanced end position locks the releasable mounting of the tool at the opposite end of the tube, and that

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the sleeve can be moved in the direction of the handle branches to release the locking of the tube. In this design, the sleeve that can be moved on the tubular holder not only fixes the locking body that secures the tube in the tubular holder, but also an outer tube on the tube, which in turn forms a locking mechanism for an interchangeable tool at the front end of the tube.

In another embodiment, it can be provided that the tubular holder forms a stop for an outer tube that is axially displaceably mounted on the tube, which in the advanced end position locks the detachable mounting of the tool at the opposite end of the tube. In this embodiment, the outer tube can only be moved on the tube when the tube is pulled out of the tubular holder, i.e. replacing the tool first requires the entire instrument to be separated.

It is advantageous if the tube is secured against rotation around the longitudinal axis of the tube by projections and recesses engaging when it is inserted into the tubular holder. This allows a defined position of the tool plane to be achieved. It can be provided that projections and recesses can engage in different angular positions, so the surgeon can optionally rotate the tube into different angular positions and fix it in these by briefly separating the tube from the instrument.

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In a modified embodiment, it can also be provided that the tubular holder is mounted on the handle branch so that it can rotate about its longitudinal axis. By rotating this tubular holder, the tube with the tool mounted on it can be turned into the desired position, so that the operator is completely free to adjust the angle of the tool.

In a first preferred embodiment, the retaining element can be designed as a collet chuck which, in the released state, allows the spherical or cylindrical end to enter or exit by elastic bending and which, in the closed state, permanently encloses it. Such a collet chuck can be locked, for example, by axially inserting it into a sleeve; this insertion can optionally be carried out using a threaded nut.

In another embodiment, it is provided that the retaining element is pivotally mounted on the other handle branch and, in the closed state, engages in a section of the actuating element that adjoins the spherical or cylindrical end, the external dimensions of which are smaller transversely to the longitudinal direction of the actuating element than those of the spherical or cylindrical end. To release the rotary connection between the actuating element on the one hand and the handle branch on the other, it is therefore sufficient to pivot the retaining element on the handle branch, i.e. one hand movement is sufficient to achieve either the closed state or the released state.

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It is particularly advantageous if the retaining element has a receiving space for the spherical or cylindrical end with an opening that includes a larger area that is sufficient for the spherical or cylindrical end to pass through and a smaller area that is too narrow for it to pass through, and that the two areas can be moved optionally in the longitudinal direction of the actuating element in front of its spherical or cylindrical end by moving the retaining element. The receiving space encloses the spherical or cylindrical end and thus reliably transmits both pulling and pushing movements. Simply by pivoting the retaining element it is possible to release the actuating element, namely when the larger area of the opening is directed in the longitudinal direction of the actuating element.

It is advantageous if the actuating element can be positioned in its end positions by means of elastic catches.

The opening of the receiving space can in particular be keyhole-shaped.

The following description of preferred embodiments of the invention serves to explain it in more detail in conjunction with the drawing. They show:

Fig. 1 A side view of a demountable

tubular shaft instruments;

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Fig. 2 is a longitudinal sectional view of the front

part and the middle part of the tubular shaft instrument of Fig. 1;

Fig. 3 is an enlarged longitudinal sectional view of the

middle part of the tubular shaft instrument of Fig. 1 in the unlocked state;

Fig. 4 a longitudinal sectional view of the tubular shaft

instrument of Fig. 1 in the area of the detachable mounting of the actuating element on the handle branch with locked retaining element;

Fig. 5 a view similar to Fig. 4 with opened

net restraint device;

Fig. 6 a view similar to Fig. 4 with a

modified embodiment of a restraint device in the closed state;

Fig. 7 a view of the retaining member in

Direction of arrow A in Fig. 6;

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Fig. 8 is a view similar to Fig. 4 for a

retaining element designed as a collet in the closed position;

Fig. 9 a view similar to Fig. 8 with the

Collet in open position;

Fig. 10 is a view similar to Fig. 4 for a

modified embodiment of a pivotable retaining element and

Fig. 11 is a sectional view along line 11-11 in

Fig.10.

The tubular shaft instrument shown in the drawing comprises two pivotally connected handle branches 1 and 2, each with a finger opening 3 and 4 respectively. The two handle branches 1 and 2 are pivotally connected to one another by a screw connection 5. A shaft 6 is held on a handle branch 1, at the free end of which is a tool 7, which can have the shape of scissors or pliers, for example. Inside the shaft 6, a rod-shaped actuating element 8 is arranged so that it can be moved longitudinally, which is articulated on the one hand to the tool 7 and on the other hand to the other handle branch, so that when the handle branches 1 and 2 are opened and closed, the tool 7 can be opened and closed by a pulling or pushing movement of the actuating element 8.

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In the embodiment shown, this tool 7 comprises 2 parts 10, 11 that are rotatably mounted on a holder 9 and are pivotally connected to the actuating element 8 via gear means 12 (Fig. 2). This holder 9 is detachably connected to a tube 13. For this purpose, the holder 9 carries an extension 14 with a circumferential groove 15 that penetrates into the tube 13. The tube 13 is divided at its free end by longitudinal slots into elastically bendable tongues 16 that are bent inwards at their free end. These tongues 16 surround the extension 14 and penetrate with the bent end into the circumferential groove 15, so that the extension 14 is fixed in the tube 6 in the axial direction. The tongues 16 are held permanently in this position by an outer tube 17, which can be moved longitudinally on the tube 13, being pushed over the tongues 16 so that the tongues 16 are prevented from moving radially outwards. The outer tube 17 thus forms a lock which can only be released if the outer tube 17 is pushed back over the tongues 16.

The tube 13 and the outer tube 17 slidably mounted on it together form the shaft 6, which can be detachably connected to the handle branch 1. For this purpose, this handle branch 1 has a tubular holder 18, which can optionally be rotated relative to the handle branch 1 about the longitudinal axis of the holder 18. The tube 13 can be inserted into this holder 18, the outer diameter of the tube 13 corresponds to the inner diameter of the holder 18. The tube 13 has a

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inserted end has longitudinal slots 19 into which a projection 20 held in the tubular holder 18 protrudes. As a result, the tube 13 is mounted in the holder 18 so that it cannot rotate. Several longitudinal slots can be provided so that the tube 13 can be fixed in the holder 18 in different angular positions.

A locking body 22 in the form of a ball is mounted in a radial bore 21 of the tubular holder 18, which, when the tube 13 is pushed into the holder 18, plunges into a recess 23 in the outer casing of the tube 13. In a way that is not apparent from the drawing, the radial bore 21 is not completely continuous on the inside, so that even if the tube 13 is missing, the ball cannot fall out of the radial bore 21 radially inwards. On the outside, however, the radial bore 21 is continuous, so that the ball 22 can move freely radially outwards.

A sleeve 24 is mounted on the tubular holder 18 so that it can move in the longitudinal direction and surrounds a helical spring 26 in an annular space 25 arranged between the holder 18 and the sleeve 24. This spring is supported on the one hand on a step 27 of the sleeve 24 and on the other hand on a step 28 of the holder 18 and thus applies a force to the sleeve 24 that moves it in the direction of the tool 7. The step 28 is guided in a longitudinal groove 29 of the sleeve 24 so that the sleeve 24 is secured against rotation relative to the holder 18.

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The movement of the sleeve 24 in the direction of the tool 7 is limited by the fact that the sleeve 24 strikes the outer tube 17 and thus moves it into its frontmost position in which the tongues 16 are locked (Fig. 2). Only when the sleeve 24 is pushed back against the action of the coil spring can the outer tube 17 be pushed back far enough for the holder 9 to be pulled out of the tube 13.

It is also possible that the sleeve 24 is permanently connected to the outer tube, in which case the tool 7 can only be replaced when the tube 13 has been pulled out of the holder 18.

In an embodiment not shown in the drawing, it could also be provided that the outer tube 17 abuts against the receptacle 18; in this case too, it would be necessary to pull the tube 6 out of the receptacle 18 in order to move the outer tube 17. In this case, the movement of the sleeve 24 could be limited by another suitable stop.

The sleeve 24 rests with its inner wall on the outside of the receptacle 18 in such a way that the radial bore 21 is closed, so that when the coil spring 26 is relaxed, the movement of the ball 22 radially outwards is prevented. The dimensions are such that in this case the ball 22 dips into the recess 23.

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When the sleeve 24 is moved into an open position by compressing the coil spring 26, a circumferential groove 30 on the inside of the sleeve 24 moves over the radial bore 21, so that the ball 22 in the radial bore 21 can then be moved radially outwards to a limited extent, namely so far that the ball completely emerges from the recess 23. In this position, the axial fixation of the tube 13 in the receptacle 18 created by the ball 22 is canceled, the tube 13 can therefore be pulled out of the receptacle 18 in this position.

The rod-shaped actuating element 8 protrudes through a central hole 31 of the extension 14 and projects backwards over the tube 13, to such an extent that it also protrudes from the handle branch 1. In this area, the rod-shaped actuating element 8 has a spherical end 32 which is connected to the actuating element 8 via a connecting section 33 with a smaller outer diameter.

The spherical end 32 forms a joint connection with the second handle branch 2.

For this purpose, in a first embodiment described in Fig. 4 and 5, a pivot lever 34 is pivotably mounted on the handle branch 2 about a horizontal axis running transversely to the longitudinal direction of the actuating element 8, which pivot lever has a blind hole 35 open on one side. This is connected to a

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its longitudinal slot 36 running in its longitudinal direction with the environment. The diameter of the blind hole 35 corresponds essentially to the outer diameter of the spherical end 32, the width of the longitudinal slot 36 is selected to be smaller and corresponds essentially to the diameter of the actuating element 8 in the narrower connecting section 33. The pivot lever 34 can be pivoted between a closed position (Fig. 4) and an open position (Fig. 5) and is fixed in both end positions by a ball 39 which engages springily in recesses 37 and 38. In the closed position, the spherical end 32 is received in the blind hole 35, this blind hole 35 thus forms a receiving space for the spherical end 32. In this position of the pivot lever 34, the blind hole 35 is open upwards, i.e. perpendicular to the longitudinal direction of the actuating element 8, so that pulling the actuating element out towards the front of the instrument is impossible.

In the open position shown in Fig. 5, the open end of the blind hole 35 points in the direction of the actuating element 8, so that it can be pulled out of the instrument in the direction of the arrow shown in Fig. 5. In this embodiment, the actuating element 8 is therefore secured solely by pivoting the pivot lever 34, which thus takes on the function of a retaining element for the actuating element 8.

In the embodiment of Fig. 6 and 7 a very similar solution is shown, the same parts therefore carry

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the same reference numerals. In this case, the pivot lever 34 is not fixed in the end positions by a spring-loaded ball, but by a retaining pin 40 which spring-loadedly engages in notches 41, 42 of the pivot lever 34. The elasticity of the material used for the pivot lever can be sufficient here to enable the necessary displacements.

In the embodiment of Fig. 8 and 9, a collet 44 is mounted on the handle branch 2 so as to be pivotable about a horizontal axis 45 arranged transversely to the longitudinal axis of the actuating element 8. This collet 44 comprises a bearing sleeve 43 and an internally threaded sleeve 47 with a handle part 46, which is mounted axially immovably and rotatably in this. A pipe section 48 is screwed into an external thread 49 in the internally threaded sleeve 47, which is drawn more or less deeply into the bearing sleeve 43 when the handle part 46 is rotated. At the free end of the pipe section 48, regions 51 are formed which can be elastically bent radially outwards by means of longitudinal slots 50 and which surround a spherical cap-shaped receiving space 52, the dimensions of which correspond to the external dimensions of the spherical end 32 of the actuating element 8. By elastically bending the areas 51, the spherical end 32 can be pushed into the spherical cap-shaped receiving space 52, so that the areas 51 partially articulate around the spherical end 32.

This connection can be released at any time as long as the areas 51 can be bent elastically outwards, as shown in Fig. 9. By turning the

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However, by tightening the handle part 46, the internally threaded sleeve 47 can be pulled into the bearing sleeve 43 so far that the elastic areas 51 rest against the inside of the bearing sleeve 43 and are thereby prevented from elastically deforming outwards. This is shown in Fig. 8. As a result, the spherical end 32 is fixed in the receiving space 52 in an inseparable but articulated manner. To loosen this connection, it is sufficient to push the internally threaded sleeve 47 out of the bearing sleeve 43 again by turning the handle part 46 until the elastic areas 51 can be bent open.

In the embodiment of Fig. 10 and 11, a swivel body 54 is inserted into a vertical bore 53 of the handle branch 2, which can be rotated about the vertical axis of the bore 53. A blind hole 55 is arranged in the swivel body 54 coaxially to the bore 53, which is connected to the outside via a transverse, keyhole-shaped opening. In a first position, the narrow area of the keyhole-shaped opening 56 is arranged in the longitudinal direction of the actuating element 8, so that the larger spherical end 32 is prevented from emerging, but in the other end position the larger part of the keyhole-shaped opening 56 is in this direction, so that in this position the spherical end 32 can emerge from the opening 56. In this embodiment too, the swivel body 54, which in this case can be rotated about the vertical axis, could be fixed by locking in the end positions; this is not shown separately in the drawing.

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When assembling the instrument described, the holder 9 with the tool 7 is always first pushed into the front end of the tube 13 until the tongues 16 snap into the circumferential groove 15. The actuating element 8 permanently connected to the tool 7 is guided through the bore 31 and the free end of the actuating element 8 protrudes beyond the rear side of the tube 13.

To fix the connection between tool 7 and tube 13, the outer tube 17 can be moved so that it covers the tongues 16. This unit is then pushed into the tubular holder 18, while at the same time the sleeve 24 is moved against the action of the coil spring 26. This allows the tube 13 to enter the holder 18 unhindered without the ball 22 preventing this entry movement. When the tube 13 is pushed in, the projection 20 enters one of the longitudinal slots 19 and thereby aligns the tube in the circumferential direction in the desired angular position. As soon as the desired insertion depth is reached, the sleeve 24 is released so that it moves into the closed position under the action of the coil spring 26 and pushes the ball 22 into the aligned recess in the tube 13. The tube 13 is thus fixed in the holder in the axial direction. This also results in a fixation of the outer tube 17 on the tube 13, so that the tool 7 is now also permanently locked in the tube 6.

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During this insertion movement of the tube 13, the spherical end 32 of the actuating element 8 has entered the retaining element in the open position. By moving the retaining element into the closed position, the spherical end 32 is partially surrounded by the retaining element in an articulated manner and the end 32 is also prevented from being displaced in the direction of the actuating element 8. This allows tensile and compressive forces to be transferred from the handle branch 2 to the actuating element 8.

To disassemble the instrument, proceed in reverse order.

Claims (15)

A 51 596 u Applicant: Aesculap AG u-219 Am Aesculap-Platz 30. November 1993 D-78532 Tuttlingen PROTECTION CLAIMS 1. Surgical tubular shaft instrument with two handle branches connected to one another in an articulated manner, with a tube held on one handle branch, a tool mounted at the end of the tube, a rod-shaped actuating element for the tool mounted longitudinally displaceably in the tube, which is connected in an articulated manner to the other handle branch via a cylindrical or spherical end, and with a releasable connection between the tube and actuating element on the one hand and the two handle branches on the other hand, characterized in that the tube (13) can be inserted into a tubular receptacle (18) on one handle branch (1) and can be axially secured therein by at least one radially movable locking body (22) which, in an end position, forms a positive connection with the tube (13), and in that a retaining member (34, 44, 54) is mounted on the other handle branch (2) which, in one end position, partially encompasses the cylindrical or spherical end (32) of the actuating element (8), which can be moved into another end position in which the cylindrical or spherical end (32) can be removed from the other handle branch (2) in the longitudinal direction. Aesculap AG! &iacgr;&iacgr; ! ' ! .' ' "&iacgr;. ! A 51 596 u 30 November 1993 u-219 - 19 - 2. Instrument according to claim 1, characterized in that the locking body (22) is a ball. 3. Instrument according to claim 1 or 2, characterized in that the radial movement of the locking body (22) is limited by a stop (24) resting on the outside of the locking body (22) and that the stop (24) is displaceable relative to the locking body (22) in such a way that the locking body (22) can be displaced radially outwards to varying degrees. 4. Instrument according to claim 3, characterized in that the stop (24) is formed by a sleeve which is axially displaceable on the tubular holder (18). 5. Instrument according to claim 4, characterized in that the sleeve is spring-loaded and displaced into the end position in which the displacement path of the locking body (22) is most restricted. Aesculap AG! !! I'! ·' ' "!· &iacgr;&lgr; 51 596 u 30 November 1993 u-219 6. Instrument according to claim 4 or 5, characterized in that the sleeve forms a stop for an outer tube (17) mounted axially displaceably on the tube (13), which in the advanced end position locks the releasable mounting of the tool (7) at the opposite end of the tube (13), and that the sleeve can be displaced in the direction of the handle branches (1, 2) to release the locking of the tube (13). 7. Instrument according to one of claims 4 or 5, characterized in that the tubular receptacle (18) forms a stop for an outer tube (17) mounted axially displaceably on the tube (13), which in the advanced end position locks the releasable mounting of the tool (7) at the opposite end of the tube (13). 8. Instrument according to one of the preceding claims, characterized in that the tube (13) is secured against rotation about the longitudinal axis of the tube (13) by engagement of projections or recesses (19, 20) when inserted into the tubular receptacle (18). Aesculap AG! !! !' ! ,' ' "!. ! A 51 596 u 30 November 1993 u-219 9. Instrument according to claim 8, characterized in that projections and recesses (19, 20) can engage in different angular positions. 10. Instrument according to one of the preceding claims, characterized in that the tubular holder (18) is mounted on the handle branch (1) so as to be rotatable about its longitudinal axis. 11. Instrument according to one of the preceding claims, characterized in that the retaining element is designed as a collet (44) which, in the released state, allows the spherical or cylindrical end (32) to enter or exit by elastic bending and, in the closed state, permanently surrounds it. 12. Instrument according to one of claims 1 to 10, characterized in that the retaining member (34, 54) is pivotally mounted on the other handle branch (2) and, in the closed state, engages in a section (33) of the actuating element (8) adjoining the spherical or cylindrical end (32), the external dimensions of which transversely to the longitudinal direction of the actuating element (8) are smaller than those of the spherical or cylindrical end (32). Aesculap AG ·..*'..· .:..:.. * .!**..' ^{A 51} ^96 ^u 30 November 1993 u-219 - 22 - 13. Instrument according to claim 12, characterized in that the retaining member (34, 54) has a receiving space (35, 55) for the spherical or cylindrical end (32) with an opening (35, 36; 56) which comprises a larger area sufficient for the passage of the spherical or cylindrical end (32) and a smaller area too narrow for it to pass through, and that the two areas can be moved selectively in the longitudinal direction of the actuating element (8) in front of its spherical or cylindrical end (32) by moving the retaining member (34, 54). 14. Instrument according to claim 13, characterized in that the retaining member (34, 54) can be positioned in its end positions by elastic catches (39, 40). 15. Instrument according to one of claims 13 or 14, characterized in that the opening (56) is keyhole-shaped.