Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
  • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
  • A61B18/14—Probes or electrodes therefor
  • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
  • A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
  • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
  • A61B18/1206—Generators therefor
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
  • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
  • A61B18/14—Probes or electrodes therefor
  • A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
  • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
• • 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
  • A61B17/2812—Surgical forceps with a single pivotal connection
  • A61B17/2841—Handles
  • A61B2017/2845—Handles with a spring pushing the handle back
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
  • A61B2018/00589—Coagulation
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
  • A61B2018/0063—Sealing
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B2018/0091—Handpieces of the surgical instrument or device
  • A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
  • A61B2018/00958—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device for switching between different working modes of the main function
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
  • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
  • A61B18/1206—Generators therefor
  • A61B2018/1246—Generators therefor characterised by the output polarity
  • A61B2018/126—Generators therefor characterised by the output polarity bipolar
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
  • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
  • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
  • A61B18/14—Probes or electrodes therefor
  • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
  • A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
  • A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/06—Measuring instruments not otherwise provided for
  • A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension

Definitions

• the present disclosure relates to a surgical preferably bipolar sealing instrument (short: instrument) with one on a distal one
• Instrument tip provided tool effector.
• Bipolar sealing instruments are mainly used in minimally invasive surgery. They both serve to prepare (patient) tissue, i.e. For example, plucking, spreading or pushing the tissue out of the way, as well as to pinch the tissue in order to seal it and, if necessary, cut it by heating. That’s why
• Tool tip designed tool relative branches or jaw parts, which are suitable for gripping tissue. Electrodes for desolating and possibly also for severing / cutting the tissue are arranged on the branches, for example by applying direct current or high-frequency alternating current. Alternatively or additionally, an additional tool, such as a blade can be provided for mechanical cutting of the tissue.
• Actuation mechanisms which may require a high level of user understanding and thus lead to a high potential for incorrect operation.
• the instrument can be overloaded and destroyed as a result of a clamping, or the tissue can be clamped too weakly and thereby incompletely sealed, which can lead to excessive damage and bleeding of the patient's tissue.
• the basic idea of the present invention for solving the above object is that the functions necessary for operating the instrument are differentiated on the basis of the required labor force and associated labor force ranges are defined. A separate actuation mechanism is then provided for each of the different functions, and these actuation mechanisms are coupled in such a way that they are automatically switched or switched on.
• the task is characterized by a bipolar
• Sealing instrument especially a combined sealing and
• the instrument has a second actuating mechanism, which has a motor, preferably an electric motor, and which is configured to operate the inventive device
• Sealing instrument to be automatically activated in a high load worker area to subsequently support the tool or motor
• the tool is operated manually in a low-load worker area and thus allows sensitive tissue preparation from
• the (electric) motor is automatically switched on and the tool is operated by this motor or its operation is at least supported by a motor.
• the low load worker area is an area in which the for the
• the high-load worker area is an area in which tissue clamping of the patient's tissue takes place under great force.
• the high-load working position is a position of the tool and the actuation mechanisms in which the clamping force required to seal the patient's tissue has been reached.
• the patient tissue can be applied with little effort, i.e. nearly
• Handle elements for manual tissue preparation can be ergonomically optimized.
• connection of the electric motor in the hole load worker range enables high actuation or clamping forces to be built up without the instrument guidance being impaired as a result, which is why this can also be carried out calmly and in a controlled manner during tissue clamping. This avoids unnecessary tissue injuries.
• fatigue of the user is largely prevented and operation of the instrument by physically weaker users is unproblematic.
• the motor support or fully automated tissue clamping can ensure that the minimal tissue clamping / compression required for a method-appropriate
• vascular sealing takes place. Furthermore, the division of the actuation mechanism into a first and second actuation mechanism enables a simple structural design.
• the workforce areas in particular reaching the hole load force area and / or the hole load work position / position, can be direct or indirectly determined by sensors, for example by pressure, position or strain sensors. This means that the corresponding manpower / actuating forces do not have to be measured directly, but can also be recorded indirectly, for example derived from known mechanical variables such as a spring force and a position or path detection.
• strain gauges, incremental encoders for position detection, contacts or contact paths or switches can be used for this.
• a rotary encoder or torque sensor can be provided to monitor the operation of the electric motor.
• the electric motor can be a linear or rotary motor. in case of a
• Rotary motor can also be a gear for translation or reduction of the
• Torque and the speed and / or for converting the rotary movement into a linear movement e.g. a screw gear with a threaded spindle and a spindle nut.
• the tool / effector provided on the instrument tip preferably has pliers-like branches that can be moved in relation to one another, which can be used for gripping the tissue, and electrodes for sealing and, if necessary, for
• Cutting / cutting the patient's tissue In principle, an additional blade can also be provided to cut the tissue.
• the (handle element-free) second actuation mechanism with a grip element of the first actuation mechanism during an actuation in the
• Actuation mechanism is in particular not coupled to a separate handle element.
• the second actuation mechanism is automatically switched on by actuating the handle element of the first actuation mechanism.
• Handle element for example, an operating lever, slide or button can be provided.
• the second actuation mechanism for example via the first actuation mechanism, is coupled to the tool by a spring element.
• This can act as an emergency overload protection serve if the electric motor is not purely force-controlled, but is operated, for example, path-controlled and the tool encounters unexpected resistance.
• the spring element can additionally serve as overload protection if a user continues to actuate the handle element despite reaching the high-load working position.
• the second actuation mechanism can be completely decoupled from the first actuation mechanism, at least during the actuation of the first actuation mechanism, so that no force is transferred to the second actuation mechanism during this time.
• the first actuation mechanism can optionally provide information about an actuation path or a position of the first actuation mechanism.
• the second actuation mechanism is configured such that it can be reset fully automatically or with motor assistance from the high-load working position.
• the motor support or resetting enables a precisely controllable or adjustable resetting from the high-load working position / position, in particular during an unlatching described later and associated with a further advantageous embodiment.
• a detection device is preferably configured to detect a first
• reaching the high-load working position can be achieved by registering a position (e.g. the
• Drawbar and / or the operating lever and / or an angle (e.g. the
• Actuating lever are detected.
• the first threshold actuation force is reached, at least one of the first and second actuation mechanisms latches and the electric motor is automatically deactivated, or the electric motor serves as
• the reset can either be completely manual and, if necessary, spring-assisted. It is possible to activate the electrodes for
• Detection device may be configured to detect a second threshold actuation force, which indicates the reaching of the Flochlast worker range.
• the electric motor of the second actuation mechanism is automatically activated when the second threshold actuation force is reached. That is, when the user exerts a force on the handle element that reaches or exceeds the second threshold actuating force, the electric motor is automatically switched on. Since this actuation on the part of the user is also common with conventional, in particular bipolar
• the first and / or second actuation mechanism is advantageously configured in order to lock in the working load position.
• the bolt load working position / position can be held safely and in an energy-saving manner and the locking can only be released by the user.
• the duration of the tissue clamping (clamping duration) and possibly the subsequent cutting process is determined by the user, so that the user can, for example, adapt a duration of the tissue clamping and sealing, depending on the tissue thickness and / or type.
• the invention can be modified in that at least the second actuation mechanism is configured to be held in the high-load working position by the electric motor.
• the resetting of at least the second actuation mechanism by the electric motor can take place fully automatically or in a motor-assisted manner and thus take place in a controlled manner. It is advantageous that no additional latching means have to be provided on the actuating mechanism and / or on the instrument housing, thus further simplifying the construction and saving space, weight and costs.
• first and / or second actuation mechanism can advantageously be motor-releasable from the high-load work position / position, depending on the process, in particular after a predetermined time, or the motor support can be provided by a manual initial actuation, e.g. a tapping of the operating lever can be initiated.
• the first and / or second actuation mechanism can also be released manually from the high-load working position.
• the first and / or second actuation mechanism latches when the high-load worker area is reached, wherein the latching can preferably be released by means of motor support triggered by a manual initial actuation.
• the user receives tactile and / or audible feedback when the high load worker range is reached. Furthermore, this can possibly further actuate the instrument
• the motor support can also ensure a uniform release of the latching, that is, the unlocking will. Manual release by the user would result in the instrument jerking.
• the second actuation mechanism in particular the activation, an actuation duration and the deactivation of the electric motor, can be controlled as a function of the process, in particular as a function of a sealing and possibly a cutting process. As already explained above, this can
• the electric motor is preferably the second
• Actuating mechanism automatically activated to achieve a clamping of patient tissue when the first and / or second actuating mechanism is locked and a sealing process is being initiated.
• Actuation mechanism can be started depending on the process, so that the clamping of the patient tissue does not take too long and this is therefore protected.
• Coagulation / sealing is feasible if a sealing process is initiated while the first and / or second actuation mechanism is not locked. In this way, the instrument can have both a sealing and possibly cutting function as well as an additional function of simple hemostasis.
• Fig. 1 shows a diagram showing the delimitation of different
• FIG. 2 shows the first embodiment of a combined sealing and cutting instrument according to the invention in a rest position
• Fig. 3 shows the instrument according to the first embodiment in one
• Fig. 4 shows the instrument according to the first embodiment in one
• Fig. 5 shows a modified variant of the instrument after the first
• FIG. 6 shows a second embodiment of the combined sealing and cutting instrument according to the invention in a transition position
• 1 shows a diagram which shows a workforce course
• the horizontal axis shows an expansion of the
• High load worker area B2 to illustrate which within a
• Instrument operation are carried out, which accordingly has a preparation phase for the preparation of patient tissue and a clamping phase for a sealing cutting process.
• the proportions and sizes shown are only exemplary in nature.
• the "sealing cutting process” is basically a simultaneous sealing and cutting of the tissue, e.g. by an appropriately designed electrode, in this preferred embodiment, however, the sealing is carried out by electrodes and, as a separate step, the cutting is carried out by a mechanical cutting blade (not shown), which is operated manually via a separate mechanism.
• the instrument 1 itself is a combined sealing cutting instrument which can carry out both process parts or steps, in particular within a single clamping phase.
• Preparation phase with a short actuation stroke and a low labor force. This corresponds to a manual actuation of a first actuating mechanism 3 having the actuating lever 2 in the low-load worker area B1.
• Threshold actuation force S2 is called. In this example, reaching the second threshold actuation force S2 by means of the strain gauge as one
• Detection device detected and thus by the actuation stroke of the
• Transition position is an automatic change from the low load Worker area B1 carried out in a high-load worker area B2, in which the further actuation of the instrument 1 is at least motor-assisted or, in particular, fully automatic.
• reaching the second threshold actuation force S2 can be detected, for example, by position or force sensors integrated in the first actuation mechanism 3 or by means of a contact activation. Supported or fully automatic by the electric motor 4 are now the worker / operating force and the
• the actuation stroke increases until a maximum clamping force is reached, which corresponds to a first threshold actuation force S1 as described above.
• the first threshold actuation force S1 can, for example, be the same
• Detection device such as the second threshold actuation force S2 are detected or detected and limited on the basis of a preset, maximum engine speed.
• the sealing cutting process can be carried out.
• the instrument 1 is released from the high-load working position / position by motor, initiated by a manual initial actuation (in particular in the case of mechanical locking of one of the actuation mechanisms 3, 5 in the high-load working position / position) or manually, and is manually spring-supported or motor-assisted or fully automatically returned from the high-load worker area B2 back to the low-load worker area B1.
• a manual initial actuation in particular in the case of mechanical locking of one of the actuation mechanisms 3, 5 in the high-load working position / position
• manually is manually spring-supported or motor-assisted or fully automatically returned from the high-load worker area B2 back to the low-load worker area B1.
• Fig. 2 shows cross-sectional view of the first embodiment of the
• Instruments 1 in a rest position, a corresponding sectional plane corresponding to a plane of symmetry of the instrument 1.
• Instrument 1 has a pistol-like structure with a
• Instrument housing 6 which has a holding section 7. Furthermore, the
• Actuating lever 2 is mounted on the instrument housing 6 at a first, inner end such that it can pivot about a bearing axis in such a way that a user grips the holding section 7 and an exposed second end of the actuating lever 2 with one hand and press them together to actuate the instrument 1, ie relative to one another can pivot.
• a return spring 8 is in the instrument housing 6 mounted and presses against the operating lever 2 to hold it in the rest position or to return it to the rest position.
• a leg of a U-shaped bow spring 9 is articulated at a distance from the bearing axis, which is articulated with its second leg to a tension element 10 and via which the
• Pivotal movement of the actuating lever 2 is converted into an axial movement of the tension element 10.
• the tension element is on the instrument shaft 11, which emerges at the mouth of the pistol-like instrument housing 6,
• the actuating lever 2 the bow spring 9 and the tension element 10 are part of the first actuating mechanism 3.
• the bow spring 9 is compressed when the first actuating mechanism 3 is excessively loaded and thus serves as one
• actuating lever 2 and the bow spring 9 optionally form a toggle lever for actuating the pulling element 10 in order to optimize a worker-actuating stroke ratio, ie in order to initially allow a small amount of labor for an actuation with a large actuating path of the pulling element 10 and to gradually shift a ratio thereof so that a large one in an end area, particularly in the high-load worker area B2
• FIG. 3 shows the instrument 1 according to the invention in a transitional position, ie at a point in time at which a second threshold actuation force S2 or an actuation stroke assigned to this second threshold actuation force S2 has been reached.
• the first actuating mechanism 3, in particular the actuating lever 2 is provided with a latching lug 12 which engages in the holding section 7 in the transition position and there presses an associated spring-loaded latching bolt 13 aside.
• the locking pin 13 and the locking lug 12 form a locking mechanism. Furthermore, reaching the second threshold actuation force S2 or the corresponding one
• Holding section 7 is arranged, automatically switched on.
• the latching mechanism or a contact between the first and the second actuation mechanism can serve as a switch to detect the second threshold actuation force S2, strain gauges 9 can be provided on the bow spring for direct measurement of the working force, or the like.
• the electric motor 4 is after this
• Gear mechanism to convert a rotary motion generated by it into a linear motion.
• the electric motor 4 has a drive rod 14 which is axially movable in the electric motor 4, substantially parallel or slightly inclined to the
• Holding section 7 instrument housing 6 extending, stored.
• the drive rod 14 is advanced by the electric motor 4.
• the drive rod 14 is rounded and forms a plunger 15, which may be designed as a contact for the contact activation of the electric motor 4.
• the plunger 15 bears against a guide surface 16 at a first end of a driver 17 and is adapted for this by the
• Electric motor 4 actuated to press against the guide surface 16 of the driver 17.
• the driver 17 is mounted at a second end in the instrument housing 6 so that it can pivot about a bearing axis such that a longitudinal axis of the driver 17 intersects a longitudinal axis of the actuating lever 2.
• the driver 17 is preferably fork-shaped or O-shaped and has two arms running on both sides of the actuating lever 2.
• a guide pin 18 is arranged such that when it reaches the transition position in a
• Guide groove 19 of the actuating lever 2 engages to mechanically couple the second actuating mechanism 5 to the first actuating mechanism 3, i.e. Transfer power.
• the guide pin 18 can also be in the
• Guide groove 19 may be arranged, in which case the guide groove 19 is shaped such that it enables free movement of the actuating lever 2, ie without the guide groove 19 transmitting force to the guide pin 18 by one To ensure complete decoupling of the two actuation mechanisms in the low-load worker area B1.
• the electric motor 4, the drive rod 14 and the driver 17 are part of the second actuation mechanism 5.
• the driver 17 serves as a transmission element, which makes it possible to transmit the power provided by the electric motor 4 with great force to the tool via the first actuating mechanism 3 in order to move the instrument 1 into the high-load working position as shown in FIG. 4. position.
• Actuating mechanism 3 snaps into place on the instrument housing 6.
• the electric motor 4 can only be switched on until a first threshold actuation force S1 or an actuation stroke, from which this first threshold actuation force S1 can be derived, is reached.
• Reaching the first threshold actuation force can be detected by the detection device as described above.
• a change in position of the first and / or second actuation mechanism 3, 5 can be detected by an incremental encoder or a contact path (for example between the plunger 15 and the guide surface 16 of the driver 17), or the first threshold actuation force S1 can be determined by limiting the engine speed or be set.
• Embodiment is at the same time the locking position is reached, the electric motor 4 can be deactivated and, if necessary, the drive rod 14 can be retracted.
• the second actuating mechanism 5, in particular the electric motor 4 is decoupled from the first actuating mechanism 3 when the high-load working position / position is reached. Since the first actuating mechanism 3 is also moved during motorized actuation in the high-load worker area B2 (clamping phase), in which the two actuating mechanisms 3, 5 are mechanically coupled, a release from the high-load working position / position as well as the complete one can Reset to the rest position can be controlled manually by the user.
• Actuating lever 2 switch on again and the resetting of the two
• Actuation mechanisms 3, 5 to support motor.
• the motor support is provided in particular in the operating area in which the
• Actuating lever 2 is unlatched or released again, since the actuating force for unlatching or releasing the actuating lever 2 is at least as great as that for engaging. It therefore makes sense to support the user not only when snapping in, but also when unlatching. It should be noted here that a
• Threshold actuating force (pressure point) for the unlocking, at which the motor support is switched on, must not be too small to prevent the actuating lever 2 from being unintentionally unlocked. In this case the
• Motorized support may only be activated if a force sensor measures the actuating force in the unlocking direction and a certain threshold actuating force is exceeded.
• the motor support can be realized in that the drive rod 14 is also coupled to the driver 17 in a pulling direction, for example by a combination of a groove and a pin.
• the drive rod 14 can with an actuation path, which corresponds to the position of the actuating lever 2 immediately before unlocking, with the locking bolt 13 or one arranged thereon Projection come into contact or engagement, in particular through the second end of the drive rod 14 facing away from the driver 17 or through a projection or recess area specially designed for this purpose on the drive rod 14.
• the latter option makes it possible to provide the motor support exclusively for unlatching the actuating lever and otherwise allowing undisturbed manual guidance.
• FIG. 5 shows a modified variant of the instrument 1 according to the invention according to the first embodiment. This corresponds essentially to the variant described above, which is why only its differences are explained below.
• no mechanical locking mechanism i.e. no locking lug 12 and no spring-loaded locking pin 13 are provided.
• the electric motor 4 remains activated even when the high-load working position / position is reached and serves as an electrical latching means or holding means in order to hold the instrument in the high-load working position / position (clamping position) during the sealing cutting process. In particular, this enables a clamping duration and a reset of the
• Control instruments in the high-load worker area B2 fully automatically, precisely and, in particular, depending on the process. Alternatively, you can use this
• FIG. 6 shows a cross-sectional view of the instrument 1 according to the invention according to a second embodiment in a transition position.
• the mechanical structure of this embodiment essentially corresponds to the first embodiment
• the locking lug 12 and the locking bolt 13 spring-mounted in the holding section 7 of the instrument housing 6 are arranged in such a way that they lock when the high-load worker area B2 is reached, ie in the transition position shown, and thus the user has a tactile and / or audible feedback of a termination of manual Actuation phase (preparation phase). Furthermore, for example
• Latching mechanism can also be used as a switch (e.g. a button or contact) which is actuated when it is latched, with a latching function serving as a starting condition in order to allow the second actuating mechanism 5 to be switched on or the electric motor 4 to be activated.
• a switch e.g. a button or contact
• a latching function serving as a starting condition in order to allow the second actuating mechanism 5 to be switched on or the electric motor 4 to be activated.
• Transition position corresponds, is done manually in the low-load worker area B1, whereby the user can prepare the patient tissue, position the instrument 1 and then bring it into the rest position or into the transition position.
• the starting condition is confirmed, for example the latching mechanism itself serving as a switch or contact confirming the starting condition in order to allow the activation of the electric motor 4.
• the sealing cutting process for sealing and cutting the patient tissue is started, for example by controlling the tool or the tool on it
• the electric motor 4 is automatically switched on in order to start the tissue clamping in a coordinated manner together with the sealing cutting process. If the starting condition is not fulfilled (ie, the actuation lever 2 is not locked) and the energization switch is nevertheless actuated, the electric motor 4 is not activated and simple, tissue-free coagulation is carried out, which is not in the sense of the sealing cutting process (vessel sealing Method) can be carried out.
• a current switch e.g. high-frequency button
• the electric motor 4 serves as a
• the electric motor 4 moves automatically into the rest position, the actuating mechanisms 3, 5 being reset fully automatically in the high-load worker area.
• the operating lever 2 Upon reaching the Transition position, the operating lever 2 must be released manually from the locking position.
• the actuation of the second actuating mechanism 5 in the high-load worker area B2 is directly assigned to the sealing cutting process and is carried out fully automatically and process-controlled (depending on
• the present embodiment is therefore distinguished by a control process-linked control, which is additionally linked to reaching the locking position of the actuating lever 2.
• tissue clamping which is at least motor-assisted, is automatically switched on for a sealing cutting process if certain conditions that occur as a standard during the process (ie energizing the electrodes or manually exerting a specific worker) are met without additional operations or
• the table below gives an overview of the exemplary embodiments of the present invention described by way of example, the columns for the first embodiment being denoted by “1, their modification being denoted by“ 1.1 ”and the second embodiment being denoted by“ 2. ”
• the left hand side of the table shows the workforce course (diagonal line).
• the individual rows each represent an actuation phase, from top to bottom: the preparation phase, the clamping phase, a reset from the high-load working position
• High load worker area B2 and a reset in the low load worker area B1. Furthermore, the column dividing lines represent the rest, transition or high-load working position. Reference symbol list

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• 2018
  • 2018-11-16 DE DE102018128870.0A patent/DE102018128870A1/de active Pending
• 2019
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  • 2019-11-15 CN CN201980074075.5A patent/CN112996451A/zh active Pending
  • 2019-11-15 US US17/293,937 patent/US20220008119A1/en active Pending
  • 2019-11-15 WO PCT/EP2019/081482 patent/WO2020099633A1/de unknown
  • 2019-11-15 EP EP19809003.7A patent/EP3880100A1/de active Pending
  • 2019-11-15 KR KR1020217018360A patent/KR20210093301A/ko unknown
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