ES2692356T3 - Dispositivo para tratamientos de resección endoscópica/ablación de tejidos - Google Patents
Dispositivo para tratamientos de resección endoscópica/ablación de tejidos Download PDFInfo
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- ES2692356T3 ES2692356T3 ES10742551.4T ES10742551T ES2692356T3 ES 2692356 T3 ES2692356 T3 ES 2692356T3 ES 10742551 T ES10742551 T ES 10742551T ES 2692356 T3 ES2692356 T3 ES 2692356T3
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- tubular element
- electric motor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/12—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B25—HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
- B25F—COMBINATION OR MULTI-PURPOSE TOOLS NOT OTHERWISE PROVIDED FOR; DETAILS OR COMPONENTS OF PORTABLE POWER-DRIVEN TOOLS NOT PARTICULARLY RELATED TO THE OPERATIONS PERFORMED AND NOT OTHERWISE PROVIDED FOR
- B25F5/00—Details or components of portable power-driven tools not particularly related to the operations performed and not otherwise provided for
- B25F5/008—Cooling means
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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
- A61B2017/0023—Surgical instruments, devices or methods, e.g. tourniquets disposable
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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
- 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
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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
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00734—Aspects not otherwise provided for battery operated
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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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22079—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with suction of debris
Abstract
Un dispositivo (1) para tratamientos de resección/ablación endoscópica de tejidos, que comprende: - una pieza de mano apta para ser sujetada por un usuario; - un elemento tubular externo (3) que comprende un extremo proximal, un extremo distal y una abertura de corte 5 dispuesta en dicho extremo distal; - un elemento tubular interno (4) apto para ser alojado de manera pivotante en dicho elemento tubular externo (3) y que comprende un extremo proximal, un extremo distal y una punta de corte en su extremo distal; - medios (5) de guía para hacer girar y/u oscilar dicho elemento tubular interno (4) con respecto a dicho elemento tubular externo (3); - dichos medios (5) de guía comprenden un motor eléctrico (19) y medios (20) de alimentación eléctrica para el motor eléctrico (19); y - dichos medios (5) de guía están contenidos dentro de dicha pieza (2) de mano caracterizado porque el dispositivo (1) comprende un circuito de succión y de enfriamiento, que tiene una conexión (9) para un aparato de succión, fuera de la pieza (2) de mano, al menos un conducto (43) que guía, desde dicha conexión (9), el fluido de enfriamiento hasta el elemento tubular interno (4) y hasta un dispositivo de regulación de la succión; el dispositivo de regulación de la succión comprende una espita (14) y una palanca (13), proporcionadas en la pieza (2) de mano para controlar la espita (14) desde fuera; el circuito de enfriamiento tiene una porción (45) de intercambio térmico con dicho motor eléctrico (19) para limitar su calentamiento.
Description
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DESCRIPCION
Dispositivo para tratamientos de reseccion endoscopica/ablacion de tejidos
La presente invencion versa sobre un dispositivo para tratamientos de reseccion endoscopica/ablacion de tejidos. En particular, la invencion versa sobre un dispositivo endoscopico para tratamientos de reseccion de tejido blando o de tejido oseo (con la ablacion relativa de los fragmentos producidos por tal accion).
Como alternativa a la cirugfa tradicional, que requiere una incision relativamente ancha para acceder al sitio quirurgico dentro del cuerpo humano, los procedimientos endoscopicos utilizan accesos naturales o como alternativa la creacion de portales pequenos (incisiones mfnimas en el tejido); por lo tanto, se suele hacer referencia a la cirugfa endoscopica con el termino de cirugfa mfnimamente invasiva. Las dos ventajas principales de la cirugfa endoscopica son la curacion mas rapida de los tejidos tras la operacion quirurgica y la menor exposicion de los tejidos internos al riesgo de una infeccion. Los desarrollos tecnologicos en este campo quirurgico, tambien denominado “cerrado”, han dado lugar a la creacion de muchos instrumentos mfnimamente invasivos, dado que el acceso al sitio quirurgico se lleva a cabo a traves de uno o mas portales. Tales instrumentos deben ser lo suficientemente alargados y lisos para permitir la entrada y el uso con un trauma pequeno para los tejidos circundantes. Una porcion del instrumento, denominado normalmente “porcion distal”, esta, asf, concebida para tener acceso al sitio quirurgico; la porcion opuesta, normalmente indicada como “porcion proximal”, permanece en el exterior del cuerpo del paciente. Normalmente, se proporciona la porcion distal del instrumento para tratar el tejido con el que hace contacto, estando estudiadas debidamente, por lo tanto, su forma y sus dimensiones en funcion de la operacion quirurgica particular para la que este destinado.
La porcion proximal esta dotada, en vez de ello, de un mecanismo para controlar, desde fuera del cuerpo del paciente, la funcion anterior. Los instrumentos motorizados quirurgicos endoscopicos, usados en la cirugfa “cerrada”, identificados normalmente como “rasuradores” endoscopicos, estan formados por un par de elementos coaxiales tubulares dispuestos concentricamente: un elemento externo que termina de manera distal con una abertura o “ventana de corte” y un elemento interno giratorio que tiene una superficie afilada en la ventana de corte. La accion giratoria del elemento tubular interno produce, por abrasion, la ablacion o el acabado del tejido, definiendose este procedimiento como “reseccion”.
Como en cada accion quirurgica, tambien en la cirugfa endoscopica, se proporciona la presencia de dos campos bien diferenciados: el campo esteril, el que esta en contacto proximo con el paciente, a traves del cual el cirujano llevara a cabo su operacion, y el que se encuentra claramente separado del paciente y de cualquier objeto que entre en contacto con el. Solamente el personal y los instrumentos tratados adecuadamente pueden acceder al campo esteril (procedimientos de esterilizacion para los instrumentos, procedimientos de lavado preoperatorios y la adopcion de ayudas de proteccion para el personal, como guantes y batas); todo lo que no pueda entrar en contacto con el campo esteril debe permanecer rigurosamente por fuera de el.
El documento US2007/0010823 describe un “rasurador” para operaciones artroscopicas y un sistema para llevar a cabo la succion y la irrigacion durante un procedimiento medico con el anterior “rasurador”.
El documento US 5.669.921 describe un dispositivo de corte que comprende:
- un tubo externo alargado que tiene un extremo proximal, un extremo distal y en dicho extremo proximal un casquillo para permitir la fijacion del tubo externo a un manguito alimentado de manera electrica; y
- un tubo interno alargado apto para ser recibido en dicho tubo externo, que tiene un extremo proximal, un extremo distal, una abertura interna en dicho extremo distal, una punta de corte y un casquillo dispuesto en el extremo proximal, permitiendo el casquillo la conexion del tubo interno para guiar los medios para el dispositivo de corte.
Se describen otros dispositivos medicos en los documentos US2004/092992, US2008/234715, WO96/29014, US2002/040229 y DE3136880. En particular, el documento US 2004/092992 A1 divulga un dispositivo segun el preambulo de la reivindicacion 1.
El solicitante ha notado que en los “rasuradores” endoscopicos que existen en la actualidad y/o en los descritos anteriormente, una pieza de mano que tiene internamente un pequeno motor electrico pone en rotacion y controla el elemento tubular interno: se lleva a cabo el accionamiento y el control bien mediante pulsadores colocados en el propio manguito o bien mediante pulsadores colocados en una pedalera. En ambos casos, las senales de alimentacion y de control llegan al manguito a traves de un hilo conectado con una fijacion externa. Esta “fijacion” esta dispuesta, normalmente, sobre un carrito suficientemente distante del campo de operacion para no contaminar el campo esteril. La pieza de mano (que hace contacto con el campo esteril) se ve sometida a un tratamiento de esterilizacion antes de cada operacion quirurgica; la fijacion, que tiene que permanecer fuera de todo contacto con la zona esteril, esta alojada fuera del campo mencionado anteriormente; en los sistemas que existen en la actualidad, se proporciona un hilo de conexion entre la pieza de mano y la “fijacion”. Tal hilo de conexion es tratado antes de cada uso para hacerlo completamente esteril y en la preparacion de la operacion quirurgica, se monta desde un lado de la pieza (esteril) de mano y desde el otro lado con la fijacion (no esteril). En los “rasuradores” que existen en la
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actualidad, la pieza de mano esta fabricada de un material metalico, de forma que no tenga un peso insignificante, y el hilo de conexion tenga un peso y una carga, de forma que limite el manejo del operario.
El personal del quirofano que es responsable del tratamiento y el manejo del instrumental al final de cada operacion, tiene que esterilizar las partes que se puedan volver a esterilizar (la pieza de mano y el hilo); la limpieza y la esterilizacion afectan de manera negativa a la vida util de los componentes esterilizables.
El personal del quirofano debe llevar a cabo, ademas, el almacenamiento en recipientes adecuados que garanticen la esterilidad, con el desperdicio de tiempo y consumo de espacio consiguientes.
Sin embargo, el personal del quirofano debe llevar a cabo el mantenimiento de los componentes que no se pueden esterilizar, es decir, la fijacion y la pedalera si esta presente, realizando inspecciones periodicas que pueden requerir intervenciones tecnicas mas complejas por personal cualificado.
El solicitante tambien ha notado que en las soluciones tecnologicas de la actualidad en el mercado o descritos, por ejemplo, en los documentos mencionados anteriormente, aun quedan algunas necesidades y algunos lfmites no satisfechos por superar: maniobrabilidad, ergonomfa, seguridad con respecto a la esterilidad, simplificacion del manejo y del mantenimiento.
El solicitante ha encontrado que con un dispositivo de reseccion endoscopica/ablacion de tejidos que tiene un motor electrico y medios de alimentacion electrica contenidos dentro de la pieza de mano, es posible aumentar la maniobrabilidad y la ergonomfa del propio dispositivo simplificando al mismo tiempo el manejo y el mantenimiento. La invencion se refiere a un dispositivo para tratamientos de reseccion endoscopica/ablacion de tejidos segun la reivindicacion 1. Se divulgan realizaciones preferentes en las reivindicaciones dependientes. El dispositivo para tratamientos de reseccion/ablacion endoscopica de tejidos segun la presente invencion esta libre, por lo tanto, de un hilo de alimentacion dado que tiene internamente los medios de gufa que comprenden medios motrices y de alimentacion.
Por lo tanto, se mejoran la ergonomfa y la flexibilidad operativa de los dispositivos para tratamientos de reseccion endoscopica/ablacion de manera notable.
Sin embargo, el personal del quirofano ya no debe llevar a cabo el mantenimiento de componentes tales como la fijacion y la pedalera si esta presente, realizando inspecciones que pueden requerir intervenciones tecnicas mas complejas por personal cualificado.
La presente invencion, en el aspecto mencionado anteriormente, puede tener al menos una de las caracterfsticas preferentes que se describen a continuacion.
Segun un aspecto preferente, la pieza de mano puede comprender una unidad de control para regular los medios de gufa.
Al proporcionar la unidad de control dentro de dicha pieza de mano, se mejoran adicionalmente la maniobrabilidad y la precision del dispositivo.
De manera ventajosa, la unidad de control puede comprender al menos un circuito electronico para regular las funciones y la velocidad del motor electrico y una pluralidad de pulsadores.
Preferentemente, el dispositivo tambien comprende un grupo de transmision de movimiento accionado por el motor electrico para hacer girar el elemento tubular interno con respecto al elemento tubular externo.
De manera ventajosa, el grupo de transmision de movimiento comprende al menos un arbol que soporta de manera pivotante el elemento tubular interno y al menos un pinon de control que hace girar el arbol, accionado por el motor electrico.
De manera ventajosa, al menos el arbol mencionado anteriormente esta fabricado de material plastico, reduciendo adicionalmente, de esta manera, el peso del dispositivo en aras de la ergonomfa y la maniobrabilidad del propio dispositivo. El dispositivo comprende un circuito de enfriamiento que tiene una conexion para un aparato de succion y un dispositivo de regulacion de la succion. El circuito de enfriamiento tiene una porcion de intercambio termico con el motor electrico para limitar el calentamiento del motor electrico, aumentando, de esta manera, la ergonomfa del dispositivo. El dispositivo de regulacion de succion comprende una espita y una palanca para controlar la espita desde el exterior.
Segun un aspecto ventajoso, el motor electrico es un motor sin escobillas.
Preferentemente la pieza de mano es estanca.
De manera ventajosa, al menos uno entre dicha pieza de mano y los medios de gufa es desechable.
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Preferentemente, solamente la pieza de mano es desechable.
Caracterfsticas y ventajas adicionales de la invencion seran mas evidentes a partir de la descripcion detallada de algunas realizaciones preferentes, pero no excluyentes, de un dispositivo para tratamientos de reseccion endoscopica/ablacion de tejidos, segun la presente invencion.
Tal descripcion sera expuesta aquf, en lo que sigue, con referencia a los dibujos anexos, dados solamente como indicacion y, por lo tanto, con un objetivo no limitante, en los que:
- la figura 1 es una vista lateral esquematica de un dispositivo para tratamientos de reseccion endoscopica/ablacion de tejidos segun la presente invencion;
- la figura 2 es una vista esquematica en seccion de un dispositivo para tratamientos de reseccion endoscopica/ablacion de tejidos segun la presente invencion, girada de manera angular con respecto a la figura 1;
- la figura 3 es una vista esquematica en seccion de una porcion ampliada del dispositivo de la figura 2;
- la figura 4 es una vista esquematica despiezada de una realizacion alternativa del dispositivo para tratamientos de reseccion endoscopica/ablacion de tejidos, segun la presente invencion;
- la figura 5 es una vista lateral esquematica en seccion de la pieza de mano del dispositivo para tratamientos de reseccion/ablacion endoscopica de tejidos mostrado en la figura 4;
- la figura 3 es una vista esquematica en seccion de una porcion interna del dispositivo en la figura 4.
Con referencia a las figuras 1-3, un dispositivo para tratamientos de reseccion/ablacion endoscopica de tejidos esta indicado con el numero de referencia 1.
El dispositivo 1 para tratamientos de reseccion endoscopica/ablacion de tejidos comprende una pieza 2 de mano apta para ser sujetada por un usuario, un elemento tubular externo 3, un elemento tubular interno 4 y medios 5 de gufa para hacer girar y/u oscilar el elemento tubular interno 4 con respecto al elemento tubular externo 3.
El elemento tubular externo 3 comprende un extremo proximal, un extremo distal y una abertura y/o una ventana de corte dispuesta en el extremo distal.
El elemento tubular interno 4 esta conformado y dimensionado de tal forma que sea recibido de manera pivotante en el elemento tubular externo 3 y comprende un extremo proximal, un extremo distal y una punta de corte en su extremo distal, orientado hacia la ventana de corte. La accion pivotante del elemento tubular interno 4 produce, mediante abrasion, la ablacion o el acabado del tejido, y se define este procedimiento como “reseccion”.
Los medios 5 de gufa comprenden un motor electrico 19 y medios 20 de alimentacion electrica para el motor electrico 19. Los medios 20 de alimentacion electrica y el motor electrico 19, segun un aspecto principal de la invencion, son recibidos completamente dentro de la pieza 2 de mano.
La capacidad de insertar en la pieza de mano todas las partes funcionales del dispositivo, en particular el motor electrico 19 y los medios 20 de alimentacion electrica, permite aumentar de manera notable la maniobrabilidad y la precision del movimiento del dispositivo segun la presente invencion con respecto a los dispositivos de corte presentes en el mercado, realizado por artroscopia.
El motor electrico 19 es preferentemente un motor de tipo sin escobillas, pero otro tipo de motor electrico con dimensiones adecuadas y potencia similar podrfa ser apto para este objetivo. El motor 19 es capaz de girar a una velocidad comprendida entre 400 y 4000 revoluciones por minuto.
El motor electrico 19 es controlado por una unidad que controla cada funcion del dispositivo 1, es decir, el comienzo, la rotacion o simple oscilacion del elemento tubular interno 4 con respecto al elemento tubular externo 3 y a la velocidad de rotacion del elemento tubular interno 4.
La unidad de control comprende al menos un circuito principal electronico 26, soportada por un circuito electronico 22 de soporte y por un circuito electronico auxiliar 25.
El circuito electronico 22 de soporte se extiende de manera axial dentro de la pieza 2 de mano entre el motor electrico 19 y un recipiente 23 de los medios 20 de alimentacion electrica, descrito a continuacion con mas detalle.
El circuito principal electronico 26 esta conectado con controles 27; 28, 29 de tipo pulsador que permiten seleccionar desde fuera el tipo de instruccion que ha de enviarse al circuito electronico principal 26, es decir, el encendido u apagado del dispositivo 1, el tipo de oscilacion/rotacion del elemento tubular interno 4 y la velocidad de rotacion.
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De manera ventajosa, se puede proporcionar una proteccion 30 de caucho para los controles 27; 28, 29 de tipo pulsador anteriormente mencionados.
El dispositivo de la figura 1 tambien muestra cinco LED 37 conectados con la unidad de control para indicar la velocidad de rotacion establecida.
Ademas, se puede evitar que el personal del quirofano que lleva a cabo el tratamiento y el manejo del dispositivo, tenga que llevar a cabo el lavado al final de cada operacion (con desinfectantes y detergentes adecuados) y, luego, la esterilizacion de las partes del dispositivo.
El personal del quirofano no debe realizar el almacenamiento del dispositivo en recipientes apropiados que puedan garantizar su esterilidad, con el consiguiente consumo de tiempo y espacio.
Segun se puede ver en la figura 1, el elemento tubular externo esta conectado a traves de una contratuerca 35 con la pieza 2 de mano.
Dentro de la pieza 2 de mano hay presente un grupo de transmision de movimiento, que comprende un reductor. En detalle, el elemento tubular interno 4 es accionado por un arbol 17 que a traves de un pinon motor 18 conecta de manera funcional el elemento tubular interno con el motor electrico 19.
Entre el pinon motor 18 y el arbol 17, un pasador giratorio de los pinones tambien esta dotado de una primera reduccion 36, de pinones de la primera reduccion 37 y de arandelas 38 de ajuste, segun se puede ver en la figura 3.
El arbol 17 esta soportado de una manera pivotante mediante un cojinete 32 y mediante un buje 34, colocados en el extremo axialmente distal con respecto al arbol 17.
Frontalmente, el grupo de transmision tiene una junta delantera 33, que gira de manera ajustada con el arbol 17, tambien comprendiendo dos arandelas 15 y 16 de ajuste. La junta delantera 33 separa el grupo de transmision de un circuito de enfriamiento, segun se describira mejor a continuacion.
Los medios 20 de alimentacion electrica estan representados por pilas alcalinas o baterfas de litio, pero se podrfa utilizar cualquier otro tipo de baterfas con este objetivo sin alejarse del alcance de la presente invencion. Las baterfas son alojadas dentro de un recipiente 23 proporcionado en el extremo proximal de la pieza 2 de mano.
El recipiente 23 tiene conexiones electricas adecuadas para alimentar el motor electrico 19 y una cubierta inmovil 10 para sustituir las baterfas y para la inspeccion de las conexiones electricas.
Preferentemente, el recipiente 23 tambien es estanco.
El motor electrico 19 esta alojado en una estructura 42 de motor que se extiende de manera axial al interior de la pieza 2 de mano.
La estructura 42 de motor contiene de manera central el pinon motor 18, en una posicion proximal, al menos parte de la unidad de control que controla y regula el motor 19 y frontalmente el grupo de transmision del movimiento. El dispositivo 1 segun la presente invencion comprende un circuito de succion y de enfriamiento, que tiene una conexion 9 para tal aparato de succion, fuera de la pieza 2 de mano y no mostrado en las figuras, al menos un conducto 43 que gufa el fluido de enfriamiento desde dicha conexion 9 hasta el elemento tubular interno 4 y hasta un dispositivo de regulacion de la succion.
El dispositivo de regulacion de la succion comprende una espita 14 y una palanca 13 para controlar la espita 14 desde fuera. De manera ventajosa, el circuito de enfriamiento tiene una porcion 45 de intercambio termico con dicho motor electrico 19 para limitar su enfriamiento.
Con este objetivo, la porcion 45 de intercambio termico se extiende de manera axial al interior de la pieza 1 de mano para pasar axialmente a traves de todo el motor 19.
Segun un aspecto ventajoso de la presente invencion, la pieza 2 de mano es estanca.
En las figuras 4-6, se muestra una realizacion alternativa y preferente de la presente invencion, completamente similar a la de las figuras 1-3, excepto por el hecho de que al menos una porcion del dispositivo 1, y en particular, la pieza 2 de mano es desechable o de un solo uso. Con este objetivo, los medios 5 de gufa son alojados dentro de un cuerpo 40 completamente alojado dentro de la pieza 2 de mano.
De esta manera, la porcion del dispositivo que es mas costosa se puede volver a utilizar, es decir, el motor y los medios de alimentacion.
Para permitir una extraccion simple y rapida de los medios 5 de gufa con respecto a la pieza 2 de mano, dicha pieza 2 de mano puede comprender una porcion distal 2a que soporta el elemento tubular externo 3 y el elemento tubular interno 4 y un extremo proximal 2b acoplable, de una manera inmovil, con la porcion distal 2a.
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La capacidad de realizar algunas partes, tales como la pieza 2 de mano, el elemento tubular externo 3 y el elemento tubular interno desechable 4, es decir, de un solo uso, reduce enormemente en cualquier caso los problemas relacionados con el almacenamiento y la esterilizacion de tales partes por el personal del quirofano.
Ademas, la capacidad de insertar dentro del cuerpo 40 algunas partes funcionales del dispositivo, en particular el motor electrico 19 y los medios 20 de alimentacion electrica, permite aumentar de manera notable la maniobrabilidad y la precision del movimiento del dispositivo segun la presente invencion con respecto a los dispositivos de corte para la artroscopia, que existen en la actualidad en el mercado.
En la realizacion mostrada en las figuras 4-6 tambien se proporciona la unidad de control en el cuerpo 40.
La unidad de control comprende, tambien en este caso, al menos un circuito electronico principal 26, soportado por un circuito electronico de soporte y por un circuito auxiliar 25.
El circuito electronico principal 26 esta conectado con controles 27; 28, 29 de tipo pulsador que permiten la seleccion desde fuera del tipo de instrucciones que han de enviarse al circuito electronico principal 26, es decir, el encendido o apagado del dispositivo 1, el tipo de funcion de oscilacion/rotacion del elemento tubular interno 4 y la velocidad de pivote.
De manera ventajosa, se proporciona en la pieza de mano para con tal fin una proteccion 30 de caucho para los pulsadores 27; 28, 29, en una posicion que corresponde a los controles mencionados anteriormente.
Preferentemente, segun la presente realizacion, dentro del cuerpo 40 tambien hay presente un grupo de transmision del movimiento que comprende un reductor con satelites.
En detalle, el elemento tubular interno 4 es accionado por un arbol 17, que por medio de un pinon motor 18, conecta de una manera funcional el elemento tubular interno con el motor electrico 19.
Entre el pinon motor 18 y el arbol 17, tambien se proporciona una caja 145 para el reductor con satelites 141, que comprende los satelites 142 y el arbol 143 de soporte de los satelites.
El grupo 60 de la transmision del movimiento tambien tiene dos cojinetes radiales 144, yuxtapuestos radialmente entre el arbol motor 17 y la caja del reductor con satelites.
El pinon motor 18 se acopla con los satelites 142 que transfieren el movimiento al arbol 17, a traves del arbol 143 de soporte con satelites.
De manera alternativa al grupo de transmision coaxial recien descrito, se podrfa proporcionar un grupo de transmision de cadena, tal como el descrito en la realizacion de las figuras 1-3 sin alejarse del alcance de proteccion de la presente invencion.
Los medios 20 de alimentacion electrica son representados por pilas alcalinas recargables o baterfas de litio, pero se podrfa usar con este fin cada uno de los otros tipos de baterfas sin alejarse del alcance de proteccion de la presente invencion.
Segun se muestra en las figuras 4 y 5, las baterfas estan alojadas dentro de un recipiente 23 proporcionado en el extremo mas proximal del cuerpo 40.
El recipiente 23 tiene las conexiones electricas adecuadas para alimentar el motor electrico 19 y una cubierta inmovil para sustituir las baterfas y para permitir inspecciones de las conexiones electricas.
Preferentemente, el recipiente 23 tambien es estanco.
En esta realizacion, el motor electrico 19 esta alojado dentro del cuerpo 40 de manera axial en el interior de la pieza 2 de mano.
El cuerpo 40 comprende de manera central el pinon motor 18, en una posicion proximal con respecto a la unidad de control que controla y regula el motor 19 y de manera frontal, tambien el grupo de transmision de movimiento. Incluso en esta realizacion, el dispositivo 1 comprende un circuito de succion y de enfriamiento que comprende una conexion 9 para un aparato de succion por fuera de la pieza 2 de mano y no mostrado en las figuras, al menos un conducto que gufa el fluido de enfriamiento desde dicha conexion 9 hasta el elemento tubular interno 4 y hasta un dispositivo de regulacion de la succion.
El dispositivo de regulacion de la succion, tambien en este caso, comprende una espita 14 y una palanca 13 para controlar la espita 14 desde fuera. El circuito de enfriamiento tiene una porcion de intercambio termico con dicho motor electrico 19 para limitar su calentamiento.
Claims (9)
- 51015202530354045REIVINDICACIONES1. Un dispositivo (1) para tratamientos de reseccion/ablacion endoscopica de tejidos, que comprende:- una pieza de mano apta para ser sujetada por un usuario;- un elemento tubular externo (3) que comprende un extremo proximal, un extremo distal y una abertura de corte dispuesta en dicho extremo distal;- un elemento tubular interno (4) apto para ser alojado de manera pivotante en dicho elemento tubular externo (3) y que comprende un extremo proximal, un extremo distal y una punta de corte en su extremo distal;- medios (5) de gufa para hacer girar y/u oscilar dicho elemento tubular interno (4) con respecto a dicho elemento tubular externo (3);- dichos medios (5) de gufa comprenden un motor electrico (19) y medios (20) de alimentacion electrica para el motor electrico (19); y- dichos medios (5) de gufa estan contenidos dentro de dicha pieza (2) de mano caracterizado porqueel dispositivo (1) comprende un circuito de succion y de enfriamiento, que tiene una conexion (9) para un aparato de succion, fuera de la pieza (2) de mano, al menos un conducto (43) que gufa, desde dicha conexion (9), el fluido de enfriamiento hasta el elemento tubular interno (4) y hasta un dispositivo de regulacion de la succion;el dispositivo de regulacion de la succion comprende una espita (14) y una palanca (13), proporcionadas en la pieza (2) de mano para controlar la espita (14) desde fuera;el circuito de enfriamiento tiene una porcion (45) de intercambio termico con dicho motor electrico (19) para limitar su calentamiento.
- 2. El dispositivo (1) segun la reivindicacion 1, caracterizado porque dicha pieza (2) de mano comprende una unidad de control para regular dichos medios (5) de gufa.
- 3. El dispositivo (1) segun la reivindicacion 2, caracterizado porque dicha unidad de control comprende al menos un circuito electronico (25; 26) para regular las funciones y la velocidad de dicho motor electrico (19) y una pluralidad de controles (27, 28, 29) de tipo pulsador.
- 4. El dispositivo (1) segun cualquiera de las reivindicaciones precedentes, caracterizado porque comprende un grupo de transmision de movimiento accionado por dicho motor electrico (19) para hacer girar dicho elemento tubular interno (4) con respecto a dicho elemento tubular externo (3).
- 5. El dispositivo (1) segun la reivindicacion 4, caracterizado porque dicho grupo de transmision de movimiento comprende al menos un arbol (17) que soporta de manera pivotante dicho elemento tubular interno (4) y al menos un pinon (18) de control para hacer girar, mediante el accionamiento de dicho motor (19), dicho arbol (17).
- 6. El dispositivo segun cualquiera de las reivindicaciones precedentes, caracterizado porque dicho motor electrico (19) es un motor sin escobillas.
- 7. El dispositivo segun cualquiera de las reivindicaciones precedentes, caracterizado porque dicha pieza (2) de mano es estanca.
- 8. El dispositivo segun cualquiera de las reivindicaciones precedentes, caracterizado porque al menos uno entre dicha pieza (2) de mano y dichos medios (5) de gufa es desechable.
- 9. El dispositivo (1) segun la reivindicacion 8, caracterizado porque solo se puede desechar dicha pieza de mano.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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CH00940/09A CH701320B1 (it) | 2009-06-16 | 2009-06-16 | Dispositivo per trattamenti di resezione/rimozione endoscopica dei tessuti. |
CH9402009 | 2009-06-16 | ||
PCT/IB2010/001411 WO2010146431A1 (en) | 2009-06-16 | 2010-06-14 | A device for treatments of endoscopic resection/removal of tissues |
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ES2692356T3 true ES2692356T3 (es) | 2018-12-03 |
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Application Number | Title | Priority Date | Filing Date |
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ES10742551.4T Active ES2692356T3 (es) | 2009-06-16 | 2010-06-14 | Dispositivo para tratamientos de resección endoscópica/ablación de tejidos |
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US (1) | US10299818B2 (es) |
EP (1) | EP2442946B1 (es) |
CH (1) | CH701320B1 (es) |
ES (1) | ES2692356T3 (es) |
WO (1) | WO2010146431A1 (es) |
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