FR2681775A1 - Pince pour chirurgie endoscopique a outil inclinable. - Google Patents

Pince pour chirurgie endoscopique a outil inclinable. Download PDF

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Publication number
FR2681775A1
FR2681775A1 FR9112328A FR9112328A FR2681775A1 FR 2681775 A1 FR2681775 A1 FR 2681775A1 FR 9112328 A FR9112328 A FR 9112328A FR 9112328 A FR9112328 A FR 9112328A FR 2681775 A1 FR2681775 A1 FR 2681775A1
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France
Prior art keywords
tool
jaw
support
axis
instrument
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FR9112328A
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FR2681775B1 (fr
Inventor
Professeur Meyer
Boutmy Christian
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BOUTMY ETS
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BOUTMY ETS
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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
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • 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
    • A61B17/2804—Surgical forceps with two or more pivotal connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2932—Transmission of forces to jaw members
    • A61B2017/2939—Details of linkages or pivot points

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention est du domaine de la chirurgie endoscopique et elle a pour objet une pince destinée à la cœlioscopie opératoire. Cette pince, comprenant une poignée (2) comportant des branches à anneau, dont l'une (4) mobile est montée pivotante sur l'autre (6) d'appui, solidaire d'un corps (8) allongé, en vue de manoeuvrer respectivement les mâchoires d'un outil (10), dont l'une (16) mobile est montée pivotante sur l'autre (18) d'appui, est principalement caractérisée en ce que l'outil (10) est inclinable par rapport à l'axe (38) longitudinal du corps (8), l'inclinaison de l'outil résultant du pivotement sur le corps (2) de la mâchoire d'appui (18); l'axe (32) de pivot de la mâchoire d'appui (18) sur le corps (2) et l'axe (30) de pivot de la mâchoire mobile (16) sur la mâchoire d'appui (18) sont confondus.

Description

L'invention est du domine de la chirurgie, et plus particulierement de la chirurgie endoscopnque ou endo-chirurgie, et elle a pour objet une pince notamment destinée à la coelioscopie opératoire.
On connaît des instruments pour endo-chirurgie du genre de ceux comprenant en une de leurs extrémités, dite proximale, une poignée de manoeuvre d'un outil à fonction de pince ou de ciseaux situé à l'autre extrémité, dite distale. La poignée comporte des branches à anneaux, dont l'une, dite mobile, est montée pivotante sur l'autre, dite fixe, qui est solidaire d'un corps allongé généralement tubulaire. L'outil est composé de deux machoires, dont l'une, dite mobile, est montée pivotante sur la première, dite d'appui, solidaire dudit corps allongé. L'outil est actionné au moyen de la poignée par l'intermédiaire d'une tringle se déplaçant à l'intérieur du corps, ladite tringle étant reliée en une de ses extrémités à la mâchoire mobile, et en son autre extrémité à la branche mobile à anneau. Pour permettre l'introduction de l'instrument dans une canule d'endo-chirurgie, l'outil, en position fermée, est dans le prolongement du corps.
Un inconvénient de ce genre d'instrument réside dans la nécessité pour le chirurgien d'opérer dans l'axe général de l'instrument. Or, il peut arriver qu'un obstacle (organe, vaisseau sanguin, etc...) se trouve situé entre la paroi incisée et le point de travail, ce qui détermine une zone d'incision qui peut ne pas être la plus favorable.
On a proposé pour palier à cet inconvénient, un endoscope pourvu d'un instrument auxiliaire dont l'extrémité distale est inclinable par déformation. Cet endoscope, décrit par le brevet FR 2556205 (WOLFF
GMBH), semble adapté pour des instruments tels que faisceau de fibres de verre ou sonde, mais présente un résultat insatisfaisant quant à la manoeuvre délicate d'instruments tels que ciseaux ou pinces.
Le but de l'invention est de proposer un instrument destiné à ltendo-chirurgie, du genre de ceux formant une pince ou un ciseau, qui permette au chirurgien, en lui offrant la possibilité de contourner un éventuel obstacle, d'opérer aisément et délicatement en de multiples points, sans nécessaire variation de l'inclinaison de l'instrument.
Selon l'invention, un instrument pour chirurgie endoscopique ou endo-chirurgie, du genre de ceux comprenant principalement en une de leurs extrémités, dite proximale, une poignée comportant des branches à anneau, dont l'une, dite mobile, est montée pivotante sur l'autre dite d'appui, qui est solidaire d'un corps allongé généralement tubulaire, et en leur autre extrémité, dite distale, un outil, composé de deux mâchoires, dont l'une, dite mobile, est montée pivotante sur l'autre, dite d'appui, qui est solidaire dudit coprs, l'outil étant manoeuvré au moyen des branches à anneau par l'intermédiaire d'une tringle se déplaçant à l'intérieur du corps, ladite tringle étant reliée d'une part à la mâchoire mobile, et d'autre part à la branche mobile, est principalement caractérisé en ce que l'outil est inclinable par rapport à l'axe longitudinal du corps.
Selon une forme préférée de réalisation, l'inclinaison de l'outil résulte du pivotement sur le corps de la mâchoire dite d'appui.
Préférentiellement, l'axe de pivot de la mâchoire d'appui sur le corps, et l'axe de pivot de la mâchoire mobile sur la mâchoire d'appui sont confondus.
La mâchoire d'appui est avantageusement manoeuvrable au moyen d'un anneau solidaire d'un manchon coulissant le long du corps en son extrémité proximale, ledit manchon étant relié à la mâchoire d'appui par une tringle se déplaçant à l'intérieur du corps.
Les tringles étant reliées de manière articulée sur les mâchoires, les axes d'articulation des tringles sur les mâchoires et l'axe d'articulation de l'outil sont de préférence alignés, cet alignement formant, en position fermée d'introduction de l'outil, un angle A d'environ 450 par rapport à l'axe longitudinal du corps, l'axe d'articulation de l'outil étant sensiblement situé sur l'axe longitudinal du corps.
Le manchon est avantageusement immobilisable sur le corps au moyen d'une vis de pression à tête moletée. L'instrument comprend favorablement des anneaux de maintien situés, de façon diamétralement opposés, aux environs de l'extrémité proximale du corps.
La présente invention sera mieux comprise et des détails en relevant apparaîtront à la description qui va être faite d'une forme préférée de réalisation, en relation avec les figures des planches annexées, dans lesquelles
- la fig.l est une vue extérieure longitudinale d'un instrument selon l'invention,
- la fig.2 est une vue en coupe longitudinale du même instrument,
- la fig.3 est une vue éclatée de l'outil d'un même instrument,
- la fig.4 est une vue assemblée du même outil,
- les fig.5 et 6 sont des représentations schématiques du fonctionement de l'outil.
Sur les fig.l et 2, un instrument pour endo-chirurgie comprend principalement en son extrémité proximale une poignée 2 comportant des branches à anneaux 4 et 6, un corps 8 allongé tubulaire et un outil 10 en son extrémité distale. L'une des branches 4 de la poignée, dite mobile, est montée pivotante sur l'autre 6, dite d'appui, qui est solidaire du corps 8. Le corps 8 est en outre doté de deux anneaux de maintien 12 et 14 situés, de façon diamétralement opposée, aux environs de l'extrémité proximale de l'instrument.
Sur la fig.2, l'outil 10 est composé de deux mâchoires 16 et 18, dont l'une 16, dite mobile, est montée pivotante sur l'autre 18, dite d'appui.
La mâchoire mobile 16 est manoeuvrée au moyen de la poignée 2, et plus particulièrement de la branche mobile 4, par l'intermédiaire d'une tringle 20 se déplaçant à l'intérieur du corps 8 : cette tringle 20 est reliée en son extrémité proximale à la branche mobile 4, et en son extrémité distale à la mâchoire mobile 16.
Cet instrument permet avantageusement de travailler en des points situés de part et d'autre de son axe général d'orientation, grâce à son outil 10 qui peut être incliné par rapport à l'axe longitudinal du corps 8. La mâchoire d'appui 18 est montée pivotante à l'extrémité distale du corps 8, et est manoeuvrée au moyen d'un anneau 22 solidaire d'un manchon 24 situé à l'extrémité proximale de l'instrument, et coulissant le long du corps 8. Le manchon 24 relié, à la mâchoire d'appui 18 par l'intermédiaire d'une tringle 26 se déplaçant à l'intérieur du corps 8 et conférant à ladite mâchoire d'appui 18 une inclinaison en la faisant pivoter, est immobilisable sur le corps 8 au moyen d'une vis de pression 28 à tête moletée.
Sur les fig.3 à 6, les tringles 20 et 26 sont reliées de manière articulée sur les mâchoires 16 et 18. L'axe de pivot 32 de la mâchoire mobile 16 sur la mâchoire d'appui 18 et l'axe de pivot 32 de la mâchoire d'appui 18 sur le corps sont confondus. Les axes d'articulation 34 et 36 des tringles 26 et 20 sur les mâchoires 18 et 16 et l'axe d'articulation 32 de l'outil 10 sont sensiblement alignés. Lorsque l'outil 10 est en position fermée d'introduction dans une canule, ledit alignement forme un angle A d'environ 450 par rapport à l'axe 38 longitudinal du corps. L'axe d'articulation 32 de l'outil 10 est sensiblement situé sur l'axe longitudinal 38 du corps.
Les fig.5 et 6 illustrent les mouvements de l'outil 10. L'ouverture de la pince, obtenue par pivotement de la mâchoire mobile 16, est représentée en trait interrompu sur les figures. Le pivotement de la mâchoire mobile 16 est obtenu par un coulissement 40 de la tringle 20 à laquelle elle est reliée, vers l'intérieur du corps de l'instrument. La fig.6 représente l'outil 10 incliné par rapport à l'axe général 38 de l'instrument. Cette inclinaison est obtenue par un coulissement 42, vers l'extérieur du corps, de la tringle 26 reliant la mâchoire d'appui 18 au manchon.
Bien que l'on ait décrit et représenté une forme préférée de réalisation, il doit être compris que la portée de la présente invention n'est pas limitée à cette forme mais qu'elle s'étend à tout dispositif comportant les caractéristiques ennoncées plus haut.

Claims (2)

REVENDICATIONS
1.- Instrument pour chirurgie endoscopique ou endo-chirur
gie, du genre de ceux comprenant principalement en
une de leurs extrémités, dite proximale, une poignée
(2) comportant des branches à anneau, dont l'une (4)
dite mobile, est montée pivotante sur l'autre (6) dite
d'appui, qui est solidaire d'un corps (8) allongé géné
ralement tubulaire, et en leur autre extrémité, dite
distale, un outil (10), composé de deux mâchoires,
dont l'une (16), dite mobile, est montée pivotante
sur l'autre (18), dite d'appui, qui est solidaire dudit
corps (8), l'outil (10) étant manoeuvré au moyen des
branches à anneau (4 et 6) par l'intermédiaire d'une
tringle (20) se déplaçant à l'intérieur du corps (8),
ladite tringle (20) étant reliée d'une part à la mâchoi
re mobile (16), et d'autre part à la branche mobile
(4) caractérisé :
en ce que l'outil (10) est
inclinable par rapport à l'axe (38) longitudinal du
corps 2.- Instrument selon la revendication l, caractérisé
en ce que l'inclinaison de
l'outil (10) résulte du pivotement sur le corps (8)
de la mâchoire (18 dite d'appui 3.- Instrument selon la revendication 2, caractérisé :
en ce que l'axe (32) de pivot
de la mâchoire d'appui (18) sur le corps (8), et l'axe
(30) de pivot de la mâchoire mobile (16) sur la mâchoire
d'appui (18) sont confondus ;
4.- Instrument selon la revendication 3, caractérisé :
en ce que la mâchoire d'appui
(18) est manoeuvrable au moyen d'un anneau (22) solidai
re d'un manchon (24) coulissant le long du corps (8)
en son extrémité proximale, ledit manchon (24) étant
relié à la mâchoire d'appui (18) par une tringle (26)
se déplaçant à l'intérieur du corps (8) 5.- Instrument selon la revendication 4, caractérisé
en ce que les tringles (20
et 26) étant reliées de manière articulée sur les mâ
choires (16 et 18), les axes d'articulation (36 et
34) des tringles (20 et 26) sur les mâchoires (16 et
18) et l'axe (32) d'articulation de l'outil (10) sont
alignés, cet alignement formant un angle A d'environ
450 avec l'axe (38) longitudinal du corps (8) lorsque
l'outil est en position fermée d'introduction dans
une canule, et
en ce que l'axe (32) d'articula
tion de l'outil (10) est sensiblement situé sur l'axe
(38) longitudinal du corps (8) 6.- Instrument selon la revendication 4, caractérisé
en ce que le manchon (24) est
immobilisable sur le corps (8) au moyen d'une vis de
pression (28) à tête moletée 7.- Instrument selon la revendication 1, caractérisé :
en ce qu'il comprend des anneaux
de maintien 12 et 14 situés, de façon diamétralement
opposés, aux environs de l'extrémité proximale du corps
(8).
FR9112328A 1991-10-01 1991-10-01 Pince pour chirurgie endoscopique a outil inclinable. Expired - Fee Related FR2681775B1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR9112328A FR2681775B1 (fr) 1991-10-01 1991-10-01 Pince pour chirurgie endoscopique a outil inclinable.

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
FR9112328A FR2681775B1 (fr) 1991-10-01 1991-10-01 Pince pour chirurgie endoscopique a outil inclinable.

Publications (2)

Publication Number Publication Date
FR2681775A1 true FR2681775A1 (fr) 1993-04-02
FR2681775B1 FR2681775B1 (fr) 1998-09-11

Family

ID=9417670

Family Applications (1)

Application Number Title Priority Date Filing Date
FR9112328A Expired - Fee Related FR2681775B1 (fr) 1991-10-01 1991-10-01 Pince pour chirurgie endoscopique a outil inclinable.

Country Status (1)

Country Link
FR (1) FR2681775B1 (fr)

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EP0732890A1 (fr) * 1993-12-06 1996-09-25 Heartport, Inc. Dispositifs et procedures de chirurgie intra-cardiaque
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US5582617A (en) * 1993-07-21 1996-12-10 Charles H. Klieman Surgical instrument for endoscopic and general surgery
US5626587A (en) 1992-10-09 1997-05-06 Ethicon Endo-Surgery, Inc. Method for operating a surgical instrument
US5662662A (en) 1992-10-09 1997-09-02 Ethicon Endo-Surgery, Inc. Surgical instrument and method
US5713951A (en) * 1993-02-22 1998-02-03 Heartport, Inc. Thoracoscopic valve prosthesis delivery device
DE19703600A1 (de) * 1997-01-31 1998-08-06 Wolf Gmbh Richard Medizinisches Instrument für endoskopische Eingriffe
US5792165A (en) * 1993-07-21 1998-08-11 Charles H. Klieman Endoscopic instrument with detachable end effector
US5814097A (en) * 1992-12-03 1998-09-29 Heartport, Inc. Devices and methods for intracardiac procedures
US5817119A (en) * 1993-07-21 1998-10-06 Charles H. Klieman Surgical instrument for endoscopic and general surgery
US5827323A (en) * 1993-07-21 1998-10-27 Charles H. Klieman Surgical instrument for endoscopic and general surgery
US5865361A (en) * 1997-09-23 1999-02-02 United States Surgical Corporation Surgical stapling apparatus
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US5972030A (en) * 1993-02-22 1999-10-26 Heartport, Inc. Less-invasive devices and methods for treatment of cardiac valves
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