RU2240740C2 - Surgical instrument - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: device has two handles, connection rod and body having exchangeable movable rotatable and fixable working parts like scissors. The device has trigger shaped as two-armed lever having one side of L-shaped spring-loaded hook on axle fixed in its slot. The second hook side is connected to fixed handle and interconnected to toothed spur rack of the movable handle. The two-armed cock has fixing protrusion in its lower part. The protrusion is engageable with fixed handle on radial surface slot. Cylindrical fit part with fixing worm hole for making fixation, button, spring, bushing and fixing member are manufactured to enable one to remove and change the movable working parts. Handle loops have removable rings manufactured from silicon rubber. Frontal edge of the fixed handle has profile of variable radius.

EFFECT: improved surgical operation features.

4 dwg

Description

The invention relates to surgical instruments and is intended for use in surgical and, in particular, in endosurgical operations.

Known surgical instrument (Journal of the company "DUFNER" 1992) in the form of scissors, tongs, grippers and clamps, containing a housing with an actuator and working movable parts (scissor blades, jaw clamps, grippers or tongs) connected to handles to hold tool and control of moving parts, as well as a mechanism for fixing the position of the working moving parts.

The simplest mechanism for fixing the position of the working moving parts in the only open position is the spring, and they are brought into the closed position and held in it only by the hand of the surgeon, which requires a constant voltage from the surgeon.

A tool with a locking mechanism in the form of serrated tooth-clamping elements requires a great effort, allows you to adjust the position of the working moving parts roughly and stepwise, which does not exclude the clamping of the tissue being operated on or vice versa with a compressible, for example, vessel, and when releasing the teeth connected by teeth, the cremaler requires considerable effort to creating a skew of the handles and their breeding, while there is an arbitrary movement (jerking) of the tool and, moreover, its working parts, which can injure them held Kani or the operated vessels.

Also known is a tool with a mechanism for fixing movable working parts, which also does not provide smooth adjustment and reliable fixation of moving parts in any position required by the surgeon, and also requires considerable effort and attention of the surgeon to the tool when it is released from the “clamped” position, because the gear rack can self-disconnect when it is accidentally grazed, since it is retained in engagement only by the force of the spring and is not mechanically insured against spontaneous folding, which is naturally an obstacle to and its use.

A known instrument as a prototype (patent application No. 95100458/14 (000890), the decision to grant a patent on 03/27/98), in which the mechanism for controlling the movable working parts and their fixation is made in the form of a spring-loaded radial cremalera, the gear surface of which interacts with a hook controlled by a trigger through the spring, which is part of the inner surface of the loop of the tool handle.

The main disadvantage of a tool with such a mechanism for controlling and fixing movable working parts is that when the tool is in the working position, it is often “clamped” that any movement of the surgeon’s finger in the limited internal space of the handle loop can lead to an accidental trigger pull and, therefore, to the opening working parts that during the operation can seriously complicate the operation. Another disadvantage of this tool is that the control mechanism does not turn off and this does not allow the tool to be used in the free, necessary for the surgeon mode, for example, in the mode of simple forceps without the locking mechanism, which narrows the applicability of the tool.

The essence of the invention is expressed by the following set of essential features that provide the surgeon with the convenience of working with a tool with the ability to select any convenient and necessary tool control mode.

This is ensured by the fact that a surgical instrument containing handles, traction and a housing with removable working movable parts in the form of scissors, forceps or clamps mounted with the possibility of rotation and fixation is additionally equipped with a trigger made in the form of a two-armed lever, in the groove of which is fixed on the axis one side of the L-shaped spring-loaded hook, the second side of the hook axially connected to the fixed handle and interconnected with the toothed rack of the movable handle, and the two-armed trigger has a locking tab in the lower part p placed with the possibility of interaction with a groove made on the radius surface of the fixed handle, while the cylindrical landing part with a groove for fixing, a button, a spring, a sleeve and a latch are made for removing and replacing working moving parts, the hinges of the handles are equipped with removable silicone rubber rings and the front edge of the fixed handle has a variable-radius profile.

Figure 1 shows a General view of the tool for endosurgery.

Figure 2 shows the locking device (section aa of figure 1).

Figure 3 shows a view of "B" - the position of the spring-loaded latch 15, when fixing the rotary node with the working parts 3.

Figure 4 shows a view "B" of the position of the two shoulders of the trigger 19, with the protrusion 20, relative to the groove 21, the handle 7 and the L-shaped hook 17 with the axes 16 and 18. The solid arrow shows the application of force to the upper shoulder of the trigger 19 and the direction of movement G -shaped hook 17. The dashed line shows the direction of application of force to the lower shoulder of the trigger 19 until the protrusion 20 is fixed in the groove 21, the handle 7 and the direction of movement of the L-shaped hook 17.

The tool of FIGS. 1, 2, 3 and 4 consists of a removable, rotatable-fixed assembly containing a rod 1, with a thickening 2 at one end and working movable parts 3 in the form of scissors, tongs or clamps at the other end, while the rod 1 located inside the cylindrical part 4 with an oval-ribbed handle 5 and the cylindrical part 6 with a fixed groove. A removable rotary-fixed unit with a fixed cylindrical part 6 with a fixed groove is connected to the housing of the front fixed handle 7, which is connected through the axis 8 to the rear movable handle 9, which has a groove 10 for connection with the thickened end 2 of the rod 1. The fixed handle 7 has a locking device ( figure 2), consisting of a button 11, a spring 12, a sleeve 13 and a latch. 14, fixing the groove of the cylindrical part 6, which ensures quick removal and installation of the entire rotary-fixed unit with working movable parts 3. In addition, a spring-loaded latch 15 is installed on the handle body 7 (Fig. 3), which ensures that the working parts 3 are fixed in the desired position after turning knob 5 in any direction.

In the slot of the front handle 7, an L-shaped hook 17 is mounted on the axis 16, the other axis 18 is connected to a two-arm trigger 19 having a protrusion 20 in the lower part, which interacts with a groove 21 on the radius of the front handle 7. The hook 17 of the L-shape is spring-loaded 22, located in the glass 23, and is interconnected with the gear rack 24, the rear, movable handle 9. The tool is equipped with an electrode 25 for connecting voltage when performing electrocoagulation. The hinges of the handles 7 and 9 are equipped with removable rings 26, for example, made of silicone rubber, and the front edge of the fixed handle 7 has a variable-radius profile, providing a convenient location of the instrument in the surgeon's hand.

The work of the proposed tool can be carried out according to any of the modes incorporated in its design.

The mode of changing the position of the working movable parts 3 from their position “open” to the position “closed” (clamped) with the fixation of any of their position in this interval, including their long fixed position is “clamped”, even when this tool is in this the moment is not in the hand of the surgeon working at the moment while another tool, and this happens during operations.

This mode is provided by mixing the handles 7 and 9, while the spring-loaded L-shaped hook 17 clicks on the teeth of the rack 24 and is fixed to it, at each moment of movement from the return stroke of the hook 17.

To disconnect (retract) the hook 17 from the cremalera 24, the surgeon just needs to press the upper shoulder of the trigger 19, the applied force (solid arrow of Fig. 4) is transmitted to the L-shaped hook 17, mounted on the axes 16 and 18, and it will move down and out meshing with the teeth of the cremallera 24. While holding the trigger 19 in the pressed position, the surgeon can manipulate the tool, changing the position of the working movable parts 3, as he needs, when releasing the trigger 19, the spring-loaded L-shaped hook 17 under the action of the spring 22 will return to mesh with the cremallera 24 and polo ix working parts 3 will be held again.

In order for the surgeon to be able to freely manipulate the tool and repeatedly change the position of the working parts 3, for example, working with scissor blades, he just needs to press the lower shoulder of the trigger 19, while the protrusion of the trigger 19 along the radius surface of the handle 7 will move forward and up to the fixation position in the groove handles 7, the L-shaped hook 17, mounted on the axes 16 and 18, will change its position (down) and will disengage from the gear rack 24, and will remain in this fixed position without holding the trigger 19 until the surgeon presses in The upper shoulder of the trigger 19 and will not lead him out of this position.

The quick replacement of the working parts 3 during the operation is carried out by turning off the rack 24, maximally diluting the handles 7 and 9, until the upper parts are closed, by pressing the locking button 11 and removing the entire rotary-fixed assembly, while the thickened end 2 of the link 1 is out of engagement of the groove 10 of the handle 9, and in place of the removed assembly in the reverse order, the assembly with other working parts 3 is instantly installed.

The spatial position of the working parts 3 is selected by turning the ribbed handle 5 to any side, the required position is fixed by a spring-loaded latch 15. Replacing the rod 1 with the working parts 3 is carried out by simply replacing the other parts 1 with the working parts 3 necessary for the surgeon and installing it in the removed rotary fixed unit with its subsequent installation on the tool.

Claims (1)

A surgical instrument containing handles, a rod and a housing with interchangeable working, movable parts in the form of scissors, forceps or clamps, mounted with the possibility of rotation and fixation, characterized in that it is equipped with a trigger made in the form of a two-armed lever, in the groove of which one is fixed on the axis side of the L-shaped spring-loaded hook, the second side of the hook axially connected to the fixed handle and interconnected with the toothed rack of the movable handle, and the two-armed trigger has a locking protrusion located at the bottom the ability to interact with a groove made on the radial surface of the fixed handle, while the cylindrical landing part with a groove for fixing, a button, a spring, a sleeve and a latch are made to remove and replace working moving parts, the hinges of the handles are equipped with removable silicone rubber rings, and the leading edge The fixed handle has a variable-radius profile.

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