WO1996024293A1 - Agrafeuse chirurgicale - Google Patents

Agrafeuse chirurgicale Download PDF

Info

Publication number
WO1996024293A1
WO1996024293A1 PCT/EP1996/000031 EP9600031W WO9624293A1 WO 1996024293 A1 WO1996024293 A1 WO 1996024293A1 EP 9600031 W EP9600031 W EP 9600031W WO 9624293 A1 WO9624293 A1 WO 9624293A1
Authority
WO
WIPO (PCT)
Prior art keywords
clip
applicator according
shaft tube
magazine
head part
Prior art date
Application number
PCT/EP1996/000031
Other languages
German (de)
English (en)
Inventor
Arnold Pier
Jörg HUMMEN
Original Assignee
Arnold Pier
Hummen Joerg
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Arnold Pier, Hummen Joerg filed Critical Arnold Pier
Publication of WO1996024293A1 publication Critical patent/WO1996024293A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for 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
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable

Definitions

  • the invention relates to a surgical clip applicator according to the preamble of claim 1.
  • Such clip applicators are used for example for laparoscopic surgery, but can also be used for open surgery.
  • the clip applicator is inserted through a trocar sleeve e.g. introduced into the abdominal area.
  • a plurality of metal clips are fed from a clip magazine to a plier-type applicator head located at the end of a hollow tube.
  • the application head is actuated by an actuating device and a thrust element which can be displaced longitudinally in the tube. After inserting the foremost clip from the magazine into the closing element and closing the clip, the next clip is brought into position in a spring-actuated manner.
  • Clamps that can be resorbed by the human body are also known, which can only be applied individually using a special clamp applicator.
  • the disadvantage of the known lamb applicators is that, owing to the complicated internal structure, they cannot be sterilized, so that they cannot be used repeatedly.
  • the invention has for its object to provide a surgical staple applicator that is resterilizable and that is suitable for staples made of plastic.
  • the invention advantageously provides that a head part of the shaft tube, which contains the clip magazine and the closing element, is detachably coupled to the proximal part of the shaft tube.
  • the clip applicator consists of only a few mechanical parts that can be sterilized without any problems.
  • the head section which is emptied of clamps, can be disposed of. After the clip applicator has been sterilized, a new sterile head part is put on, so that the clip applicator can be used again.
  • the invention accordingly provides that the elements not suitable for sterilization are accommodated in the disposable staple magazine in the head part.
  • clip applicators Since only the head part of the shaft tube and not the entire clip applicator has to be disposed of, a considerable reduction in costs is possible with regard to the use of clip applicators.
  • the staple magazine can hold a sufficient number of staples for an operation. If the number of staples is not sufficient for an operation, it is possible to replace an empty head part with a new one during the operation. Because the clips in the clip shaft are in engagement with one another, only all clips located in the clip magazine can be transported together.
  • the push rod of the proximal part of the socket acts on a spring-loaded piston element in the head part, the piston element being connected to a transport slide for the clips in the clip magazine.
  • the push rod actuates the piston element in the head part, which is spring-loaded and automatically resets due to the spring force when the push rod is moved in the proximal direction. In this way, it is only necessary for the push rod to exert a force in the diagonal direction on the piston element.
  • a locking tongue holds the clips in position in the clip magazine when the transport slide moves in the proximal direction.
  • the locking tongue thus prevents the clamps located in the clamp magazine from being moved in the proximal direction during the return movement of the piston element with the associated transport slide.
  • the locking tongue deflects in the groove in the head part in the di ⁇ tal direction when a clamp is being transported.
  • the locking tongue can thus one in di ⁇ taler Allow the clamp to be transported and only blocks the movement of the clamp in the proximal direction.
  • the transport slide has a sliding head which presses with a distal end face against a proximal end of a clip.
  • the transport slide can be deflected into a groove in the head part when moving in the proximal direction while passing over a clip located in the clip magazine. In this way, after the foremost clamp has been ejected, the transport slide can engage behind the clamp following in the clamp magazine, while the locking tongue holds it in position.
  • the clips have projections arranged on the outer sides of the legs, which engage recesses on the inner sides of the legs of another, proximally arranged clip which are adapted in the projections.
  • the second clip located in the proximal direction in the clip magazine, is held by the locking tongue, as a result of which all subsequent clips are also held in their position.
  • the head part is screwed to the proximal part of the shaft tube.
  • the head part can also be coupled to the proximal part of the shaft tube with a snap connection.
  • the staple shaft is inclined in the distal region of the head part relative to the longitudinal axis of the shaft tube by approximately 10 ° to 20 °, preferably 12 °.
  • the inclination of the staple well facilitates handling of the staple applicator during an intervention.
  • the closing element consists of a narrowing of the staple shaft at the distal end, in which the legs of the foremost staple close during advancement. Apart from the transport slide, such a closing element does not require any moving parts and is particularly suitable for plastic clips.
  • the locking part has at least partially the same outer contour as the clips and prevents the clip applicator from being operated incorrectly by the fact that it cannot be pressed together in the closing element. The surgeon is thus informed that there are no more brackets in the bracket magazine.
  • the shaft tube is preferably rotatably mounted in the handle and thus enables the shaft tube including the head part to be pivoted through 360 ° during the application.
  • the head part can have a viewing window so that during the operation it can be determined that enough clips are still present in the clip magazine.
  • the actuating device consists of a trigger lever mounted on the handle, which acts on the push rod.
  • the release lever is part of the push rod drive with which the piston element can be moved in the distal direction.
  • the release lever can be acted against the restoring force of the push rods by the force of a leaf spring which forms a displaceable stop for the release lever.
  • the stop formed by the leaf spring can be pushed back until the push rod is released.
  • the push rod can then be removed from the shaft tube and the actuator, making it easy to disassemble the clip applicator for sterilization.
  • FIG. 1 is a side view of a clip applicator
  • Fig. 2 is an enlarged view of the head part in
  • Fig. 3 shows a further cross section through the head part in a compared to FIG. 2 level offset by 90 °
  • Fig. 4 shows a second exemplary embodiment for the connection of the head part to the shaft tube.
  • the clip applicator 1 shown in FIG. 1 has a handle 2, in which an actuating device 4 consisting essentially of a release lever 18 and a push rod 8 is mounted. With the release lever 18, the push rod 8 can be pushed in the direction of the istal end 16 of the clip applicator 1. After completion of the actuation process, the push rod 8 is pushed back into the starting position by means of a return spring 5. The push rod 8 rests with a plunger 9 on the lever arm 21 of the release lever 18, a counter-torque being exerted on the lever arm 21 by a leaf spring 15. The leaf spring 15 forms a stop. The leaf spring 15 can be rotated counter to the usual direction of actuation, as a result of which the lever arm 21 is shifted further to the right in the drawing, as a result of which the push rod 8 can be removed from the shaft tube 6 for sterilization.
  • the shaft tube 6 is rotatably mounted in the housing 3 of the handle 2 and can be turned using a handle ring 7.
  • the shaft tube 6 receives in its distal region 16 in a head part 17 a clip magazine 12, which essentially consists of a clip shaft 26 and a transport slide 24.
  • the shaft tube 6 receives the head part 17 as an exchangeable unit, which is detachably connected to a proximal part 20 of the shaft tube 6.
  • the shaft tube 6 is rotatably connected to the grip ring 7 and coupled to the housing 3 via the grip ring 7.
  • the push rod 8 runs in a circular cross section through the grip ring 7 into the housing 3, the push rod 8 having at its proximal end a plunger 9 which abuts the lever arm 21 located in the housing 3.
  • the return spring 5 consists of a helical spring which surrounds the proximal end of the push rod 8 and which abuts at one end against the end face of the plunger 9 opposite the lever arm 21 and is supported at the other end against a disk ring 29 which can be displaced on the push rod 8, which in turn is attached to the shaft tube 6.
  • the plunger 9 is, for example, screwed onto the proximal end of the push rod 8.
  • the clip applicator 1 can be completely dismantled in a few simple steps. As already mentioned, the head part 17 with the closing element 14 and the clip magazine 12 can be removed. After loosening screws, the shaft tube 6 can be separated from the housing 3.
  • the head part 17 is preferably made of plastic and is a disposable article that cannot be resterilized.
  • the other elements of the clip applicator 1, on the other hand, can be dismantled and have a simple structure, so that resterilization is possible without problems.
  • the clip applicator 1 is therefore preferably made of metal.
  • a view window can be located laterally in the clip magazine 12, which allows a visual inspection of the clips 10 still located in the clip magazine 12.
  • the shaft tube has a circular shape in cross section with a maximum diameter of approximately 10 to 15 mm, preferably 12 mm. It is a major advantage of the design that such a small cross-sectional diameter can be achieved.
  • a locking part 11 can be provided which essentially corresponds to the clip 10 in its outer contour, but which, in contrast to the clip 10, cannot be pressed by the closing element 14.
  • the locking part 11 therefore serves to prevent the clip applicator 1 from being emptied without a clip 10. An actuation of the closing element 14 is excluded with the locking part 11.
  • FIG. 2 shows the interchangeable head part 17, which is connected to the proximal part 20 of the shaft tube 6 via a thread 38.
  • the push rod 8 protrudes from the proximal part 20 and engages in a sleeve part 34 of the head part 17, at the free end of which the thread 38 is provided.
  • the distal end face 40 of the threaded sleeve 34 forms a stop for a piston element 25 which is spring-loaded in the proximal direction.
  • the piston element 25 is pressed against the end face 40 by a compression spring 23, the compression spring 23 being supported on the clip magazine 12 at its distal end.
  • a transport slide 24 is fastened to the piston element 25 and serves to transport the clamps 10 in the clamp magazine 12.
  • the clip magazine can consist of two halves, namely a lower part 35 and an upper part 36. Between the upper part and the lower part 35, 36 of the clip magazine 12, a clip shaft 26 is kept free, in which several clips 10 arranged one behind the other and in engagement with one another are arranged.
  • the transport slide 24 with a slide head 27 at its distal end is in contact with the proximal end of the foremost clip 10 in the clip magazine 12.
  • a locking tongue 19 fastened to the lower part 35 of the clip magazine 12 is shown in FIG. 2 upwards into the bracket shaft 26.
  • the di ⁇ tale end of the locking tongue 19 lies against the proximal end of the second clip in the clip magazine 12 and prevents all clips in the clip magazine from sliding back in the proximal direction during the movement of the transport slide 24. If the transport slide 24 is moved in the distal direction as a result of the actuation of the push rod 8, the legs 10a and 10b of the clip 10 close as a result of the closing element 14, which provides a narrowing 42 at the distal end of the clip magazine 12.
  • the forward movement of the foremost clamp 10 closes it automatically, with projections 44 protruding from the legs 10a, 10b and corresponding projections 44 of the opposite leg 10a, 10b lock, whereby the clip is closed and at the same time ejected from the clip shaft 26.
  • the projections 13 arranged on the outside of the legs 10a, 10b also detach themselves from the recesses 30 of the clamp 10 lying behind them in the proximal direction move back the action of the compression spring 23.
  • the sliding head 27 can be deflected upwards due to a bevel on its proximal side and a groove 22 in the upper part 36 of the clip magazine 12 when it slides over the foremost clip 10 in the clip magazine 12.
  • the locking tongue 19 holds all the clips 10 located in the clip magazine 12 in their position.
  • the last clip 10 in the clip magazine 12 is in engagement with a locking part 11, which at least partially corresponds to a clip in its outer contour, and which has the task of blocking the triggering process in order to indicate to the operator that the clip magazine 12 is empty and against one new must be exchanged.
  • FIG. 4 shows an alternative embodiment for coupling the head part 17 to the proximal part 20 of the shaft tube 6.
  • a latching connection 31 is provided, in which two spring levers 46 are inserted into the proximal part 20 of the shaft tube 6 and there with outward facing Snap projections 48 into the corresponding recess 50 of the shaft tube 6.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Reproductive Health (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

Une agrafeuse chirurgicale (1) comprend une poignée (2) avec un dispositif d'actionnement (4) et une tige tubulaire (6) assujettie à la poignée (2). Une bielle (8) montée dans la tige tubulaire peut être déplacée dans le sens longitudinal par le dispositif d'actionnement (4) et peut retrouver sa position initiale au moyen d'un ressort. Un magasin d'agrafes (12) situé dans la tige tubulaire (6) abrite plusieurs agrafes (10). Un élément de fermeture (14) des agrafes (10) est situé à l'extrémité distale (16) de la tige tubulaire (6). Une partie frontale distale (17) de la tige tubulaire (6) contient le magasin d'agrafes (12) et l'élément de fermeture (14). Cette partie frontale (17) est couplée de façon détachable à la partie proximale (20) de la tige tubulaire (6).
PCT/EP1996/000031 1995-02-08 1996-01-05 Agrafeuse chirurgicale WO1996024293A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE1995104002 DE19504002A1 (de) 1995-02-08 1995-02-08 Chirurgischer Klammerapplikator
DE19504002.3 1995-02-08

Publications (1)

Publication Number Publication Date
WO1996024293A1 true WO1996024293A1 (fr) 1996-08-15

Family

ID=7753373

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1996/000031 WO1996024293A1 (fr) 1995-02-08 1996-01-05 Agrafeuse chirurgicale

Country Status (2)

Country Link
DE (1) DE19504002A1 (fr)
WO (1) WO1996024293A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103356266A (zh) * 2013-08-05 2013-10-23 杭州康基医疗器械有限公司 一次性钛夹钳同步异向操作装置

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10120367A1 (de) * 2001-04-25 2002-10-31 Arnold Pier Chirurgischer Klammerapplicator
DE102010037758A1 (de) * 2010-09-24 2012-03-29 Aesculap Ag Chirurgisches Halteinstrument, chirurgisches Instrumentarium und chirurgisches Handhabungsinstrument
DE102021134277A1 (de) 2021-12-22 2023-06-22 Karl Storz Se & Co. Kg Medizinisches Instrument

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1984001280A1 (fr) * 1982-09-30 1984-04-12 United States Surgical Corp Dispositif d'application d'agrafes chirurgicales a machoires fixes
GB2162782A (en) * 1984-08-09 1986-02-12 American Cyanamid Co Improved surgical instrument
EP0442482A2 (fr) * 1990-02-13 1991-08-21 Ethicon, Inc. Agrafeuse chirurgicale à tête rotative pour la peau
EP0536903A2 (fr) * 1991-09-12 1993-04-14 Ethicon, Inc. Mécanisme d'agrafage endoscopique, à actionnement multiple
EP0576835A2 (fr) * 1992-06-30 1994-01-05 American Cyanamid Company Pince chirurgicale de ligature en deux pièces et applicateur modulaire de pince de ligature
EP0605254A2 (fr) * 1992-12-31 1994-07-06 Pilling Weck Incorporated Instrument chirurgical
DE9413296U1 (de) * 1994-08-17 1994-10-13 Aesculap Ag, 78532 Tuttlingen Chirurgisches Anlegegerät für Clipse
EP0622048A1 (fr) * 1993-04-27 1994-11-02 American Cyanamid Company Applicateur laparoscopique et automatique de pinces de ligature
EP0622049A1 (fr) * 1993-04-29 1994-11-02 Ethicon, Inc. Méchanisme endoscopique pour procédure ouverte combinée et méthode d'utilisation

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1984001280A1 (fr) * 1982-09-30 1984-04-12 United States Surgical Corp Dispositif d'application d'agrafes chirurgicales a machoires fixes
GB2162782A (en) * 1984-08-09 1986-02-12 American Cyanamid Co Improved surgical instrument
EP0442482A2 (fr) * 1990-02-13 1991-08-21 Ethicon, Inc. Agrafeuse chirurgicale à tête rotative pour la peau
EP0536903A2 (fr) * 1991-09-12 1993-04-14 Ethicon, Inc. Mécanisme d'agrafage endoscopique, à actionnement multiple
EP0576835A2 (fr) * 1992-06-30 1994-01-05 American Cyanamid Company Pince chirurgicale de ligature en deux pièces et applicateur modulaire de pince de ligature
EP0605254A2 (fr) * 1992-12-31 1994-07-06 Pilling Weck Incorporated Instrument chirurgical
EP0622048A1 (fr) * 1993-04-27 1994-11-02 American Cyanamid Company Applicateur laparoscopique et automatique de pinces de ligature
EP0622049A1 (fr) * 1993-04-29 1994-11-02 Ethicon, Inc. Méchanisme endoscopique pour procédure ouverte combinée et méthode d'utilisation
DE9413296U1 (de) * 1994-08-17 1994-10-13 Aesculap Ag, 78532 Tuttlingen Chirurgisches Anlegegerät für Clipse

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103356266A (zh) * 2013-08-05 2013-10-23 杭州康基医疗器械有限公司 一次性钛夹钳同步异向操作装置
CN103356266B (zh) * 2013-08-05 2015-08-19 杭州康基医疗器械有限公司 一次性钛夹钳同步异向操作装置

Also Published As

Publication number Publication date
DE19504002A1 (de) 1996-08-14

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