WO2000059392A1 - Surgical instrument - Google Patents

Surgical instrument Download PDF

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Publication number
WO2000059392A1
WO2000059392A1 PCT/EP2000/002908 EP0002908W WO0059392A1 WO 2000059392 A1 WO2000059392 A1 WO 2000059392A1 EP 0002908 W EP0002908 W EP 0002908W WO 0059392 A1 WO0059392 A1 WO 0059392A1
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WO
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Application
Patent type
Prior art keywords
λ
hook
distal
surgical instrument
characterized
Prior art date
Application number
PCT/EP2000/002908
Other languages
German (de)
French (fr)
Inventor
Gerhard Buess
Ludger Schnieder
Klaus Roth
Heike Raestrup
Hans-Jörg SAILE
Original Assignee
Erbe Elektromedizin
Gerhard Buess
Fischer Sabine Cecile
Ludger Schnieder
Klaus Roth
Heike Raestrup
Saile Hans 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
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B17/295Forceps for use in minimally invasive surgery combined with cutting implements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445Probes 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00353Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • A61B2017/2945Curved jaws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/30Surgical pincettes without pivotal connections
    • A61B2017/303Surgical pincettes without pivotal connections with four or more legs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00404Blood vessels other than those in or around the heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00601Cutting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/126Generators therefor characterised by the output polarity bipolar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1412Blade
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1425Needle
    • A61B2018/1432Needle curved
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B2018/145Probes having pivoting end effectors, e.g. forceps wherein the effectors remain parallel during closing and opening
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B2018/1452Probes having pivoting end effectors, e.g. forceps including means for cutting
    • A61B2018/1455Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws

Abstract

Surgical instruments comprising a hook-shaped section are known. Said hook-shaped sections have a distal section with a free end and a proximal section which is connected to an actuating device. The invention is characterised in that the distal and the proximal sections are divided on a plane which runs substantially through the middle of the distal section, to form partial hooks. Said partial hooks are configured to be moved by the actuating device on an expansion plane, in such a way that the hook can be expanded in two parts.

Description

A surgical instrument

description

The invention relates to a surgical instrument according to the preamble of claim 1.

The Praperation, Disse tion and hemostasis carried be carried s nd steps of an operation which currently still using two or more different instruments. Here, a tool change is always associated with a time and organizational effort, which complicates the operations and moves into the long.

The implementation of minimally invasive operations required by the limited view of the surgical field especially true suitable methods of dissection gefaßfuhrender structures. The stilling of possibly occurring bleeding is due to the indirect access to the surgical field much more difficult than in open surgery so that a prophylactic hemostasis is particularly important in minimally invasive Chriurgie.

The energy necessary for the thermal hemostasis can be introduced into the tissue by means of laser radiation, ultrasonic vibration or high frequency current. The laser technology is still too expensive and complex and therefore only for acquired special applications such as in the ENT and neurosurgery importance.

Ultraschalldisektoren are increasingly used in operations and for have led a number of applications to a significant improvement of the surgical technique. Laser and ultrasound applicators are to purchase entails substantial costs 0th In the application of lasers also a number of security measures have to be taken.

When hemostasis by high-frequency current of the high frequency current can be coupled both monopolar and bipolar ^. The monopolar application has

Disadvantage that the Stom from the applicator through the patient to the neutral electrode and flows may arise thermal damage to tissues in this manner, where actually no energy input was intended. 0

Scissors or forceps are used for bipolar application, the current is limited to the tissue between the two electrodes. Such a device is known for example from DE 44 21 822 Cl known wherein a knife is provided for severing S tissue. Both the design and the handling of the known surgical instrument s nd consuming. A dissecting tissue by means of the instrument is almost impossible.

ιθ The invention has for its object, with the simplest possible means a combination of the functions of preparation that dissection and hemostasis to allow. This object is achieved by a surgical instrument according to claim. 1

A first essential point of the invention is that a blunt dissection by means of a hook-shaped

Instrument and a spread apart tissue with this one instrument is made possible in a simple manner. Thus, a significant relief in operations is achieved. Preferably, e is ne pressure device 0 is provided at least, which is connected to the actuating device and, fixed to a support member biasing member comprises that at least one of the distal portions for clamping of tissue or the like ^ is andruckbar in a movement substantially perpendicular to the spreading plane. This is another

Praparationsmoglichkeit created. Hiebei two pressing devices are preferably each with a pressure element are provided which are each andruckbar to a distal section. Preferably, the compression means 0 are here designed to simultaneously test prints of the two pressing elements to the distal portions, which facilitates the handling of the instrument.

The pressure elements are preferably such complementary, preferably schalenformig formed that they are andruckbar planar manner to the distal portions. In this way, despite low surface pressure a high holding force is ensured.

) Connected to said securing means cutting device is preferably provided which is such hindurchfuhrbar between the distal sections that the spread hook part resting tissue can be severed. So you can prepare with the instrument first, then take the fabric and pull apart and then cut.

Preferably electrical electrode means are provided at least at the distal part portions which are connected to a controllable current source so that a coagulation current can be supplied to the hook-hook tissue. This can be effected hemostasis.

If pressure elements are provided, so both of these pressure elements and on the hook

Electrode means are provided which are connected to a controllable current source, so that a coagulation current at spread-hook each between a distal portion and a pressing member for coagulating between the distal portion and the pressure element clamped tissue portions is preferably supplied. It can thus be coagulated spaced locations simultaneously captured tissue or a blood vessel at two spaced. After such coagulation a division between the coagulation sites without the risk of bleeding can be performed. Thus are the most important functions such as blunt dissection, prophylactic and acute hemostasis, coagulation and

By separation combined in a single instrument. This enables continuous operation, without having to change instruments. The use of high-frequency current as an energy source and its delivery via bipolar electrode has several advantages. are, firstly,

High frequency generators as standard in all well-equipped operating rooms. The energy input is still limited to the top between the electrodes tissue. Finally, the Koagulationserfolg by detection and evaluation of electrical parameters of current and voltage and the derived impedance of the tissue can be assessed and controlled accordingly.

Preferably, the distal portions are formed in such a mirror symmetry with rounded surfaces at their sides facing away from each other, that at least the distal portion of the hook has smooth outer surfaces in the unexpanded state. This can be with the

To set instrument tissue particularly safe without the risk lesions, prepare blunt. After preparing a portion of the tissue is charged and clamped or spread on the hook, then bipolar coagulation and finally severed. It is our goal here is to let take coagulation only until the vessels included in the charged tissues are closed. This should be avoided effects (such as carbonization) that occur with excessive heating of the vessel. This is achieved by a correspondingly controlled or controlled (or, for example, on the impedance-controlled) interrupting the power supply by the generator before the final drying out of the tissue. Furthermore, a hemostasis of vascular stumps and with smaller areal bleeding is made possible by the construction.

The actuating means preferably includes a distal hollow-rod-shaped section having a substantially smooth outer surface in which is movably mounted at least one proximal subsection. Such a structure can be manufactured with small dimensions. If the contact pressure elements are provided, the actuating device also comprises a distal hohlstabformigen portion having a substantially smooth outer surface, in which on the one hand at least a proximal portion, and the other, the holding elements of the

Pressure elements are movably mounted. The assembly is then particularly simple if one of the two proximal sections is fixedly attached to hohlstabformigen section, while the other part is for this purpose movable section. The holding elements are preferably mounted in such a way hohlstabformigen portion axially slidably on this, that the pressure elements to the hohlstabformigen section or even into the latter are zuruckziehbar. This is a particularly useful instrument for dissecting hook is created.

The hook elements are preferably guided in such a way relative to the proximal sections, that the pressing members come into abutment at least in spread-hook for axial displacement in the direction of the distal portions to this. By this positive connection of the movements thus two tong-like instruments safely taken by means of which tissue (and coagulated) can be formed.

Preferred embodiments of the invention emerge from the dependent claims.

The invention based on a near Ausfuhrunsbeispieles will be explained, which is described with reference to the accompanying drawings. Shown are

Fig. 1 shows an embodiment of the invention with a closed hook,

Fig. 2 shows the arrangement according to FIG. 1 spread-hook

s Fig. 3, the embodiment of Figures 1 and 2 applied to the hook part and pressing means

Fig. 4 shows the arrangement of Figures 1 to 3 with extended cutting device for cutting through tissue 10 of

In the following description for identical and identically acting parts are used the same reference numbers.

i As shown in Fig. 1, the Ausfuhrunsform of the surgical instrument according to the present invention a umfaß hohlstabformigen portion 40, which leads to not shown here holding and actuating elements at a proximal portion. 0

From the here shown in the figures distal end of the hohlstabformigen portion 30 projects a hook-shaped portion 10 having a proximal portion 12 and a distal from this projecting vertically upward portion 11

includes 2 ^, which has a free end. 13 The hook-shaped

Portion 10 is 10 λ and a second part hook 10 λ x of a first portion of hook, wherein the hook part 10, 10 respectively λ substantially equal shaped distal portions 11 λ, 11 λ λ and proximal sections 12,

V) having 12 x. The distal sections 11 λ, ll 11 are in the embodiment shown here designed as a half-truncated cones, with the outer surfaces 14 ', 14 λ are rounded to form said truncated cone. The thus-formed hooks is suitable (as shown in Fig. 1 position) for blunt dissection as a "normal" Praparationshaken.

In the embodiment shown here Ausfuhrunsform one of the proximal portions is 12 λ of the first part of the hook 10 fixedly connected λ with the hohlstabformigen portion 40, while the other proximal portion of section 12 x λ of the second hook 10 ^ with respect to the first proximal section 12 Λ or first relative to the part of hook 10 is pivotable such λ that the distal sections 11, 11 λ from the position shown in Fig. 1 collapsed position can be moved apart to a position shown in figures 2- 4 spread position.

Furthermore, excellent compression means 40 20 λ, 20 λ λ along the axis of hohlstabformigen portion 40 are disposed slidably in the embodiment shown here from the hohlstabformigen section. The compression means 20, 20 comprise a λ λ excellent from the hohlstabformigen portion 40 holding element 21 λ, 21 as well as at the end of each pressure element 22 a v, 22 λ. The pressure elements 22, 22 Λ Λ instruct your, the portion of hook 10, 10 λ facing sides rounded surfaces, which are shaped such that they during a displacement of the pressure elements 20 ', 20 λ of the hohlstabformigen section 40 out towards the hook-shaped portion 10 in engagement with the distal portions 11 λ, 11 λ x arrive, as shown in particular in figures 3 and 4. FIG.

Between the sub-hooks 10, 10 λ and the proximal sections 12 λ, 12 vv and the compression means 20 λ, 20 Λ λ st a cutting device 30 in hohlstabformigen portion 40 langsverschieblich (parallel to its axis), as shown in particular in Figures 3 and is shown. 4 The amount by which the cutter can be extracted from the portion 40 hohlstabformigen 30 is such that in each case, the plane between the hook-shaped portions 10 and the pressing means 20 λ, 20 ^ "broken" is.

From the above description in connection with the figures 1 to 4 that was added with the illustrated embodiment of the surgical instrument tissue (after blunt Praparation) on the hook and by movement apart of the portion of hook 10 v, 10 λ λ can be spread becomes clear. Thereafter can the captured tissue section by retracting the pressing means 20 λ, 20 λ clamp (Fig. 3). By moving out of the cutting device 30 the recorded and retained tissue stucco can then be easily severed.

Preferably, now at the distal sections 11, 11 'and the pressure elements 22 x, 22 as well as to the distal end (front edge) of the cutting device 30 the electrodes are provided which are connected to not shown high-frequency generator means. Thus, if the above-described operation was performed and recorded and a portion of tissue or a vessel on the hook in the position shown in Fig. 3 position of the surgical instrument between the pressing elements 22 λ, 22 and the associated distal sections 11 v, 11 λ of the sub hook 10 x, is clamped 10 '', which generators are driven such that the coagulated respectively between a pressing member 21 or 22 λ and the corresponding counter-electrode on the distal section 11, 11 λ x a coagulation current flows through the tissue at this point. It is thus here to two bipolar Koagulationseinrichtungen, which are electrically connected such that the tissue which is clamped between the part of hook 10 and λ 10 λ ', is not traversed by current. In another embodiment of the invention, a specific flow of current is set here, which also causes coagulation of this tissue portion.

In the above VERSIONS of Elektrodeneinπchtunge was talk. It should however be emphasized here that in an advantageous manner, the hook-shaped portions 10 and the pressing means 20, 20 λ λ of electrically conductive material, may be made in particular of metal, which, however, such isolated on their outer surfaces, that a current flow only into the tissue at the contact points between the pressure elements 22 λ, 22 λ λ and the distal sections 11 v, 11 can take place λ N. Furthermore, it should be noted that the parts shown, in particular the hook-shaped portion 10 are coated with an anti-adhesive layer, which facilitates the dissection.

The cutting device 30 is also preferably used as the HF surgical instrument configured thus has an opening formed as an electrode edge which is connected to a (not shown here) RF generator. The other pole of the HF generator is 11, 11 connected λ x or a pressure element 22 λ, 22 λ λ with at least one of the other instrument parts, namely, one of the distal sections v, so that en RF cutting current between the cutting edge of the cutting device 30 and can flow this other pole. Through appropriate circuitry measures it is possible that said parts 11, 11 ', 22, 22 λ be connected in parallel during the cutting operation.

It is also possible that the distal portions 11 λ, i 11 'and the electrode means thereon to make such that it (bipolar) as

Coagulation usable nd s. In this case also can (optionally additional) electrodes be provided on the portion facing away from the hohlstabformigen 40 of the distal sections 11 0 λ, Λ 11, to be able to make ne particular flachige coagulation e.

(Not shown here) for the Betatigungseinπchtungen (movable) part hook 10 λ λ or the compression means is 20, 20 v λ are preferably formed such that Andruckkrafte defined can be applied. Such Andruckkrafte can also upon movement of the part of hook 10 v, 10 λ λ from the position shown in Fig. 2 position back into the position shown in Fig. 1 position between the distal 0 sections 11 λ, act 11 λ, so that the part of hook 10 λ , 10 N not only for spreading but also for Zangenformigen hold tissue can be used. To fabric which 11 λ, 11 Λ λ is kept between the distal sections, koagul to older, can the facing ^ surfaces of the distal portions 11 λ, 11 v mitumfassen turn be formed as electrodes or such, so that then a bipolar coagulation of tissue is possible, which is clamped between the hook part 10 x, 10 λ λ

) The hohlstabformige portion 40 for recording and

(movable) leadership of the hook-shaped portion 10, the pressing means 20 λ, 20 λ N and the cutting device 30 is used, may additionally serve for supplying a Spulflussigkeit or for sucking rinsing or Korperflussigkeit.

LIST OF REFERENCE NUMBERS

10 hook-shaped portion

10 \ 10 "part hook

11 distal portion 11 \ 11 distal sections

12 proximal portion

12 λ, 12 λ λ proximal portions

13 free end

14, 14 rounded surfaces Λ

20 v, 20 λ N pressure device

21 \ 21 '* holding element

22 x, 22 Λ λ pressure element

30 cutter

40 hohlstabformiger section

Claims

claims
comprising 1. A surgical instrument comprising a hook-shaped portion (10) having a distal portion (11) having a free end (13) and a proximal portion (12), which is connected to an actuating device,
characterized in that
the distal and the proximal portion (11, 12) along a substantially through the center of the distal portion (11) extending plane to form part of hook (10 λ, 10, v) each having a proximal section (12 12, λ) and a distal portion (11 ll, λ) of divided construction and in such a way by the actuator in a spreading plane are movable, that the hook (10) into the two part hook (10 λ, 10 λ) spread apart and again (as forceps instrument to a hook 10) can be brought together.
2. A surgical instrument according to claim 1,
marked by
at least one pressing means (20 λ, 20 λ), which is connected to the actuating device and a to a holder element (21, 21, x) mounted pressure element (22 ', 22, λ) includes, which in a movement substantially perpendicular to the spreading plane can be pressed against at least one of the distal sections (11 λ, ll) for clamping of tissue or the like.
3. A surgical instrument according Anpruch 2,
characterized in that
two compression means (20 λ, 20,) each with a pressure element (22 v, 22) are provided, each connected to a distal section (11 λ, ll, λ) can be pressed.
4. A surgical instrument according to claim 3,
characterized in that
said pressing means (20, 20 λ λ) for simultaneously
Pressing the two pressing elements (22 λ, 22) to the distal portions (11 λ, ll, λ) are formed.
5. The surgical instrument of Anpruch 2,
characterized in that
(v 22, 22, λ) the pressing elements in such a way complementary, preferably cup-shaped, that they flat against the distal sections (11 λ, ll, λ) can be pressed.
Surgical instrument according to one of the preceding claims, characterized by,
means connected to the actuating device cutting device (30) between the distal s sections (11 v, ll, λ) is such hindurchfuhrbar that the spread part of hook (10 10 u) can be severed rest dens tissue.
7. Surgical instrument according to one of the preceding claims 0,
characterized in that
at least at the distal sections (11 Λ, 11 λ>) is electrode means are provided, which are connected to a controllable current source, so that a coagulation on the hook lifting the tissue or between the part of hook (10 λ, 10 λ λ) clamped or the part of hook (10 10, v) adjoining tissue 0 is preferably bipolar zufuhrbar.
8. A surgical instrument according to any one of claims 2 or
3,
S characterized in that
on the hook (10) and the pressure elements (22 λ, 22 λ X) are provided electrode devices and connected to a controllable current source, so that em ^ "coagulation preferably spread-hook
(10) each between a distal portion (11 λ, 11 x) and a pressure element (22 v, 22, λ) for coagulating between the distal portion (11 \ II '') and the pressure element (22 λ, 22 λ) can be fed to clamped tissue sections.
9 A surgical instrument according to claim 1,
characterized in that
the distal portions (11, 11 Λ X) in such a manner mirror-symmetrically with rounded surfaces (14 λ, 14 VΛ) are 0 formed at their sides facing away from each other, that at least the distal portion (11 λ,
11 λ λ) of the hook (10) in ungespreiztem state comprising smooth exterior surfaces.
s 10. A surgical instrument according Anpruch 1,
characterized in that
the actuating device comprises a distal 0 hohlstabformigen portion (40) having a substantially smooth outer surface, in which at least a proximal section (12 λ, 12) movably mounted
^ 11 The surgical instrument according to claim 2,
characterized in that
the actuating means comprises a distal) hohlstabformigen portion (40) having a substantially smooth outer surface, in which at least a proximal section (12 λ, 12 λ), and the holding elements (21 λ, 21, Λ) of the pressure elements (22 λ, 22 λ , J are movably mounted.
12. A surgical instrument according to claim 10 or 11
characterized in that
a proximal portion (12 N, 12 λ) is fixedly attached to hohlstabformigen portion (40).
13. A surgical instrument according to claim 11,
characterized in that
the holding elements (21 v, 21, λ) in such hohlstabformigen portion (40) are mounted axially slidably on this, that the pressure elements (22 λ, 22) to the hohlstabformigen portion (40) or into the latter are retractable.
14. A surgical instrument according to claim 13,
characterized in that
the holding elements (21, 21 λ) are guided in such a way relative to the proximal part sections (12 12 λ), that at least in spread-hook (10) the pressing elements (22 22, λ) for axial displacement in the direction of the distal sections (11, ll come λ) at these in plant.
15. A surgical instrument according to claim 6, characterized in that
the cutting device (30) comprises an electrode in order to cut tissue by supplying an RF cutting current.
16. A surgical instrument according to claim 15,
characterized in that
the opposite pole to the electrode of the cutting device (30) by the hook (10) and / or the pressing device (20 λ, 20, Λ) and there attached electrodes is formed.
PCT/EP2000/002908 1999-04-01 2000-03-31 Surgical instrument WO2000059392A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
DE19915061.3 1999-04-01
DE1999115061 DE19915061A1 (en) 1999-04-01 1999-04-01 A surgical instrument

Publications (1)

Publication Number Publication Date
WO2000059392A1 true true WO2000059392A1 (en) 2000-10-12

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ID=7903375

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DE (1) DE19915061A1 (en)
WO (1) WO2000059392A1 (en)

Cited By (133)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2005906A3 (en) * 2007-06-18 2010-06-23 Hitachi Ltd. Surgical tools and operation system
EP2368504A1 (en) * 2010-03-26 2011-09-28 Tyco Healthcare Group, LP Clamp and scissor forceps
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