WO2009153015A1

WO2009153015A1 - Surgical forceps with blade and return spring

Info

Publication number: WO2009153015A1
Application number: PCT/EP2009/004310
Authority: WO
Inventors: Thomas Aue
Original assignee: Olympus Winter & Ibe Gmbh
Priority date: 2008-06-20
Filing date: 2009-06-16
Publication date: 2009-12-23
Also published as: DE102008028992B3

Abstract

The invention relates to surgical forceps (1) with an elongated tubular shaft (2), provided on the distal end of which with jaws (3) and on the proximal end thereof with a handle (4), wherein the jaws (3) comprise two jaw pieces (5, 6), of which at least one may be pivoted relative to the other by means of the action of an elongated body (11) operated by the handle (4), with a device for electrical heating of tissue held in the forceps and with a blade (18), which may be displaced in the longitudinal direction of the tubular shaft (2) against the force of a return spring (25) by means of a sliding body (26) operated by the handle (4), characterised in that the jaws (3) are detachably fixed to the tubular shaft (2) and the longitudinal body (11) is detachably fixed to the handle (4) and the sliding body (26) has a separate arrangement from the blade (18) and contacts the same in the longitudinal direction, wherein the blade (18) is pressurised by the return spring (25).

Description

Surgical forceps with knife and return spring

The invention relates to a surgical forceps referred to in the preamble of claim 1 Art.

With such pliers, tissue can be captured by the mouth, crushed and coagulated by heat and cut with a knife. In particular, such forceps are used for welding and severing blood vessels. It is important that the two ends of the blood vessels, which are separated by a cut, are securely welded together by coagulation.

Tissue coagulation requires heat input into the tissue. This can be done in different ways, eg. B. by the introduction of ultrasonic energy in the area between the jaw parts. In conventional technology can also be heated with high frequency current, the z. B. between arranged on the jaws electrodes flows, as the extensive literature on this subject is removable, including the cited below font. The knife is loaded with a return spring to always return it automatically to the starting position.

The US 2006/0189981 Al shows a generic construction. On the handle of this construction, a finger-operated lever is provided which advances the knife in the axial direction of the shaft tube via a rod. The finger lever is loaded with the return spring. Upon return of the finger lever by the spring, he pulls back the rod and the knife. To do this, the finger lever, rod and knife not only have to be designed to transmit pressure but also to transmit by train. A simple decomposition of this pliers is therefore not possible.

On the other hand, e.g. from EP 0 633 002 A1, demountable pliers known that can be better cleaned and sterilized in disassembled state. There are various constructions known in which as the minimum requirement, the mouth of the shaft tube must be separable. The longitudinal member controlling the closing movement of the mouth in the form of a rod arranged in the shaft tube can be pulled off with the mouth. The disassembled parts are then easily accessible and can be rinsed for cleaning and disinfection purposes. This dismantling and the subsequent reassembling must be easy by hand, so that even a nurse without consulting a technician can do this work quickly. These are z. As bayonet connections between the jaw and the shaft tube known and simple snap connections between the distal end of the longitudinal member and the handle.

The object of the present invention is to make the generic pliers disassembled for cleaning purposes. This object is achieved with the features of the characterizing part of claim 1.

According to the invention, the mouth is releasably attached to the shaft tube and also the longitudinal member is releasably attached to the handle. For this purpose, recourse can be had to the known state of the art. However, the provided at the cited prior art tensile connection of the knife is inventively avoided. The return spring is moved distally from the known proximal arrangement and acts on the knife, which is formed separately from the thrust member and can be acted upon by this only in the printing direction by contact. The knife can thus be operated in a widely familiar manner, where it can be acted upon by the thrust member in the thrust direction and pushed back by the spring. The advantage of this design is that at the separation point, the knife is separable from the pusher member. When loosening and removing the mouth, the knife remains on the mouth and the push member remains on the shaft tube. The knife may sometimes protrude very far in the proximal direction, u. U. over the entire length of the shaft tube to further improve the cleanability.

The return spring, which acts on one end of the knife, must be mounted stationary at the other end. This storage can z. B. on the shaft tube, but advantageously according to claim 2 to a jaw carrier, which carries the jaws and the entire joint mechanism and the longitudinal member, so that all these parts are jointly handled as a unit.

In the drawing, the invention is shown in a single figure 1, for example, and schematically in a longitudinal section through a pliers according to the invention. 1 shows a surgical forceps 1 with an elongate shaft tube 2 at the distal end of a mouth 3 and at the proximal end of a handle 4 are arranged.

The mouth 3 has two jaw parts 5 and 6, which are pivotally mounted on a common axis 7 in the embodiment. The axis 7 is held in a substantially tubular support 8 of the mouth. The tubular carrier 8 fits snugly in the distal end of the shaft tube 2 and carries on the outside a pin 9 which removably engages in a known manner in an internal bayonet groove 10 on the inside of the shaft tube 2.

For pivotal drive of the two jaws 5 and 6 is a rod-shaped longitudinal member 11, which is the shaft tube 2 arranged continuously and runs at the distal end with a transverse pin 12 in an oblique groove 13 in the jaw part 5. The drawing simplistic only partially illustrated other jaw part 6 has a mirror-symmetrically arranged, not shown groove, which is also engaged with the pin. During longitudinal actuation of the longitudinal member 11, the jaws 5 and 6 are opened or closed in a conventional manner.

At the proximal end of the longitudinal member 11 is releasably held with a ball 14 in a ball receiving a movable handle portion 15 of the handle 4, which is articulated via a hinge 16 with a fixed handle 17, which is fixed to the proximal end of the shaft tube 2.

At the free ends of the handle parts 15 and 17, the surgeon can attack with the fingers of one hand and move the grips towards each other at their free ends. Then the ball 14 and thus also the longitudinal member 11 is pulled in the proximal direction. The mouth 3 closes. Countermovement opens the mouth. The illustrated forceps 1 should be tissue, z. B. pinch a blood vessel between the jaws 5, 6 and coagulate by heat. For this purpose, devices not shown are provided for the sake of drawing simplification, which can generate heat in the area between the jaws 5, 6. This can z. B. electrodes on the jaws 5, 6, between which current flows, as such. B. describes the cited prior art.

Subsequent to the coagulation of the tissue, the tissue, so z. As a blood vessel, are cut at the site of coagulation. For this purpose, a knife 18 is provided, with a cutting edge 19. The knife 18 has a longitudinal slot 20, with which it surrounds the axis 7. The knife 18 is formed very flat over its entire length and arranged in the region of the axis 7 between the two jaws 5, 6. In the distal end region of the jaw parts, when they are closed, it runs in central longitudinal slots 21, which are arranged in both jaw parts 5, 6. In FIG. 1, the slot 21 can be seen in the lower jaw part 6, which is cut in the sectional plane of FIG. 1 for this purpose.

The knife 18 is longitudinally displaceable with its slot 20 on the axis 7 over a larger area. It can thus be retracted in the proximal direction until it rests directly against the axis 7 with the cutting edge 19, or can be advanced until the cutting edge 19 is in the region of the distal tips of the two jaw parts 5, 6.

At the proximal end of the blade 18, this is flared laterally with flanges 22 which are longitudinally guided in the inner surface of the tubular support 8. At its proximal end, the carrier 8 has an inner flange 23, to which the flanges 22 of the knife 18 can come into abutment. As a result, the movement of the blade 18 in the proximal direction is limited. The carrier 8 also has a distal inner flange 24 in the distal end region. Between this distal inner flange 24 of the carrier 8 and the outer flanges 22 of the knife 18, a return spring 25 designed as a helical spring is arranged, which presses the knife 18 in the proximal direction.

In the shaft tube 2, surrounding the longitudinal member 11, a tubular thrust member 26 is arranged, which rests with its distal end face against the flanges 22, so the proximal end face of the blade 18. Upon movement of the thrust member 26 in the distal direction, the knife 18 is advanced against the restoring force of the return spring 25 in the distal direction. If the pusher member 26 is force-free set or withdrawn, the knife 18 is pressed by the return spring 25 again in the proximal direction to the stop on the inner flange 23 of the support 8.

The thrust member 26 extends beyond the proximal end of the shaft tube 2 with its proximal end and is actuated there by a lever 27, which is mounted at 28. At its free end, the lever 27 on a curved handle on which can be attacked with a finger to push the pusher member 26 in the distal direction.

The illustrated pliers 1 can be disassembled for cleaning purposes. For this purpose, the mouth 3 is touched and this is rotated relative to the shaft tube 2, so that the bayonet engagement between the pin 9 and the bayonet groove 10 is released. Now the jaw 3 with its carrier 8 can be pulled out of the shaft tube 2 in the distal direction. In this case, the ball 14 at the proximal end of the longitudinal member 11 is separated from the handle part 15. Thus, the mouth 3 can now be pulled out of the shaft tube 2 in the distal direction together with the longitudinal member 11. In this case, the thrust member 26 remains in the shaft tube. 2 In a not shown, suitable manner, the pliers 1 can be formed even further separable, for example, the handle 4 from the shaft tube 2 can be solved. Further precautions can be taken to improve cleanability and sterilizability. For example, the carrier 8 of the mouth 3 shown as a tube part can be designed to be largely open in order to allow rinsing and cleaning agents to enter.

Claims

CLAIMS:

1. surgical forceps (1) with an elongate shaft tube (2), at the distal end of a mouth (3) and at the proximal end of a handle (4) are arranged, wherein the mouth (3) has two jaw parts (5, 6) of which at least one relative to the other by the action of a handle (4) acted upon longitudinal member (11) is pivotable, with a device for generating electrical heat in tissue held by the mouth and with a knife (18), one of the handle (4) actuatable pusher member (26) in the region of the mouth (3) in the longitudinal direction of the shaft tube (2) against the force of a return spring (25) is displaceable, characterized in that the jaw (3) releasably on the shaft tube (2) and the Longitudinal member (11) are releasably attached to the handle (4) and that the thrust member (26) separated from the knife (18) and arranged in the longitudinal direction against this, wherein the knife (18) from the return spring (25) is acted upon.

2. Forceps according to claim 1, characterized in that the jaw (3) has a jaw parts (5, 6) carrying on the shaft tube (2) releasably secured to the carrier (8) on which the return spring (25) is mounted.