WO2019145540A1 - Dispositif de préhension d'outil pour instrument laparoscopique - Google Patents

Dispositif de préhension d'outil pour instrument laparoscopique Download PDF

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Publication number
WO2019145540A1
WO2019145540A1 PCT/EP2019/052010 EP2019052010W WO2019145540A1 WO 2019145540 A1 WO2019145540 A1 WO 2019145540A1 EP 2019052010 W EP2019052010 W EP 2019052010W WO 2019145540 A1 WO2019145540 A1 WO 2019145540A1
Authority
WO
WIPO (PCT)
Prior art keywords
tool
rod
hollow sleeve
shank
gripping device
Prior art date
Application number
PCT/EP2019/052010
Other languages
English (en)
Inventor
Azad Najar
Original Assignee
Laprotech Ab
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
Priority claimed from SE1851029A external-priority patent/SE542609C2/en
Application filed by Laprotech Ab filed Critical Laprotech Ab
Priority to EP19702557.0A priority Critical patent/EP3745964A1/fr
Publication of WO2019145540A1 publication Critical patent/WO2019145540A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062—Needle manipulators
    • A61B17/0625—Needle manipulators the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/0608—J-shaped
    • 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
    • A61B2017/2901—Details of shaft
    • A61B2017/2902—Details of shaft characterized by features of the actuating rod
    • A61B2017/2903—Details of shaft characterized by features of the actuating rod transferring rotary motion
    • 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
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2919—Handles transmission of forces to actuating rod or piston details of linkages or pivot points
    • A61B2017/292—Handles transmission of forces to actuating rod or piston details of linkages or pivot points connection of actuating rod to handle, e.g. ball end in recess
    • 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
    • A61B2017/2933—Transmission of forces to jaw members camming or guiding means
    • A61B2017/2937—Transmission of forces to jaw members camming or guiding means with flexible part
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0813—Accessories designed for easy sterilising, i.e. re-usable

Definitions

  • the present application relates to a tool gripping device for a laparoscopic instrument which enables a tool member held therewith to be repositioned in relation to the tool gripping device during surgical procedures using only a one-handed grip.
  • Laparoscopic surgery During laparoscopic surgery, operations are performed far from their location through small incisions (usually 0.5-1.5 cm) elsewhere in the body. Laparoscopic surgery provides a number of advantages to the patient compared to the more common, open surgery procedure. Pain and hemorrhaging are reduced due to substantially smaller incisions and recovery times are much shorter.
  • the key element is the use of a laparoscope, a long fiber optic cable system which allows viewing of the operation area by snaking the cable from a more distant, but more easily accessible location.
  • a laparoscope a long fiber optic cable system which allows viewing of the operation area by snaking the cable from a more distant, but more easily accessible location.
  • instruments with long handles are used in order to perform all steps of the operation.
  • a plurality of tubular members e.g. trocars may be inserted through offset incisions and advanced proximal to the tissue site of interest.
  • the tubular members utilized are relatively rigid and of a diameter sufficient to facilitate the passage of a variety of devices there through, including for example gas inflation conduits, electrosurgical devices, imaging apparatuses, forceps, scissors, probes, dissectors, hooks, retractors and suturing devices.
  • suture material An important step in laparoscopic surgery is to effectively suture an internal tissue site of interest.
  • suturing entails the passage of suture material into and back out of the tissue at least once, and most typically, a plurality of times, followed by the provision of a knot adjacent to the sutured tissue.
  • the tool gripping device as described herein can
  • a laparoscopic instrument during laparoscopic surgery when there is a need to e.g. adjust the grip and/or the angle of a tool member, such as e.g. a suturing tool member at the surgical site without the use of additional forceps or other instruments.
  • a tool member such as e.g. a suturing tool member at the surgical site without the use of additional forceps or other instruments.
  • the present disclosure relates to a tool gripping device that is particularly suitable for use with a laparoscopic instrument.
  • Said tool gripping device comprises a rod, the rod having a longitudinal axis A, a distal end and a proximal end, wherein said proximal end is configured to be attached to a handle assembly of a laparoscopic instrument.
  • the distal end of the rod is provided with a tool holding assembly capable of gripping, holding and manipulating a tool member.
  • the tool gripping device further comprises a hollow sleeve having a distal end with an opening, and a proximal end.
  • the hollow sleeve partially surrounds and is longitudinally and independently displaceable parallel to the longitudinal axis A along an outer surface of said rod.
  • the tool holding assembly comprises a first shank member and a second shank member located at the distal end of the rod.
  • Each of said first and second shank members are provided with a curved flexible portion and a stiff tool holding portion, and when said hollow sleeve is displaced along said longitudinal axis A on the outer surface of the rod, it will cover or uncover said first and second shank members, thereby moving the first and second shank members between an open and a closed position.
  • the stiff tool holding portions form a clamping jaw assembly configured to secure said tool member.
  • the tool member is advantageously a suture needle having a first end provided with a piercing tip, a second end opposite to the first end and a mid-portion having a square or rectangular cross section.
  • the second end of the suture needle is advantageously provided with an eyelet arranged to hold a suturing thread.
  • the tool member may be crescent-shaped.
  • An imaginary axis B extends along the mid-portion of the tool member, around which axis B the tool member may rotate.
  • each of the first and second shank members comprise a curved flexible portion made from a resilient material configured to deflect said first and second shank members away from one another. Consequently the first and second shank members are spring-biased and arranged to inherently oppose each other, i.e. whereby they will be forced apart to an open position unless an opposing force is applied.
  • the distal end of the stiff tool holding portion of the first shank member has a claw ended configuration and the stiff tool holding portion of the second shank member is shorter than the first shank member.
  • said claw ended configuration and said stiff tool holding portion of the second shank member together form a receiving cleft in the clamping jaw assembly configured to receive and surround said tool member in a tight grip when the first and second shank members are brought together into a closed position. In the closed position, the inner walls of the receiving cleft apply pressure onto all four surfaces of the square/rectangular mid-section of the tool member, clamping it in a firm grip.
  • the hollow sleeve is displaceable along longitudinal axis A of the rod and is configured to receive and surround said first and second shank members such that the clamping jaw assembly is moved between a relaxed mode wherein the shank member are in an open position, a tool clamping position wherein the clamping jaw are in a closed position holding the tool member in a tight grip, and a tool turning mode wherein the tool member is able to slide and rotate inside the clamping jaw.
  • the relaxed mode of the tool gripping device is reached when said hollow sleeve is displaced in the proximal direction along the longitudinal axis A of said rod, uncovering said first and second shank members completely, thereby moving the first and second shank members with the clamping jaw into the open position.
  • the tool clamping mode of the tool gripping device is reached when said hollow sleeve is displaced in the distal direction along the longitudinal axis A of said rod until the stiff tool holding portions and the curved flexible portions of the first and second shank members are completely received into the distal opening of the hollow sleeve, moving the first and second shank members including the clamping jaw assembly into the closed position, and abutting a distal end of said hollow sleeve towards said tool member.
  • the tool turning mode of the tool gripping device is reached when said hollow sleeve is displaced along the longitudinal axis A of said rod until the curved flexible portions and at least part of said stiff tool holding portions, are received into the distal opening of the hollow sleeve.
  • the tool turning mode enables a user to slide the tool member along a tool member axis B, to rotate the tool member 360° around a tool member axis B and to rotate the tool member 360° around the longitudinal axis A of the rod.
  • the tool turning mode will disengage the rod from a locked position inside the handle assembly, thereby enabling a user to rotate the rod, including the clamping jaw assembly with the tool member, 360° around the longitudinal axis A of the rod.
  • the proximal end of the rod is provided with a slit configured to cooperate with a resilient locking device.
  • the distal end of the hollow sleeve is advantageously provided with a longitudinal recess extending in the proximal direction parallel to the longitudinal axis A.
  • the invention also relates to a laparoscopic instrument comprising a handle assembly by which a user may hold the laparoscopic device and a tool gripping device capable of holding and manipulating a tool member.
  • the tool gripping device comprises a rod having a longitudinal axis A, a distal end and a proximal end, wherein the proximal end is configured to be attached to the handle assembly.
  • the distal end is provided with a tool holding assembly capable of gripping, holding and manipulating a tool member.
  • the tool gripping device further comprises a hollow sleeve having a distal end with an opening and a proximal end, and the hollow sleeve partially surrounds and is longitudinally and independently displaceable parallel to the longitudinal axis A along an outer surface of the rod.
  • the tool holding assembly comprises a first shank member and a second shank member.
  • Each of the first and second shank members are provided with a curved flexible portion and a stiff tool holding portion, and when the hollow sleeve is displaced along the longitudinal axis A on the outer surface of the rod it will cover or uncover the first and second shank members, thereby moving the first and second shank members between an open and a closed position.
  • the stiff tool holding portions form a clamping jaw assembly configured to grip the tool member.
  • the tool member is advantageously a suture needle having a first end provided with a piercing tip, a second end opposite to the first end and a mid-portion having a square or rectangular cross section.
  • the second end of the suture needle is advantageously provided with an eyelet arranged to hold a suturing thread.
  • the tool member may be crescent-shaped.
  • An imaginary axis B extends along the mid-portion of the tool member, around which the tool member may rotate.
  • each of the first and second shank members comprise a curved flexible portion made from a resilient material configured to deflect said first and second shank members away from one another. Consequently the first and second shank members are arranged to inherently oppose each other, i.e. to be forced apart to an open position unless an opposing force is applied.
  • the distal end of the stiff tool holding portion of the first shank member has a claw ended configuration while the stiff tool holding portion of the second shank member is shorter than the first shank member.
  • the claw ended configuration and the stiff tool holding portion of the second shank member together form a receiving cleft in the clamping jaw assembly configured to receive the tool member and surround it in a tight grip when the first and second shank members are brought together into a closed position. In the closed position, the inner walls of the receiving cleft apply pressure onto all four surfaces of the square/rectangular mid-section of the tool member, clamping it in a firm grip.
  • the proximal end of the rod is provided with a slit configured to cooperate with a resilient locking device.
  • the handle assembly comprises an actuation lever and a housing, the housing including a spring and a slider.
  • the actuation lever is articulated to the hollow sleeve via a first and a second linking arm and the slider.
  • the first and second linking arms each have a first and a second end, and wherein the first end of the first linking arm is connected to the slider, the second end of the first linking arm is connected to the first end of the second linking arm by means of a sliding pin slidably coupled in an actuation lever slit arranged in the actuation lever, and the second end of the second linking arm is connected to the housing.
  • the actuation lever has one relaxed mode and two working modes; the tool clamping mode and the tool turning mode.
  • the relaxed mode of the laparoscopic instrument is reached by fully releasing the actuation lever, whereby the hollow sleeve is displaced in the proximal direction along the longitudinal axis A of the rod, uncovering the first and second shank members completely, thereby moving the clamping jaw assembly into an open position.
  • the tool clamping mode of the laparoscopic instrument is reached by pressing the actuation lever all the way towards the housing, whereby the hollow sleeve is displaced in the distal direction along the longitudinal axis A of the rod until the stiff tool holding portions and the curved flexible portions of the first and second shank members are fully received into the distal opening of the hollow sleeve, thereby forcing the first and second shank members into a closed position, and abutting the tool member with a distal end of the hollow sleeve.
  • the tool turning mode of the laparoscopic instrument is reached by pressing the actuation lever half way towards the housing, whereby the hollow sleeve is displaced along the longitudinal axis A of the rod until the curved flexible portions of the first and second shank members, and a least part of the stiff tool holding portions, are received into the distal opening of the hollow sleeve.
  • the tool turning mode enables a user to slide the tool member along a tool member axis B, and to rotate the tool member 360° around a tool member axis B.
  • the tool turning mode further disengages the rod from a locked position inside the handle assembly, thereby enabling a user to rotate the tool member 360° around the longitudinal axis A of the rod.
  • the proximal end of the rod is provided with a slit configured to cooperate with a resilient locking device.
  • the distal end of the hollow sleeve is advantageously provided with a longitudinal recess reaching in the proximal direction parallel to the longitudinal axis A.
  • proximal is intended to mean a part of the instrument located closest to the user of the instrument when in normal use
  • distal is intended to mean a part of the instrument located furthest away from a user (and closest to the patient) during normal handling of the instrument.
  • Figure 1 discloses a laparoscopic instrument comprising a tool gripping device.
  • Figure 2 discloses a cross sectional view of the laparoscopic instrument.
  • Figure 3a discloses the tool gripping device in an open position.
  • Figure 3b discloses the tool gripping device in a closed position.
  • Figure 4 discloses the tool member clamped by the tool gripping device.
  • FIG. 5 is a detailed view of the housing
  • Figure 6 is a cross sectional view of the laparoscopic instrument in a relaxed mode.
  • Figure 7a is a cross sectional view of the laparoscopic instrument in a tool clamping mode.
  • Figure 7b is a cross sectional view of the laparoscopic instrument in a tool turning mode.
  • Figures 8a - c are detailed views of the tool gripping device and illustrate the sliding motion of the tool member along the tool member axis B during the tool turning mode
  • Figures 9a-d are detailed views of the tool gripping device and illustrate rotation of the tool member around the tool member axis B during the tool turning mode
  • Figures 10a and b are detailed views of the tool gripping device and illustrate rotation of the tool member around the longitudinal rod axis A during the tool turning mode
  • Figures 1 1a-c are detailed views of the tool gripping device and the combined rotation of the tool member around both the tool member axis B and the longitudinal rod axis A during the tool turning mode
  • Figures 12a and b are views of a further embodiment of the tool gripping device
  • Figure 13a is a detailed view of the resilient locking device.
  • Figure 13b is a detailed view of the rod in a locked position by the resilient locking device.
  • Figure 1 is a view of a laparoscopic instrument 100 comprising a handle assembly 130 by which the user may hold the laparoscopic device 100, and a tool gripping device 1 10 which may hold a tool member 120.
  • the one or more tool members 120 is a curved suturing needle.
  • the handle assembly 130 comprises a housing 131 and an actuation lever 133 (figures 1 and 2).
  • the handle assembly 130 is designed to be held by one hand (left or right) by gripping around the housing 131 and the actuation lever 133.
  • the housing 131 encloses a slider 134 and a spring 135 (explained further below) and the actuation lever 133 is in one embodiment provided with a finger grip 136 to enable safe and precise handling of the laparoscopic instrument 100.
  • the tool gripping device 110 comprises a rod 170 having a longitudinal axis A, a distal end 171 and a proximal end 172 (see figure 2).
  • the rod 170 extends from the distal end 171 of the laparoscopic device 1 10, through the entire handle assembly 130 (see figure 2) and is at its proximal end 172 connected with a resilient locking device 132 arranged on the exterior of the handle assembly 130.
  • the distal end 171 of the rod 170 is configured as a tool holding assembly 150 (see figure 3a) capable of holding a tool member (not shown).
  • the distal end 171 of the rod 170 is split into two parts along its longitudinal axis A forming a first shank member 151 and a second shank member 152.
  • the first and second shank members 151 , 152 together form the tool holding assembly 150.
  • Each shank member 151 , 152 is provided with a stiff tool holding portion 153, 154 arranged at the distal end 171 , and a flexible portion 155, 156 arranged at the proximal end of the each shank member 151 , 152.
  • the flexible portions 155, 156 are spring elements which are arranged to oppose one another, i.e. they will inherently make the first and second shank members 151 , 152 deflect away from each other in the absence of a biasing force pressing the shank members 151 , 152 together.
  • the stiff tool holding portions 153, 154 of the shank members 151 , 152 together form a clamping jaw assembly 157 (see figure 3b) configured to hold a tool member 120.
  • the stiff tool holding portion 153 on the first shank member 151 is provided with a claw- ended formation 158 at its distal end 171 , while the stiff tool holding portion 154 of the second shank member 152 is slightly shorter than the first shank member 151. Together they form a receiving cleft 160 in the clamping jaw assembly 157 (see figure 3b) which will receive and surround the tool member 120 in a tight grip between the first and second shank members 151 , 152.
  • the tool member 120 is a curved suture needle having a first end provided with a piercing tip 122, a second end 123 opposite the first end, and a mid-portion 124 (as illustrated in figure 4).
  • the second end may be provided with an eyelet arranged to receive a suturing thread 126.
  • the mid-portion 124 of the tool member 120 has a square or rectangular cross section configured to fit in the receiving cleft 160 formed when the first shank member 151 and the second shank member 152 (see figures 3b and 4) are brought together.
  • an imaginary axis B can be found that extends parallel to the mid-portion 124 of the tool member 120 around which the tool member 120 may turn when the tight grip of the clamping jaw assembly 157 is eased in the tool turning mode as described further below.
  • the square or rectangular cross section prevents rotation or sliding of the tool member 120 in the tool clamping mode keeping it firmly clamped in the receiving cleft 160.
  • the clamping jaw assembly 157 doesn’t necessarily have to have the shape as described herein.
  • the clamping jaw assembly 157 may be adapted to the shape of the specific tool member it is intended to grip.
  • the tool gripping device 110 further comprises a hollow sleeve 180 (see figures 3-4).
  • the hollow sleeve 180 has a distal end 181 and a proximal end 182. The distal end is provided with an opening, while the proximal end 182 of the hollow sleeve 180 is attached to a slider 134 inside the housing 131 (see figure 5) of the handle assembly 130 as explained further below.
  • the hollow sleeve 180 has an extension in its longitudinal direction which
  • the longitudinal extension of the hollow sleeve 180 is at least 5 times, at least 10 times, such as more than 15 times longer than its transverse extension.
  • the hollow sleeve 180 receives and surrounds the rod 170 and extends along substantially the entire length of the rod 170.
  • the hollow sleeve 180 is configured to be longitudinally and independently displaceable parallel to the longitudinal axis A along the outer surface of said rod 170 (see figures 2, 3a, 3b and 4). By displacing the hollow sleeve 180 along the longitudinal axis A of the rod 170, the clamping jaw assembly 157 can be moved between an open and closed position as will be explained below.
  • the actuation lever 133 which forms part of the handle assembly 130 is articulated to the hollow sleeve 180 via a first and a second linking arm 137, 138 and a slider 134 (see figures 2, 5 and 6).
  • the first and second linking arms 137, 138 each have a first end 139, 140 and a second end141 , 142, wherein the first end 139 of the first linking arm 137 is rotatably connected to the slider 134 located inside the housing 131.
  • the first end 139 of the first linking arm 137 is mounted to the slider 134 by means of a first mounting pin 143 around which the first end 139 of the first linking arm 137 may rotate.
  • the first and second linking arms 137, 138 are connected to each other by means of a sliding pin 144 slidably coupled in an actuation lever slit 145 (best seen in figures 6, 7a an 7b) on the actuation lever 133.
  • the second end 142 of the second linking arm 138 is rotatably connected to the housing 131 by means of a second mounting pin 146 around which the second end 142 of the second linking arm 138 may rotate.
  • the laparoscopic device 110 When not in use the laparoscopic device 110 is in a relaxed mode. In the relaxed mode the user releases any pushing force applied on the actuation lever 133, whereby the hollow sleeve 180 is displaced in the proximal direction towards the handle assembly along the longitudinal axis A of the rod 170 completely uncovering the stiff holding portions 153, 154 and the flexible portions 155, 156 of the shank members 151 , 152. In this mode the clamping jaw assembly 157 of the tool holding assembly 150 is in an open position due to the inherent resilient opposing power of the curved flexible portions 155, 156 keeping the first and second shank members 151 , 152 apart (see figures 3a and 6). In the open position a tool member 120 may be placed in the tool holding assembly 150.
  • the actuation lever 133 may reach one of two different working modes; the tool clamping mode (figure 7a) or the tool turning mode (figure 7b).
  • the tool clamping mode is reached when the actuation lever 133 is pressed all the way towards the housing 131 (see arrow 147A in figure 7a).
  • the sliding pin 144 slides towards the distal end 171 of the handle assembly 130, increasing the obtuse angle b between the first and second linking arms 137, 138, thereby pushing the slider 134 towards the distal end of the handle assembly 130 (see arrow 147B in figure 7a).
  • the slider 134 is resiliently biased towards the proximal end of the housing 131 by means of an opposing spring 135 (see dashed arrow in figure 7a). Since the hollow sleeve 180 is coupled to the slider, the sleeve 180 is displaced along the longitudinal axis A in the distal direction of the rod 170.
  • the tool holding portions 153, 154 of the tool holding assembly 150 are made from a stiff material that will not flex when a pressure or force is applied thereto, the tool holding portions 153, 154 will be forced together in a close abutment, thereby closing the clamping jaw assembly 157 around the tool member 120 (see enlarged portion of the clamping jaw assembly in figure 7a).
  • the distal end 181 of the hollow sleeve 180 will press the tool member 120 towards the claw-end 158 of the rod 170 in a tight grip.
  • walls forming the receiving cleft 160 will firmly abut all four sides of the square/rectangular tool member 120 mid-portion 124, thereby preventing the tool member 120 from sliding or rotating inside the clamping jaw 157 (not shown).
  • the resilient spring 135 provides an opposing force (see dashed arrow in figure 7a) to the pressure provided when the actuation lever 133 is pressed towards the housing 131.
  • the hollow sleeve 180 will automatically move in the proximal direction along the rod 170 and parallel to the longitudinal axis A towards the handle assembly 130 when the actuation lever 133 is released.
  • the clamping jaw 157 will automatically spring back to the open position when the hollow sleeve 180 is fully retracted from the flexible portions 155, 156 of the first and second shank members 151 , 152, thereby releasing the tool member 120 from the receiving cleft 160.
  • the tool turning mode is reached when the actuation lever 133 is pressed only half the distance or less towards the housing 131 (see arrow 148A in figure 7b). In this mode the sliding pin 144 slides towards the proximal end of the handle assembly 130, increasing the obtuse angle b between the first and second linking arms 137, 138 compared to the relaxed mode.
  • the tool turning mode can also be reached from the tool clamping mode by releasing the pressure on the actuation lever 113 slightly, thereby causing a displacement of the hollow sleeve opening 181 in the proximal direction along the longitudinal axis A of the rod 170 towards the handle assembly 130 to remove the abutment of the distal end of the hollow sleeve 180 from the tool member 120.
  • the stiff tool holding portions 153, 154 are at least partially uncovered by the hollow sleeve 180 in the tool turning position (see figure 3b).
  • the tool member 120 In some situations it is also useful to be able to rotate the tool member 120 in order to place it in an optimal position for surgery.
  • the eased grip of the clamping jaw 157 will also enable the tool member 120 to rotate 360° around its own axis B (see figures 9a-9d), enabling the user of the laparoscopic instrument to position the tip 122 of the tool member 120 in an optimal position in relation to the surgical site.
  • the user simply eases the grip around the actuation lever 133 to reach the tool turning mode, and abuts one end of the tool member 120 (either piercing tip 122, or second end 123) towards a tissue surface at the surgical site, such that the tool member 120 turns around the axis B of its mid- portion 124 until the desired position of the tool member 120 is reached inside the receiving cleft 160 (see figures 9a-9d).
  • the user again presses the actuation lever 133 all the way towards the housing in order to reach the tool clamping mode wherein the tool member 120 again becomes firmly clamped inside the receiving cleft 160 and is unable to rotate or slide.
  • a further advantageous feature enabled by the tool turning mode is that in this mode i, the proximal end 172 of the rod 170 becomes disengaged from its locked position inside the handle assembly 130, thereby permitting the rod 170 to rotate freely around its longitudinal axis A. This enables the user to position the piercing tip 122 to point in any direction required by the surgical task (see figures 10a-b).
  • the user In order to change direction of the piercing tip 122 for example 180°, the user eases the grip around the actuation lever 133 to reach the tool turning mode. In this position the rod 170, and thereby the complete tool holding assembly 150 including the tool member 120, is able to rotate 360° around its longitudinal axis A inside the handle assembly 130.
  • the user abuts one end of the tool member 120 (either the piercing tip 122, or second end 123) towards a tissue surface at the surgical site, and while keeping the grip around the actuation lever 133, and the tool holding assembly 150 firmly abutted towards the tissue surface, the user turns the entire handle assembly 130 180° in either the clock-wise or counter clock-wise direction around the axis A of the rod 170. Since the rod 170 has been disengaged from the locked position inside the handle assembly, the handle assembly will rotate freely around the axis A of the rod at its proximal end 172, while the firm abutment of the tool holding assembly 150 at the distal end 171 of the rod 170 is still maintained at the tissue site.
  • the simple switching between the tool clamping mode and the tool turning mode is very advantageous as the user of the laparoscopic instrument is able to change the position of the tool member freely into any position required by the surgical task using only one hand. This may be very advantageous when for example the operator wants to relocate the piercing tip 122 of the tool member 120 closer or further away from the clamping jaw 157, rotate the tool member 120 around its own axis B, or maybe flip the tool member 120 180° to have it point in the opposite direction.
  • FIG. 11 a, b and c show in figures 11 a, b and c.
  • the piercing tip 122 of the tool member 120 points upwards towards the left of the device (when viewed from the user). From this position the tool member has been rotated 90° around the rod axis A in the counterclockwise direction (when viewed from the user), while it is simultaneously rotated 90° around the mid-portion B- axis in the distal direction such that the piercing tip 122 now points in the downwards and distal direction (see figure 1 1 b).
  • the tool member may be rotated a further 90° around the rod A-axis in the counter clockwise direction, and 90° around its mid-portion B-axis in the proximal direction to now point upwards and towards the right of the device (when viewed from the user) as seen in figure 1 1c.
  • a tool member 120 may be released, rotated, turned and gripped continuously without the use of further tools, and using only a one-hand grip.
  • Figures 12a and b disclose a further embodiment of the laparoscopic instrument described herein.
  • the distal end hollow sleeve 180 is provided with a longitudinal recess 200 reaching in the proximal direction along the longitudinal axis A (see figure 12a).
  • the recess 200 is configured to accommodate the mid-portion of the tool member 120.
  • the user will displace the hollow sleeve 180 in the distal direction along the rod 170 to receive the shank members 151 , 151 inside the hollow sleeve 180, thereby closing the clamping jaw assembly 157 around the tool member 120 (as described above).
  • the mid-portion of the tool member 120 When entering the clamping mode, the mid-portion of the tool member 120 is received into the recess 200 on the hollow sleeve 180, while the hollow sleeve distal edge opposite the recess 200 will abut the tool member mid-portion.
  • the mid-portion of the tool member 120 will not be clamped in a direction that extends perpendicular to the hollow sleeve edge (and the longitudinal axis A), but will abut the hollow sleeve edge at an angle (see figure 12b) which will depend on the depth of the recess 200. This enables the user to direct the tool member 120 and the piercing tip 122 at a required angle.
  • the hollow sleeve 180 may be provided with more than one recess 200, such as two, three of four recesses 200 of different depths (not shown).
  • the tool member 120 may be tilted to different angles according to need, depending on the number of recesses 200 with different depths provided around the edge of the hollow sleeve 180.
  • the laparoscopic device 100 After use the laparoscopic device 100 has to be disassembled in order to clean all parts that have been in contact with a patient.
  • the longitudinal extending rod 170 extends through the handle assembly 130 and is attached to a resilient locking device 132 arranged on the exterior of the handle assembly 130.
  • the resilient locking device 132 comprises a nut 191 with a through bore and a resilient shackle 192 provided with a notch 193 shaped as a keyhole (see figure 13a).
  • the proximal end 172 of the rod 170 is provided with a slit 195 configured to cooperate with the keyhole-shaped notch 193 of the resilient shackle 192.
  • the proximal end 172 of the rod 170 When the proximal end 172 of the rod 170 exits the handle assembly 130, it passes through a loop 194 of the shackle 192, the through bore of the nut 191 and thereafter the slit 195 at the proximal end 172 is fitted into the narrow part of the keyhole-shaped notch 193 (see figure 13b).
  • the slit 195 at the proximal end 172 of the rod 170 is dislodged from the narrow end of the keyhole-shaped notch 193 and the rod 170 can be pulled out from the handle assembly.

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

La présente invention concerne un dispositif de préhension d'outil pour un instrument chirurgical. Le dispositif de préhension d'outil comprend une tige ayant un axe longitudinal A, une extrémité distale et une extrémité proximale. L'extrémité proximale de la tige est configurée pour être fixée à un ensemble de manche et l'extrémité distale est pourvue d'un ensemble de porte-outil pouvant maintenir un élément d'outil. Le dispositif de préhension d'outil comprend en outre un manchon creux ayant une ouverture distale et une extrémité proximale. Ledit manchon creux entoure partiellement et est longitudinalement et indépendamment déplaçable parallèlement à l'axe longitudinal A le long d'une surface extérieure de ladite tige s'étendant longitudinalement. L'ensemble de porte-outil comprend un premier élément de tige et un deuxième élément de tige. Chacun desdits premier et deuxième éléments de tige est pourvu d'une partie flexible incurvée et d'une partie de maintien d'outil rigide. Lorsque ledit manchon creux est déplacé le long dudit axe longitudinal A sur la surface externe de ladite tige s'étendant longitudinalement, les premier et deuxième éléments de tige sont déplacés entre une position ouverte et une position fermée. Dans la position fermée, lesdites parties de maintien d'outil rigide forment un ensemble de mâchoire de serrage configuré pour serrer ledit élément d'outil dans une prise ferme.
PCT/EP2019/052010 2018-01-29 2019-01-28 Dispositif de préhension d'outil pour instrument laparoscopique WO2019145540A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP19702557.0A EP3745964A1 (fr) 2018-01-29 2019-01-28 Dispositif de préhension d'outil pour instrument laparoscopique

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
SE1850097 2018-01-29
SE1850097-5 2018-01-29
SE1851029A SE542609C2 (en) 2018-01-29 2018-08-30 A tool gripping device for a laparoscopic instrument
SE1851029-7 2018-08-30

Publications (1)

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WO2019145540A1 true WO2019145540A1 (fr) 2019-08-01

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5628757A (en) * 1992-02-04 1997-05-13 Hasson; Harrith M. Surgical instrument for holding a needle
US20150320417A1 (en) * 2010-09-10 2015-11-12 Pivot Medical, Inc. Method and apparatus for passing suture through tissue
WO2017212040A1 (fr) * 2016-06-10 2017-12-14 Laprotech Ab Dispositif laparoscopique

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5628757A (en) * 1992-02-04 1997-05-13 Hasson; Harrith M. Surgical instrument for holding a needle
US20150320417A1 (en) * 2010-09-10 2015-11-12 Pivot Medical, Inc. Method and apparatus for passing suture through tissue
WO2017212040A1 (fr) * 2016-06-10 2017-12-14 Laprotech Ab Dispositif laparoscopique

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