WO2024023047A1 - Connexion haute fréquence pour un instrument chirurgical - Google Patents

Connexion haute fréquence pour un instrument chirurgical Download PDF

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Publication number
WO2024023047A1
WO2024023047A1 PCT/EP2023/070504 EP2023070504W WO2024023047A1 WO 2024023047 A1 WO2024023047 A1 WO 2024023047A1 EP 2023070504 W EP2023070504 W EP 2023070504W WO 2024023047 A1 WO2024023047 A1 WO 2024023047A1
Authority
WO
WIPO (PCT)
Prior art keywords
frequency
connection
section
contact
designed
Prior art date
Application number
PCT/EP2023/070504
Other languages
German (de)
English (en)
Inventor
Daniel Kärcher
Dominik Längle
Robin Merz
Original Assignee
Karl Storz Se & Co. Kg
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 Karl Storz Se & Co. Kg filed Critical Karl Storz Se & Co. Kg
Publication of WO2024023047A1 publication Critical patent/WO2024023047A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical 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
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical 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
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1442—Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445—Probes 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
    • 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
    • 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
    • A61B2017/00464—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for use with different instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A61B2017/00482—Coupling with a code
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A61B2017/00486—Adaptors for coupling parts with incompatible geometries
    • 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
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00172—Connectors and adapters therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00172—Connectors and adapters therefor
    • A61B2018/00178—Electrical connectors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/0091—Handpieces of the surgical instrument or device
    • 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
    • A61B2090/0807—Indication means
    • A61B2090/0808—Indication means for indicating correct assembly of components, e.g. of the surgical apparatus
    • 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

  • High-frequency connector for a surgical instrument FIELD OF THE INVENTION
  • the present invention relates to a high-frequency connector for a surgical instrument.
  • TECHNICAL BACKGROUND Surgical instruments are used for different applications.
  • these can be designed as micro-invasive medical instruments for high-frequency surgery and have a base, for example in the form of a handling device, at the proximal end, a long and generally thin shaft, which extends from the proximal end to a distal end of the instrument, and a high-frequency accessory, ie a tool designed for HF treatment or another effective device for gripping, squeezing, coagulating, cutting, punching or for other applications at the distal end of the instrument.
  • a high-frequency accessory ie a tool designed for HF treatment or another effective device for gripping, squeezing, coagulating, cutting, punching or for other applications at the distal end of the instrument.
  • One or more transmission devices run in the shaft for transmitting a force and/or a torque from the handling device at the proximal end to the active device at the distal end. Furthermore, for the electrosurgical function, particularly in the case of monopolar or bipolar electrosurgical microinvasive medical instruments, the transmission device is also involved in transmitting electrical power from the proximal end to the distal end.
  • the instruments can often be dismantled into individual components, so that different tools, different shafts and other connecting elements can be combined can. A system with different and therefore versatile possible uses can therefore advantageously be provided.
  • High-quality microinvasive medical instruments are also generally designed to be reusable.
  • a high-quality microinvasive medical instrument can advantageously be dismantled.
  • a dismountable medical instrument in which the transmission device is also involved in the transmission of electrical power it should be possible to establish a mechanically separable and safely re-establishable electrical contact to the transmission device, particularly at the proximal end of the instrument.
  • the publication DE 102017 124 775 A1 shows a microinvasive medical instrument with an instrument base and an accessory shaft that can be inserted into the instrument base with a transmission device for transmitting electrical power and for transmitting a force and / or a torque from a proximal position a distal position.
  • a contact device is arranged in the instrument base and is connected to a plug contact on the side facing away from the accessory shaft.
  • the disadvantage of such instruments is that the plug contact, for example a high-frequency connection, is permanently mounted in the instrument base, ie in the handle element.
  • Another disadvantage of an HF connection element is that it requires a complex sleeve system with internal cables in order to ensure the required safety distances and sufficient insulation. The cables therefore have to be connected in a complex manner during assembly. Care must be taken to ensure that no increased contact resistance occurs at the transition points between the connector sleeves and the respective cable. Correct assembly is therefore time-consuming and requires sufficient specialist knowledge.
  • a high-frequency connection for a surgical instrument with a connection body which has a locking section and an alignment section, the alignment section defining a connection axis of the high-frequency connection and the locking section for connection with a rotary wheel arrangement of the surgical instrument at a predetermined angle of a rotary wheel axis to the connecting axis, wherein in the area of the arm Retaining section, a high-frequency contact arrangement connected to the connecting body is provided, which is designed to contact a high-frequency tool of the surgical instrument within an instrument base, and wherein the high-frequency connection is used as a pre-assembled plug-in module for modular ren installation and removal in an instrument base of the surgical instrument is designed.
  • the finding underlying the present invention is that by constructing the high-frequency connection (HF connection) with a locking section and an alignment section, a connection of the HF connection to a rotary wheel arrangement within the instrument base is established at a predetermined angle can.
  • the idea underlying the present invention is to create a connection solution for surgical instruments that is easy to assemble and clean, easily replaceable if necessary, and technically optimized through a modular structure of the HF connection as a pre-assembled plug-in module.
  • connection body is to be understood in particular as a structural element which, on the one hand, can be contacted with the rotary wheel arrangement, in particular with a coupling section of the rotary wheel arrangement, and, on the other hand, enables a predetermined alignment of the HF connection in the instrument base and in the assembled state.
  • the connecting body can, for example, have two sections that are angled relative to one another, with one section serving as a locking section and the other section is designed as an alignment section. The two sections that are angled relative to one another allow, on the one hand, an alignment of the HF connection in the instrument base and, on the other hand, an alignment of the HF connection relative to the rotary wheel arrangement.
  • a surgical instrument can, for example, be modularly disassembled into individual components, such as a handle, the HF connection, an outer shaft and a working insert.
  • An instrument base suitable for the high-frequency connection can have different designs and, for example, include a handle element or a robot coupling.
  • the instrument base is designed as a handle.
  • the instrument base has at least one connection slot for inserting the HF connection.
  • an accessory shaft or the like can be arranged on the instrument base, in particular in a shaft opening.
  • a connection shaft is to be understood in particular as a receptacle for the HF connection.
  • connection axis can be defined by the orientation of the connection shaft in combination with the design of the connection body.
  • the alignment of the connection shaft and the connection axis can be the same.
  • the orientation of the rotary wheel axis can be defined by the orientation of the shaft opening.
  • the HF connection is designed as a pre-assembled plug-in module for modular installation and removal in an instrument base. In this way, a modular system can be provided for an electrosurgical instrument, which is characterized by the highest possible number of pre-assembled components. In particular, this allows a simple exchange and/or change between a monopolar and a bipolar design of the surgical instrument.
  • the connecting body can have a through opening in the area of the locking section, which is designed to guide a transmission element of a high-frequency tool that can be passed through the rotary wheel arrangement.
  • the transmission element is a tie rod.
  • the through opening serves to guide and/or electrically contact the pull rod guided in an accessory shaft.
  • the opening is advantageously larger than the largest diameter of a tie rod head of the tie rod element.
  • the tie rod element can be passed through the through opening and hung on an actuating element.
  • the actuation may be
  • the supply element is a thumb ring element that can be movably mounted on the instrument base to operate the pull rod.
  • the high-frequency contact arrangement can have at least one high-frequency contact element arranged in the area of the through opening, in particular on a side facing away from the locking section, which is designed to contact the pull rod.
  • the high-frequency contact element can be at least one spring contact, which can in particular be designed as a resilient bent sheet metal part.
  • the high-frequency contact arrangement can have at least one high-frequency contact element for contacting an accessory shaft of the high-frequency tool.
  • the at least one HF contact element can be designed as a, in particular resilient, bent sheet metal part. It can be fixed, for example welded, to the locking section.
  • several, in particular identical, HF contact elements can be arranged around the through opening, in particular distributed around the circumference of the through opening.
  • the HF contact elements are, for example, equally spaced and arranged adjacent to one another.
  • the connection body can have a protective geometry in the area of the locking section to protect a high-frequency contact arrangement.
  • the locking section can have a locking geometry which is designed for rotation-proof engagement with a coupling section of the rotary wheel arrangement.
  • the locking geometry can be adapted to the coupling section in terms of shape and dimensions in such a way that a fixation between the HF connection and the rotary wheel arrangement can be provided.
  • the locking geometry can be adapted to the geometry of a shaft connecting element that is inserted into the rotary wheel arrangement and guides the accessory shaft.
  • a rotation-proof engagement can be achieved in particular by clamping and/or by latching.
  • the protective geometry and the locking geometry can be designed integrally with one another.
  • the protective geometry and the locking geometry can be formed by one and the same component or by the same components.
  • it can be an injection molded part, preferably made of a plastic suitable for surgical use.
  • additive manufacturing would also be conceivable in other embodiments.
  • the HF connection can be functionally integrated and yet designed to save space and can be manufactured easily and in large quantities.
  • the locking geometry and/or the protective geometry can have at least one alignment projection, in particular two or more alignment projections, wherein the at least one alignment projection and the high-frequency contact arrangement are arranged adjacent to one another.
  • the HF contact arrangement is arranged next to at least one alignment projection and projects beyond this in the longitudinal direction of the rotary wheel axis. This means that when the accessory shaft is inserted into the instrument base, it contacts the at least one alignment projection when contact is made with the HF contact arrangement. In this way, a predetermined permissible elastic deformation of the HF contact arrangement is made possible without it being damaged by excessive deformation.
  • the high-frequency contact arrangement can have two or more high-frequency contact elements pre-assembled on the locking section, the alignment projections and the high-frequency contact elements being arranged next to one another, preferably alternately, on the locking section, so that the contact elements are each arranged in a space between the alignment projections.
  • this allows the HF contact elements to be installed in a pre-assembled HF connection correctly aligned and, on the other hand, arranged in the gaps to protect against excessive deformation.
  • the arrangement in the gaps means that even small tolerances can be correctly compensated for during assembly, since the freedom of movement of the HF contact elements is limited by the size of the gaps.
  • connection body for the rotational alignment of the connection body and the rotary wheel arrangement in the instrument base, at least one engagement element can be arranged on the connection body, in particular at a transition from the locking section to the alignment section, which is connected to a corresponding coupling element of the rotary wheel arrangement and /or the instrument base can be contacted.
  • the HF connection can be aligned with respect to the rotary wheel arrangement by clamping and/or by snapping.
  • the connection body can have a plug section that can be connected in the direction of the connection axis and to which the contact arrangement is conductively coupled. This allows the surgical instrument to be connected to an RF source.
  • the plug section can have at least one plug pole and a high-frequency contact element that is made from a bent sheet metal part.
  • a bent sheet metal part is elastic and can deflect into the spaces between the alignment projections, for example in the event of an overload. This allows the contact element to be protected from plastic deformation caused by an overload.
  • the at least one high-frequency contact element of the contact arrangement and the at least one high-frequency contact element of the plug section can be made from a common continuous bent sheet metal part.
  • the high-frequency contact element can be arranged, for example, on a distal side of the locking section.
  • the bent sheet metal part can, for example, be guided through the locking section and designed to protrude from the locking section on two opposite sides of the axis of rotation.
  • the plug section can have a, in particular solid, steel core inside, preferably in the form of a turned part made of solid material.
  • the HF connection is particularly robust because the steel core provides a high level of structural stability.
  • the steel core can form a second plug pole and a second high-frequency contact element designed as a bent sheet metal part can be materially connected, in particular welded, to the steel core to form a low-resistance connection.
  • the second bent sheet metal part can be designed to contact a second pole of the accessory, for example via a transmission element of the accessory, in particular the pull rod.
  • the second high-frequency contact element designed as a bent sheet metal part can be arranged on a proximal side of the locking section.
  • an HF connection can be formed that requires only a small amount of installation space, since one component has several Functions fulfilled.
  • the two power poles can be arranged on the connection body to save space.
  • FIG. 1 an embodiment of a shaft connecting element of a connecting device
  • 2 shows a further embodiment of a shaft connecting element of a connecting device
  • Fig. 3 shows an embodiment of a recording device
  • 4 shows the receiving device from FIG. 3 with the shaft connecting element inserted
  • 5 shows the receiving device from FIG. 3 with inserted shaft connecting element and pull rod
  • Fig. 6 shows a connecting device with non-matching elements
  • Fig. 7 shows a connecting device with non-matching elements
  • Fig. 8 shows a connecting device with mismatching elements
  • 9 shows an embodiment of a connection arrangement
  • Fig. 1 an embodiment of a shaft connecting element of a connecting device
  • 2 shows a further embodiment of a shaft connecting element of a connecting device
  • Fig. 3 shows an embodiment of a recording device
  • 4 shows the receiving device from FIG. 3 with the shaft connecting element inserted
  • 5 shows the receiving device from FIG. 3 with inserted shaft connecting element and pull rod
  • Fig. 6 shows a connecting device with non-matching
  • FIG. 10 is a further view of the embodiment from Fig. 9; 11 shows an embodiment of a connection body; Fig. 12 is a further view of the embodiment from Fig. 11; 13 shows an embodiment of an instrument base with a high-frequency connection; 14 shows a detailed view of the embodiment according to FIG. 13 with a detailed view of an embodiment of the high-frequency connection; 15 shows an embodiment of a coupling of the tie rod head with the handle element; 16 shows an embodiment of a connecting device in a detailed view; 17 shows an embodiment of a surgical instrument; 18 shows a further embodiment of a connecting device in a detailed view; 19 shows an embodiment of a shaft connecting element arranged on an accessory shaft.
  • the accompanying figures of the drawing are intended to provide a further understanding of the embodiments of the invention.
  • FIG. 1 shows an embodiment of a shaft connecting element 3 of a connecting device 1.
  • the shaft connecting element 3 is designed to connect an accessory shaft 4 to an instrument base 5 (not shown).
  • the shaft connecting element 3 is designed as a hollow body 8 for the passage of a transmission element guided in the accessory shaft 4, such as a pull rod (not shown).
  • the shaft connecting element 3 has a first shape coding dimension and a second shape coding dimension. In the embodiment shown in FIG. 2, these are characterized, for example, by a diameter D and a length L.
  • the first and second shape coding dimensions are dimensioned such that they correspond to a first and a second shape coding dimension of a receiving device 18 of an instrument base 5, shown for example in FIG. 3, when the shaft connecting element 3 and the instrument base 5 are closed belong to a common system and are intended to be connectable in an assembled state. However, if the shaft connecting element 3 and the instrument base 5 are not designed to correspond, they cannot be inserted into one another and cannot be coupled.
  • the coupling or fixation between the shaft connecting element 3 and the instrument base 5 or the receiving device 18 can take place, for example, with a projection 15 on the shaft connecting element 3; this is shown in detail in FIGS. 5 to 8.
  • a cover 37 with a so-called 4 x 90° geometry on the accessory shaft This means that four depressions are arranged along the circumference on the cover, which can engage in a counter contour on a rotary wheel arrangement 30, shown in FIG. 3 ff. and FIG. 16.
  • 3 shows an embodiment of a receiving device 18.
  • the receiving device 18 is arranged on a shaft opening 19 of an instrument base 5 and has a first and second shape coding dimension. A detailed representation of the shape codes is shown in FIG. 18, for example.
  • a first shape coding dimension can be, for example, a smallest inner diameter D' and a second shape coding dimension can be an intended shortest distance L' between a locking means 13 and a stop 20. Consequently, for a corresponding connection, the dimensions D and L must match or correspond to the dimensions D' and L', so that a shaft connecting element 3 with an accessory shaft 4 can be mounted in an instrument base 5.
  • 4 shows the recording device from FIG.
  • the catch has a through opening through which the shaft connecting element 3 can be passed.
  • An outer head section 40 of the detent is provided as an actuation section, while a spring 42 biasing the detent is arranged on a foot section 41.
  • the shaft connecting element 3 is designed to be too long for the receiving device 18, so that the locking means 13 cannot lock with the projection 15. Securing the shaft connecting element 3 in the longitudinal direction 14 of the surgical instrument is therefore not possible. A connection between the shaft connecting element 3 and the receiving device 18 is therefore not possible in this embodiment. This can be the case, for example, if mismatching elements of de-energized and live surgical instruments are to be incorrectly connected.
  • 5 shows the receiving device from FIG. 4 with the shaft connecting element 3 and pull rod 7 inserted. The pull rod 7 touches the through opening 11, but cannot penetrate it.
  • a diameter D2 of the through opening 11 represents a third shape coding dimension of the receiving device 18, and a diameter D3 of the pull rod 7, which is designed as a transmission element for electrical contacting, represents a third shape coding dimension of the shaft connecting element 3.
  • the diameter of the transmission element ie in this case the diameter D3 of the tie rod 7 or the tie rod head 10 can be, for example, between 2 mm and 2.5 mm.
  • the diameter D2 of the through opening 11 can therefore be, for example, between 2.1 mm and 2.3 mm, so that a tie rod head 10 with a larger diameter cannot be guided through the through opening 11. In this way, coding can be provided for different instrument systems.
  • the too large tie rod head 10 first touches the stop 20 or the too small through opening 11, so that a faulty combination can be recognized very early by a user through a protruding shaft connecting element 3. In particular, damage caused by excessive force can therefore be avoided.
  • Fig. 6 also shows a connecting device 1 with non-matching elements.
  • the diameter of the shaft connecting element 3 is more than a diameter of the receiving device 18 and therefore cannot engage in the diameter of the receiving device 18.
  • the diameter can be approximately 0.1 mm to 1 mm larger, preferably 0.1 mm to 0.5 mm, preferably 0.1 mm to 0.3 mm, for example 0.2 mm.
  • the diameter of the shaft connecting element 3 could be, for example, 8 mm and therefore not interfere with the diameter of the receiving device 18 with a dimension of 7.8 mm.
  • the blocking areas are shown with dashed circles.
  • Fig. 7 shows another connecting device 1 with non-matching elements.
  • the diameter of the tie rod head 10 is too large for the diameter of the through opening 11. This corresponds to the case as in FIG. 5.
  • FIG. 8 shows another connecting device 1 with non-matching elements.
  • the shaft connecting element 3 can, for example, be at least 1 mm, in particular 1 mm to 5 mm, preferably 1 mm to 3 mm, for example 2 mm, longer than the distance between the stop 20 and the locking means 13 of the receiving device 18.
  • FIGS. 6 to 8 represent different shape encoding dimensions.
  • FIG. 6 shows a first shape encoding dimension
  • FIG. 8 shows a second shape encoding dimension.
  • the situation in Figure 7 may represent a third shape encoding dimension.
  • 9 and 10 show an embodiment of a connection arrangement 100.
  • the instrument base 5 is designed to control and/or operate a high-frequency tool 2, for example shown in FIG. 17.
  • a high-frequency connection 17 mounted in the instrument base has a connection body 16.
  • connection body 16 has an alignment section 22, which serves for the predetermined alignment of the HF connection 17 on a connection axis H within the instrument base 5. Furthermore, the connection body has a locking section 21 for connection to a rotary wheel arrangement 30 of the surgical instrument at a predetermined angle of a rotary wheel axis DR to the connection axis H.
  • the rotary wheel arrangement 30 has a coupling section 31 for coupling to the connecting body 16. Through the coupling, the rotary wheel arrangement 30 can be aligned in the predetermined rotary wheel axis DR with respect to the connection axis H in the instrument base 5. For the rotational alignment of the connecting body 16 and the rotary wheel arrangement 30, at least one engagement element 25 shown in FIG.
  • the receiving device 18 can be designed to be pre-assembled.
  • the rotary wheel arrangement 30 can be manufactured pre-assembled with corresponding receiving elements 9, which in particular have the shape coding dimensions, as a specially coded version.
  • the rotary wheel arrangement 30 and the HF connection 17 can be inserted into the instrument base 5 from different directions.
  • the coupling can take place without visibility through the predetermined axes H and DR or their predetermined angles.
  • the two assemblies can finally be connected to one another in the instrument base 5 without any further aids.
  • the HF connection 17 and the receiving device 18, ie the rotary wheel arrangement 30, can be aligned without any aids.
  • the alignment ensures that the HF contacts are aligned concentrically to the inserted accessory shaft 4, the axis of which is defined by the rotary wheel arrangement 30.
  • Tolerance compensation of the components can also take place to a certain extent.
  • the axes H and DR are always the same and arranged at a predefined angle to one another in order to ensure perfect function of the surgical instrument. In particular, this avoids a misalignment, which could lead to contact problems during power transmission or to the pull rod 7 rubbing or even blocking.
  • the rotary wheel arrangement 30 can first be partially, in particular minimally, screwed into the instrument base 5 via a thread 43.
  • the HF connection 17 can then be inserted into the instrument base 5.
  • the rotary wheel arrangement 30 is then advantageously completely screwed into the instrument base 5.
  • the HF connection 17 comes into contact with the receiving device 18 (with the rotary wheel arrangement 30), these are aligned with one another. Since HF contact elements 23 are pre-assembled on the HF connection 17, any axial misalignments that may occur can be tolerated or compensated for.
  • complex and elaborate designs can still be implemented, which can still be assembled comparatively easily due to their easy accessibility and/or can be designed with a comparatively small number of connection points.
  • connection body 16 of an HF connection 17 has a locking section 21 and an alignment section 22.
  • a protective geometry 26 is provided to protect the HF contact arrangement. Consequently, the protective geometry 26 can protect the HF contact elements 23 from damage when inserting the HF tool 2, in particular when inserting the shaft and/or the pull rod.
  • the protective geometry 26 can be formed by a plurality of alignment projections 24, with the alignment projections 24 and the HF contact elements 23 being arranged adjacent and alternating to one another. Consequently, the contact elements 23 are each because it is placed in a kind of gap between the alignment projections 24.
  • an incompatible accessory shaft with an incompatible tie rod head 10 is inserted into the instrument base 5, it touches the surfaces of the alignment projections 24, thereby avoiding damage to the HF contact elements 23. Furthermore, it is possible for the HF contact elements 23 to deflect into the spaces between the alignment projections 24 in the event of an overload, so that they are not destroyed or rendered unusable by plastic deformation. Furthermore, the alignment and position of the HF contact elements 24 can be ensured by the protective geometry 26.
  • the alignment projections 24, together with the engagement element 25, also form a locking geometry 27, which is designed for rotation-proof engagement with the rotary wheel arrangement 30.
  • the receiving device 18 can have not only a rotary wheel arrangement 30, but also at least one receiving element 9, which can also come into contact with the locking geometry 27 and have a fixing effect.
  • a receiving element 9 can be designed in several parts and is shown, for example, in FIG. 18 in an exemplary embodiment.
  • 13 shows an embodiment of an instrument base 5 with an HF connection 17, the assemblies mounted with the instrument base 5 also being shown individually.
  • the HF connection 17 is designed as a pre-assembled plug-in module for modular installation and removal in the instrument base 5.
  • the HF contact elements 23 are also pre-assembled on the plug-in module.
  • the plug-in module can go along like this a connecting axis H can be inserted into the instrument base 5 and mounted.
  • a removable thumb ring 34 is arranged on the instrument base.
  • the rotary wheel arrangement is mounted or screwed in along the rotation axis DR.
  • Fig. 14 shows a detailed view of the high-frequency connection 17, once in the mounted position and once insulated.
  • the connection body 16 has a plug section 39 which can be connected in the direction of the connection axis H and to which the HF contact arrangement is conductively coupled.
  • the plug section 39 can have at least one plug pole 28 and an HF contact element 23 that is made from a coherent bent sheet metal part. In the area of the through opening 11, in the illustration on a side facing away from the locking section 21, further HF contact elements 23 'are arranged, which serve to contact the pull rod 7.
  • One HF contact element 23 and one HF contact element 23' can each be made from a continuous bent sheet metal part.
  • the plug section 39 can also have a solid steel core inside, which, for example, forms a second plug pole 29 and is welded to the HF contact element 23'.
  • the receiving device 18 and the HF connection 17 can be inserted into the instrument base 5 from different sides, for example shown in FIG. 13. Both assemblies are structurally designed in such a way that they are functional and modern with a minimum number of components. dular can be mounted or exchanged.
  • the steel core protects against damage and is therefore particularly robust during use.
  • the contact resistances within the HF connection 17 are produced by a cohesive connection, for example by welding, and are therefore designed to have a very low resistance.
  • the components 17 and 18 can therefore be pre-assembled completely independently and then inserted and used directly into the instrument base 5 in the sense of a “plug-and-play” assembly.
  • 15 shows an embodiment of a coupling of the tie rod head 10 with an actuating part of the instrument base 5.
  • the tie rod 7 with the tie rod head 10 is passed through the through opening 11 in the connecting body 16 and guided up to a coupling area 33 of the actuating element designed here as a thumb ring 34 .
  • the thumb ring 34 forms a movable handle leg and has a ball receptacle in the coupling area 33. This ball receptacle can be integrated in a form-fitting manner when the thumb ring 34 is manufactured, in particular by an injection molding process.
  • the tie rod head 10 can be accommodated in this ball receptacle and thus transmit a movement, in particular for opening and closing the accessory insert 12, such as a scissor tool, from proximal to distal.
  • Fig. 16 shows an embodiment of a connecting device 1 in a detailed view.
  • a cover 37 with a so-called 4 x 90° geometry on the accessory shaft.
  • the four recesses 44 provided for this purpose along the circumference on the cover 37 can engage in the counter contour on the rotary wheel arrangement 30.
  • the counter contour on the rotary wheel arrangement 30 is formed by protruding pins 45 corresponding to the recesses 44; two of four pins 45 can be seen in the view. 17 shows an embodiment of a surgical instrument 50.
  • the surgical instrument 50 has an accessory insert 12 in the form of an HF tool 2 at the distal end.
  • the accessory shaft 7 runs from the distal end proximally to the instrument base 5.
  • There the accessory shaft 4 is accommodated in the instrument base 5 as a receiving device via the rotary wheel arrangement 30.
  • an HF connection 17 is inserted into the instrument base 5 on a different axis.
  • the HF connection 17 is attached at an angle of 45° on the top of the instrument base 5 and thus leads the high-frequency cable away from the operating field.
  • An actuating element, here the thumb ring 34 is also mounted on the side of the instrument base 5 opposite the accessory shaft 4.
  • the accessory shaft can be decoupled from the actuating element; in particular, the tie rod head can then be removed from the ball head receptacle.
  • the rotary wheel arrangement 30 has the locking means 13 already explained. With the actuating element positioned horizontally, all you need to do is press a button on the head section 41 of the locking element. using 13 to separate the accessory shaft 4 from the actuating element. Then, for disassembly, the rotary wheel arrangement 30, here by unscrewing, and the HF connection 17, here by pulling out, can also be removed from the instrument base 5 in a modular manner.
  • the receiving device 18 of the rotary wheel arrangement 30 has a receiving element 9, which is designed in several parts.
  • the receiving device 18 can thus be formed from several sleeve-shaped elements that are fixed together. When assembled, individual elements can rotate within the instrument base 5, others can be fixed with it.
  • the sleeve-shaped element 46 shown in the middle which has the greatest extent in the longitudinal direction 14, can be screwed to the instrument base 5 via the thread 43.
  • the other sleeve-shaped elements rotate when the rotary wheel of the rotary wheel arrangement 30 is adjusted.
  • the rotary wheel 47 and the locking means 13 of the rotary wheel arrangement 30 can also be seen on the left side of the illustration.
  • the locking means 13 is shown detached from the rotary wheel 47.
  • the pin elements 45 integrated therein can be seen, which can engage in the recesses 44 of the cover 36, shown in FIG. 1.
  • the first and second shape coding dimensions are formed by the plurality of elements in the assembled state. These are shown schematically by a maximum diameter D' and a maximum length L', indicated by dashed lines and of course adjusted when installed.
  • 19 shows an embodiment of a shaft connecting element 3 arranged on an accessory shaft 4.
  • the pull rod 7 runs in the accessory shaft 4.
  • An insulating coating 38 is provided on the outside of the accessory shaft 4, for example a Halar coating ( ECTFE).
  • a seal 37 is provided between the accessory shaft 4 and the cover 36, for example in the form of a sealing lip.
  • the projection 15 can be seen on the shaft connecting element 3, which represents a measure for the first and second shape coding dimensions. These are characterized by the diameter D and the length L.
  • the seal 37, the cover 36 and the shaft connecting element 3 can form a two-component insert injection molded part.
  • the shaft connecting element 3 can have a geometry that deviates from that shown.
  • the receiving device 18 can have a geometry that deviates from the embodiment shown have, in particular through differently shaped individual elements, such as individual shaped receiving elements 9.
  • the coupling between the rotary wheel arrangement 30 and the cover 36 can be designed differently.

Landscapes

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

L'invention concerne une connexion haute fréquence pour un instrument chirurgical, comprenant un élément de connexion ayant une section de blocage et une section d'orientation, la section d'orientation définissant un axe de connexion de la connexion haute fréquence et la section de blocage étant conçue pour se connecter à un ensemble roue rotative de l'instrument chirurgical à un angle prédéterminé d'un axe de roue rotative par rapport à l'axe de connexion, un ensemble de contact haute fréquence connecté à l'élément de connexion étant disposé dans la région de la section de blocage, qui est conçue pour entrer en contact avec un outil haute fréquence de l'instrument chirurgical à l'intérieur de la base d'instrument, et la connexion haute fréquence étant conçue sous la forme d'un module d'insertion pré-assemblable pour une insertion modulaire dans une base d'instrument de l'instrument chirurgical et son retrait d'une base d'instrument de l'instrument chirurgical.
PCT/EP2023/070504 2022-07-26 2023-07-25 Connexion haute fréquence pour un instrument chirurgical WO2024023047A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102022118636.9A DE102022118636A1 (de) 2022-07-26 2022-07-26 Hoch-Frequenz-Anschluss für ein chirurgisches Instrument
DE102022118636.9 2022-07-26

Publications (1)

Publication Number Publication Date
WO2024023047A1 true WO2024023047A1 (fr) 2024-02-01

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PCT/EP2023/070504 WO2024023047A1 (fr) 2022-07-26 2023-07-25 Connexion haute fréquence pour un instrument chirurgical

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DE (1) DE102022118636A1 (fr)
WO (1) WO2024023047A1 (fr)

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6270497B1 (en) * 1998-08-27 2001-08-07 Olympus Optical Co., Ltd. High-frequency treatment apparatus having control mechanism for incising tissue after completion of coagulation by high-frequency treatment tool
DE20309776U1 (de) * 2003-06-20 2003-10-02 Aesculap Ag & Co Kg Chirurgisches Instrument
DE202007000428U1 (de) * 2007-01-08 2007-03-08 Aesculap Ag & Co. Kg Elektrochirurgisches Verbindungsglied und elekrochirurgisches Instrument
DE102016117268A1 (de) * 2016-09-14 2018-03-15 Olympus Winter & Ibe Gmbh Chirurgisches bipolares Handinstrument und Verfahren zur Herstellung eines chirurgischen bipolaren Handinstrumentes
DE102017124775A1 (de) 2017-10-24 2019-04-25 Karl Storz Se & Co. Kg Handhabungseinrichtung für ein mikroinvasives medizinisches Instrument
EP3135235B1 (fr) * 2015-08-31 2020-02-19 Eubanks, Steve Instrument chirurgical laparoscopique
US20210322044A1 (en) * 2019-12-27 2021-10-21 Konmex Limited Liability Company Laparoscopic instrument

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE202008012057U1 (de) 2008-09-11 2008-12-18 A.M.I. Gmbh Chirurgisches Instrument mit integriertem Handschalter

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6270497B1 (en) * 1998-08-27 2001-08-07 Olympus Optical Co., Ltd. High-frequency treatment apparatus having control mechanism for incising tissue after completion of coagulation by high-frequency treatment tool
DE20309776U1 (de) * 2003-06-20 2003-10-02 Aesculap Ag & Co Kg Chirurgisches Instrument
DE202007000428U1 (de) * 2007-01-08 2007-03-08 Aesculap Ag & Co. Kg Elektrochirurgisches Verbindungsglied und elekrochirurgisches Instrument
EP3135235B1 (fr) * 2015-08-31 2020-02-19 Eubanks, Steve Instrument chirurgical laparoscopique
DE102016117268A1 (de) * 2016-09-14 2018-03-15 Olympus Winter & Ibe Gmbh Chirurgisches bipolares Handinstrument und Verfahren zur Herstellung eines chirurgischen bipolaren Handinstrumentes
DE102017124775A1 (de) 2017-10-24 2019-04-25 Karl Storz Se & Co. Kg Handhabungseinrichtung für ein mikroinvasives medizinisches Instrument
US20210322044A1 (en) * 2019-12-27 2021-10-21 Konmex Limited Liability Company Laparoscopic instrument

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