• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    The invention relates to a device (100) for a medical instrument for attaching a surgical suture, comprising a triggering unit (200) and an operating unit (300), wherein the operating unit (300) comprises two pivotable gripping jaws (310, 320), and wherein each Gripping jaw (310, 320) has a needle holder (340) and a Nadelelfixiereinrichtung, and wherein the trigger unit (200) for movement of the two gripping jaws (310, 320) is arranged, and the trigger unit (200) is set up in addition to the operation of the Nadelelfixiereinrichtung.
    公开号:AT518032A1
    申请号:T50991/2015
    申请日:2015-11-20
    公开日:2017-06-15
    发明作者:Johann Klaffenböck Mag；Lukas Klaffenböck Ing；MAIR Julian
    申请人:Johann Klaffenböck Mag；Lukas Klaffenböck Ing；MAIR Julian；
    IPC主号:
    专利说明:

    The invention relates to a device for a medical instrument for attaching a surgical suture, comprising a triggering unit and an operating unit, the operating unit having two pivotable gripping jaws, each gripping jaw having a needle holder and a needle fixing device, and wherein the triggering unit is arranged to move the two gripping jaws and the use of this device in a surgical instrument.
    In many surgical procedures, it is necessary to set a surgical suture. Due to new instruments, the surgical methods have improved so much that numerous procedures can be carried out endoscopically in order to be able to minimize the burden on the patient. Thus, EP 2 083 727 B1 describes a device of the type mentioned in the introduction, wherein a forceps-like end effector is set up to set a surgical suture. Similar devices can also be found in EP 2 462 877 A2.
    The devices for setting a surgical suture described in the prior art are often constructed extremely complicated and require two independent actuation systems, namely a first for actuating the gripping jaws and a second for fixing the needle in the respective jaw or for the needle transfer between the two gripping jaws ,
    It is therefore an object of the invention to further develop the devices known, and in particular to provide a device which is easy to use and provides a stable and correctly set surgical suture.
    This object is achieved by the device mentioned above according to the invention in that the trip unit is set up in addition to the operation of the needle fixing device. The invention has the advantage that a single trigger system is responsible for both the movement of the jaws and the needle transfer. This allows easy operation and a slim design, which is particularly advantageous in endoscopic surgical methods.
    In this context, it should be noted that in the present disclosure "operation unit" is understood to mean that part of the device according to the invention which directly fulfills the stated task, namely the setting of a surgical suture, while the "trigger unit" covers the movements and functions of the operating unit controls.
    According to the invention, it is provided that the triggering unit is additionally set up for actuating the needle-fixing device. In a general embodiment of the invention, this can for example be realized such that the trip unit closes the jaws in a first stroke, and fixed in a second, subsequent stroke, the needle in a gripping jaw. It can be determined via an external signal in which of the two jaws the needle is fixed. This can be realized for example by an electrically controlled changeover.
    However, particularly preferred is a particular embodiment of the present invention, in which the switching is fully automatic. In this case, the triggering unit fixes, for example, in the second stroke of a first actuation the needle on a first gripping jaw, and in a subsequent second stroke of a second actuation, the needle on the second gripping jaw. After the first actuation takes place an intermediate step in which the two gripping jaws are moved apart before the second operation for fixing the needle in the second jaw, so the needle transfer takes place.
    Preferably, the gripping jaws are hinged together and can be pivoted to each other during the operation or moved apart. This articulated connection is realized in a particularly preferred embodiment such that the two gripping jaws each have a slot-like recess with a first end and a second end, in which a triggering element of the trip unit, preferably a sliding block is arranged. When a movement is triggered via the release unit, the pivoting of the jaws is caused. Here, the sliding block is moved within the slot-like recess, wherein the curved course of the slot-like recess allows the adoption of defined operating conditions, which will be described in detail elsewhere.
    A particularly simple and safe operation of the device according to the invention is made possible when the trip unit has a hydraulic system. A hydraulic system suitable for this purpose can be found, for example, in EP 2 429 377 B1 of the Applicant.
    A precise transfer and fixation of the needle in the respective jaw is obtained in a particularly preferred embodiment of the invention, when the needle fixing has at least one pawl member which is movable via the trigger unit.
    In a further embodiment of the invention, the at least one pawl element cooperates with a triggering means, preferably a gear element.
    The terms "gear" and "gear member" are not limited to machine elements that mesh with other gears or racks. In a preferred embodiment, a first gear cooperates with a pawl, which drives the gear by a movement in its longitudinal direction with appropriate operation. The second gear is about a wheel having a plurality of circumferentially disposed cams that move a bumper in its axial direction. It is particularly preferred that the second gear has twice as many teeth as the first gear.
    In this case, it is particularly preferably provided that the gear element has two gears, which are arranged plane-parallel to each other and have a different number of teeth. These two gears are interconnected so that as soon as a first gear is rotated, the second gear is also rotated. It is particularly preferred in this case provided that the gear element is made in one piece.
    When moving the pawl member along the jaw the first gear of the gear member is rotated. Since the two gears of the gear member are connected to each other, rotates upon movement of the pawl member and the second gear member. Due to the different numbers of teeth of the two gears results in a change in
    Operating frequency, whereby different positions of the jaws to each other and / or the at least one suture needle are adjustable.
    It is further preferably provided that the needle fixing device has at least one movable slide element, wherein the at least one slide element is adapted to fix at least one suture needle in the needle holder. In this case, the at least one slide element cooperates with the at least one gear element, in particular with the second gear, while, as already described above, the catch element is in engagement with the first gear wheel.
    The movement of the slider element for fixing the at least one surgical suture needle and in particular the release of the fixation of the at least one surgical suture needle is supported in a further embodiment of the invention in that at least a first spring element cooperates with the at least one slider element.
    Alternatively, in principle, a forced operation is possible in which the movement of the slider element in both directions is necessarily effected by the second gear. In this case, the sliding element engages around the gear, for example, and no spring element is needed.
    A further improvement of the fixation of the at least one suture needle is achieved if at least one further spring element cooperates with the at least one pawl element.
    The device according to the invention has proved to be particularly useful when used in a surgical instrument, in particular a flexible endoscopic instrument, which is preferably configured for transoral placement in a stomach. In this case, an actuating device is arranged at the proximal end of the elongated element of the surgical suture surgical instrument, the device according to the invention being arranged at the distal end of the elongated element and cooperating with the actuating device.
    The invention is explained in more detail below with reference to non-limiting exemplary embodiments with associated figures. Show:
    FIGS. 1A and 1B: two side views of the device according to the invention in a first, opened position;
    FIGS. 2A and 2B: two side views of the device from FIGS. 1A and 1B in a first closed position,
    FIGS. 3A and 3B show two side views of the device from FIGS. 1A and 1B in a second closed position;
    FIGS. 4A and 4B show two side views of the device from FIGS. 1A and 1B in a third closed position,
    FIG. 5: a first embodiment of the device according to the invention in a perspective view,
    FIGS. 6A and 6B: the operating unit of the device from FIG. 5,
    FIG. 7: the operating unit in the opened state,
    FIG. 8A: a first side view of the gear element according to the invention, and FIG
    FIG. 8B shows a second side view of the gear element according to the invention.
    In FIGS. 1A and 1B, the device 100 according to the invention is shown in a first open position. This device 100 is usually referred to as an end effector, wherein in the context of this disclosure, the term "end effector" is used synonymously for the device according to the invention for applying a surgical suture.
    The end effector 100 has a triggering unit 200 and an operating unit 300. The trip unit 200 is preferably designed as a hydraulic piston system (not shown).
    The operating unit 300, which is responsible for setting the surgical suture, has two gripping jaws 310, 320, which in this embodiment of the invention have a substantially mirror-image construction. The operation unit 300 is operated by the release unit 200, which relates to both the movement of the two jaws 310, 320 and the fixation of the suture needle 400 in the jaw 310, 320.
    The trip unit 200 itself is in turn driven by an actuator of a surgical instrument (not shown). For illustrative purposes, the outer housing of end effector 100 mounted in use is removed.
    The jaws 310, 320 each have a slot-like recess 330, wherein the gripping jaws 310, 320 are arranged to each other such that in the recesses 330, a sliding block 210 of the trip unit 220 engages. In the open state of the end effector 100 shown in FIGS. 1A and 1B, the sliding block slide 210 is located at a first end 331 of the recess 330. The release unit 200 further has a stop plate 220 (FIG. 1B) which is in frictional connection with the sliding block slide 210 stands. In this position, a suture needle 400 is fixed with its first end 401 in the needle holder 340 of the first jaw 310. For this purpose, the suture needle 400 has a groove-like needle recess 410 which serves to fix the suture needle 400 in a needle receptacle 340.
    Upon actuation of the sliding block slide 210 this moves in the recess 330 from the first end 331 in the direction of the second end 332. Upon actuation of the trip unit 200 of the slide slide 210 is moved to a second position, whereby the two gripping jaws 310, 320 are moved to each other, and the second needle end 402 of the suture needle 400 is inserted into the needle receptacle 340 of the second jaw 320 (FIGS. 2A and 2B).
    If the sliding block slide 210 is moved further in the direction of the second end 332 of the slot-like recess 330 via the tripping unit 200, as shown in particular in FIGS. 3A and 3B and FIGS. 4A and 4B, the position of the gripper jaws 310, 320 no longer changes with respect to one another. The movement of the slide cam 210 beyond the position shown in Figures 2A and 2B now causes a triggering of the two Nadelelfixiereinheiten, which are respectively disposed within the gripping jaws 310, 320 and in particular in Figures 5 to 9 described in more detail below.
    In FIG. 5, the end effector 100 according to the invention is shown in the position corresponding to the first closed position according to FIGS. 2A and 2B. The suture needle 400 is fixed here in the needle receptacle 340 of the first gripping jaw 310. The stop plate 220 is in direct contact with a pawl element 350, which can be displaced by means of the stop plate 220 substantially along the longitudinal axis of the first gripping jaw 310 via a latching nose 351.
    The pawl member 350 engages in a first gear 361 of a gear member 360, which is shown in detail in Figures 8A and 8B. The gear member 360 consists of two plane-parallel gears 361, 362, which have a different number of teeth 363. If now the first gear 361 is rotated, the second gear 362 also rotates due to the same axis of rotation. In the present example, the first gear 361 has ten teeth 363, while the second gear 362 of the gear element 360 has five teeth 363. Thus, this gear member 360 has a ratio of the operation frequency of 1: 2. In addition, the first gear 361 is designed as a ratchet wheel.
    When the stopper plate 210 is moved toward the needle 400, the pawl member 350 is also moved in this direction, whereby the first gear 361 of the gear member 360 is rotated counterclockwise as shown in Fig. 6A. By the rotation of the first gear 361 at the same time in the same direction with the first gear 361 rotationally connected second gear 362 is rotated, due to the unequal number of teeth 363 of the first gear 361 and second gear 362 only with sufficient feed of the stop plate 210, a movement of a slider element 370 via the second gear 362 is triggered, which in turn takes place a fixation or release of an end 401 of the suture needle 400.
    The slider element 370 engages in the second gear 362, as shown in particular in FIG. 5 in the region of the second gripping jaw 320. This slide element 370 has at its end facing away from the second gear 362 a plunger 371, which is adapted to the groove-like
    Needle recess 410 of the suture needle 400 to engage, so as to fix the end 401, 402 of the suture needle 400 in the needle holder 340.
    In the figure 6A, the second end 402 of the suture needle 400 is still unfixed in the needle holder 340 of the second jaw 320, wherein due to a further feed of the sliding block 210, a rotation of the second gear 362 in the second jaw 320 causes the plunger 371 of Slider element 370 in the second gripping jaw 320 is displaced such that it engages in the groove-like needle recess 410 of the suture needle 400, and so fixes the second end 402 of the suture needle 400 in the needle holder 340.
    Upon further advancement of the stop plate 210, the rotation of the gear element 360 of the first gripping jaw 310 causes the plunger 371 to be retracted by means of a first spring element 372 and releases the first needle end 401 of the suture needle 400 in the needle receptacle 340 of the first gripping jaw 310.
    If now the end effector 100 is opened again by moving the gripping jaws 310, 320 apart (FIG. 7), the suture needle 400 is now fixed in the second gripping jaw 320. By again closing the end effector 100 to the end position according to FIGS. 4A and 4B, the suture needle 400 is again arranged and fixed in the first gripping jaw 310. Thus, by alternately opening and closing the end effector 100, the needle 400 can be reciprocated between the two gripping jaws 310, 320 so as to perform a sewing motion to produce a surgical suture.
    It is understood that the present invention is not limited to the illustrated embodiments. In particular, the shape of the jaw and / or the suture needle can be designed differently, and it is not absolutely necessary that the movement of the gripping jaw and / or the slider element and / or the pawl member is triggered by means of a hydraulic system. For example, in a further embodiment of the invention, the fixation or release of the respective ends 401, 402 of the suture needle 400 is further improved by providing additional spring elements for stabilizing the ram 371. These additional spring elements ensure a constant contact pressure of the plunger 371 in the groove-like needle recess 410.
    Further spring elements may further be provided for the stabilization and movement of the pawl member 350.
    权利要求:
    Claims (10)
    [1]
    A medical suture attaching device (100) comprising a triggering unit (200) and an operating unit (300), the operating unit (300) comprising two pivotable gripping jaws (310, 320), each jaw (310 , 320) has a needle receptacle (340) and a needle fixing device, and wherein the release unit (200) is arranged for moving the two gripping jaws (310, 320), characterized in that the triggering unit (200) is set up in addition to the operation of the needle fixing device.
    [2]
    2. Device (100) according to claim 1, characterized in that the two gripping jaws (310, 320) each have a slot-like recess (330) with a first end (331) and a second end (332), in which a triggering element the trip unit (200), preferably a slide gate (210) is arranged.
    [3]
    3. Device (100) according to claim 1 or 2, characterized in that the release unit (200) has a hydraulic system.
    [4]
    4. Device (100) according to one of claims 1 to 3, characterized in that the needle fixing device has at least one pawl member (350) which is movable over the triggering unit (200).
    [5]
    5. Device (100) according to claim 4, characterized in that the at least one pawl element (350) cooperates with a triggering means, preferably a gear element (360).
    [6]
    6. Device (100) according to claim 5, characterized in that the gear element (360) has two toothed wheels (361, 362), which are arranged substantially plane-parallel to one another and have a different number of teeth (363).
    [7]
    7. Device (100) according to one of claims 1 to 6, characterized in that the needle fixing device has at least one movable slide element (370), wherein the at least one slide element (370) is adapted to at least one suture needle (400) in the Needle holder (340) to fix.
    [8]
    8. Device (100) according to claim 7, characterized in that the at least one slide element (370) cooperates with the at least one gear element (360).
    [9]
    9. Device (100) according to claim 7 or 8, characterized in that at least one first spring element (372) cooperates with the at least one slide element (370), and preferably at least one further spring element cooperates with the at least one latch element (350).
    [10]
    10. Surgical instrument for attaching a surgical suture with an elongated member, at the proximal end of an actuator is arranged, characterized in that a device (100) according to any one of claims 1 to 9 is arranged at its distal end and cooperates with the actuating device ,
    类似技术:
    公开号 | 公开日 | 专利标题
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    EP0768838B1|1998-08-05|Surgical suturing device
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    DE202008015763U1|2010-04-08|Instrument for laparoscopic surgery
    WO1997018757A1|1997-05-29|Device for carrying out manipulations in the human body, in particular in the uterus
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    DE112013001860T5|2014-12-24|Electrosurgical instrument
    EP2497522A1|2012-09-12|Slitter Tool
    CH671724A5|1989-09-29|
    EP1992293B1|2013-11-20|Medical gripping device
    同族专利:
    公开号 | 公开日
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    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    US5632751A|1995-07-28|1997-05-27|Piraka; Hadi A.|Surgical suturing device|
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    US9498207B2|2012-12-13|2016-11-22|Ethicon Endo-Surgery, Llc|Cartridge interface for surgical suturing device|
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    法律状态:
    优先权:
    申请号 | 申请日 | 专利标题
    ATA50991/2015A|AT518032B1|2015-11-20|2015-11-20|MEDICAL INSTRUMENT|ATA50991/2015A| AT518032B1|2015-11-20|2015-11-20|MEDICAL INSTRUMENT|
    US15/776,330| US11000269B2|2015-11-20|2016-11-17|Medical instrument|
    KR1020187017552A| KR20180103048A|2015-11-20|2016-11-17|Medical equipment|
    CA3005638A| CA3005638A1|2015-11-20|2016-11-17|Medical instrument|
    PCT/AT2016/060111| WO2017083897A1|2015-11-20|2016-11-17|Medical instrument|
    JP2018526198A| JP6904950B2|2015-11-20|2016-11-17|Equipment for medical devices|
    CN201680068030.3A| CN108601586B|2015-11-20|2016-11-17|Medical instrument|
    EP16805716.4A| EP3376966B1|2015-11-20|2016-11-17|Medical instrument|
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