Handle for a medical instrument

Details Handle for a medical instrument Handle for a medical instrument

2000-09-01

2002-08-20

Truong, Kevin T. (Department: 3731)

Surgery

Instruments

Forceps

Reexamination Certificate

active

06436122

ABSTRACT:

BACKGROUND OF THE INVENTION
The invention generally relates to a handle for a medical instrument comprising at least one movable grip element and a coupling portion through which a shaft can be or is joined with the handle. The movable grip element is joined or can be joined with a force transmission element axially movable in the direction of the longitudinal axis of the shaft for translating motion of the at least one movable grip element into a linear motion of the force transmission element.
Such a handle is known for example from the German firm catalogue of the company Karl Storz GmbH & Co., Tuttlingen, “Karl Storz-Endoskope”, volume “Endoskopische Chirurgie”, second edition January 1994, page DGC 5/1 A.
Medical instruments are employed for various types of surgical operations on the human and animal body, in particular in minimal invasive surgery. Such instruments, for example tubular shaft instruments, can be configured as forceps, for example preparing or grasping forceps, forceps for cutting tissue, or as stamping or punching tool or the like. Depending on their varying function, the instruments differ in the corresponding configuration of the tools at the distal end. Cutting, grasping or punching tools can be provided at the distal end, where such an instrument comprises at least one movable tool, for example in the form of a jaw or a jaw part. However, such instruments can also comprise two or more movable tools at the distal end.
The instruments have a handle at the proximal end of the shaft to actuate the at least one movable tool. The shaft of the instrument is normally releasably or non-releasably joined with a coupling portion of the handle. In addition, the handle comprises at least one movable grip element for providing the actuation of the at least one movable tool at the distal end of the shaft. To actuate the at least one movable tool at the distal shaft end, the at least one movable grip element of the handle is joined in force-locking manner with the at least one movable tool through a force transmission element axially movable in the direction of the longitudinal axis of the shaft, for example a push and pull rod. Thus, motion of the movable grip element, for example a rotation or axial motion, is translated into axial relative motion of the force transmission element with respect to the shaft and finally motion of the movable tool.
A handle of the above-mentioned type is known in various configurations. The handle usually comprises a second grip element which is either stationary and fixed to the shaft or is also movable. Such a handle can also be formed as a scissors handle, where the two grip elements extend sidewards from the shaft of the instrument, as illustrated in the above-mentioned company brochure. In the sense of the present invention, the handle however can also be formed like a pistol grip element or like a bar grip element held in the fist of one hand.
Common to all these types of handles is that the handles in the joined condition with the shaft have a fixed, invariable angular position with respect to the shaft, i.e. the handle axis and the longitudinal axis of the shaft form a fixed angle with respect to one another.
However, a handle having a fixed angle with respect to the axis of the shaft is not always adapted to the requirements of the operating doctor with respect to its handling properties. Different doctors prefer different grip element orientations of the same type of handle with respect to the shaft depending on what they are accustomed to. To always have the handle with the optimal ergonomic angular position with respect to the shaft, it would therefore be necessary to have a set of several handles for each type of handle, which have different angular positions when joined with the shaft, so that the doctor can select the most ergonomic and optimal handle for himself. If the handles are not exchangeable, this means that for each instrument, an entire set of such instruments with differently angled handles must be available.
In addition, it can be desirable or necessary in some cases that the handle of the same instrument should take on different angular positions with respect to the shaft during the operation to have the most comfortable and therefore safest hand position for the operation procedure to be carried out. This would mean with the known handles, assuming a complete set were available, that the handle would have to be exchanged several times during the operation or with the nonexchangeable handles, the entire instrument would have to be exchanged which would substantially prolong the operation.
Accordingly, the known handles have disadvantages with respect to their ergonomic properties.
The object of the present invention is therefore to provide an improved handle of the above-mentioned type, which allows an ergonomic handling of the instrument, without having to exchange the handle or possibly even the entire instrument.
SUMMARY OF THE INVENTION
This object is achieved according to the invention by providing a handle for a medical instrument, comprising:
at least one movable grip element for being joined with a force transmission element axially movable in direction of a longitudinal axis of a shaft of said instrument to transfer motion of said at least one movable grip element into linear motion of said force transmission element;
a coupling portion for joining said shaft with said handle, said coupling portion being pivotal relative to a handle axis about at least one first pivot axis running transversely to the longitudinal axis of said shaft;
a lever arrangement for joining said at least one movable grip element with said force transmission element, comprising at least two double-arm levers, a first lever of which being pivotal about a first axis stationary with respect to said handle and a second lever of which being pivotal about a second axis stationary with respect to said coupling portion, and said two levers being joined to another to be pivotal with respect to one another about said first pivot axis.
According to the invention, the coupling portion through which the handle is joined or can be joined with the shaft is pivotal, so that the handle can be disposed in different angular positions with respect to the shaft. Preferably, the adjusted angle of the handle can be locked for rigid connection of the shaft to the handle to then employ the instrument in an operation procedure. With the pivotal configuration of the coupling portion, the doctor himself can adjust the optimal ergonomic angle between the handle and the shaft, without having to exchange the handle or even the entire instrument. The handle according to the invention is therefore substantially improved with respect to ergonomics.
In providing the adjustability of the handle axis with respect to the longitudinal axis of the shaft, the problem arises that the force transmission element must be joined with the movable grip element such that the motion of the movable grip element can be translated into axial motion of the force transmission element for all angles of the handle. In the conventional handles, the force transmission element, normally formed as a push and pull rod, is directly joined with the movable grip element at its proximal end. This type of connection of the force transmission element however cannot be retained if the handle is placed at an angle with respect to the shaft. This would mean that the force transmission element in the area of the pivot axis of the coupling portion would also have to be deflected, angled or bent and a compensation for the length of the force transmission element would also be provided depending on the angle of the shaft with respect to the handle axis. The use of a flexible transmission element, for example in the form of a Bowden cable, which could adapt to the different angles in the angled region, would have the disadvantage that increased friction would arise at the deflection position. Also, when angling the shaft with respect to the handle, the movable grip element would be undesirably moved

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