Holding device for a surgical instrument

Supports – Brackets – Adjustable

Reexamination Certificate

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Details

C248S123200, C248S281110, C074S490060, C414S729000, C414S735000

Reexamination Certificate

active

06290196

ABSTRACT:

The present disclosure relates to the subject matter disclosed in German patent application No. 198 22 195.9 of May 16, 1998, the entire specification of which is incorporated herein by reference.
BACKGROUND OF THE INVENTION
The invention relates to a holding device for a surgical instrument comprising a holder for the instrument.
When performing operations it is often necessary to position surgical instruments in a certain position relative to the body and to fix the surgical instruments by means of a holder on the holding device which enables movement of the instrument relative to the holding device. For example, endoscopes have to be brought into different positions, etc.
When the instruments are guided through openings of the body, the problem arises, particularly when pivoting such instruments, that the instruments can only be pivoted through very small angles when the openings of the body are narrow, since the pivotal movement is limited by the size of the body opening.
The object of the invention is to so design a holding device of the generic kind that an instrument can be mounted at a spacing from an opening of the body in such a way as to be movable over a large pivot angle in spite of the expanse of the opening of the body being limited.
SUMMARY OF THE INVENTION
This object is accomplished with a holding device of the kind described at the beginning, in accordance with the invention, in that the holder is held via at least two guide rods on a frame, the guide rods being rotatably connected to the frame and to the holder, the bearing points of the guide rods on the holder being arranged at a spacing from one another, and the spacing of the bearing points on the frame being greater than the spacing of the bearing points on the holder.
Such a holding device design makes it possible to pivot the holder in the holding device along the path predetermined by the guide rods. An instrument mounted on the holder and directed at an opening of the body at a distance from the holder can then target this opening of the body during the entire movement of the holder as the holder is moved on a path which is essentially an approximation of the path of a circle or the surface of a sphere owing to the described kinematics. The center point of this circular path or spherical surface remains substantially unchanged, and if the holding device is arranged relative to the opening of the body in such a way that this center point lies in the region of the opening of the body, an instrument mounted on the holder can be positioned at a different angle of inclination such that its prolongation always runs through this center point and hence through the opening of the body. With each pivotal movement of the instrument, only the angle of inclination changes in the region of the center point, not the sideways position of the instrument, and, therefore, the pivotal movement is not impeded by the opening of the body or by the tissue surrounding the instrument in this region.
When within the scope of this invention, mention is made of a mounting of the holder via “guide rods”, real guide rods are primarily being referred to, i.e., rod-shaped connecting elements between frame and holder. However, such guide members as movably guide a holder on the frame in such a way that the holder is guided relative to the frame so that the bearing points on the holder and on the frame which a real guide rod would assume are at a constant spacing from one another, even when these points are not connected to one another by real guide rods, also come under the term “guide rods”. In an arrangement with two guide rods, i.e., in which the holder is only pivotable two-dimensionally, such a guidance of the holder could, for example, be realized by an orbital curve with which drivers on the holder match.
In this sense, the invention thus relates to real guide rods as well as to “virtual guide rods” which are defined solely by the constant spacing of the bearing points between which a real guide rod could engage.
It is crucial to the invention that owing to the special kinematics of the holder, a center point is created for the movement of the holder, which during all movements of the holder relative to the frame essentially maintains its position and is arranged at a spacing from the frame and from the holder so that the holding device can be placed on a patient's body in such a way that this unchangeable center point can be arranged at an opening of the body or inside the body where the holding device itself has no room.
Such a holding device could, for example, also be used to apply a beam with a different direction, for example, a laser beam, which is then incident in the region of this center point at a different angle but unmoved sideways.
Provision may, however, also be made for the surgical instrument to protrude on the side remote from the guide rods half-way between the bearing points on the holder beyond the line connecting the bearing points on the holder, i.e., for the instrument, seen from the holder, to approach this center point.
In particular, it is advantageous for the instrument to protrude at least so far out of the holder that it intersects a line which runs between the bearing points on the frame perpendicularly to their connecting lines. In other words, the instrument protrudes to such an extent out of the holder that it at least reaches the described center point.
It is expedient for the guide rods to be of the same length.
In a first embodiment, two guide rods are provided. Herein the movement of the holder is limited by guidance to a pivotal movement in the plane defined by the four bearing points. In this case, the holder can only be pivoted in one plane.
The guidance can, for example, be realized by the guide rods being pivotable at the bearing points about parallel axes which extend perpendicularly to the plane spanned by the bearing points.
In another embodiment, three guide rods are provided. These are cardanically mounted at the bearing points. The bearing points are offset uniformly along a circle in the circumferential direction. In such a construction, the holder can be pivoted in space. In this case, the holder moves approximately on a spherical surface and thus defines a center point which is identical in all positions of the holder.
It is expedient herein for the cardan mounting to be formed by a ball-and-socket joint mounting.
Provision is made in a preferred embodiment for the holder to carry a displacement device on which the instrument is displaceable along a line which runs between the bearing points perpendicularly to the lines connecting the bearing points on the holder. The instrument can thus be adjusted with respect to its spacing from the center point which remains the same. For example, the penetration depth of an endoscope is thereby adjustable.
In a preferred embodiment, the displacement device comprises a sleeve-type shaft which receives the instrument and is preferably held telescopically in a sleeve of the holder. In particular, the shaft can be screwable into the sleeve.
It is expedient for the frame to be of ring-shaped configuration.
In particular, provision may be made for the frame to comprise a side wall which surrounds the guide rods on the outside thereof and preferably widens in the shape of a funnel.
On the underside thereof, the frame can be closed off by the holder of plate-shaped construction.
In a particularly preferred embodiment, further provision is made for there to be mounted on the frame an adjustment device which displaces the holder relative to the frame along the paths predetermined by the guide rods and fixes it in any desired position.
For example, the adjustment device may comprise at least one toggle lever which is mounted at one end on the frame for pivotal movement about an axis of rotation and at its other end is connected in the manner of a swivel joint to the holder. By opening the toggle lever to a greater or lesser extent, the holder can be pivoted relative to the frame.
For this purpose, provision may be made for an adjusting memb

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