Surgery – Instruments – Suture – ligature – elastic band or clip applier
Reexamination Certificate
1997-04-03
2001-04-03
Leubecker, John P. (Department: 3739)
Surgery
Instruments
Suture, ligature, elastic band or clip applier
C606S151000, C606S158000, C606S205000, C600S104000
Reexamination Certificate
active
06210418
ABSTRACT:
TECHNICAL FIELD
The present invention relates to an instrument for use in endoscopic surgery in human and animal bodies.
In recent years, endoscopic surgery has increasingly replaced “open surgery”. The actual operating instruments, such as endoscopes, tongs, scissors, etc., are introduced into the body through a channel of a charging instrument, by way of illustration, an operating trocar.
STATE OF THE ART
In some endoscopic surgery so-called tube shaft instruments, such as tongs, scissors, clip applicators, etc., are inserted into the channel of a trocar in order to conduct the respective surgical procedure. For a number of operations, trocars are employed having a channel with an interior diameter of only about 5 mm. It, therefore, is usually impossible to insert two instruments into the trocar channel simultaneously. Consequently, when using conventional endoscopic instruments, additional access has to be found if, by way of illustration, a clamp needs to be used to cut off peripheral arteries during a surgical procedure.
DESCRIPTION OF THE INVENTION
The object of the present invention is to create an instrument for use in endoscopic surgery in the body of a human or an animal in such a manner that this instrument carrying out a specific task during in-patient surgery does not require an additional access to the cavity in the human or animal body in which the surgery is conducted.
An invented solution to this object is set forth in claim
1
. An element of the present invention is that the instrument is composed of at least one distally disposed operating element and an oblong introduction and control component that connects the operating element to the proximal region. The operating element and the introduction and control component are connected via a connecting mechanism in such a manner that the operating element can be disconnected intracorporally from the introduction and control component and can be reconnected to it.
In this way it is possible to first insert the operating element of the invented instrument, by way of illustration through the trocar channel serving as the insertion instrument, to position the operating element inside the body and subsequently disconnect the introduction and control component from the operating element. The introduction and control component can then be removed from the trocar channel in such a manner that an additional operating instrument, such as by way of illustration a pair of tongs or a pair of scissors or an endoscope can be inserted. After conclusion of the work with the additional operating element and after fulfillment of the function of the operating element inserted inside the body, the operating element is reconnected to the introduction and control component and removed from inside the body. However, the operating element can, of course, also be repositioned inside the body after reconnection to the introduction and control component and therefore be reused at a different site.
In this event, it is preferred if the operating element remains in at least one function state after separation from the introduction and control component. If, by way of illustration, the distal part of the instrument is a clamp, which is closed in the non-operative state, the clamp can be inserted and positioned before commencing the actual surgical procedure in such a manner that it, e.g., “cuts off” a peripheral artery. In this case, it is preferred if the clamp is designed like a bulldog clamp, like those used in open surgery. The clamp can be removed again after termination of the actual surgical procedure.
The distal part of the invented instrument, i.e. the operating element can, of course, be designed not solely as a clamp. But rather a great variety of instruments, like those known for conducting in-patient procedures during surgery, can be employed as the operating element. By way of illustration, the distal part can be a retainer or a retractor, e.g. a liver retractor.
A liver retractor is composed of a “wire cage” which “opens” after insertion of the instrument into the cavity. The retractor is closed by drawing in the introduction component.
Of course, operating elements can also be employed which can assume at least two stable function states after separation from the introduction and control component. Operating elements of this type can, by way of illustration, have the function state “active” and “passive”. In order to convey the operating element from a passive to an active state without active adjustment elements, such as by way of illustration electro-mechanic elements, a preferred embodiment of the operating element has at least one adjustment element composed of a material having form memory. Moreover, super-elastic materials, etc. can also be utilized.
Furthermore, it its preferred if the connecting mechanism can transfer at least axial tensile and pressure forces to the operating element, because most of the functions of conventional operating elements can be controlled thereby and, in particular, simple conveyance of the elements to the respective desired function state is possible.
The embodiment according to which the connecting mechanism is provided with a safeguard against accidental disconnection ensures that the operating element does not accidentally get lost inside the body.
Moreover, it is preferred if the introduction and control component is composed of a rod-shaped component, which can be inserted into the channel of the insertion instrument, and a proximal operator component. In this way, the invented instrument has the same basic construction as conventional instruments, thus the operator does not have to “relearn” for operation. The proximal operator component can be disconnected from the rod-shaped component in a known manner as is known from the Karl Storz & Co “Take apart” instruments. In this way not only cleaning is simplified, but other operator components, by way of illustration, handles of different shape can also be attached if a user does not “like” a specific handle.
Furthermore, the operating element can be made rigid by withdrawal into the introduction component simplifying in this way the insertion and removal procedure and, moreover, reducing the risk of the operating element getting lost.
The connecting mechanism joining the operating element and the introduction and control component in a disconnectable manner can be designed in a great variety of ways:
For example, the connecting mechanism can be provided with a pair of tongs disposed on the introduction and control component. The jaws of these tongs can be opened and closed by operating the operator component and the tong elements have the same toothing as the gripping surfaces of the operating element.In this way, it is ensured that the tongs grip the operating element in a “non-slipping and non-turning” manner. The toothing can, in particular, be designed as squares the individual teeth of which are designed by way of illustration pyramid-shaped.
In an alternative, the operating element is connected via a hook-and-eye connection to an introduction and control component. The introduction and control component can, in this case, comprise a cylindrical tube and a rod, being movable inside the tube in direction of its longitudinal axis and bearing the hook at its distal end.
Designing the hook-and-eye connection like a keyhole connection ensures that the connection does not disconnect accidentally.
REFERENCES:
patent: 5304183 (1994-04-01), Gourlay et al.
patent: 3044186 (1980-11-01), None
Cuschieri Alfred
Storz Karl
Storz-Reling Sybill
Karl Storz GmbH & Co. KG
Leubecker John P.
St. Onge Steward Johnston & Reens LLC
Storz-Reling Sybill
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