Surgery – Instruments – Cutting – puncturing or piercing
Patent
1996-09-18
1998-08-25
Buiz, Michael
Surgery
Instruments
Cutting, puncturing or piercing
606170, A61B 1732
Patent
active
057979367
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND AND SUMMARY OF THE INVENTION
This application claims the priority of German application PCT/DE 94/01553 and P 44 00 409.5, the disclosures of which are expressly incorporated by reference herein.
The present invention relates to a microsurgery instrument, and more particularly, to a microsurgery instrument for surgical endoscopy/arthroscopy, having a first jaw part which protrudes from the distal end of a hollow shaft connected on its other end with a first handle part, and which is stationary on the hollow shaft, as well as having a second jaw part which is swivellably arranged on it and which can be actuated by means of a first connecting rod extending through the hollow shaft, by way of a second handle part provided on its other hand, in order to carry out a gripping or clamping operation.
In surgery, minimally invasive (microsurgical) operating methods and the instruments suitable for this purpose are gaining more and more importance. Their use is also proven mainly in arthroscopy. However, it is also becoming more and more established in other fields--such as abdominal surgery.
Thus, in the case of injuries of the meniscus in which a removal of the meniscus is unavoidable, it is known to carry out this removal by instruments which are advanced through a narrow transcutaneous opening in the area of the knee joint to the injured meniscus or to the rear wall of the capsule.
In a first operating phase--which in itself already consists of several steps--, by way of punching forceps or by way of a hooked punch, as it is described approximately in DE 38 02 907 A1 (in a special construction having a suction device), the meniscus is perforated along its base by adjoining punchings. This operating phase is terminated shortly before the meniscus is completely separated in this manner from the rear wall of the capsule. Now, instead of the punching forceps, the distal end of gripping forceps is introduced, as it is described approximately (in a special construction with an additional endoscope) in DE 37 38 692 A1, and the meniscus is gripped by thereby, is torn off the rear wall of the capsule and is removed from the knee joint. Finally, in a third operating phase, by way of another instrument, the rear wall of the capsule is smoothed in the area of the perforations carried out in the first operation.
This described approach requires a lot of time and, because of the necessity of intracorporally positioning several instruments successively in an exact coordination with the respective preceding operating phase, results specific sources of errors and thus in potential risks to the patient. The providing, sterilization and handling of several different instruments requires high expenditures of material and is cumbersome.
Also, in the case of appendectomies and gall bladder operations, surgery is increasingly carried out endoscopically which results in the necessity of ligating and severing vessels.
In this case, in a first and second operating step, by way of special forceps--so-called ligature forceps--vessel closing elements (ligature clips) are first arranged on both sides of an intended severing point on the vessel by way of which this vessel is permanently closed. Then, in a third operating step, a suitable device--such as microsurgery scissors according to DE 38 08 877 A1--severs the vessel between the ligature clips.
This approach, which again requires several operating steps and two different instruments, has the above-mentioned disadvantages.
The invention is therefore based on the object of providing a microsurgery instrument which, during the described and similar operations, permits a shortening of the operating time and simultaneously results in a simplification and a reduction of the number of potential sources of errors.
This object is achieved by a microsurgery instrument on the distal end of the hollow shaft, a cutting device is provided which can be actuated by way of a third handle part by means of a second connecting rod which is axially displaceable in the hollow shaft, in order to, i
REFERENCES:
patent: 5217460 (1993-06-01), Knoepfler
patent: 5620453 (1997-04-01), Nallakrishnan
Buiz Michael
Truong Kevin
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