Abstract:
The invention allows an increase in scope of application of a surgical device wherein the operational handpiece is embodied in the form of two parts, one of which includes a handpiece with an injection cannula and the other being a complementary part. The complementary part includes a stabilization handle and can be placed onto the injection cannula in addition to being able to be fixed to the handpiece of the operational handpiece.

Description:
BACKGROUND OF THE INVENTION 
     1) Field of the Invention 
     The invention relates to a surgical device for injecting a fluid and/or for removing tissue cells from a biological body or structure, including a supply device having a fluid jet unit for injecting a separation fluid or a process fluid and/or including a suction device for suctioning off separated or dissolved tissue cells and/or the separation fluid or the process fluid, and a surgical hand piece with an inner injection cannula and an outer suction tube, both of which form an annular suction channel in the region of the surgical hand piece. The outer suction tube is adapted to be placed on the injection cannula and to be secured to the surgical hand piece. The injection cannula includes a front nozzle opening and the suction tube includes a plurality of suction bores distributed along its periphery. Such device and instrument is used in surgical clinical settings to suction off fatty tissue for health and cosmetic reasons. Such device and instrument is also used for removing vital tissue cells, for example from the liver, for the purpose of reproducing these tissue cells through cell division and then inserting the tissue cells in the same or in a different biological body or structure. 
     2) Description of the Related Art 
     A number of methods and devices are known that can achieve this goal. 
     For example, DE 299 14 230 U1 describes a cannula for suctioning off fatty tissue, with the cannula formed as a tube that has one closed end and an other open end that is connected by an adapter to a suction device. The tube includes several suction openings distributed along the periphery, with the size of the openings adapted to the size of the fatty tissue cells. 
     The cannula is pierced into the corresponding tissue layers and is continuously moved back and forth during the procedure. Through the force generated by the vacuum and with support of the mechanical force of the moving cannula, tissue cells are destructively torn away and then suctioned off. This method is very stressful for the patient and is therefore only rarely used in practice. 
     It is known to reduce the stress by injecting, in a separate process step before the surgical procedure, a process fluid into the affected tissue to dissolve the tissue cells, which can then be more effectively and more easily suctioned off. The injected process fluid together with the dissolved tissue cells are suctioned off through the suction tube. 
     DE 200 09 786 U1 describes a device for suctioning off fatty tissue, which functionally combines the two aforedescribed process steps, i.e., injecting the tissue-dissolving process fluid and suctioning off the dissolved tissue cells. For this purpose, an interior injection line for the tissue-dissolving process fluid is arranged in the suction cannula, with the exit opening of the injection line disposed on the distal end of the suction cannula and connected to a process fluid pump. In this way, process fluid is injected continuously and suctioned off together with the fatty tissue cells. This makes the process more continuous and shortens the duration of the surgical procedure. 
     Disadvantageously, however, the aforementioned technical solutions have in common that they destroy not only the fatty tissue cells, but also adjacent tissue cells, such as blood cells. This can harm the human body and complicate and prolong the healing process. These technical solutions are therefore not suitable for removing healthy tissue cells for further use. 
     DE 100 33 278 A1 describes a surgical device for removing tissue cells from a biological structure that obviates this disadvantage. This device includes a water jet unit with a pressure generator and an injection cannula emitting a separation water jet under pressure, and a suction device that includes a suction pump and a suction tube with the suction openings distributed along the periphery, through which the separated tissue cells are discharged together with the used water. The injection cannula for the emitted water jet is arranged in the interior of the suction tube, with both the cannula and the suction tube combined in a hand piece that can be interchanged via a screw-in adapter. 
     The exit opening of the injection cannula has a cross-section and the exiting water jet a pressure suitable to cause the water jet to exert a peeling effect. 
     The water jet is able to cut through or separate tissue parts. However, the tissue cells are not destroyed, because due to the curved surface and the pliability of the tissue cells, the water jet does not experience any resistance and is therefore not deflected in its effective direction. As a result, the water jet finds its way between the tissue cells in an intelligent manner, until it meets resistance essential for developing a separation force, thereby urging the adjacent tissue cells apart and separating them, without destroying them. Because the selection is gentle, there is no need to inject a process fluid for dissolving the tissue cells, as was required in the prior art. 
     The relatively large number of applications and the large number of implementations of such hand piece, due to the different required diameters, and the desired high utilization rate for the entire apparatus make it necessary to have a large number of hand pieces available with different lengths, different diameters of the suction tube, and different suction openings in the suction tube. This large number of tools makes the entire unit unduly expensive. 
     Moreover, many situations require application of an anesthetic before the surgical procedure, which necessitates special injection instruments. This further increases the cost of the surgical procedure and the conversion time from the injection unit to the tissue removal unit, and vice versa. 
     It is therefore an object of the invention to develop a device of the aforedescribed type for removal of tissue cells, which can be used universally for anesthesia and for tissue removal and which has a simple design and is easy to operate. 
     BRIEF SUMMARY OR THE INVENTION 
     This object is solved utilizing a surgical hand piece which is implemented in two parts, with a first part comprising a hand piece with a injection cannula and a second part comprising a complementary part that can be placed onto the injection cannula and which is configured for attachment to the hand piece of the surgical hand piece. Further embodiments are recited in the dependent claims. The novel surgical device eliminates the aforementioned disadvantages of the state of the art. 
     The particular advantage of the novel surgical device is its universal applicability. The basic configuration, which includes the handle and the injection cannula, can be provided with a variety of complementary parts and hence be adapted to the respective specific application. The complementary parts can be easily and quickly exchanged, which saves significantly time in the operating theater. 
     Considerable expenditures for the device and setup can be saved by requiring only a single supply device, so that no longer complete surgical hand pieces need to be exchanged for the different applications, but instead only the various complementary parts. This also saves time during surgery. 
     The invention will now be described with reference to an exemplary embodiment. 
     It is shown in: 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  a simplified schematic diagram of the novel surgical device; 
         FIG. 2  a basic configuration of the surgical hand piece with the detail X; 
         FIG. 3  a first complementary part in form of a stabilizing handle for the injection cannula; 
         FIG. 4  a second complementary part in form of a stabilizing handle with a stabilizing tube; and 
         FIG. 5  a third complementary part in form of a stabilizing handle with a suction tube and the details X and A-A. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     As seen in  FIG. 1 , the surgical device includes a supply unit  1  and a surgical hand piece  2 . The supply unit  1  includes a vacuum pump  3  with a receptacle container  4 , a supply pump  5  with a supply container  6  for a sterile separation fluid that can be formed into a jet, and a supply pump  7  with a supply container  8  for an anesthetic or another process fluid. 
     The vacuum pump  3  is connected via a vacuum line  9  with the surgical hand piece  1 . Conversely, the two supply pumps  5  and  7  each have respective pressure lines  10  and  11 , with both pressure lines  10 ,  11  terminating at a switchable distribution valve  12 . The distribution valve  12  is provided to enable alternative use of the two supply pumps  5  and  7 , and is connected on the consumption side with the surgical hand piece  1  via a pressure supply line  13 . 
     The surgical hand piece  1  includes, as also shown in greater detail in  FIG. 2 , a hand piece  14  with an interior injection line  15  and a suction line  16  that surrounds the injection line  15 . The injection line  15  emerges from the suction line  16  on the proximal side of the hand piece  14  and is connected with the pressure supply line  13  via a coupler  17 , whereas the suction line  16  is connected to the vacuum line  9  with a coupler  18 . A stationary injection cannula  19  that is connected with the injection line  15  is located on the distal side of the hand piece  14 . The free end of the injection cannula  19  is formed as a conically tipped injection nozzle and preferably has a nozzle opening  20  formed as a slit and disposed on the conical surface. Because of this configuration of the nozzle opening  20  on the conical surface, the fluid jet exits in a direction different from the axis of the injection cannula  19 . The nozzle opening  20  is sized so that, for a selected pressure in the pressure supply line  13 , a substantially flat fluid jet exits which exerts a peeling separation effect on the tissue cells. 
     The length of the injection cannula  19  can be adapted to reach also the deeper tissue regions. 
       FIG. 3  shows a first complementary part for stabilizing the injection cannula  19  for injecting an anesthetic. Since the relatively long and thin injection cannula  19  is not dimensionally stable, but only a relatively shallow puncture depth is required for injecting an anesthetic, the complementary part in the depicted embodiment consists of a stabilizing handle  21  that is placed onto the injection cannula  19  and screwed into the hand piece  14 . This arrangement increases the guided and supported length on the hand piece  14 . For ergonomic reasons, the stabilizing handle  21  and the hand piece  14  have the same outside dimensions and a complementary design. 
       FIG. 4  shows another complementary part which includes a stabilizing handle  21 ′ and an attached stabilizing tube  22  that supports the injection cannula  19  over its entire length. The free end of the injection cannula  19  is open and has a suitable length, so that a sufficiently long section of the nozzle opening  20  of the injection cannula  19  protrudes from the stabilizing tube  22 . The stabilized injection cannula  19  can be used to apply an anesthetic or another process fluid to deeper tissue layers. 
     Finally,  FIG. 5  shows a complementary part with a stabilizing handle  21 ″ and an attached suction tube  23 . The suction tube  23  is dimensioned so as to encompass the injection cannula  19  and to form in conjunction with the injection cannula  19  an interior annular suction channel. Several suction bores  24  distributed about the periphery of the suction tube  23  terminate in the annular suction channel. An axial bore  25  with a diameter that conforms with clearance to the diameter of the injection camera  19 , is arranged on the distal end of the suction tube  23 . Moreover, the suction tube  23  has a suitable length so that a sufficiently long section of the nozzle opening  20  of the injection cannula  19  protrudes from the axial bore  25 . 
     The novel surgical device for removing tissue cells can be used universally and replaces a large number of special tools. 
     For example, the surgical device for injecting an anesthetic can be used in the same manner as is typical before tissue removal. For this procedure, if required, the first complementary part in form of the stabilizing handle  21  or the second complementary part in the form of the stabilizing handle  21 ′ with the stabilizing tube  22  is initially placed onto the injection cannula  19  and connected with the hand piece  14 . The distribution valve  12  of the supply unit  1  is then switched to a position where the supply pump  7 , for example for the anesthetic, is connected with the injection line  15  via the pressure supply line  13 . When the injection cannula  19  has entered the corresponding tissue part, the supply pump  7  is activated and a pre-measured quantity of anesthetic is injected. 
     The novel surgical device with the same configuration of the surgical hand piece  2  can also be used for injecting a process fluid, for example, for dissolving tissue cells in advance. The distribution valve  12  is then switched to a position, where the pressure supply line  13  is connected with a supply container containing a corresponding tissue-dissolving process fluid. 
     However, the novel surgical device is primarily used for removal of excess fatty tissue or of tissue cells that can reproduce. For this application, the third complementary part in the form of the stabilizing handle  21 ″ with the suction tube  23  is placed over the injection cannula  19  and connected with the hand piece  14  of the surgical hand piece  1 . The distribution valve  12  is switched to a position where the pressure supply line  13  is connected with the supply pump  5  for the sterile separation fluid  6 . 
     After the suction tube  23  with the complementary injection cannula  19  has been inserted in the corresponding tissue layer, the supply pump  5  for the separation fluid and the vacuum pump  3  are turned on, whereby the pumping capacity of the two pumps  3 ,  5  is matched. The separation fluid then exits the nozzle opening  20  of the injection cannula  19  as a flat jet that is directed away from the axial direction, and is deflected in an intelligent manner into the gaps between the tissue cells. As a result, the tissue cells are not exposed to the separation force, but are instead only urged apart and separated. The tissue cells peeled away in this manner are simultaneously suctioned off together with the consumed separation fluid by vacuum force and transported through the suction bores  24 , the inner annular suction channel and the suction line  16  of the surgical hand piece  2  and through the vacuum line  9  into the receptacle container  4 . From there, the collected tissue cells are disposed of or sorted for further processing, as required. 
     LIST OF REFERENCE CHARACTERS 
       1  supply device 
       2  surgical hand piece 
       3  vacuum pump 
       4  receptacle container 
       5  supply pump 
       6  supply container for a sterile separation fluid 
       7  supply pump 
       8  supply container for an anesthetic or a process fluid 
       9  vacuum line 
       10  pressure line 
       11  pressure line 
       12  switchable distribution valve 
       13  pressure supply line 
       14  hand piece 
       15  injection line 
       10  suction line 
       17  coupler 
       18  coupler 
       19  injection cannula 
       20  nozzle 
       21  stabilizing handle 
       22  stabilizing tube 
       23  suction tube 
       24  suction bore 
       25  axial bore