Medical treatment device, in particular for surgical purposes

A medical treatment device, in particular for surgical purposes, having at least one treatment instrument in the form of a hand piece which can be connected to a control unit by means of a flexible supply line, there being associated with the treatment device, preferably with the control unit, a source of treatment agent, in particular for cooling fluid, to which it is possible to connect a treatment agent line, which extends at least in part through the supply line to the front end of the hand piece, in the form of a hose, the treatment agent line having a hose section which extends with radial play for movement in the supply line as far as the hand piece and is there connected to a plug-in spigot which is plugged in a releasable manner in an axial plug-in socket in the hand piece and has an axial and a radial channel section, of which the axial channel section issues from the hose connection and the radial channel section is connected to the continuing treatment agent line.

TECHNICAL FIELD OF THE INVENTION 
The invention relates to a medical treatment device, in particular for 
surgical purposes. 
BACKGROUND OF THE INVENTION AND PRIOR ART 
In the treatment of the human or animal body with a medical treatment 
instrument, in many cases it is necessary to add a gaseous or, in 
particular, fluid treatment agent, which can be air, water or a mixture 
thereof (spray). In many cases, in particular in surgical and 
microsurgical treatment, a cooling fluid is required, in which case it is 
usual to use a salt solution (NaCl). 
The treatment agent is fed to the treatment instrument through a flexible 
tube line, in particular a hose line. It has already been proposed to 
arrange the flexible tube line on or in the supply line. On account of it 
hollow construction, the flexible tube line is sensitive to severe 
bending, something which often cannot be precluded during the treatment. 
The life of such a flexible tube line can therefore be reckoned to be 
shorter than other lines, for example, electric cables. If a defective 
flexible tube line is exchanged, the supply line itself can therefore be 
used further. 
In particular after surgical treatment, sterilization not only of the 
treatment instrument, but also of the supply line fixedly connected 
therewith is necessary, this occurring in many cases by means of steam 
pressure sterilization. The strength and life of the flexible tube line 
are impaired in particular as a result of this thermal stressing. 
In particular when a mineral solution, such as for example a salt solution, 
is used as a cooling fluid, there is then the danger of crystallization 
and deposits in the flexible tube line which can diminish the latter's 
free cross section or even block it and thus can impair the cooling. This 
danger is greater the smaller the cross section of the flexible tube line. 
Removal of the flexible tube line from the supply line is not possible in 
the case of the known treatment devices without unjustifiable effort or 
expense. 
It has also already been proposed to guide the flexible tube line in the 
end region of the supply line remote from the treatment instrument 
substantially radially out of this region and thus, by by-passing the 
plug-in connection for the supply line, be able to connect it to the 
available treatment agent source or pump respectively. 
OBJECT OF THE INVENTION 
The object of the invention is to develop a treatment device of the kind 
specified at the beginning so that the flexible tube line can be removed 
and installed or exchanged with little effort or expense. 
SUMMARY OF THE INVENTION 
According to the present invention there is provided a medical treatment 
device, in particular for surgical purposes, having at least one treatment 
instrument in the form of a hand piece which can be connected to a control 
unit by means of a flexible supply line, there being associated with the 
treatment device, preferably with the control unit, a source of treatment 
agent, in particular for cooling fluid, to which it is possible to connect 
a treatment agent line, which extends at least in part through the supply 
line to the front end of the hand piece, in the form of a hose, wherein 
the treatment agent line has a hose section which extends with radial play 
for movement in the supply line as far as the hand piece and is there 
connected to a plug-in spigot which is plugged in a releasable manner in 
an axial plug-in socket in the hand piece and has an axial and a radial 
channel section, of which the axial channel section issues from the hose 
connection and the radial channel section is connected to the continuing 
treatment agent line. 
In the treatment device according to the invention, the flexible tube line 
is secured with clamping, in the sense of a fitting, and thus so as to be 
tight on a preferably pin-shaped fitting portion, only in its front end 
region, whilst it is received in its remaining region in the supply line 
with play for movement. The fitting portion itself is likewise held in a 
plug-in socket in the treatment instrument and in particular can be drawn 
out towards the front with the flexible tube line. The installation of the 
flexible tube line can be effected by insertion from the front, something 
which can be carried out easily and quickly, because the plug-in socket of 
the fitting portion is dimensioned so that it has a greater cross section 
than the flexible tube line and the latter can therefore be inserted and 
removed with play for movement. If an exchange of the flexible tube line 
is to be carried out, before the old tube line is drawn out, a new tube 
line can be connected at the rear end of the old tube line by means of an 
associated connecting element which can likewise be drawn through the 
supply line and the plug-in socket with play for movement. In this way, 
when drawing the old tube line out towards the front, the new tube line is 
simultaneously drawn in from the rear towards the front. All that is 
required then is the connection of the fitting portion to the front end of 
the new tube line and the positioning of the fitting portion in the 
treatment instrument. In this way, a supply line with a defective flexible 
tube line can be repaired simply and in a cost-favourable manner. It is 
also possible to remove the flexible tube line merely for the purpose of 
rinsing and/or sterilizing it in a position remote from the supply line 
and then to install it again. 
The solution according to the invention is suitable in particular for 
treatment instruments which are realized in two parts and which can be 
detached from each other by means of a rapid-action coupling or plug-in 
arrangement. With such a development, the fitting portion which holds and 
fixes the flexible tube line is located in the rear portion of the 
treatment instrument which is also suitable for the accommodation of a 
drive motor for a treatment tool of the treatment instrument. 
Features of particular embodiments of the invention further improve the 
present solution to the problem and lead, moreover, to a simple and 
cost-effective to manufacture mode of construction which is also practical 
and rugged, also guaranteeing good sealing.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS ACCORDING TO THE INVENTION 
The main portions of the treatment device 1 are the treatment instrument in 
the form of a hand piece 2 and a control unit 3 with control keys on its 
front side and with an integrated electronic control device to which the 
hand piece 2 is connected by means of the bendable or flexible supply line 
4. The hand piece 2 bears at its front end a treatment tool 5 which can 
preferably be exchanged for different, selectively required tools. In the 
case of such treatment instruments in which the feed of a treatment agent, 
in particular a cooling fluid such as a salt solution (NaCl), to the 
treatment position is required, associated with the control unit 3 there 
is a pump in the form of the hose pump 6 which can preferably be added on 
to the control unit 3 at the side or can be integrated in said unit. The 
coolant line 7 which leads to the front end of the hand piece 2 extends at 
least in part through the supply line 4 and the hand piece 2 respectively. 
Arranged on the control unit 3 there is a plug-in coupling 8 into which a 
plug 9, which is arranged at the free end of the supply line 4, can be 
plugged for the purpose of connection to the electronic control device. 
For the purpose of positioning the control unit 3, it is possible to 
provide a frame or table 11 with which a holding arrangement 12 for the 
hand piece 2, in its standby position, is associated. In the case of the 
present development, a depository portion is provided in the form of a 
trough-shaped, oblique plate 13 which is inclined towards the treatment 
location and on which the hand piece 2 is supported in a form-fitting 
manner in a position with the tool 5 pointing obliquely downwards. The 
hand piece 2 is secured against lateral displacement on account of the 
trough-shaped form of the plate 13. The trough base is preferably adapted 
to the waisted form of the hand piece 2 so that a form-fitting support 
also results in the longitudinal direction of the latter. The plate 13 can 
be held by means of a supporting arm 12a, which projects away from the 
table 11, or from the housing of the control unit 3, in an approximately 
horizontal manner, and is mounted thereon preferably so that it can be 
swung horizontally and the length of which supporting arm 12a is variable, 
being is freely pivotable at the end of said arm preferably in a joint 
about an approximately vertical swivel axis. 
In order to be able to sterilize the depository portion (plate 13) easily 
as well, it is advantageous to hold the depository portion by means of a 
rapid-action coupling or plug-in socket, in particular to arrange it so 
that it can be plugged in from above, for which purpose a joint pin can be 
used, which pin can be plugged from above into a joint bore of the 
supporting arm 12a. 
The hand piece 2 consists of two portions which are arranged one after the 
other in its longitudinal direction, namely a drive portion 2a, which is 
mounted on the supply line 4, and a work piece carrier portion 2b which 
can be releasably secured to the drive portion's front end by means of a 
rapid-action coupling. Arranged in the drive portion 2a there is a 
suitable drive motor, for example an electric motor or a compressed-air 
operated turbine motor, which is encapsulated in a housing in the form of 
a motor cartridge 14 in the manner of a cartouche. The drive portion 2a, 
for the purpose of accommodating the motor cartridge 14, has a cylindrical 
sleeve 15 which is open on the front side and the longitudinal dimensions 
of which are such that it completely covers at least the housing of the 
motor cartridge 14. Provided on the rear side of the motor cartridge 14 
there are two contact elements, preferably lying diametrically opposite 
each other, in particular in the form of plug-in couplings 16 which 
correspond with two contact elements in the form of contact pins 17 which 
protrude from the base of the sleeve parallel to the axis. The contact 
pins 17 are plugged in a housing insert piece 18 which is round in cross 
section, sits in an annular collar 19 arranged at the rear end of the 
sleeve 15 and is secured by means of at least one screw which passes 
radially in a hole through the rearwardly projecting annular collar 19. 
The insert piece 18 consists of electrically non-conductive material, in 
particular plastics material. There projects, moreover, from the insert 
piece 18 parallel to the axis a positioning pin 21 which fits into a 
corresponding positioning hole 22 at the rear end of the motor cartridge 
14. The positioning pin 21 is arranged so as to be offset in the 
circumferential direction relative to the contact pins 17 and for the 
purposes of illustration is displaced into the sectional plane so that 
only one contact pin 17 is visible. The insert piece 18 has at the rear a 
tapered cylindrical extension 23 on which a flexible protective hose 24 is 
plugged and secured by means of a hose clip 24a or the like. There extend 
in the protective hose 24, according to the embodiment, several 
conductors, for example two electric cables 25, the cores of which are 
connected with the contact pins 17 in a manner which is not illustrated, 
at least one treatment agent hose, in particular coolant hose 7a, and, if 
applicable, a light guide, all constructed in a flexible manner. 
The drive portion 2a has two housing portions which are arranged coaxially 
relative to each other, namely, on the one hand, the sleeve 15 and a 
sleeve cap 26 which is at the rear relative to the sleeve and which 
engages over the rear end region or the rear half of the sleeve 15, covers 
the insert piece 18 and extends as far as the free end region of the 
extension 23 where it surrounds the protective hose 24 with play for 
movement. The sleeve cap 26 has, substantially in its central region, an 
inner ring extension 27 with a cylindrical inner face 28 which is 
preferably dimensioned so as to be somewhat smaller in diameter compared 
with the cylindrical inner face 29 of the ring extension 19. Provided in 
the rear region of the insert piece 18 between the latter and the ring 
extension 27 there is an inner thread/outer thread with which the sleeve 
cap 26 can be screwed on from the rear. The front end of the sleeve cap 
26, which is round in cross section, sits on a cylindrical outer ring 
extension 31 of the sleeve 15 and is sealed by means of a sealing ring 
(O-ring) which is arranged in a groove preferably in the outer ring 
extension 31. The inner faces of the ring extension 19 and inner ring 
extension 27 are also sealed each by means of a respective O-ring which 
sits in a groove in the insert piece 18. Located behind the front free 
edge region of the sleeve cap 26 there is a further inner ring extension 
33 which is penetrated by a bore which extends obliquely towards the front 
and outside and in which the rear end of a small tube 34 is inserted in a 
firm and tight manner, which tube is angled outside the sleeve cap 26 
approximately axis-parallel towards the front. Between the outer ring 
extension 31 and the inner ring extension 27 there extends between the 
sleeve 15 and the sleeve cap 26 a free annular space 35 from which the 
small tube 34 issues and which forms a section of the coolant line 7. The 
latter is connected with the annular space 35 by means of a channel 
section 36 which extends axially and a channel section 37 which extends 
radially in the insert piece 18. For the purpose of sealing the plug-in 
fitting, sealing elements are provided in front of and behind the radial 
channel section 37, for example O-rings which are arranged in grooves of 
the fitting cylinder 44. 
In the region between the hose pump 6 and the insert piece 18, the coolant 
line is formed by the coolant hose 7a which is connected to a connection 
fitting of the hose pump 6, penetrates radially inwards through the plug 9 
in a lead-through hole 41 and then extends in the supply line 4 as far as 
the insert piece 18. Provided for the connection of the coolant hose 7 to 
the insert piece 18 there is a plug-in spigot 42 which is preferably round 
and which can be plugged into a coaxial through plug-hole 43 in the insert 
piece 18 and can be fixed therein in an axial direction in a manner which 
is not illustrated. The plug-hole 43, in the case of the present 
development, is a cylindrical through bore hole in which the plug-in 
spigot 42 can be plugged, with little play, in particular from the front. 
The plug-in spigot 42 consists of a fitting cylinder 44 from which there 
projects a working member 45 in the form of a tapered spigot which in the 
plugged-in position projects beyond the insert piece 18 towards the front 
and has a working element preferably in the form of a peripheral groove 
47. A recess is provided in the motor cartridge 14 for the accommodation 
of the working member 45. Pre-formed on the rear side of the fitting 
cylinder 44 there is a sleeve-like hose nozzle 48 on which the front end 
of the coolant hose 7a is plugged and is secured by means of a hose clip 
49. The radially extending channel section 37 extends in part in the 
insert piece 18 and in the fitting cylinder 44, with the axial channel 
section 36 being coaxially arranged in the plug-in spigot 42, running into 
the hose nozzle 48 at the rear and connecting the coolant hose 7a with the 
radial channel section 37. The plug-hole 43, the protective hose 24 or its 
free space respectively and the lead-in hole 41 have such large dimensions 
in terms of their cross section that the coolant hose 7a, if applicable 
with hose clip 49, can be guided through with free play. In this 
connection, the coolant hose 7a must also be set through an axial hole 51 
in the rear region of the nozzle 52 of the plug 9 on which the protective 
hose 24 is clamped with a hose clip 53. 
The coolant hose 7a can thus be removed from the supply line 4 quickly, in 
a simple manner and with ease of handling. For this, it is merely 
necessary to split up the drive portion 2a and to draw out the motor 
cartridge 14. With one tool (not illustrated) in the form of a pair of 
tongs which can be introduced from the front into the sleeve 15, it is 
possible to grip the working member 45 and draw it with the coolant hose 
7a towards the front out of the supply line 4. This can then, if 
applicable after further disassembly of its individual parts, be 
steam-sterilized, without the coolant hose 7a, for example in an autoclave 
at a temperature of approximately 150.degree. C. and a pressure of, for 
example, 3 bar. The fact that the coolant hose 7a can be removed makes 
this possible as the latter can be exempted from such stresses of 
temperature, whereby its life is extended. 
In order to install the coolant hose 7a, the latter can either be 
introduced from the front or from the rear through the lead-through hole 
41 into the supply line 4, in which case its connection to the plug-in 
spigot 42 can be effected beforehand or afterwards. 
The last operation of this installation consists in inserting the plug-in 
spigot 42 with the coolant hose 7a secured thereon from the front into the 
insert piece 18 into the correct axial position. 
It is also possible to exchange the coolant hose 7a in a comparatively 
simple manner. For this purpose, a new hose 7b is preferably connected to 
the rear end of the coolant hose 7a by means of a coupling piece which is 
preferably formed by a connecting pin 54 onto which the pertinent ends of 
the coolant hoses 7a, 7b can be plugged and secured by means of one common 
or two hose clips. Subsequently, the old coolant hose 7a can be drawn out 
towards the front in the previously described manner, with the new coolant 
hose 7b being drawn in at the same time. After separation of the two hoses 
7a, 7b and connection of the new hose 7b to the plug-in spigot 42, the 
latter with the new hose 7b can then be plugged into its plug-in position 
in the insert piece 18. 
For the purpose of further facilitating the installation and removal, it is 
also possible to detach the sleeve 15 and the rear sleeve cap 26 from each 
other and separate them from each other so that the insert piece 18 is 
freely accessible with its working member 25, as represented in FIG. 3.