Source: https://patents.google.com/patent/WO2001015614A1/en
Timestamp: 2019-08-23 18:57:54
Document Index: 288475520

Matched Legal Cases: ['art 16', 'art 18', 'art 18', 'art 18', 'art 24', 'art 16', 'art 24', 'art 16', 'arts 16', 'art 16', 'art 18', 'art 18', 'art 16', 'art 16', 'arts 16']

WO2001015614A1 - Bipolar medical instrument - Google Patents
WO2001015614A1
WO2001015614A1 PCT/EP2000/008072 EP0008072W WO0115614A1 WO 2001015614 A1 WO2001015614 A1 WO 2001015614A1 EP 0008072 W EP0008072 W EP 0008072W WO 0115614 A1 WO0115614 A1 WO 0115614A1
PCT/EP2000/008072
1999-08-27 Priority to DE1999140689 priority Critical patent/DE19940689A1/en
1999-08-27 Priority to DE19940689.8 priority
2000-08-18 Application filed by Karl Storz Gmbh & Co. Kg filed Critical Karl Storz Gmbh & Co. Kg
2000-08-18 Priority claimed from DE2000508973 external-priority patent/DE50008973D1/en
2001-03-08 Publication of WO2001015614A1 publication Critical patent/WO2001015614A1/en
The invention relates to a bipolar medical instrument, comprising a tubular shaft, with at least two jaw parts which are movable relative to each arranged at the distal end of the tubular shaft and connected to one another by a joint and each of which forms a work electrode of different polarity, wherein each jaw part is assigned a separate power line , one of which is formed by a valve disposed in the tubular shaft, axially movable force transmission element which is non-positively connected to at least one of the jaw parts. Such an instrument is known from DE 196 08 716 Cl.
In minimally invasive surgery an instrument of the type mentioned for performing endoscopic procedures within the human or animal body is used.
The two jaw parts at the distal end of the tubular shaft are connected together via a hinge and can be closed and opened by operating a handle at the proximal end of the tubular shaft. Depending on the surgical use of such an instrument, the jaw parts are constructed as cutting tools with cutting edges to sever tissue in the body, or as a grasping tools with correspondingly truncated abutting surfaces to hold severed tissue with the jaw members and to remove from the body, or to keep an organ or a vessel in order to move this from the operating site. The jaws may also comprise a combination of a cutting and a Faßfunktion.
In the above-mentioned type of a medical instrument is furthermore provided that the two jaw parts in each case form a supplied with high frequency current working electrode of different polarity. Both jaw parts can each be connected to one pole of a high-frequency voltage source with a correspondingly separated. By applying the two jaw parts with bipolar high-frequency current on the one hand in case of forming can be increased by the thermal effect of the high frequency current in the tissue as the cutting tools of the cutting action, on the other hand, a design as grasping tools by the heat generation between the jaw parts can coagulate tissue grasped in the case and a bleeding the tissue are satisfied with it.
In such bipolar instruments, there is always the problem of a sufficient electrical insulation between the two jaw parts in the region of the hinge on which both jaws are in contact also in the open state. When applying the jaw parts with high frequency current electrical isolation must exist, since both jaw parts are applied to different potentials. The problem of electrical isolation of the two jaw parts from each other, turns out to be the greater is the smaller one such instrument in the area of ​​the jaw parts, and is thus formed in the region of the joint. However, a narrow-build configuration of the instrument in the area of ​​the jaw members is particularly important for minimally invasive surgery.
In the method known from the already mentioned DE 196 08 716 Cl instrument, the two jaw parts are formed entirely of metal and thus over its entire body electrically conductive. A force transmission element in the form of a push and pull rod is connected via a toggle lever arrangement with the two movable jaw parts. The push-pull rod also serves as a power line to one of the two jaw parts with being able to connect one pole of a high-frequency voltage source.
In this known instrument the electrical insulation of the two jaw parts is accomplished by running metallic joint of the two jaw parts ceramic elements are used in the most Anson, so forming a part of the hinge itself. However, this type of electrical insulation of the two jaw parts from each other in the region of the joint has the disadvantage that, with a miniaturization of the instrument and the ceramic elements must be reduced in strength. Since usually the jaw parts, a high frequency voltage is applied in the order of 2.5 kV, this means that with a reduction of the thickness of the ceramic elements, a dielectric breakdown can occur through the ceramic member therethrough. Another disadvantage of the ceramic members is that occurring at the ceramic elements used when moving the jaw parts of friction, so that these can be crushed in the course of time. Another disadvantage of the embodiment of the known instrument is that due to the intended ceramic elements, the number of parts of the clamp in the area of ​​the jaw parts, and thus the construction effort and the manufacturing costs of this known instrument is disadvantageously increased.
Further, a bipolar medical instrument is known from DE 43 12 284 Al is known in which the jaw parts are made entirely of plastic, wherein Un-isolated in the plastic end sections are embedded by power lines. The jaw members are configured as cutting elements made of plastic, being embedded in the plastic of the jaws working electrodes. At this embodiment, it is disadvantageous that the power supply to the jaw parts is carried out by separate electrical lines running isolated inside the push and pull rod. The push-pull rod is therefore not used in this pliers as power line. Thus, there is also in this instrument in turn, the disadvantage that the number of necessary parts is increased because of the additional power lines. A further disadvantage is that which extends into the plastic of the jaws out end portions of the power lines are claimed respectively to bending during opening and closing of the jaw parts, so that the end portions can break down over time and the current flow is thus stopped at the electrodes.
A similar instrument to the known above-mentioned instrument is known from WO 99/40861. This known bipolar medical instrument has at the distal end of the shaft on two relatively movable jaw parts, wherein the one jaw member movable and the other jaw part is immovable. The movable jaw member is biased by a spring into a position in which it is pivoted away from the fixed jaw part, that is in the open position. As an actuating mechanism for the movable jaw part, a stem surrounding axially displaceable tube shaft is provided, which slides open by moving in the distal direction to the outer side of the movable jaw member and thereby pushes it against the immovable jaw part. The movable jaw member is connected to the immovable jaw part via an articulated pin joint. The two jaw parts are again entirely of plastic, said metal electrodes are secured to the plastic. When power supply to the electrodes in turn serve individual wires that are connected to the electrodes. Thus, there is also in this instrument in turn, the disadvantage that the number of necessary parts is increased because of the additional power lines, and that the current leads are designed as wires subjected to bending stress during opening and closing of the jaw members. The invention is therefore the object of developing a bipolar medical instrument of the kind mentioned above such that a secure insulation of the jaw parts in the region of the joint is achieved without increased parts cost and with little constructional effort.
According to the invention this object is achieved in a bipolar medical instrument of the aforementioned type in that at least one of the jaw parts in the region of the joint comprises at least one one-piece base body of electrically insulating material to which a the corresponding working electrode-forming electrically conductive jaw part insert is fastened, which is electrically conductively connected to its associated power line.
According to the invention, therefore, to design at least one of the jaw members having an electrically insulating piece base body. Such an electrically insulating base body can for example be formed of a hard plastic so that the instrument in the region of its mouth parts meets the high stability requirements. The fact that now the joint of the connection between the first jaw and the second jaw part is provided in the region of the integral insulating base body, an electrical separation of the two jaw parts is without additional components, such as ceramic elements from each other accomplished. The basic body of insulating material may be formed in a particularly solid, so that the stability of this jaw part and the stability of the joint is as high as when the jaw members would be made entirely of metal. This design is suitable for both instruments whose both jaw parts are movable, as well as instruments, in which only one of the jaw members is movable. A hinge pin of the joint that connects the two jaw parts hinged to each other may be formed in the inventive embodiment even of metal, because of the consisting of the insulating material body safely prevents current transmission to the other jaw part.
The at least one jaw part, which has the basic body of electrically insulating material may, for example, in the case of only one movable jaw part be the immovable jaw part, while the other movable jaw part which is connected non-positively to the force transmission member can be formed in total metallic, without that a current transfer of said movable jaw on said fixed jaw member by the hinge occurs therethrough. In this way, the desired current flow between the power transmission element can be effected on the movable jaw part, without further measures of electrical connections. While in the 196 08 716 Cl also known from DE Instrument an insulating ceramic member in the region of the articulation of the push-pull rod is required at the toggle lever arrangement, eliminating such an additional insulating member in the present invention. Overall, a particularly simple, few parts is achieved-requiring design of the instrument by the invention.
In a preferred embodiment, the base body has a distal portion in which the disposed therein jaw part insert is enclosed on the outside isolated. The advantage here is that only the coming into contact with the working surface of the jaw part insert web is acted upon by the high-frequency current, while uninvolved tissue that comes in contact in the operating area with the outer side of the jaw part, is not affected by the high frequency current. The treatment of the tissue with high-frequency current can thus be performed much more targeted.
In a further preferred embodiment of the jaw part insert is positively and non-positively connected to the base body.
The non-positive and positive connection has the advantage that the jaw part insert is securely anchored to the base body. The non-positive and positive connection is meant in the manner of a toothing between the jaw part insert and the basic body, which prevents the lifting of the jaw part insert of the base body. Such a compound can be prepared, for example in the form of a T-shaped groove in the base body and a complementary T-shaped spring on the jaw part insert. A non-positive and positive connection has the particular advantage of high mechanical resistance, which can not be achieved by a casting or embedding the jaw part insert in the basic body, as provided in the prior art. Moreover, such a compound is particularly temperature resistant, as no material connection is required here as a bonding.
Preparation technically particularly preferred if the jaw part insert is fastened to the base body by a dovetail connection. The jaw part insert may additionally shift at its proximal end by a screw or a pin against a Relatiwer- be secured relative to the base body.
In a further preferred embodiment one of the jaw parts is immovably connected with the tubular shaft, and has at least this jaw part the basic body of electrically insulating material.
As mentioned above, this has the advantage that the movable jaw part can be completely made of metal, whereby the power transmission can be easily accomplished constructively from the power transmission member to the movable jaw part. Since the immovable jaw part attached to the tubular shaft and, accordingly, at its proximal portion with respect to its dimension corresponding to the diameter of the tubular shaft, the said measure has the further advantage that the stationary jaw part can be formed with a basic body of insulating material with a particularly high stiffness.
It is particularly preferred if both jaw parts each have a base body made of an electrically insulating material on which a respective work electrodes of the jaw parts forming an electrically conductive jaw part insert is located is.
This measure has the particular advantage that both jaw parts are at least in its proximal area outside completely isolated so that only the coming into contact with the jaw part inserts fabric is subjected to the high frequency current. In a further preferred embodiment, the tubular shaft forms the other current line, and this is isolated from the force transmission element electrically conductively connected to the other jaw part.
This measure known per se continues to contribute to simplify the design of the pliers according to the invention, as for the power supply to the two jaw parts, no additional power lines are needed.
In a further preferred embodiment, at least the mouth part connected to the force transmission element to the basic body of insulating material, in which case the force transmission element is hinged on a proximal portion of the body on which an electrically conductive connecting element is present which the force transmission element is electrically conductively connected to the associated jaw part insert links.
This embodiment, according to which the movable jaw part having a base body made of an electrically insulating material, is advantageous. The proximal portion of the body of insulating material is in fact bridged by the electrically conductive connecting element for transmitting current to the jaw part insert, without the electrically conductive connection element is subjected to bending when the jaw part is moved, as between the force-transmitting element and the connecting element is a hinged connection and no flexible connection. It is preferred that passes through the connecting element is a hinge pin of the hinge connecting the first jaw member to the second jaw member.
In this case, is that the connecting element causes an amplification of the hinge pin and prevents the hinge pin free to operate in the non-metallic proximal portion of the two jaw parts of advantage. The hinge pin of the joint can thereby be electrically isolated, for example by a corresponding jacket to reach, in the case, to expose the two ends of the hinge pin, in that the entire outer side of the instrument is formed insulated in the region of the articulation of the jaw parts.
In a further preferred embodiment of the force transmission element via a spring-loaded contact in a proximal region of the force transmission element is connected to a power supply.
Through the power transmission by means of a spring-loaded contact the advantage of a particularly simple construction current transfer results on the axially movable force transmission element, which has the further advantage that arranged the power supply itself, for example in the form of a connector housing or the connector terminal for a power cable, itself fixed to the instrument can be.
In preferred embodiments of this measure the spring-loaded contact is a sliding contact, for example, an elongated metallic element in the form of a leaf spring, and / or, the contact a pressed down against the force transmission element with spring element, in particular a ball, on. In the latter embodiment, there is the further advantage that a substantially lower friction occurs between the ball and the force transmission element.
In a further preferred embodiment, the jaw part insert of the immovably connected with the tubular shaft jaw part via an electrically conductive wire element which is embedded in the proximal portion of the second base body, an electrically conductive manner to the tubular shaft.
advantageously an isolated by embedding in the body of the immovable jaw part of the force transmission element electrically conducting connection between the tube shaft and the jaw part insert of the stationary jaw part is provided by this measure. Since the jaw part is immovable, the wire element is not subjected to bending stress. Furthermore, the wire element is protected by the embedding in the body of the immovable jaw part against mechanical influences.
In a further preferred embodiment, a proxima- ler portion of the second jaw member to an outbreak with two longitudinally extending legs, between which the main body of the first jaw part is arranged and hingedly connected to the legs.
This feature is that a particularly slim, little space beanspruchende construction and housing-like connection of the two jaws to one another is achieved the advantage. In a further preferred embodiment, a proximal portion of the first jaw member to a fork portion into which the force-transmitting element engages.
This measure has the further advantage that the coupling of the power transmission member on the movable jaw part particularly stable and little space can be accomplished claiming.
In a further preferred embodiment of the base body of the one jaw part and / or optionally the main body of the second jaw member from a hard, in particular temperature-resistant plastic.
By this measure, a particularly high stability of the base of the jaw members is achieved. If the plastic is temperature-resistant in addition, this has the advantage that the jaw parts can be sterilized in an autoclave. Such hard plastics are generally known and available.
The pliers according to the invention can be designed both as a grasping instrument, by opposing inner sides of the working electrodes are of flat construction or as a cutting instrument by the opposing inner surfaces of the work electrodes are configured as cutting elements. In both types of instruments, the embodiments of the invention mentioned above may be used to advantage. In an embodiment of the working electrodes as grasping tools, it is further preferable to form this cross section complementary to each other V-shaped, whereby a lateral deflection of the tissue to be grasped is avoided. In the case that the work electrodes are configured as cutting elements, it is preferable that the inside of a working electrode longitudinally extending groove and the inside of the other working electrode having a a cutting cooperating with the notch cutting.
This configuration of the jaw parts is that of a similar Amboßzange can be transmitted with the high cutting forces on the tissue to be cut.
Embodiments of the invention are shown in the drawings and will be described in more detail with reference thereto. Show it:
1 is an overall view of a bipolar medical forceps according to the invention in side view.
2 is a perspective view of the forceps of Figure 1 in the area of ​​the jaw parts in greatly enlarged scale..; 3 shows a longitudinal section through the clamp in the area of ​​the jaw parts, the jaw parts are in their open position.
Fig. 4 is a view corresponding to Figure 3, in which the jaw members are in their closed position.
Fig. 5 is a highly schematic, partly broken away view of the proximal end of the forceps;
Fig. 6 is a section along the line VI-VI in Fig. 3;
7 shows a section along the line VII-VII in FIG. 3.
Fig. 8 is a section along the line VIII-VIII in Fig. 3;
Figure 9 is a side view of the jaw part insert in Figure 8 without the associated base body..;
10 shows a further embodiment for the shape of the jaw inserts in cross-section.
11 shows a still further embodiment of a jaw part insert in side view.
Figure 12 is a plan view of the jaw part insert in Fig. 11.;
13 shows a still further embodiment of the shape of the jaw inserts in a perspective view. 14 shows a still further embodiment of jaw inserts in cross-section.
Fig. 15 is a representation corresponding to Fig 5 of the proximal end of the forceps according to a further embodiment. and
Fig. 16 shows a detail from Fig. 15 in an enlarged scale in a 90 ° rotated side view.
In Fig. 1 a provided as a whole by the general reference numeral 10 bipolar medical instrument is shown. Details of the instrument 10 are shown in Figures 2 to ninth
The instrument 10 is used in minimally invasive surgery for the treatment of tissue in the human or animal body for the preparation by means of high frequency current.
The instrument 10 is in the embodiment shown, a grasping instrument or as will be hereinafter explained in greater detail a grasping forceps.
The instrument 10 comprises an elongated tubular shaft 12th The tubular shaft 12 is designed as a current conductor metallic tube, which is surrounded by an insulating sheath fourteenth
At the distal end of the tubular shaft 12, a first jaw part 16 is arranged. At the distal end of the tubular shaft 12, a second jaw part 18 is further arranged. The first jaw member 16 and the second jaw member 18 are movable relative to each other. In the embodiment shown, the first jaw member 16 is movably connected to the tubular shaft 12 and the second jaw member 18 is immovably connected with the tubular shaft 12th
The first jaw member 16 and the second jaw part 18, hinged together by a hinge 20th
The instrument 10 further includes at its proximal end a handle 22 which has a first, movable handle portion 24 and a second, immovable handle element 26th
In order to move the first movable jaw member 16 relative to the second immovable jaw part 18, extends between the movable grip part 24 and the movable jaw part 16, a power transmission member 28 which is designed here in the form of a push and pull rod. The force transmission element 28 is axially movably arranged in the tubular shaft 12th
At its proximal end 30, the force transmitting element 28 is positively connected to the movable grip part 24, for example by a ball-headed ball socket connection. With its distal end 32 of the force transmitting element 28 is positively connected to the movable jaw part 16, as will be hereinafter explained in more detail.
Further, the instrument 10 at the proximal end a tilted male terminal 34 is arranged through which the instrument 10 can be connected to a non-illustrated external high-frequency voltage source. The two jaw parts 16 and 18 each form a working electrode 36 and 38 of different polarities, ie the working electrode 36 is operatively connected to the one pole of the high-frequency power source, while the working electrode 38 is connected to the other pole of the high-frequency voltage source.
The power transmission element 28 also serves as a power line and is formed corresponding metallic. Compared with the metallic tubular shaft 12, the force transmission element 28 is isolated by an insulating sheath 40 which is applied to the force transmission element 28th
The force transmission member 28 serves as an electrically conductive connection to the first jaw part 16, while the tubular shaft as will be hereinafter described in greater detail 12 serves as an electrical connection to the second jaw member 18.
With reference to Figures 2 to 4 and 6 to 9, the instrument 10 will be described in the region of its distal end in more detail now. The second jaw member 18 has a one-piece base body 42 made of an electrically insulating material. This material is for example a hard, temperature-resistant plastic, which has a high bending strength.
The base body 42 has a distal portion 44 and a proximal portion 46th
At the distal portion 44 of the base body 42, a jaw insert 48 is arranged, which is electrically conductive, and preferably consists of metal. The jaw part insert 48 forms the working electrode 38th
As is apparent from Fig. 2 and Fig. 8, the distal portion bordered 44 of the base body 42 disposed therein jaw part insert 48 outside insulating, so that no power transfer to the the jaw part insert 48 opposite outer side of the base body can take place coming tissue in contact 42.
The jaw part insert 48 has a dovetailed bar or spring 50, with which the jaw part insert 48 frictionally and in a complementary groove 51 of the base body 42 is positively connected in the manner of a toothing to the base body 42nd The dovetail-shaped spring 50 is also electrically conductive, that is formed of metal and extends to the distal tip of the mouth part 18 where it is not isolated to the outside.
At its proximal end the jaw part insert is screw 48 by a screw 52 to the base body 42 and thus additionally secured to the base body 42 against a relative displacement to the body 42nd
The proximal portion 46 of the base body 42 is secured via an integrally connected thereto receptacle 54, which further consists of the same electrically insulating material, fixedly connected to the tubular shaft 12 in a press fit, and optionally by means of an adhesive. The tubular shaft 12 is connected to the jaw part insert 48 of the second jaw member 18 via an electrically conductive wire element 56 electrically conductive. The wire element 56 is, as shown in Figures 2, 6 and 7 embedded in the body 42 laterally to the longitudinal central axis of the base body 42, including an extending bore therein is present in the base body 42, which at its proximal end 58 in an open groove ends.
While FIG. 2 shows the basic body 42 in the withdrawn from the shaft condition, it will be appreciated that in the assembled state, the wire element is pressed 56 with the inside of the tubular shaft 12 in intimate contact therewith, so that a current transfer from the tubular shaft 12 to the wire element is ensured 56th
, A distal end 60 of the wire element 56 protrudes into the jaw part insert 48 into (see. Fig. 8) so that a power transmission is ensured on the jaw part insert 48 from the wire element 56.
The above-mentioned hole extends correspondingly by the jaw part insert 48 and terminates distally in an opening 62. The opening 62 serves for easier insertion of the wire element 56 in the jaw part insert 48 and the base body 42 and then with an electrically insulating Auffüllmasse, for example a adhesive sealed. The distal end 60 of the wire member 56 is located at approximately half the length of the jaw part insert 48. The first jaw member 16 also has a one-piece base body 62 of an electrically insulating material. The base body 62 has a distal portion 64, 36 forming jaw part insert 66 is located in the turn, an electrically conductive, the working electrode. The distal portion 64 of the base body 62 and the jaw part insert 66 correspond to the distal portion 44 of the base body 42 and the jaw part insert 48, so that a more detailed description here is unnecessary.
The only difference is the fact that the jaw part insert 66 is additionally fixed at its proximal end by a pin 68 on the base body 62nd
The proximal portion 46 of the base body 42 of the jaw part 18 has between the plug-in sleeve 54 and the distal portion 44 to an outbreak 70 in which a proximal portion 72 is arranged of the base body 62 of the first jaw part sixteenth The outbreak 70 is approximately rectangular in shape and forms two legs 74, one of which is shown in Figures 3 and 4, the left leg 74th The leg 74 connecting the receptacle 54 and the distal portion 44 of the base body 42 integrally with each other and consist of the same accordingly also electrically insulating material.
The already mentioned with reference to Fig. 1 hinge 20 over which the movable jaw part 16 is connected to the fixed jaw portion 18 hingedly is now at the proximal portion 72 of the base body 62 and the proximal portion 46 of the base body 42 is disposed, that is proximally behind the jaw part inserts 48 and 66. the hinge 20 is formed by a hinge pin 74 which passes through the leg 74 of the base body 42 and through the proximal portion 72 of the base body 62nd The hinge pin 74 is electrically insulated at least at the ends, which are exposed on the base body 42nd
The proximal portion 72 of the base body 62 of the first jaw part 16 is formed in the shape of a fork portion 76 which is engaged by the force transmission element 28th
The force transmitting element 28 has for this purpose at its distal end a Anlenkungsabschnitt 78, which is formed in the shape of an angle. The Anlenkungsabschnitt 78 is, as is apparent from Fig. 3, attached to the distal end of force transmitting member 28, but also a one-piece design with the rest of the body of the power transmission element 28 is possible. The Anlenkungsabschnitt 78 of the power transmission member 28 is not isolated on its outer side, but can also carry an insulating coating, although this is not necessary. About a hinge pin 80 of the Anlenkungsabschnitt 78 is frictionally connected to the proximal portion of the basic body 62, wherein the hinge pin 80 is electrically conductive and has no insulating coating.
To transfer 28 current supplied to the jaw part insert 66 via the force transmission element is provided between the Anlenkungsabschnitt 78 and the jaw part insert 66, an electrically conductive connecting element 82 is arranged, which is fixedly connected to the fork portion 76 of the base body 62, however, articulated 28 to the force transmitting member the electrically conductive pin 68, the connecting element 82 is finally connected to the electrically conductive jaw part insert 66th
The current flow between the tubular shaft 12 and the jaw part insert 48 of the second jaw member 18 via the wire member 56. This current flow is indicated in Fig. 2 with a minus sign.
The current flow between the power transmission member 28 and the jaw part insert 66 via the Anlenkungsabschnitt 78, the connecting member 82, the pin 68. This current flow is indicated in Fig. 3 with a plus sign. the hinge pin also holds 80 of the current flow.
The jaw inserts 66 and 48 form working electrodes 36 and 38, the effective working surface blunt abutting end faces form, so that the working electrodes 36 and 38 are configured as grasping tools, so that the instrument 10 is used as a grasping forceps use. In order to increase the grip of the working electrodes 36 and 38, the abutting working surfaces of the jaw inserts are formed serrated 66 and 48, as is apparent in particular from FIG. 2.
In Fig. 10 a with respect to the jaw part inserts 48 and 66 modified embodiment is shown, wherein the jaw part inserts 48 'and 66', shown in Fig. 10 without the associated base body having working surfaces comprising a mutually cross-section complementary V-shape respectively.
In Figs. 11 and 12 is a further embodiment of a possible embodiment of jaw inserts 48 '' and 66 ' ", which is particularly suitable for particularly slender jaw parts.
In this embodiment the jaw part inserts 48 '' and 66 '', these only at its proximal end, the dovetail-shaped spring 50 ', so that the jaw part inserts 48 "' and 66 '' only at its proximal end to a respective base body as is not shown in FIGS. 11 and 12, non-positively and positively connected, while its distal section 67 is not enclosed by the main body. in this embodiment, therefore, the distal portion 67 of the jaw inserts 48 '' and 66 '' on the outside not isolated.
Fig. 13 shows another embodiment of jaw inserts 104 and 106 for use in the instrument 10. The jaw inserts 104 and 106 form working electrodes 36 'and 38' which are formed as cutting tools. To this end, the jaw part insert 104 has a cutting edge 108 that cooperates with a notch cutting 110th
While the notch is formed in Fig. 13 in cross section generally V-shaped 110 in Fig. 14 an embodiment is shown in which a notch 112 of a jaw insert 106 'in cross-section is rectangular is formed. A with the jaw part insert 106 'cooperating jaw part insert 104' is modified with respect to the jaw insert 104 that the jaw part insert 104 'extends laterally approximately the same width as the jaw part insert 106'. When closing the jaw parts having the jaw inserts 104 'and 106', the jaw inserts thus lie 104 'and 106' at their lateral areas flat on one another. With the results shown in Fig. 13 and 14, jaw inserts 104 and 106 or 104 'and 106', the instrument 10 is thus used as a bipolar electric cutting instrument.
In Fig. 5 is further shown that the power transmission from the the power transmitting member 28 associated with plug pole of the plug terminal via a configured as a sliding contact 84 spring-loaded contact 34 elastically against a non-insulated portion 86 of the force transmitting member 28 spring wire is formed from a.
A second contact 88 presses against an uninsulated proximal males end 90 of the tubular shaft 12 in order to conductively connect the tubular shaft 12 to the other plug pole of the plug terminal 34th However, it is understood that the tubular shaft 12 is immobile, so that the contact 88 is not a sliding contact.
In Fig. 15 and 16 compared to FIG. 5 alternative embodiment of the proximal end of the instrument 10 is illustrated, where 5 same or similar parts with the same reference numerals have been provided with the embodiment in Fig..
A male terminal 34 "is formed approximately vertically in contrast to the example shown in Fig. 5 and in Fig. 1 embodiment to the instrument axis running.
In this embodiment, the power transmission takes place on the force transmitting member 28 by a spring loaded contact 96, the contact between the corresponding lead and the power transmission member 28 is formed by a spring-loaded ball 98 held in a housing 100 by means of a in the housing 100 arranged, spring not shown is pushed against the force transmission element under 28th
A further spring-loaded contact 102 which in its construction, corresponds to the contact 96, is used for power transmission to the tubular shaft 12, wherein the proximal end of the tubular shaft 12, an insulating member 104 for flow separation between the force transmitting element 28 and the tubular shaft 12 is provided.
The contacts 96 and 102 are received in corresponding receptacles isolated 106 and 108 on the plug connector 34 'from each other.
Referring again to FIG. 1, the tubular shaft 12 together with the force-transmitting element 28 and the jaw parts 16 and 18 rotatable about the longitudinal axis, to which a wheel 94 is provided, which is connected to the tubular shaft 12.
Further, a notch 92 is provided on the tubular shaft 12 and hence the force transmission element is detachably verastet 28 of the handle 22nd
A bipolar medical instrument, comprising a tubular shaft (12), with at least two jaw parts (16, 18) which are movable relative to each other at the distal end of the tubular shaft (12) and by a joint (20) connected to each other and each having a working electrode (36 , 38 form) of different polarity, wherein each jaw member (16, 18) is assigned a separate power line, one of which is arranged by a (in the tubular shaft 12), axially movable force transmission element (28) is formed which is non-positively with at least one of the jaw parts , (16, 18), characterized in that at least one of the jaw parts (16, 18) at least in the region of the joint (20) comprises a one-piece base body (42, 62), made of an electrically insulating material to which a the corresponding working electrode (36, 38) forming an electrically conductive jaw part insert (48, 66; 48 '', 66 '; 48' ', 66' '; 104, 106; 104', 106 ') is fixed, with said associated therewith St romleitung is electrically conductively connected.
Instrument according to claim 1, characterized in that the base body (42, 62) having a distal portion in which the jaw part insert (48, 66; 48 ', 66'; 104, 106; 104 ', 106') is bordered on the outside isolated ,
Instrument according to claim 1 or 2, characterized in that the jaw part insert (48, 66; 48 ', 66'; 48 '', 66 ''; 104, 106; 104 ', 106') positively and positively (to the base body 42, 62) is connected.
4. An instrument according to claim 3, characterized in that the jaw part insert (48, 66; 48 ', 66'; 48 '', 66 ''; 104, 106; 104 ', 106') on the base body (42, 62) is secured connection - by a dovetail.
5. An instrument according to any one of claims 1 to 4, characterized in that one of the jaw parts (16, 18) immobile to the tubular shaft (12) is connected, and that at least this jaw part (18) of the base body (42) of electrically insulating material having.
6. An instrument according to any one of claims 1 to 5, characterized in that both jaw parts (16, 18) each comprise a base body (42, 62) made of an electrically insulating material on which a respective working electrode (36, 38) of the jaw parts (16, 18) forming an electrically conductive jaw part insert (48, 66; 48 ', 66 "; 48' ', 66' '; 104, 106; 104', 106") is attached.
7. Instrument according to one of claims 1 to 6, characterized in that the tubular shaft (12) forms the other current line, and isolated from the power transmission element (28) is electrically conductively connected to the other jaw part (16, 18).
8. Instrument according to one of claims 1 to 7, characterized in that at least the to the force transmission element (28) connected to the jaw part (16), the base (62) of insulating material in which case the force transmission element (28) at a proximal portion ( 72) of the body is hinged, at which an electrically conductive connecting element (82) is present, the force transmission element (28) is electrically conductively connected to the associated jaw part insert (66; 66 '; 66 "'; 104 connects 104 ').
9. Instrument according to claim 8, characterized in that through the connecting element (82) comprises a hinge pin (74) of the joint (20) passes the connection of the first jaw part (16) with the second jaw part (18).
10. Instrument according to one of claims 1 to 9, characterized in that the force transmission element (28) via a spring-loaded contact (84; 96) in a proximal region of the force transmission element (28) to a power supply.
11. An instrument according to claim 10, characterized in that the spring-loaded contact is a wiper contact (84).
12. The instrument of claim 10 or 11, characterized in that the contact (96) comprises a pressed down against the force transmission element with spring element, in particular a ball (98).
13. Instrument according to claim 5 and any of claims 6 to 12, characterized in that the jaw part insert (48) of the immovable to the tubular shaft (12) connected to the jaw part (18) via an electrically conductive wire element (56) (in the basic body 42) of this jaw part (18) is embedded, electrically conductive (to the tubular shaft 12).
14. Instrument according to one of claims 1 to 13, characterized in that a proximal portion (46) of the second jaw part (18) has a breakout (70) having two longitudinally extending legs (74) between which (a proximal portion arranged 62) of the first jaw part (16) and articulated (with the legs 74).
15. Instrument according to one of claims 1 to 14, characterized in that a proximal portion (62) of the first jaw part (16) has a fork portion (76) which is engaged by the force transmission element (28).
16. Instrument according to one of claims 1 to 15, characterized in that the basic body (42) of the one jaw part (18) and / or optionally the basic body (66) of the other jaw part (18) of a hard plastic is / are.
17. Instrument according to one of claims 1 to 16, characterized in that mutually opposite sides of the working electrodes (36, 38) are formed flat, so that the working electrodes (36, 38) on closing the jaw parts (16, 18) together operate as grasping tools ,
18. An instrument according to claim 17, characterized in that the working electrodes (36, 38) in cross section complementary to each other V - shaped design.
19. Instrument according to one of claims 1 to 16, characterized in that mutually opposite inner sides of the working electrodes (36, 38) are formed as cutting elements, so that the working electrodes (36, 38) on closing the jaw parts (16, 18) as cutting tools work together.
20. Instrument according to claim 19, characterized in that the inside of a working electrode, a longitudinally extending groove and the inside of the other working electrode having a cutting cooperating with the notch cutting.
PCT/EP2000/008072 1999-08-27 2000-08-18 Bipolar medical instrument WO2001015614A1 (en)
DE19940689.8 1999-08-27
EP20000956462 EP1211995B1 (en) 1999-08-27 2000-08-18 Bipolar medical instrument
DE2000508973 DE50008973D1 (en) 1999-08-27 2000-08-18 Bipolar medical instrument
US10/084,562 US6669696B2 (en) 1999-08-27 2002-02-26 Bipolar medical instrument
US10/084,562 Continuation US6669696B2 (en) 1999-08-27 2002-02-26 Bipolar medical instrument
WO2001015614A1 true WO2001015614A1 (en) 2001-03-08
EP1211995B1 (en) 2004-12-15
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