Carrier

Abstract

Transporter (1) of a resectoscope, comprising an optical guide tube (2) which can be attached longitudinally to the resectoscope and on which a sliding body (3) is mounted so as to be longitudinally displaceable, a coupling piece (4) arranged distally from the sliding body (3), which is penetrated by the optical guide tube (2) and is attached to it, a probe guide tube (5) which breaks through the sliding body (3) and which passes through the coupling piece (4), the probe guide tube (5) being detachably connected to the sliding body (3), wherein the probe guide tube (5) is adapted to receive a working tool (6) which can be guided and moved in the probe guide tube (5), characterized in that the probe guide tube (5) extends in a circular arc (9) between an inlet (7) into the sliding body (3) and an outlet (8) from the coupling piece (4) when the sliding body (3) is positioned most distally on the optics guide tube (2), wherein a line (10) running between the inlet (7) of the probe guide tube (5) into the sliding body (3) and its outlet (8) from the coupling piece (4) defines a bowstring which, starting from the outlet (8) of the probe guide tube (5) from the coupling piece (4), runs offset from a central axis of the optical guide tube (2) at an angle α in the range of 5° -15°.

Description

Technical field

[0001] The invention relates to a conveyor of the type mentioned in the preamble of claim 1. State of the art

[0002] In urology, transporters are known that, in combination with electrodes and laser fibers, are used as a resectoscope, or in combination with a knife as a urethrotome. Resectoscopes are primarily used for the resection of a hypertrophied prostate starting from the urethra. However, resectoscopes can also be used in other surgical fields, for example, for work on the bladder or in gynecological operations.

[0003] Resectoscopes with transporters of the generic type form the standard design in the prior art, see, for example, DE 10 2013 022121 A1. A transporter has a shaft tube in which an optical guide tube and a further guide tube for guiding and moving the working tool, for example, for guiding a knife, run. In a conventional resectoscope for HF surgery, a longitudinally displaceable electrode carrier is located in the shaft tube next to the optical guide tube instead of the further guide tube, with the cutting being carried out with the electrode arranged in the region of the distal end of the shaft tube. In this configuration, at least the end of the shaft tube is provided with insulation. The need for insulation is not given for transporters that are selected merely to guide and move a working tool; transporters that, for example, carry a cutting tool, e.g., a knife, or an injection tool, e.g.guide and move a cannula or a laser fiber.

[0004] Depending on the working device passing through the conveyor, the commonly used conveyors each have their own design. Depending on the design, a maximum of two different or even identically acting working devices can be combined (e.g., a combination of laser probe / electrode carrier or laser probe / cannula), although additional guide tubes may be required. For example, US Pat. No. 6,971,989 B2 discloses a resectoscope that combines two surgical working devices.

[0005] Overall, the number of conveyors is large according to the required functionalities and their production is cost-intensive.

[0006] It is therefore the object of the present invention to provide a conveyor of the above-mentioned type that overcomes the disadvantages of the prior art. In particular, a universal conveyor is to be provided for applications in which a working tool is merely guided and moved (cutting tool, injection tool, laser probe) – so that no additional insulation is required. Description of the invention

[0007] The invention relates to a transporter for a resectoscope, which has an optics guide tube that can be attached longitudinally to the resectoscope and on which a sliding body is mounted for longitudinal displacement. Distal to the sliding body is a coupling piece that is penetrated by the optics guide tube and is attached to it. The term "distal" refers to the part of the transporter remote from the user, while the term "proximal" refers to the part of the transporter closest to the user. The transporter further has a probe guide tube that penetrates the sliding body and passes through the coupling piece, wherein the probe guide tube is preferably detachably connected to the sliding body. The probe guide tube can be integral or multi-part, preferably two-part.Preferably, the portion of the probe guide tube that penetrates the sliding body is formed as a tubular recess in the sliding body, which is open to the outside at the proximal end region of the sliding body and defines an entrance into the sliding body, while the portion of the probe guide tube that extends distally from the sliding body is preferably formed as a tube, for example made of a rigid polymer compound or metal, which is preferably fastenable in the distal end region of the sliding body by means of a locking knob. Alternatively, the probe guide tube can also be formed as an integrally designed tube. The probe guide tube is adapted to accommodate a working device that can be guided and moved in the special guide tube or in the tube formed by the probe guide tube. Working devices for accommodation in a probe guide tube of a conveyor are known from the prior art.These are, for example, cutting tools such as a knife, clamping or gripping tools, or laser probes or injection tools. The probe guide tube runs in an arc between an inlet into the sliding body and an outlet from the coupling piece when the sliding body is positioned at its most distal on the optics guide tube. A line running between the inlet of the probe guide tube in the sliding body and its outlet from the coupling piece defines a bow chord, which, starting from the outlet of the probe guide tube from the coupling piece, runs offset from a central axis of the optics guide tube at an angle α in the range 5° - 15°. The term “arc” can refer to any line curved to one side or to part of a circle (circular arc). The arc can also be an involute.An involute is a curve from a family of curves that can be assigned to any rectifiable curve. The term "bow chord" refers to the straight line connecting any two points on the arc line.

[0008] In the probe guide tube designed in this way, a cutting tool, e.g. a knife, as well as an injection tool, e.g. a cannula, or even laser fibers can be guided as a working device for separate applications. The conveyor according to the invention is designed such that the curved path of the probe guide tube, or of the working devices to be guided (cutting tool, injection tool, laser probe), is maximal in order to, on the one hand, allow the mobility of the sliding body and, on the other hand, to place minimal mechanical stress on the working devices, for example, to bend a laser fiber only minimally in order to avoid breakage of the fiber. If the angle α is too small, the inserted working device, e.g. a cannula or a laser probe, could interfere with the end plate of the resectoscope firmly anchored to the guide tube and the optics protruding from it, thus disadvantageously reducing the mobility of the sliding body.

[0009] In a preferred embodiment of the conveyor according to the invention, the bowstring, starting from the exit of the probe guide tube from the coupling piece to the central axis of the optics guide tube, can be formed at an angle α in the range of 10°-15°. Within this angular range, rapid and maximally trouble-free insertion of both a laser probe and an injection tool into the conveyor is ensured, since the different material properties of the various tools, namely the flexibility of the injection tool inserted proximally or the stability of the laser probe, also inserted proximally, are optimally taken into account in this range.

[0010] In an advantageous development of the conveyor according to the invention, the probe guide tube can be firmly connected to the distal end region of the sliding body, for example via a glued connection. Alternatively, the probe guide tube can be detachably connected to the sliding body, for example via a locking button or a screwed connection. The probe guide tube preferably has a two-part shape, i.e. the proximal part of the probe guide tube running in the sliding body is designed as a tubular recess in the sliding body, while the part running distally from the sliding body is designed as a tube, preferably with a round cross-section, made of a metal or a correspondingly rigid polymer material. The latter, tubular section can be connected to the sliding body in a simple manner in the distal end region of the sliding body via a locking button, as described above.A locking mechanism is understood, in particular, to be a movable or rotatable component that, together with a counterpart, advantageously formed in the sliding body, can be brought into a positive and releasable connection. A mechanical locking mechanism, in particular, is simple and cost-effective to manufacture.

[0011] In a further embodiment of the conveyor, a working unit designed as a cutting tool can be locked in the probe guide tube via a first lock on the sliding body. This first lock is located in the distal end region of the sliding body, preferably adjacent to the outlet of the probe guide tube from the sliding body. The first lock can preferably be designed, for example, as a snap-in connection; the cutting tool can have, for example, a groove at the proximal end, into which a pin adjustably arranged on the sliding body can engage for locking. For use, the cutting tool is inserted from distal to proximally along the probe guide tube until it can be releasably attached to the first lock on the sliding body.An integrally formed probe guide tube is expediently designed with a corresponding recess to enable the locking of the cutting tool in the first locking position. The conveyor according to the invention, used to guide and move a cutting tool, allows the easy insertion and locking of a corresponding cutting tool, for example, a knife, into the probe guide tube from the distal end of the resectoscope.

[0012] In a preferred embodiment, the sliding body can be formed with a sealing element proximal to the first locking mechanism. A sealing element is understood to be an element that can prevent or limit the transfer of substances from one space to another. The sealing element arranged proximal to the first locking mechanism can close off the probe guide tube distally and proximally, so that the entry of contaminants both from distal to proximal (for example via a cutting tool arranged in the probe guide tube) and from proximal to distal (for example via the entrance to the sliding body) can be prevented. The sealing element can preferably be designed as a sealing ring made of a polymer material, for example silicone, which seals at least in the axial and / or radial direction.The sealing element can be designed to be adjustable by the user, for example via a lever mechanism attached to the sliding body, and can thus be advantageously adapted to the different material properties of the working tools guided in the probe guide tube.

[0013] In a further advantageous development of the conveyor according to the invention, the sliding body can have a second locking mechanism for locking a working device inserted into the probe guide tube, wherein the working device can be a laser probe or an injection tool, for example a cannula. The second locking mechanism is located proximal to the first locking mechanism in the sliding body; preferably, the second locking mechanism is formed adjacent to the inlet of the probe guide tube into the sliding body. The laser fibers or cannulas inserted proximally into the probe guide tube extending in the curve according to the invention can be locked separately by means of the second locking mechanism, depending on their material properties.This ensures precise control of the corresponding working device from the sliding body, while at the same time the connection to the laser source via a laser cable or to the injection liquid via a corresponding liquid line is not impaired. The second locking mechanism can preferably be designed as a clamping connection, as is known from the prior art (e.g. DE 10 2013 018972), whereby the laser fiber or the injection tool (cannula) is pressed into the surface over its circumference. The second locking mechanism can be a locking button, for example. A second locking mechanism designed as a clamping connection enables gentle and easily controllable fixation, in particular of the laser probe. The additional second locking mechanism enables the secure and material-adapted locking of other working devices in a probe guide tube, which can also be used to guide and move a cutting tool.The universal conveyor according to the invention is therefore simple and cost-effective to manufacture, since a wide variety of work equipment can be safely guided and moved in it.

[0014] In a preferred embodiment of the conveyor, the sealing element can be arranged in the sliding body between the first locking mechanism and the second locking mechanism. The sealing element arranged in this way can, on the one hand, effectively seal a cutting tool located in the first locking mechanism against material transfer from the proximal direction, for example, against contaminants that can enter the sliding body via the inlet of the probe guide tube. On the other hand, a laser probe arranged in the probe guide tube can be effectively insulated from material transfer from the distal direction, which can occur, for example, via the outlet from the sliding body and the first locking unit.

[0015] In an advantageous development of the conveyor according to the invention, the coupling piece can have a tubular recess for the optics guide tube and another tubular recess for the probe guide tube. In particular, it is advantageous to separately introduce the section of the arc-forming recess through which the probe guide tube extends, if the recess for the optics guide tube is designed identically for each type of conveyor. This allows for different material requirements to be taken into account if necessary. Short description of the characters

[0016] In the following, some specific embodiments of the invention are described by way of example and not exhaustively, with reference to the accompanying figures. These specific embodiments serve only to illustrate the general inventive concept; they do not limit the invention. Fig. 1 shows a cross-section through a resectoscope with the conveyor according to the invention, in which a knife is guided. Fig. 2 shows a partial aspect of a cross-section through the conveyor according to the invention, in which a laser probe is guided. Fig. 3 shows an enlarged section of the cross section of Fig. 2.

[0017] Fig. Figure 1 shows the cross-section of a resectoscope with a shaft tube (16) attached to a main body (17). The main body is connected to a guide plate (18) via an optics guide tube (2) of the conveyor (1). An optic (19) with an eyepiece arranged at the proximal end runs through the optics guide tube (2) and the shaft tube (16) to their distal ends. A sliding body (3) is mounted on the optics guide tube (2) for longitudinal displacement. Distal to the sliding body (3) is a coupling piece (4) which is connected to the optics guide tube (2) and is penetrated by the latter. The sliding body (3) has a handle (20), and the coupling piece (4) has at least one further handle (21). The sliding body can be moved in the sliding direction relative to the guide plate (18) by actuating the handles (20, 21) against the force of a spring (22).The conveyor (1) has a probe guide tube (5), which can be integral or multi-part. In the present case, the two-part probe guide tube (5) in the form of a bore (dashed line) penetrates the sliding body (3) and runs distally from the sliding body (3) as a tube, for example made of metal or a rigid polymer material, along the optics guide tube (2) to the distal end of the conveyor (1). The probe guide tube (5) is adapted for guiding and moving a working device (6). The probe guide tube (5) enters in the form of a bore (dashed line) at an inlet (7) of the sliding body (3). The bore runs through the sliding body (3) and opens in the distal end region thereof at an outlet (7a) into the part of the probe guide tube (5), which is usually made of metal.The probe guide tube (5) is then guided through the coupling piece (4), which is designed to accommodate the probe guide tube (5) with a corresponding inlet (8a) and outlet (8). Between the inlet (7) in the sliding body (3) and the outlet (8) from the coupling piece (4), the probe guide tube (5) forms a tubular recess that forms a curved line (see . Fig. 3) when the sliding body (3) is positioned most distally on the optics guide tube (2), ie when the gap between the sliding body (3) and the coupling piece (4) is minimal. The probe guide tube (5) can be releasably connected to the sliding body (3) via a first locking mechanism (11). Fig. 1 also shows the cutting tool (15), a knife, guided in the probe guide tube (5) and locked into the sliding body (3) by means of the first locking mechanism (11). The cutting tool (15) is inserted distally into the probe guide tube (5) and releasably locked to the sliding body (3) by means of the first locking mechanism (11), for example by means of a snap-in connection, thereby enabling precise control of the knife from the sliding body (3). The passage of liquids or other substances is effectively prevented by the sealing element (12) arranged proximal to the first locking mechanism (11).

[0018] Fig. Figure 2 shows a partial aspect of a cross-section through the conveyor according to the invention, in which a laser probe (14) comprising a laser fiber is guided as the working device (6). The laser probe (14) runs in the probe guide tube (5) and protrudes with its proximal end from the inlet (7) of the probe guide tube (5) into the sliding body (3) for connection to a laser generator via a laser cable. The probe guide tube (5) is formed in two parts in the present case: in the sliding body (3) as a tubular recess (overlaid by the laser probe 14 in the image) and distally from the sliding body (3) as a tube (densely hatched). The laser probe (14) is releasably fastened in the sliding body (3) via a second locking mechanism (13), for example a clamping connection, while the probe guide tube (5) is connected to the sliding body (3) via a locking button (not shown).Instead of a laser probe (14), an injection tool (14a) can also be guided in the probe guide tube (5) in this configuration. The passage of liquids or other substances is effectively prevented by the sealing element (12) located distal to the second locking mechanism (13); in this configuration, the first locking mechanism (11) is not occupied by a working tool (6).

[0019] Fig. 3 shows an enlarged section of the cross section of Fig.2, wherein the sliding body (3) and the coupling piece (4) are in maximum proximity, i.e. the sliding body (3) is displaced furthest distally on the optics guide tube (2). The sliding body (3) is shown in a simplified manner for better clarity, i.e. the first (11) and the second locking mechanism (13) as well as the sealing element (12) are not shown. The probe guide tube (5) forms a tubular recess between the inlet (7) of the probe guide tube (5) into the sliding body (3) and the outlet (8) from the coupling piece (4), which recess runs in an arc (9, dotted line). The line (dashed) extending between the inlet (7) of the probe guide tube (5) into the sliding body (3) and its outlet (8) from the coupling piece (4) defines a bowstring (10).This runs from the outlet (8) of the probe guide tube (5) from the coupling piece (4) to the central axis of the optics guide tube (2) at an angle α in the range of 5° -15°, preferably at an angle α of 10° -15°. List of reference symbols 1 carrier 2 optical guide tube 3 sliding bodies 4 coupling piece 5 Probe guide tube 6 Work equipment 7 Entrance into the sliding body 7a Exit from the sliding body 8 Exit from the coupling piece 8a Entrance into the coupling piece 9 sheets 10 line, bowstring 11 first locking 12 Sealing element 13 second locking 14 laser probe 14a Injection tool 15 Cutting tool 16 Shaft tube 17 main body 18 Guide plate 19 Optics 20 Handle sliding body 21 Handle coupling piece 22 spring

Claims

[1] Transporter (1) of a resectoscope, comprising an optical guide tube (2) which can be attached longitudinally to the resectoscope and on which a sliding body (3) is mounted so as to be longitudinally displaceable, a coupling piece (4) arranged distally from the sliding body (3), which is penetrated by the optical guide tube (2) and is attached to it, a probe guide tube (5) which breaks through the sliding body (3) and which passes through the coupling piece (4), the probe guide tube (5) being detachably connected to the sliding body (3), wherein the probe guide tube (5) is adapted to receive a working tool (6) which can be guided and moved in the probe guide tube (5), characterized by , that the probe guide tube (5) extends in a circular arc (9) between an inlet (7) into the sliding body (3) and an outlet (8) from the coupling piece (4) when the sliding body (3) is positioned most distally on the optics guide tube (2), wherein a line (10) running between the inlet (7) of the probe guide tube (5) into the sliding body (3) and its outlet (8) from the coupling piece (4) defines a bowstring which, starting from the outlet (8) of the probe guide tube (5) from the coupling piece (4), runs offset from a central axis of the optical guide tube (2) at an angle α in the range of 5° -15°. [2] Conveyor (1) according to claim 1, wherein the bowstring (10) extends from the outlet (8) of the probe guide tube (5) from the coupling piece (4) to the central axis of the optical guide tube (2) at an angle α in the range of 10° -15°. [3] Conveyor (1) according to one of claims 1 or 2, wherein a working device (6) designed as a cutting tool (15) can be locked in the probe guide tube (5) via a first locking device (11) on the sliding body (3). [4] Conveyor (1) according to claim 3, wherein the first locking device (11) is designed as a snap-in connection. [5] Conveyor (1) according to one of the preceding claims, wherein the sliding body (3) is formed proximal to a first locking means (11) with a sealing element (12). [6] Conveyor (1) according to claim 5, wherein the sealing element (12) is adjustable. [7] Conveyor (1) according to one of the preceding claims, wherein the sliding body (3) has a second locking device (13) for locking a working device (6) inserted into the probe guide tube (5), and wherein the working device (6) is preferably a laser probe (14) or an injection tool (14a). [8] Conveyor (1) according to claim 7, wherein the second locking means (13) is designed as a clamping connection. [9] Conveyor (1) according to one of claims 7 or 8, wherein a sealing element (12) is arranged in the sliding body (3) between the first locking means (11) and the second locking means (13). [10] Conveyor (1) according to one of the preceding claims, wherein the coupling piece (4) has a tubular recess for the optics guide tube (2) and a further tubular recess for the probe guide tube (5).

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