Instrument with holding device

Abstract

The invention relates to an instrument (10) comprising an instrument body (15), which is configured in particular in an elongated and flexible manner. It can be completely or partially wound in the form of at least one or more windings (17, 18, 19) and can thus be stowed in a space-saving and easy-to-handle manner. In order to hold the instrument body (15) in this position, a holding device (24) is provided, which is arranged on the instrument body (15) and is preferably held there in a non-detachable manner. The holding device comprises a clamp (32) rotatably supported around the instrument body, the clamp (32) having a lock (34) capable of holding and fastening the windings (17, 18, 19). The clamp (32) can be manipulated by fingers of a user's hand, which is used to hold the instrument (10).

Description

Technical Field

[0001] The present invention relates to apparatus for use in the treatment of human and animal patients, in particular apparatus for use in endoscopic treatment. Background Art

[0002] Probes for surgical treatment of patients for endoscopic use are generally known from the prior art. For example, WO 03 / 00150 A1 discloses a probe for argon plasma coagulation. The device comprises a long device body with at least one flexible section. The flexible section is suitable for insertion into the working channel of an endoscope.

[0003] During the use of the instrument on the patient, it may happen that the instrument must be withdrawn from the working channel of the endoscope and temporarily put down, such as placed in a corresponding sterile bowl, such as to temporarily insert another instrument into the working channel of the endoscope. During the temporary storage of the instrument in the sterile bowl or at another suitable position, the instrument must not contact with other objects (such as non-sterile objects or surfaces) in an uncontrolled manner. Since the length of the instrument may, for example, exceed two meters, this cannot be easily guaranteed by default. For example, it may be convenient to pack the instrument in several windings. Due to its typically inherent spring elasticity, it has a tendency in the form of rebound extension anyway. It is known from US 5,372,592 A and WO 2010 / 068739A1 that the instrument to be packed is attached by means of a clamp. According to US2012 / 0220897A1, the clamp can be configured with the type of spiral spring, which includes a spirally expanded winding on one end. However, handling is troublesome and has a hygienic risk. US 5,364,355 proposes to arrange a sleeve with a spiral groove on the proximal section of a flexible instrument in a longitudinally movable and rotatable manner. EP 0 888 793 A1 proposes to arrange a clamp with a movable bracket on the proximal end of the instrument, which can pivot back and forth between an open position and a closed position. In contrast, US2014 / 0259544 A1, US2008 / 0264993A1 and WO 2010 / 068739A1 use a rigid clamp that is immovably arranged on the instrument to hold the winding of the stored instrument. In order to hold the optical conductor, US2003 / 0072552 A1 proposes a retainer, which includes an end having two mounting holes and a section adjacent to the end, which has a sheet metal strip that is bent to form a spiral member. The optical conductor can be inserted therein. Summary of the invention

[0004] The object of the present invention is to provide an improved concept for operating an instrument, in particular during its non-use period.

[0005] This object is achieved by means of the device according to the invention and by means of the holding device according to the invention:

[0006] The apparatus of the invention is provided in particular for endoscopic use. For example, the apparatus is a probe that can be inserted into the working channel of an endoscope and can be moved in different directions by means of the end of the endoscope that can be angled. For this purpose, the apparatus comprises an apparatus body having at least one flexible section. The flexible section can have, for example, a length of more than 1 meter and can be wound in the form of at least one and preferably a plurality of windings. A retaining device arranged on the apparatus body is part of the apparatus, wherein the retaining device can retain and secure one or more windings. The apparatus body can be formed by a catheter having one or more lumens with a cylindrical outer contour, i.e. a circular cross section. The apparatus body can also have a non-circular, for example an oval cross section or can be composed of two or more catheters arranged parallel to each other.

[0007] Due to the arrangement of the holding device on the instrument body, the holding device can be operated with one hand (i.e. the hand holding the instrument body). By means of the configuration of the holding device claimed for protection, it has a short axial dimension and is therefore easy to handle. The operator can receive the instrument body in one or more windings with the other hand and can operate the holding device with one of his / her hands in order to arrange and tighten the windings. With this concept, simple handling is achieved and the risks regarding the sterility of the instrument are eliminated. The holding device arranged on the instrument body is as sterile as the instrument body itself. Due to the holding device being non-releasably connected to the instrument body, it cannot be put down next to the instrument body. The risk of contamination is minimized.

[0008] By means of the invention, temporary storage of instruments during instrument changes is simplified. Instruments can be stowed with a low space requirement and fastened quickly and in a simple manner. Instruments with a length of more than 2 meters can be handled safely in this way without the stowed windings being able to pop open and, for example, fall to the ground.

[0009] The instrument body can be composed of a supply section and a detector section. The detector section and the supply section can have different diameters, can be composed of different materials and / or can have different flexibility. However, the instrument body can also be continuously formed by a catheter of uniform thickness and / or a catheter of one and the same material. However, in addition in this case, the part of the instrument body to be inserted in the endoscope can be considered as the detector section. The part of the instrument body retained outside the endoscope during treatment can be considered as the supply section. The retaining device is preferably arranged on the supply section. It can be retained there in a way that it cannot be axially moved, that is, it can be fixed against axial displacement. Alternatively, the retaining device can also be arranged on the detector body to be axially displaceable in a limited manner. For example, the axial movement range can be limited on two sides by means of a stop element. The stop element can be formed on one side by the manipulation of the instrument. In addition, the stop element can be formed by a rubber element (such as an O-ring) on ​​one side or on two sides.

[0010] For example, the instrument can be an argon plasma probe comprising a channel extending from a proximal end to a distal end, said channel being able to be supplied with a gas and an electrode arranged therein. However, the instrument can also be another instrument, such as an instrument for cryotherapy, a fiber optic instrument for laser therapy, etc. However, what is common to all these instruments is that they comprise an elongated instrument body which is (at least in sections) flexible so that it can be retracted to form one or more windings.

[0011] Preferably, the holding device comprises a holder rotatably supported relative to the instrument body. The holder is preferably a one-piece rigid plastic component without a movable section. The axis of rotation of the holder is thus preferably identical to or parallel to the longitudinal direction of the instrument body. This allows particularly simple ergonomic handling by the user. With his or her hand in which the instrument body is held, he or she can simultaneously rotate the rigid holder of the holding device. The holder can thus retract and secure one or more windings of the retracted instrument body that may be held with the other hand of the user.

[0012] For this purpose, it is particularly advantageous if the holder comprises a holding space for the detector segment, wherein the holding space is curved around the instrument body, in particular around its longitudinal axis. Thus, for a viewing direction parallel to the longitudinal direction of the detector body, the holder is shaped like a hook. The holding space is thus preferably longer than one third of the circumference of the holder, particularly preferably longer than half the circumference of the holder, along an arc-shaped path curved around the axis of rotation of the holder. By doing so, a plurality of windings of the instrument body can be reliably gripped and held.

[0013] One or more structures for holding a section of the instrument body, in particular a distal section thereof, can be provided on the holding device. These structures can act to secure the distal end of the instrument body so that it remains with the compactly packed instrument body. This in particular achieves protection of the distal end of the instrument body from contamination and thus of the patient from contact with bacteria or dirt.

[0014] The structure for at least temporarily holding and handling the distal end of the instrument body can be one or more locker recesses, which are arranged on the base of the holding device or on a rotatably supported holder. Such a locker recess can be a C-shaped recess in which the detector catheter can be clamped. The configuration of such a locker recess in the holder has the particular advantage that once the distal end or another section of the instrument body has been clamped in the locker recess, further rotation of the holder is also blocked and the winding of the instrument is fixed in the holder. The end of the instrument held in the locker recess blocks the path for the winding to come out of the holder. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] Further details of advantageous embodiments and modifications of the invention are the subject matter of the preferred embodiment and the figures of the accompanying drawings and the corresponding description.

[0016] Figure 1 An endoscope with an instrument inserted therein is shown in a schematic overall view,

[0017] Figure 2 The overall view shows the stowed instruments removed from the endoscope,

[0018] Figure 3 The instrument is shown in a cross-sectional view cut through at the holding device,

[0019] Figure 4 The holding device is shown in a perspective exploded view,

[0020] Figure 5 The instrument and the holding device are shown in a partial longitudinal section,

[0021] Figure 6 The base is shown in a front view, which is part of the holding device,

[0022] Figure 7 A holder is shown in a perspective view, which is part of the holding device,

[0023] Figure 8 Shown in different perspectives Figure 7 The clamp,

[0024] Fig. 9A modified embodiment of a holding device for an instrument with a double-cannula arrangement in the supply section is shown.

[0025] Fig.10 An apparatus is shown having two catheters in a supply section and a holding device with a base,

[0026] Fig.11 The instrument is shown in a cross-sectional view in the vicinity of its holding device, the instrument having the holding device without a base. DETAILED DESCRIPTION

[0027] Figure 1 1 , an instrument 10 is illustrated, which is configured as a flexible probe and is provided for use in an endoscope 11. The endoscope 11 comprises a working channel extending through the instrument 10. Furthermore, the endoscope 11 comprises an operating unit 13 at its proximal end 12, which acts to control a distal end 14 of the endoscope, for example to angle it laterally.

[0028] The instrument 10 can be any instrument suitable for treatment of human or animal patients. It can in particular be a cryosurgical instrument, an electrosurgical instrument, a plasma surgical instrument or also an instrument for treatment with radio waves or light, for example a fiber optic instrument for laser treatment of biological tissue. In the context of the present invention, it is important that the instrument 10 comprises an instrument body 15 having a flexible section 16 which can be housed in one or more windings 17, 18, 19, as in Figure 2 As shown in the figure.

[0029] For example, the instrument body 15 can be formed by a supply section 20 and a detector section 21. Both sections 20, 21 can be formed, for example, by a catheter having one or more lumens. The material of the supply section 20 can be the same material as the material of the detector section 21. However, different materials can also be used. However, preferably, the supply section 20 and the detector section 21 are made of plastic. The supply section 20 and the detector section 21 can have a circular cross-section and can include equal or different diameters. Similarly, the supply section 20 and the detector section 21 can include equal or different flexibility. It is also possible that the supply section 20 is formed by a single continuously formed body.

[0030] At the proximal end of the instrument 10 a connection means, such as a plug 22, can be provided via which the instrument 10 can be supplied with electric current and / or operating medium, light or other forms of energy. However, the distal end 23 acts to influence biological tissue on or in a patient.

[0031] According to the invention, the device 10 comprises a retaining device 24 which acts to hold the windings 17, 18, 19 of the device 10 together, as in Figure 2 As shown in the figure. Figure 1 As shown in FIG. 1 , the holding device 24 can be arranged, for example, on the operating member 25 (which is optionally provided and thus Figure 1 Its function is to manipulate the instrument 10, in particular during insertion into the endoscope 11 and / or during treatment of a patient. For example, the manipulation member 25 can be arranged at a position of the instrument 10, at which the supply section 20 adjoins the detector section 21.

[0032] exist Figure 3 , Figure 4 and Figure 5 2 shows a holding device 24, which is preferably arranged on the supply section 20. The holding device 24 can include a base 26 arranged on the instrument 10 (for example on the supply section 20), which is preferably made of plastic. The base 26 can be arranged on the instrument 10, for example on the supply section 20, as in Figure 5 The base 26 can thereby be clamped or glued or fixed to the supply section 20 in another way against axial displacement. By way of example only, for this purpose Figure 5 , an adhesive layer 27 is illustrated. As an alternative, the base 26 can be held on the outer surface of the instrument 10 in a friction fit (for example by means of a rubber element, such as a rubber ring). It is also possible to arrange the base 26 on the instrument 10 (in particular the supply section 20) in an axially displaceable manner with clearance. However, the base 26 can also be omitted.

[0033] Preferably the base 26 comprises a support section 28 which is cylindrical on the outside and adjoined by a radially outwardly protruding head 29. On the other end of the support section 28 a locking collar 30 is provided which has an annular surface axially limiting the support section 28. A longitudinal slit 31 which can extend into the support section 28 divides the locking collar 30 so that its halves can flex radially inwardly.

[0034] Independently of whether the holding device 24 comprises a base 26 or not, the clamp 32 is part of the holding device 24, which is rotatably held at the instrument 10. For example, the clamp can be held on the support section 28. Alternatively, the clamp 32 can also be directly rotatably held on the instrument 10. The clamp 32 is preferably a plastic part. It comprises a central part 33, for example, of tubular shape, from which a hook-shaped or spiral-shaped lock 34 extends. The central part 33 can be configured like a sleeve with closed walls. Alternatively, the central part 33 can comprise a longitudinal slit, which is attached to the instrument 10 or the base 26 by means of a clamp-type movement.

[0035] The lock 34 is thus wound around the central part 33 (at a distance from the central part 33). In this manner, the lock 34, together with the tubular central part 33, delimits a curved holding space 35, the width (i.e. the distance towards the central part 33) and the depth of which are sufficient to hold the windings 17, 18, 19 (e.g. of the detector segment 21). The holding space 35 extends in an arcuate manner around the tubular central part 33 and thus preferably extends approximately more than half a revolution, i.e. more than 180° around the central axis 36.

[0036] One or more locking recesses 37, 38, 39 can be configured on the base 26, such as in particular from Figure 4 , 5 and 6. Preferably, the locking recesses 37-39 are formed in the head 29 of the base 26, for example in the form of a straight groove which is slightly narrower in the central region than the diameter of the probe section 21. The distal end 23 or part of the probe section 21 adjoining in the proximal direction can thus be clipped into the locking recesses 37-39 and temporarily attached in this way. However, it is also possible to form the locking recess 40 on the free end of the lock 34, such as from Figure 4 Obviously. The distal end 23 of the detector section 21 or its adjacent part can be inserted into this lock recess 40. It is also possible to form a plurality of such lock recesses 40, 41, 42 on the free end of the lock 34 of the holder 32. Likewise, an additional lock recess 43 can be arranged in the side of the lock 34. Such lock recesses 40-42 are arranged from Figure 8 It is also obvious.

[0037] The device 10 described thus far can be sterilely packaged by the device manufacturer (e.g., in Figure 2 The windings 17, 18, 19 can be released by rotating the clamp 32, so that the instrument 10 can be connected to the supply device with one hand and can be inserted into the working channel of the endoscope 11 with the other hand.

[0038] If the instrument 10 must be removed from the working channel of the endoscope 11 during a surgical operation and placed aside, it can be easily stowed again, such as in Figure 2 , because in particular its detector section 21 is wound in the manner of several windings 17, 18, 19. This is easily possible with two hands, wherein the holder 32 can be rotated with one hand so that it holds and fixes the windings 17, 18, 19. If necessary, the distal end 23 can now be additionally fixed in one of the locker recesses 37-43. If the locker recesses 40, 41, 42 or also the locker recess 43 are used, the back rotation of the holder 32 can thereby be prevented. This is an additional guarantee against the unfolding of the windings 17, 18, 19. The instrument 10 securely stowed in this way can now be stored intermediately, for example in a sterile bowl, without the risk of uncontrolled movement and contamination.

[0039] Device 10 from Fig. 9 It is further evident that it comprises two wires 20a, 20b in its supply section 20. The base 26 is configured for the arrangement of the two wires 20a, 20b. However, it does not necessarily have to surround these along the entire periphery, wherein a thinner configuration can be achieved. A similar configuration is obtained from Fig.10 Here, a base 26 is also provided for the arrangement of the two wires 20a, 20b, to which the base 26 can be glued, as in the case of Fig. 9 In the embodiment of the clamp 32, or can be connected with it in a clamping manner. Regarding the embodiment of the clamp 32, the description provided for all other embodiments applies accordingly.

[0040] The embodiment of the holding device 24 is as follows Fig.11 It is evident that the holder 32 is held without a base directly on the supply section 20 or also on another section of the instrument 10. It is thereby rotatable about the longitudinal axis of the supply section 20, i.e. it is held on the supply section 20 with some radial play. Furthermore, the holder 32 is axially movable on the supply section 20. In order to limit the movement path, corresponding stop elements can be provided, which are not shown. The stop element can be, for example, an O-ring attached to the supply section 20, a structure formed by a clamping element, or also a structure originally provided on the instrument, such as a manipulation piece. The tubular central part 33 can be configured as a closed hollow cylinder similar to a sleeve, as in Fig.11 As an alternative, it is also possible to form a slot 44 in the central section 32, if appropriate with rounded sides, as in Fig.11This has the advantage that the holder 32 can then be clipped onto a corresponding support structure, i.e. a base or also a supply section 20 or another part of the instrument 10. By doing so, the holder 32 is also suitable for subsequent attachment on instruments 10 which were not previously equipped with a holding device 24. The slot 44 can be used for all the above-described embodiments.

[0041] Each of the above descriptions is in the context of the instrument 10, the subsequently claimed holding device 24 can also be provided and sold independently of the instrument 10. In this case, the holding device 24 must be attached to the instrument 10 subsequently.

[0042] The device 10 of the invention comprises a device body 15, which is configured in particular in an elongated and flexible manner. It can be completely or partially wound in the form of at least one or more windings 17, 18, 19 and in this way can be stowed in a space-saving and easy-to-handle manner. In order to hold the device body 15 in this position, a holding device 24 is provided, which is arranged on the device body 15 and is preferably held there in a non-detachable manner. The holding device comprises a holder 32 supported rotatably around the device body, which has a lock 34, which can hold and tighten the windings 17, 18, 19. The holder 32 can be manipulated by the fingers of the hand of the user that is used to hold the device 10.

[0043] List of reference numerals:

[0044] 10. Instruments

[0045] 11. Endoscope

[0046] 12 Proximal end of the endoscope

[0047] 13 Operating unit

[0048] 14 Distal end of the endoscope

[0049] 15. The device body of the device 10

[0050] 16 Flexible section of the device 10

[0051] 17-19 Winding

[0052] 20 Supply Sections

[0053] Line 20a, 20b

[0054] 21 detector sections

[0055] 22 Connecting device of device 10

[0056] 23 The distal end of the instrument 10

[0057] 24 Holding device

[0058] 25 Control parts

[0059] 26 base

[0060] 27 Adhesive

[0061] 28 Support Section

[0062] 29 Head

[0063] 30 Locking ferrule

[0064] 31 Vertical gap

[0065] 32 Clamp

[0066] 33 Central part

[0067] 34 Lock

[0068] 35. Keep Space

[0069] 36 Central Axis

[0070] 37-43 Locking device recess

[0071] 44 gap.

Claims

1. A device (10) for use in the medical treatment of a human or animal patient, A device body (15) is provided, which comprises at least one flexible section (16), which can be wound in the manner of at least one winding (17, 18, 19), A holding device (24) is provided, comprising a holder (32) for holding the at least one winding (17, 18, 19), the holder (32) being rotatably supported on the instrument body (15), characterized in that: The holder (32) has a tubular central portion (33), a locking device (34) extending away from the tubular central portion (33) around at least a portion of the periphery of the central portion (33) at a radial distance from the central portion (33), the holder is a one-piece rigid plastic component, the retaining device (24) includes a base (26) arranged on the instrument (10), the holder (32) is arranged on the base (26) and is rotatably supported, the instrument body (15) is composed of a supply section (20) and a detector section (21), the holder (32) includes a holding space (35) for the detector section (21), wherein the holding space (35) is curved around the instrument body (15).

2. The device according to claim 1, characterized in that The detector section (21) is flexible and can be wound in the manner of at least one winding (17, 18, 19).

3. The device according to claim 2, characterized in that The detector section (21) can be wound in the form of a plurality of windings (17, 18, 19).

4. The apparatus according to claim 1, characterized in that The device is used for endoscopic treatment.

5. The apparatus according to claim 1, characterized in that The holding space (35) is longer than one third of a turn of the holder (32) in the rotation direction of the holder (32).

6. The apparatus according to claim 1, characterized in that The holder (32) includes at least one lock recess for retaining the distal end (23) of the instrument body (15).

7. The apparatus according to claim 1, characterized in that The base (26) includes at least one locker recess for retaining the distal end (23) of the instrument body (15).

8. The device according to any one of claims 1 to 7, characterized in that The retaining device (24) is fixed to the instrument body (15) in a non-displaceable manner.

9. The device according to any one of claims 1 to 7, characterized in that The holding device (24) is held on the instrument body (15) in an indetachable manner.

10. The device according to any one of claims 1 to 7, characterized in that The base (26) is configured for attachment to an instrument having a non-circular cross-section.

11. The apparatus according to claim 10, characterized in that The instrument body (15) is composed of a supply section (20) and a detector section (21), and the base (26) surrounds the supply section (20) or the detector section (21) around the entire circumference or, alternatively, around only part of its circumference.

12. The apparatus according to claim 1, characterized in that The holding device (24) is arranged axially displaceably on the supply section (20) or the detector section (21).

13. A holding device (24) for an instrument (10) for medical treatment of human or animal patients, wherein the instrument comprises an instrument body (15), the instrument body (15) having at least one flexible section (16), the at least one flexible section (16) being capable of being wound in the form of at least one winding (17, 18, 19), wherein the holding device (24) comprises a holder (32) for holding the at least one winding (17, 18, 19), wherein the holder (32) can be rotatably arranged on the instrument body (15), The holder (32) comprises a tubular central portion (33), a locking device (34) extending away from the tubular central portion (33) around at least a portion of the periphery of the central portion (33) at a radial distance from the central portion (33), the holder being a one-piece rigid plastic component, the retaining device (24) comprising a base (26) arranged on the instrument (10), the holder (32) being arranged on the base (26) and being rotatably supported, the instrument body (15) being composed of a supply section (20) and a detector section (21), the holder (32) comprising a retaining space (35) for the detector section (21), wherein the retaining space (35) is curved around the instrument body (15).

14. The holding device according to claim 13, characterized in that The device is used for endoscopic treatment.

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