ELECTROSURGICAL DEVICE

Abstract

Surgical instrument (1) comprising a body section having a handle (10) arranged at its proximal end region and a shaft (12) extending at least partially through the body section in a distal direction and projecting from a distal end thereof, wherein an end effector (14) is arranged on the shaft (12), the shaft (12) being rotatably attached with respect to the body section to allow the shaft (12) carrying the end effector (14) to be rotated with respect to the body section when the surgical instrument (1) is used; wherein the shaft (12) and the body section are provided with a plurality of sets of corresponding interacting rotation control elements (1500, 1502, 1504, 1600, 1602, 1604) which, when the surgical instrument (1) is used, control the angular rotation of the shaft (12) with respect to to limit the body section to an angular rangewherein a first set of the plurality of sets of corresponding interacting rotation control elements (1600, 1602, 1604) is arranged on the shaft (12) at a first position in the longitudinal direction, which is located in the distal end region of the body segment, and a second set of the plurality of sets of corresponding interacting rotation control elements (1500, 1502, 1504) is spatially spaced apart from the first set and is arranged on the shaft (12) at a second position in the longitudinal direction, which is located in the proximal end region of the body segment, whereby, when using the surgical instrument (1), control of the angular rotation of the shaft (12) with respect to the body segment is provided at said first and second positions in the longitudinal direction.

Description

Field of invention

[0001] Embodiments of the present invention described herein relate to an electrosurgical device and, in particular, an electrosurgical forceps, wherein a mechanical blade provides a tissue cutting function in combination with electrosurgical electrodes which provide a tissue coagulation or sealing effect. Background of the invention and prior art

[0002] Electrosurgical instruments offer advantages over conventional surgical instruments because they can be used for tissue coagulation and sealing. Such an arrangement is known from US 2015 / 223870 A1, which describes an endoscopic bipolar forceps comprising a housing and a shaft. The shaft has an electrosurgical end-effector assembly at its distal end, which includes two clamping jaw elements for grasping tissue between them. Each clamping jaw element is suitable for connection to an electrosurgical power source, enabling the sealing of tissue held between the clamping jaw elements. A control arrangement is incorporated in the housing to move the clamping jaw elements.A movable handle is also present, so that a movement of the handle actuates the control mechanism to move the clamping jaw elements relative to each other. A knife channel is part of the end effector to allow a blade to move forward and backward within the channel, thus enabling the cutting of fabric.

[0003] Further prior art arrangements include the following: US 5,730,740, US 5,104,397, US 4,800,880, WO 98 / 14124, US 2012 / 0109186, US 5,352,235, WO 2014 / 074807, US 7,846,161, WO 2008 / 024911, US 5,776,130, US 6,039,733, US 6,179,834, US 7,131,971, US 7,766,910, EP 2628459, US 2014 / 0221999, US 7,083,618, US 2009 / 0248020, US 2015 / 0209103, US 5,797,938 and US 7,101,373. Brief description of the invention

[0004] Embodiments of the invention provide an improved surgical instrument comprising an end effector attached to the end of an elongated shaft extending from a handle. The shaft, and thus the end effector, is rotatable with respect to the handle to allow various rotational orientations of the end effector to be achieved without having to rotate the entire instrument. To enable control over the degree of rotation of the shaft with respect to the handle, for example, to prevent excessive stress on any internal wiring due to excessive rotation in the same direction, shaft rotation control elements are provided to allow rotational or torsional control of the shaft. The shaft rotation control elements can be arranged at one or a plurality of different positions longitudinally along the shaft.For example, the shaft rotation control elements may be provided in the form of correspondingly interacting stops on or around an adjustment wheel at the proximal end of the housing, which is used to rotate the elongated shaft. Alternatively, rotation control elements in the form of cooperating stops may be provided elsewhere, such as in a rotatable shaft support element located at the end of the handle distal to the user, which is nominally intended to support the shaft at the transition from positions inside the handle to the outside of the handle along the length of the shaft. In other embodiments, rotation control stops are provided on both elements, thus offering very effective rotation control, which provides the user with a very positive and high-quality feel.

[0005] In light of the above, according to a further aspect, a surgical instrument is provided with a handle having a longitudinal axis defining a generally forward and a backward direction, an elongated shaft extending from the forward end of the handle, an end effector arranged at the distal end of the elongated shaft, a rotatable adjusting wheel arranged on the handle, wherein a rotation of the adjusting wheel causes a corresponding rotation of the elongated shaft, wherein the adjusting wheel is provided with one or more stop elements suitable for engaging with corresponding features on the handle in order to limit the rotation of the adjusting wheel to a predetermined angular rotation.Providing stop features on the adjustment wheel, which is operated by the user to rotate the shaft, eliminates any shaft torsion that could occur if the stops were located elsewhere and the user used the adjustment wheel to try and rotate the wheel, and also improves the user's perception of the device's quality, since the stops are struck at precisely the same point (i.e., on the adjustment wheel) where the rotational force for rotating the shaft is applied (i.e., on the adjustment wheel).

[0006] According to further training, the adjusting wheel is equipped with a variety of stop elements. This allows the definition of a range of permissible angular rotation of the shaft.

[0007] In one embodiment, the one or more stop elements have the form of projections, and more preferably, the one or more stop elements have the form of projections formed on an annular surface of the adjusting wheel. The handle can be provided with one or more shoulders, which form the features with which the one or more stop elements are designed to engage.

[0008] In one embodiment, the permissible predetermined angular rotation lies between 180 and 360 degrees, but more preferably it may be between the smaller range of 250 and 300 degrees, or most preferably approximately 270 degrees.

[0009] In one embodiment, the outer surface of the adjusting wheel is provided with a notched surface comprising a plurality of notches suitable for receiving the fingers and thumb of the user operating the wheel. This ensures improved ergonomic operation by the user. The adjusting wheel can have between 6 and 10 notches, but preferably 8 notches.

[0010] The surgical instrument may further include an actuating mechanism that is movable between a first position and a second position, wherein moving the actuating mechanism from its first position to its second position causes the end effector to move from a first state to a second state. In this respect, the end effector may have a pair of opposing first and second clamping jaw elements, wherein moving the actuating mechanism from its first position to its second position causes at least one of the clamping jaw elements to move relative to the other from a first open position, in which the clamping jaw elements are spaced apart relative to each other, to a second closed position, in which the clamping jaw elements cooperate to grasp intervening tissue.

[0011] In one embodiment, the end effector comprises one or more electrodes and the instrument comprises electrical connections that allow the instrument to be connected to an electrosurgical generator.

[0012] According to another aspect, a surgical instrument is provided which: comprises a body section having a handle arranged at its proximal end, and a shaft extending at least partially through and protruding from the body section in a distal direction, the shaft being rotatably attached to the body section in order to allow, in use, the shaft carrying the end effector to be rotated relative to the body section;wherein the shaft and the body section are provided with a plurality of sets of corresponding interacting rotation control elements, which are arranged in application to limit the angular rotation of the shaft relative to the body section to within a predetermined angle, wherein the plurality of sets of corresponding interacting rotation control elements are spatially distributed at a plurality of corresponding positions in the longitudinal direction along the shaft, thereby providing, in use, control of the angular rotation of the shaft relative to the body at said plurality of corresponding positions in the longitudinal direction.

[0013] This arrangement has the advantage of providing rotational control at multiple points along the shaft, thus making any unwanted torsion in the shaft due to attempts to twist it past the stops unlikely. Furthermore, ergonomics are improved, as the user experiences a high-quality and solid instrument.

[0014] At least one of the numerous longitudinal positions is located at or near the proximal end of the body section. This prevents rotation of the shaft at a point close to the user, which also contributes to the feeling of quality.

[0015] In one embodiment, the set of interacting rotation control elements, which are arranged at or near the proximal end of the body section, includes a rotatable adjusting wheel, wherein a rotation of the adjusting wheel causes a corresponding rotation of the elongated shaft, and the adjusting wheel has one or more stop elements suitable for engaging with complementary stop elements on the body section.

[0016] At least one of the numerous longitudinal positions is located, either alternatively or additionally, at or near the distal end of the body segment. This allows rotational and thus torsional control to be applied closer to the end effector, helping to ensure that the end effector does not rotate beyond its normal range of rotation and thus reducing the risk of the power cables to the end effector being severed by over-rotation of the shaft.

[0017] The set of interacting rotation control elements, arranged at or near the distal end of the body section, may include a rotatable shaft support element suitable for allowing the shaft to extend from the interior of the body section to the exterior and to rotate with the shaft when the latter is rotated relative to the body section, wherein the rotatable shaft support element includes one or more stop elements suitable for engaging with complementary stop elements on the body section.

[0018] In this advanced training, numerous sets of spatially distributed sets of corresponding interacting rotation control elements along the shaft are rotationally aligned to prevent further rotation of the shaft at the same angular position(s). Thus, the multiple sets work together to provide an ergonomic design with a high sense of quality for the user by ensuring that the shaft cannot rotate past the stops at at least two points.

[0019] According to this aspect, as with the aspect described above, the predetermined rotation angle of the shaft is between 180 and 360 degrees, or more preferably between 250 and 300 degrees, or most preferably at approximately 270 degrees.

[0020] According to yet another aspect, a surgical instrument is provided which comprises a handle having a longitudinal axis defining a generally anterior and a posterior direction, an elongated shaft extending from within the interior of the handle through the front end of the handle, an end effector located at the distal end of the elongated shaft, and a rotatable shaft support element suitable for allowing the elongated shaft to extend from the interior of the handle to the exterior and to rotate with the shaft when the latter is rotated relative to the handle. The rotatable shaft support element has one or more stop elements suitable for engaging with complementary stop elements on the handle. The provision of the rotatable shaft support element with the stop elements ensures a convenient arrangement that is easy to construct.

[0021] In one embodiment, the rotatable shaft support element is provided with a plurality of stop elements. This makes it possible to define acceptable arc dimensions for the rotation, for example to ensure that cabling passing through the support member to any end effectors is not stressed or stretched.

[0022] In one embodiment, the one or more stop elements have the form of projections, for example, formed on the rotatable shaft support element. Such an arrangement can be easily manufactured using molds. To complement these features, in one embodiment the handle is provided with one or more shoulders that form the features with which the one or more stop elements are designed to engage. In this way, the shoulders on the handle and the stop elements on the rotatable shaft support element interact to prevent over-rotation of the element and the shaft. In some embodiments, the permissible predetermined angular rotation is between 180 and 360 degrees, more preferably between 250 and 300 degrees, and most preferably approximately 270 degrees.Such a degree of rotation ensures user comfort without complicating the design by using electrical slip rings instead of fixed wiring. Brief description of the drawings

[0023] Embodiments of the invention will now be described only as examples and with reference to the accompanying drawings, wherein similar reference numerals in the drawings refer to similar parts and wherein:

[0024] Fig. 1 a side view of an electrosurgical instrument according to an embodiment of the present invention;

[0025] Fig. 2 a side view of a handle of the electrosurgical instrument according to the embodiment of the present invention;

[0026] Fig. 3 an exploded view of an electrosurgical instrument according to the embodiment of the present invention;

[0027] Fig. 4 a cross-sectional view of the clamping mechanism of the electrosurgical instrument Fig. 3 shows in an open arrangement;

[0028] Fig. 5a a cross-sectional view of the clamping mechanism of the electrosurgical instrument made of Fig. 3 shows in a closed arrangement;

[0029] Fig. 5b a cross-sectional view of the clamping mechanism of the electrosurgical instrument Fig. 3 shows in a closed arrangement with tissue trapped inside;

[0030] Fig. 6 a cross-sectional view of part of the clamping mechanism of the electrosurgical instrument made of Fig. 3 shows;

[0031] Fig. 7 a perspective view of the clamping mechanism of the electrosurgical instrument from Fig. 3 shows;

[0032] Fig. 8a–f the assembly of a part of the electrosurgical instrument from Fig. 3 show;

[0033] Fig. 9a–b Cross-sectional views of a part of the electrosurgical instrument made of Fig. 3 are;

[0034] Fig. 10a–c a blade guide part of the electrosurgical instrument made of Fig. 3 show;

[0035] Fig. 11 a locking part of the electrosurgical instrument made of Fig. 3 shows;

[0036] Fig. 12 a blade angle alignment part of the electrosurgical instrument made of Fig. 3 shows;

[0037] Fig. 13a–b Cross-sectional views of the blade angle alignment part of the electrosurgical instrument made of Fig. 3 show;

[0038] Fig. 14a–b a blade angle control wheel part of the electrosurgical instrument made of Fig. 3 show;

[0039] Fig. 15a–b the rotary movement of the blade angle control wheel of the electrosurgical instrument from Fig. 3 show;

[0040] Fig. 16a–d the rotary motion of the end effector of the electrosurgical instrument from Fig. 3 show;

[0041] Fig. 17 a cross-sectional view of the electrosurgical instrument from Fig. 3 shows and illustrates a wiring path;

[0042] Fig. Figures 18a–b show details of an electrical wiring path used in the electrosurgical instrument made of Fig. 3 is used;

[0043] Fig. 19 further details of an electrical wiring path shown in the electrosurgical instrument made of Fig. 3 is used;

[0044] Fig. 20a–b Side views of part of the cutting mechanism of the electrosurgical instrument made of Fig. 3 are;

[0045] Fig. 21 a cross-sectional view of part of the cutting mechanism of the electrosurgical instrument made of Fig. 3 is;

[0046] Fig. 22 a cross-sectional view of another part of the cutting mechanism of the electrosurgical instrument Fig. 3 shows;

[0047] Fig. 23 a partially transparent perspective view of the cutting mechanism of the electrosurgical instrument from Fig. 3 is;

[0048] Fig. 24a–c the assembly of part of the cutting mechanism of the electrosurgical instrument from Fig. 3 show;

[0049] Fig. 25a–c Cross-sectional views of the cutting mechanism and the clamping mechanism of the electrosurgical instrument from Fig. 3 show;

[0050] Fig. 26a–f are cross-sectional views showing the operation of the locking mechanism of the electrosurgical instrument. Fig. 3 illustrate;

[0051] Fig. 27. A diagram is shown that illustrates the cutting mechanism of the electrosurgical instrument. Fig. 3 illustrated;

[0052] Fig. 28a–b are line drawings that illustrate the cutting mechanism of the electrosurgical instrument. Fig. 3 illustrate;

[0053] Fig. 29a–b a blade angle alignment part of the electrosurgical instrument made of Fig. 3 show;

[0054] Fig. 30 a perspective view of part of the clamping mechanism of the electrosurgical instrument Fig. 3 is;

[0055] Fig. 31 a partial cross-sectional view of the cutting mechanism and the clamping mechanism of the electrosurgical instrument from Fig. 3 is;

[0056] Fig. 32 a partial cross-sectional view of the cutting mechanism and the clamping mechanism of the electrosurgical instrument Fig. 3 is;

[0057] Fig. 33 the blade angle control wheel part and the electrode control switch of the electrosurgical instrument Fig. 3 shows;

[0058] Fig. 34 the blade angle control wheel part of the electrosurgical instrument made of Fig. 3 shows;

[0059] Fig. Figures 35a–b show the handle of the electrosurgical instrument from Fig., held by users with different sized hands;

[0060] Fig. 36a–c the rotational movement of the end effector of the electrosurgical instrument from Fig. 3 show;

[0061] Fig. 37 the rotational movement of the blade angle control wheel of the electrosurgical instrument from Fig. 3 shows;

[0062] Fig. 38 is a schematic perspective view of an example of an end effector;

[0063] Fig. 39 an enlarged perspective view of part of the end effector from Fig. 38 is;

[0064] Fig. 40 a schematic cross-sectional view of a part of the end effector made of Fig. 38 is;

[0065] Fig. 41 is a schematic perspective view of an alternative end effector;

[0066] Fig. 42 an enlarged perspective view of part of the end effector from Fig. 41 is,

[0067] Fig. 43 a schematic cross-sectional view of part of the end effector made of Fig. 41 is,

[0068] Fig. 44 is a schematic cross-sectional view of part of another alternative end effector;

[0069] Fig. 45 is a representation of an electrosurgical system comprising a generator and an instrument according to the embodiments of the invention;

[0070] Fig. 46 furthermore a locking part of the electrosurgical instrument made of Fig. 3 shows and

[0071] Fig. 47a–e the distal end of the electrosurgical instrument Fig. 3 cutting blades used are illustrated. Description of the embodiments

[0072] One embodiment of the invention will now be described. First, a brief overview of the entire embodiment will be given, followed by detailed descriptions of certain aspects thereof. 1. Overview of the instrument's structure

[0073] Fig. Figure 1 shows an electrosurgical instrument 1 according to an example of the present invention. The instrument 1 includes a proximal grip section 10 , an outer shaft 12 , extending in a distal direction away from the proximal handle section, and a distal end-effector arrangement 14, which is attached to a distal end of the outer shaft. The end effector arrangement 14 For example, it may be a set of opposing jaws arranged to open and close, comprising one or more electrodes arranged on or formed by their opposing inner surfaces, and which, when in use, have connections for receiving a radiofrequency (RF) electrosurgical signal for sealing or coagulating tissue. The jaws are further provided with a slot or other opening in the opposing inner surfaces through which a mechanical cutting blade or similar device may protrude when activated by the user. During use, the handle 10 activated by the user in a first way to clamp tissue between the jaws 14to clamp the tissue, and in a second way to supply the electrodes with RF current to coagulate the tissue. The clamping jaws 14 can be curved, so that the active elements of the instrument 1 are always visible. This is important in vessel sealing devices, which are used to operate on body regions that obstruct the user's view of the device during application. The handle 10 can be activated by the user in a third way to cause the blade to be positioned between the clamping jaws. 14 The protruding jaws cut the fabric clamped between them. After the necessary cutting and sealing are complete, the user can remove the fabric from the clamping jaws. 14 release.

[0074] The handle 10 includes, as in Fig. 2 shown, a housing 20 made from two shell mold parts 300 , 302, which is all necessary for the actuation and rotation of the clamping jaws 14 , which accommodates the components required for coagulation and tissue cutting. The shell-shaped parts in the assembled device are ultrasonically welded after the internal components have been arranged inside. The handle 10 includes a clamping handle 22 for clamping fabric between the clamping jaws 14 , a trigger 24 to cut the fabric, a switch 26 for activating and deactivating the RF supply to the electrodes in the clamping jaws 14 for tissue coagulation, and a rotary dial 28 for turning the clamping jaws 14 to reach tissue at different angles. The handle 10 is constructed in such a way that the instrument 1 and all its functions can be operated with just one hand, with all operating mechanisms easily accessible.

[0075] Fig. 3 shows all features of the instrument 1 , which are required to perform its functions, including those in the two shell moldings 300 , 302 of the case 20 Recorded. For clamping fabric between the clamping jaws. 14 A clamping mechanism is used with the clamping handle. 22 activated. The clamping handle 22 also includes a collar ring 304 , which is a joint 306 includes, which acts as a pivot point around which the clamping handle 22 rotates at the joint 306 For example, it could be two outward-facing pins that fit into corresponding molded parts. 308 snap into place, forming a single piece with the shell molding parts 300 , 302 are designed to provide an anchor point around which the clamping handle 22 rotates. The clamping mechanism also includes a collar ring component. 310 , a feather312 and an inner molded part 314 , as in Fig. 4 to Fig. Figure 7 illustrates this, with all of these along a drive shaft. 316 are lined up.

[0076] The collar ring 304 includes a through-opening 318 , in which the collar ring molding 310 recorded. The opening 318 has a larger diameter at the top than at the bottom, with the collar ring molded part 310 is arranged to be in the lower part of the opening 318 to be accepted, as Fig. Figure 8a illustrates this. The collar ring fitting fits together when assembled. 310 easily through the larger part of the opening 318 , so that the collar ring 304 between two flanges 800 , 802 recorded as Fig. 8b–c show how Fig. As can be seen in section 8d, the collar ring 304 then pushed upwards to close the smaller part of the opening318 with the collar ring molding 310 to intervene. Is the joint 306 with the joint components 308 inside the housing 20 connected, the collar ring molded part 310 in the lower part of the opening 318 held where it is inside the opening 318 can rotate freely.

[0077] The collar ring molding 310 , the spring 312 and the inner molded part 314 will be, as in Fig. 6 shown, between the preceding elements 600 , 602 held in such a way that they do not extend axially beyond these protruding elements 600 , 602 can move outwards. In this respect, the foregoing elements are 602 at the proximal end of the drive shaft 316 compressible to allow the drive shaft 316 through a canal 604 at the proximal end of the inner molded part 314The drive shaft runs. 316 is through the canal 604 pushed until he found an opening 606 achieved, whereby the foregoing elements 602 then they can no longer be compressed, so that they are flush against the walls of the drive shaft. 316 concerns. Instead, the preceding elements will be addressed. 602 fanned out and pressing against the walls of the opening 606 , so that the width of the preceding elements 602 about the diameter of the channel 604 extends beyond. Consequently, the drive shaft can 316 not through the canal 604 It can be retracted and has locked into place.

[0078] The distance between the preceding elements 600 , 602 is chosen so that the spring 312 at least partially between the collar ring molding 310 and the inner molded part 314is compressed. This pre-compression is essential to ensure that the correct clamping load is applied when the clamping mechanism is activated, as described in more detail below. Both the collar ring form part 310 as well as the inner molded part 314 include cavities 608 , 610 , into which the feather 312 extends. In particular, a significant portion of the length of the collar ring molded part is occupied by 310 the spring 312 This arrangement allows for a longer spring 312 to which is important to ensure that the spring 312 never reached its block length during use.

[0079] The main body of the drive shaft 316 lies within the outer shaft 12 , wherein the distal end of the drive shaft 316 both with the distal end of the outer shaft 12 as well as with the clamping jaws 14is connected. The drive shaft 316 moves axially within the outer shaft 12 and this axial movement causes the clamping jaws to 14 moved from an open to a closed position, as if from Fig. 4 and Fig. 5a emerges. The drive shaft 316 for example, by a drive pin 400 in a cam slot 402 to the clamping jaws 14 coupled, whereby the movement of the drive pin 400 in the cam slot 402 the clamping jaws 14 moves between the open and closed positions. The connection between the drive shaft 316 , the outer shaft 12 and the clamping jaws 14 This is achieved by a rotational movement of the drive shaft. 316 on the outer shaft 12 and the clamping jaws 14 is transferred.

[0080] The outer shaft 12 and the drive shaft316 are connected at another point by a shaft-shaped component 320 connected. The shaft molding 320 is in a version 322 of the case 20 absorbed and thus connects the outer shaft 12 with the case 20 The outer shaft 12 is attached to the shaft molding by any suitable means 320 fastened, for example by locking lugs 900 , which have corresponding grooves 902 in the shaft molding 320 cooperate, as in Fig. 9b is shown. The drive shaft 316 is through an opening (not shown) that connects to the T-shaped cross-section of the drive shaft 316 is adapted by the body of the shaft molding part 320 guided, as by Fig. 10a illustrates the shaft molding. 320 is arranged in such a way that it is in the version 322 can rotate freely. The shaft component 320For example, cylindrical flange elements can 904 , 906 include those in concentric opposite surfaces 908 , 910 rotate, which are in the shell moldings 300 , 302 are provided. Thus, the shaft component rotates. 320 with the drive shaft 316 , which in turn causes this rotational movement on the outer shaft 12 and the clamping jaws 4 transfers. The shaft molding 320 It thus functions as a rotational guide and axial guide for the drive shaft. 316 .

[0081] The clamping handle 22 includes a snap-in element 324 , which is arranged to be fitted with a snap-fit ​​component 326 to work together, which is in the proximal end 328 of the case 20 is present. The snap-fit ​​component 326 can be done by any suitable means, such as a molding pin 330, which is integrally formed with one of the shell mold parts 300 , 302 is trained, as in Fig. 3 shown, or simply through the mold walls 1100 , which are integrally formed with the shell mold part 300 are trained, as in Fig. As shown in 11, it must be held in place. The clamping handle 22 towards the casing 20 driven to tighten the clamping jaws 14 To close, the locking element engages. 324 into the case 20 via an opening 1102 one and reaches with the snap-fit ​​part 326 in engagement to tighten the clamping handle 22 to maintain this position. As from Fig. 26a to Fig. As can be seen from 26f, the snap-fit ​​component includes 326 a two-way spring 1104 and a cam path 1106 , along which the locking element 324 moved. As in Fig. As shown in 46, the locking mechanism can also be an override component. 4600 include, to allow the user to use the snap-in element 324 to manually release if it gets stuck, as well as a locking component 4602 , to completely deactivate the locking mechanism. The override component 4600 and the locking component 4602 can be on the snap-fit ​​part 326 provided or inside the housing 20 be integrated.

[0082] As described above, the handle includes 10 furthermore, a rotary knob 28 , where the rotary knob 28 is arranged to form the inner molded part 314 to frame. For this purpose, the rotary wheel 28 and the inner molded part 314 interlocking elements 1200 , 1202 up, as if from Fig. 12 emerges. These interlocking elements 1200 , 1202connect in such a way that the rotary wheel 28 and the inner molded part 314 rotate together, while the inner molded part continues to move axially. 314 inside the rotary dial 28 is made possible, as from Fig. 13a–b. Thus, a rotation of the rotary wheel causes 28 the rotation of the inner molded part 314 , consequently the drive shaft 316 and the collar ring molding 310 to be set in rotation. For stability reasons, the rotary wheel includes 28 cylindrical surfaces 1204 , which rotate and slide on inner counter surfaces (not shown), which are integral with respect to the shell moldings 300 , 302 are trained.

[0083] To allow a user to rotate the clamping jaws 14 To enable this, the housing 20 two openings 332 , 334 on, through which notched sections 336of the rotary dial 28 extend. The two openings 332 , 334 They are located opposite each other on both sides of the handle and are trapezoidal. In particular, the trapezoidal openings have parallel sides that are perpendicular to the longitudinal axis of the handle, and one of the parallel sides may be longer than the other, with the longer side at the front end of the opening and the shorter side at the rear end of the opening. The notched sections 336 They are beveled in a suitable way so that they fit well to the user's thumb or fingers. The notched sections are used for this purpose. 336 cut at an angle to the plane of rotation, as in Fig. Figures 14a–b are shown. In particular, the angle of the chamfered part of the notched sections should substantially correspond to the angle of the outer casing in the area of ​​the rotary knob. 28 are equivalent to.

[0084] The rotary dial28 also includes at least one stop element 1500 to limit the degree of rotation, as in Fig. 5a–b is shown. The stop element 1500 enters with stop parts 1502 , 1504 , which are integral with the housing 20 are formed, in interaction. 28 turned, the stop element 1500 through the stop parts 1502 , 1504 blocked, thus preventing further rotation. The stop parts 1502 , 1504 For example, they can limit the rotation of the rotary knob to 270°. Similarly, the shaft molding includes 320 also a stop element 1600 , which includes stop parts 1602 , 1604 interacts, being integrally integrated with the housing 20 are trained, as in Fig. 16a–d can be seen. The stop element 1600 of the shaft molding 320and its corresponding stop piece 1602 , 1604 are in relation to the stop element 1500 of the rotary dial 28 and its corresponding stop parts 1502 , 1504 so that the rotation is restricted to the same extent. This means that when the rotary wheel is turned... 28 the radial point at which the stop element 1500 on the rotary dial 28 is blocked, coincides with the radial point where the stop element 1600 on the shaft molding 320 is blocked. In Fig. 15b and Fig. 16a the clamping jaws were 14 for example, from a neutral orientation (which is in Fig. (as shown in Figure 16b) is rotated 90° counterclockwise. This freedom of rotation means that the user can capture tissue from different angles without having to move the entire instrument. 1 having to turn.

[0085] As described above, the switch 26 provided to hold the electrodes in the clamping jaws 14 via a suitable circuit, such as two ingress-resistant switches on a small printed circuit board (PCB) 338 , supplied RF signal 26 to activate or deactivate. As from Fig. As can be seen from 17, the PCB 338 with a connecting cable 1700 connected to receive the RF output signal from a generator (not shown), and with electrical lines 1702 , 1704 , to direct the RF current to the electrodes in the clamping jaws 14 to supply, for example with one lead for the active electrode and one lead for the counter electrode. As in Fig. 17 and Fig. As shown in 18a–b, the lines are 1702 , 1704 below and around the shaft molding 320 wrapped before being placed in a guide slot 1800into the inner cavity 1802 of the shaft molding 320 enter and the outer shaft 12 run downwards. Wrapping the shaft molding. 320 with the lines 1702 , 1704 In this way the lines stay in place. 1702 , 1704 in a compact arrangement to allow for easy assembly and simultaneous rotation of the drive shaft 316 to enable this. The lines will be used in the process. 1702 , 1704 with the rotation of the drive shaft 316 unwound and rewound. In addition, one of the shell molding parts includes 300 also two shaped compartments 1900 , 1902 , which are arranged sequentially to connect the line contacts 1904 , 1906 to include the active lines and return lines 1702 , 1704 with the wiring 1908 , 1910 the intrusion-protected switches 338connect. The opposite shell molding 302 includes corresponding rib sections (not shown) to secure the contacts 1904 , 1906 in the subjects 1900 , 1902 to be held. Consequently, the two line contacts are 1904 , 1906 separated longitudinally so that only one contact passes through each compartment 1900 , 1902 can proceed, creating a physical barrier between each compartment 1904 , 1906 and is provided to every line. This reduces the risk of a connection through the contacts. 1904 , 1906 This prevents damage to the insulation on one of the wires and simultaneously protects the contacts. 1904 , 1906 even protected from fluids that damage the outer shaft 12 along and into the housing 20 can walk.

[0086] With regard to the cutting mechanism, a blade 340for cutting between the clamping jaws 14 trapped tissue in a central path 342 along the length of the drive shaft 316 provided. The mechanism for operating the blade 340 along the railway 342 and between the clamping jaws 14 is triggered 24 activated. The trigger 24 actuates a drive assembly consisting of a trigger component 344 , a blade drive component 346 , a blade collar ring molded part 348 , a tension spring 350 and a blade shape 352 The drive assembly is located between the shaft molding part. 320 and the handle collar ring 304 of the clamping mechanism. As in Fig. As shown in 20a–b, the drive arrangement functions as an offset push-crank mechanism, through which the trigger is operated by the user 24Force applied in an axial movement of the blade shape 352 along the drive shaft 316 is converted, which in turn converts the attached blade. 340 drives.

[0087] As from Fig. 21, Fig. 22 and Fig. As can be seen from 23, the blade shape is 352 arranged to be in the blade collar ring molded part 348 to be included. How Fig. Figure 22 shows that the blade collar ring molding includes 348 a lip border 2200 , which leads into a depression 2202 , which surround the circumference of the blade shape 352 It runs around, intervenes. How Fig. 23 shows the blade shape 352 a T-shaped opening 2300 for mounting the drive shaft 316 and the blade 340 up. The blade shape 352 It also includes an inner section. 2100 , How Fig. 21 shows, for the proximal end of the blade 340, where the end of the blade 2102 is shaped in such a way that it fits into the inner cutout 2100 of the blade shape 352 fits to allow for easy assembly, as in Fig. 24a–c illustrates the blade shape. 352 is in contrast to the blade collar ring molding 348 Independently rotatable, so that the two molded parts can rotate concentrically. Consequently, the blade molded part 352 able to use the drive shaft 316 to rotate.

[0088] The clamping jaws 14 They can be curved, as described above. This allows the blade to... 340 The frictional force of the cutting blade must be sufficient to ensure that the blade is pushed around the curve while retaining sufficient cutting ability. 340 The frictional force is minimized in the curved path. It is a product of the blade's coefficient of friction. 340 on the train 342and the force generated by bending the blade 340 on the walls of the railway 342 is exerted. This frictional force can be reduced, for example, by adding a friction-reducing coating to both sides of the blade and / or, preferably, by weakening the blade. 340 to adjust the flexibility of the distal end of the blade so that it moves along the path 342 The bending ability, while remaining rigid in the cutting force direction, can be reduced. This preferential weakening can be achieved, for example, by providing one or more openings. 354 in the distal end, as in Fig. 3 and Fig. 47a–c shown, or by a gradation of the blade thickness 340 , as in Fig. 47d shown. Alternatively, as in Fig. 47e shown, structured laser cutouts 4712or chemical etching may be applied to the distal end to adjust the bending stiffness along the blade length, the spacing of such cutouts being constant or increasing stepwise from the distal to the proximal end.

[0089] During use, blood and tissue may accumulate in the distal end of the instrument. 1 accumulate. In particular, blood and tissue can cause the blade to become damaged. 340 inside the drive shaft 316 is stuck. Therefore, the distal end of the drive shaft can 316 cut-out sections 1000 , 1002 include, to cover the surface of the drive shaft 316 , to which blood and tissue can adhere, as in Fig. Figures 10b–c show the cut-out sections. For example, the distal end may comprise two side walls without a base, or the distal end may comprise a base with forked side walls. 2. Operating the instrument

[0090] After describing the overall structure of the device, the complete operation of the electrosurgical instrument will now be described. 1 The application process is explained. This is followed by a more detailed description of the setup and operation of certain aspects of the device.

[0091] As explained above, the handle 10 of the electrosurgical instrument arranged to i) clamp tissue between a set of jaws 14 to clamp, ii) to lock the clamping jaws into place (if the user so wishes), iii) electrodes in the clamping jaws 14 to supply an RF signal for coagulation of the tissue trapped between them, and iv) a blade 340 between the clamping jaws 14 to move in order to cut the tissue trapped between them. The handle 10 can the clamping jaws 14It can also rotate to allow the user to clamp fabric at different angles without removing the entire handle. 10 This eliminates the need to rotate the instrument. Consequently, the tissue clamped between the jaws can be sealed using the same electrosurgical instrument before or during the incision. Furthermore, this effect can be achieved with one-handed operation by the surgeon. 2.1 Clamping mechanism

[0092] For clamping fabric between the clamping jaws 14 The user presses the clamping handle 22 towards the proximal end 328 of the case 20 , until the locking element 324 with the snap-in part 326 inside the housing 20 The drive handle engages. This movement causes it to pivot. 22 around its joint 306 , as in Fig. 8e–f shown, and pushes the edge of the collar ring 304 against the flange 800 , to create the collar ring molding 310 , the spring and the inner molded part 314 along the drive shaft 316 to shift in the proximal direction, as in Fig. 4 and Fig. 5a is shown. As described above, the inner molded part 314 on the drive shaft 316 by means of the aforementioned elements 602 This secures the inner molded part. 314 axially retracted, the drive shaft is also pushed back. 316 axially moved, causing the pen 400 into the cam slot 402 the clamping jaws 14 is moved, causing the clamping jaws to move. 14 to be closed. This transfers the force from the drive handle. 22 about the spring mechanism of collar ring molding 310 , Feather 312 and inner molded part 314 on the drive shaft 316 transmitted.

[0093] Is there fabric between the clamping jaws? 14 trapped, as in Fig. As shown in 5b, the spring causes 312 a limitation of the force acting on the tissue. Is the axial movement of the collar ring component 310 , Feather 312 and inner molded part 314 finished and the collar ring 304 continues to press against the flange 800 , finally the threshold compression force of the spring 312 achieved, so that the spring 312 begins between the collar ring mold part 310 and the inner molded part 314 to compress. Compresses the spring. 312 Furthermore, the drive handle can 22 can be moved into the locked position without exerting any further force on the trapped tissue. This means that the force of the drive handle 22 no longer on the drive shaft 316 is transferred, but effectively through the spring312 is absorbed. Thus, the spring represents 312 Make sure the correct force is applied to the clamping jaws. 14 is transferred. Without the spring 312 This causes the drive handle to be actuated. 22 a continued increase in the pressure on the drive shaft 316 and consequently onto the clamping jaws 14 and the force transmitted to the tissue. This could cause mechanical damage to the tissue if the user uses the drive handle. 22 presses further to engage the locking element 324 to intervene.

[0094] As explained above, the cavities 608 , 610 in the collar ring molding 310 and the inner molded part 314 together, to provide a larger spring 312 to enable this. This allows for a greater spring stroke, so that the spring 312It is not compressed to its full spring length during use. When the spring reaches its full length... 312 its spring length, it would no longer be affected by the drive handle 22 absorb the exerted force, and the force would be transferred back to the clamping jaws. 14 be transferred. 2.2 Locking mechanism

[0095] Is there fabric between the clamping jaws? 14 If the clamping jaws get caught, they can... 14 can be locked in a closed position by engaging the locking element 324 on the drive handle with the locking element 326 inside the case 20 is intervened, as in Fig. 26a–f shown. With the engagement of the locking element. 324 into the case 20 through the opening 1102 , the locking element 324 with the snap-in part 326 in engagement, whereby the mold part 326 in the case 20pushed downwards and thus the spring 1104 is pulled apart. As in Fig. As shown in 26b–c, the locking element moves 324 on the side of the cam path 1106 upwards until it reaches its maximum position. At this point, the drive handle can 22 cannot be compressed further, and the spring 1104 pulls the snap-fit ​​part 326 inside the case 20 back up, so that the locking element 324 into the V-shaped compartment of the cam path 1106 is plugged in to power the drive handle 22 in the compressed position and the clamping jaws 14 to hold in the closed position, as in Fig. 26d shown.

[0096] In this locked position, the user's hand is free to operate the other functions of the instrument. 1 , as explained below.

[0097] To the locking element 324 from the case 20 to release and the clamping jaws 14 To open, the user must use the drive handle. 22 towards the casing 20 press to engage the locking element 324 from the cam path category 1106 to solve, as in Fig. 26e shown. The force of the spring 1104 pulls the snap-fit ​​part 326 further into the case 20 upwards, so that the locking element 324 in the opposite direction on the side of the cam path 1106 down, as in Fig. 26e–f shown, and back from the opening 1102 moved outwards. The snap-fit ​​part 326 It then returns to its starting position inside the housing. 20 back. 2.3 Cutting mechanism

[0098] If the clamping jaws 14If the device is in a closed position, the user may wish to cut the fabric trapped between them. A blade is used to cut the fabric. 340 by actuating the drive assembly between the clamping jaws 14 advanced.

[0099] The drive mechanism is a three-pivot arrangement that functions as a push-pull mechanism. When the user pulls the trigger 24 back towards the case 20 , as in Fig. As shown in 25b–c, the trigger mold part 344 levered around a pivot point A, which is attached to the housing 20 is anchored, for example in the form of outward-facing pins. 358 , which with corresponding molded parts 356 , which are integrally formed with the shell mold parts 300 , 302 out of Fig. 3 are formed, are connected. This connects the pivot point B, which is the trigger part. 344and the drive component 346 connects, pushed beyond its central position, thereby creating the blade collar ring 348 , the blade shape 352 and the blade 340 with a force sufficient to make the blade 340 can cut the trapped tissue along the drive shaft 316 be displaced. In this context, the trigger will be... 24 Force exerted via the trigger fitting 344 and the drive component 346 on the blade collar ring 348 and the blade shape 352 transferred. As pivot point B moves past the center point into its advanced position, the speed at which the blade collar ring moves increases. 348 and the blade shape 352 along the drive shaft 316 are displaced, causing the blade to... 340 The effective force is increased. Thus, the force with which the blade... 340cuts into the tissue without the user applying additional force to the trigger. 24 exercises.

[0100] The shaft molding 320 functions as an anchor point for the blade collar ring 348 and the blade shape 352 Consequently, the pivot point B remains in relation to the drive shaft. 316 always above the two other pivot points A, C.

[0101] During the activation of the trigger 24 is the trigger 24 The applied force is sufficiently high to overcome the compression force of the tension spring. 350 to overcome, so that it extends along the same plane as the drive shaft 316 , to allow axial movement of the blade collar ring 348 and the blade shape 352 to enable this. Upon release of the trigger. 24 will the tension spring 350compressed again to retract the drive assembly to its starting position. The tension of the tension spring is then released. 350 strong enough to cut the blade 340 to retract through thick tissue without the need for user intervention. 2.4 Shaft rotation

[0102] During application, the user may need to access tissue from different angles without using the entire instrument. 1 to have to move. For this reason, the clamping jaws 14 advantageously by the rotary knob 28 Regarding the handle 10 rotatable. This is particularly advantageous when the clamping jaws 14 on a curved path, such as the one in Fig. shown in 16a–d. As explained above, the rotary dial 28 with the inner mold part 314 via interlocking elements 1200 , 1202 connected, so that the inner molded part 314with the rotary dial 28 rotates. Since the end of the drive shaft 316 with the inner mold part 314 When connected, the drive shaft rotates. 316 also, which consequently also affects the clamping jaws 14 be rotated at their opposite end.

[0103] To enable this rotational movement without impairing the function of the clamping mechanism, the collar ring molded part 310 in the handle collar ring 304 independently rotatable, so that the collar ring molding 310 also with the drive shaft 316 rotates. The blade shape is similarly formed. 352 to enable the rotation of the drive shaft 316 without impairing the function of the cutting mechanism in the blade collar ring 348 Rotatable independently.

[0104] To transfer the rotational movement to the outer shaft 12 is the shaft molding 320in its version 322 rotatable. As described above, the shaft component functions 320 as a rotation guide for controlling the rotational movement in relation to the shaft 316 along the entire length of the instrument 1 In addition, the active lines and return lines 1702 , 1704 inside the housing 20 arranged to prevent damage to these lines 1702 , 1704 to prevent this from happening due to the rotating components. As described above, the lines are 1702 , 1704 around the shaft molding 320 wound to determine the degree of rotation of the drive shaft 316 to enable this. Consequently, the lines will be 1702 , 1704 unwound and then wrapped around the shaft molding again 320 wound up when it rotates. 2.5 Electrode activation

[0105] Are the clamping jaws located 14In a closed position, the user may wish to coagulate and seal the tissue trapped between the electrodes. For this purpose, the user initiates electrode activation using the switch. 26 on the case 20 , which is conveniently positioned so that the user can simply press the switch 26 This allows access while operating the device with one hand. This transmits an RF signal to the electrodes in the clamping jaws. 14 The substance is applied to coagulate and seal the tissue. Depending on the desired effect, the RF signal can have a pure or mixed waveform.

[0106] Following an overview of the structure and operation of the entire device, further detailed descriptions of the structure and operation of specific aspects of it will now follow. 3. Construction and operation of the clamping mechanism

[0107] As described above, the proximal grip section includes 10 of the electrosurgical instrument 1 a first mechanism for actuating one aspect of a distal end-effector arrangement 14 , so that the end effector arrangement 14 It switches between a first and a second state. In the end-effector arrangement 14 It could, for example, be a set of opposing clamping jaws. 14 These are devices that are arranged to be opened and closed. The mechanism that triggers the movement of these clamping jaws 14 The mechanism used is the so-called clamping mechanism, which is a drive handle. 22 and two barrel-shaped molded parts 310 , 314 with a compressed spring in between 312 comprising, with all elements along an elongated rod 316 are lined up, positioned between the clamping jaws 14 and the handle 10extends, as in Fig. 4 and Fig. 5a–b shown.

[0108] As from Fig. As can be seen in section 8a, the drive handle includes 22 a collar ring 304 , in which the collar ring molding 310 is recorded. The collar ring 304 includes an opening 318 , which look like a keyhole or the number 8 is shaped. The opening 318 consists of two adjacent openings 804 , 806 , wherein the upper opening 804 has a larger diameter than the lower opening 806 .

[0109] The collar ring molding 310 is a cylindrical or barrel-shaped component with two flange sections 800 , 802 , spaced longitudinally. The diameter of the proximal flange 800 is larger than that of the upper and lower opening 804 , 806 The diameter of the distal flange802 is smaller than the upper opening 804 , but larger than the lower opening 806 .

[0110] During the assembly process, the collar ring molded part is formed first. 310 through the upper opening 804 introduced, as in Fig. 8b–c shown. Since the distal flange 802 smaller than the upper opening 804 , he passes through them easily, while the proximal flange 800 is large enough to prevent the collar ring molding from 310 completely through the upper opening 804 is being pushed forward. As from Fig. As can be seen in section 8d, the collar ring 304 then pushed upwards to close the lower opening 806 with the collar ring molding 310 to intervene.

[0111] After assembly, the collar ring molded part remains. 310 inside the lower opening 806 of the collar ring 304and is arranged such that its two flanges 800 , 802 on both sides of the collar ring 304 present, as can be seen from Fig. 8e emerges. Since the lower opening 806 a smaller diameter than both flanges 800 , 802 exhibits, the collar ring molding part 310 cannot be removed by simply pushing it through the bottom opening. 806 is pushed. In contrast, the body of the collar ring molding has 310 between the two flanges 800 , 802 a slightly smaller diameter than the lower opening 806 Thus, the collar ring molded part 310 sufficiently loose in the lower opening 808 recorded to allow for rotational movement.

[0112] As from Fig. As can be seen in section 8e, the longitudinal distance between the two flanges is 800 , 802 only slightly larger than the thickness of the collar ring304 , so that it fits exactly between the flanges 800 , 802 is recorded. This ensures that the movement of the drive handle is captured. 22 directly onto the collar ring mold 310 and subsequently transferred to the other components of the clamping mechanism. This is particularly important to ensure that the clamping jaws 14 on the movement of the drive handle 22 react and that there is no delayed reaction between actuation of the drive handle 22 and the movement of the clamping jaws 14 gives.

[0113] Is this the collar ring molding part? 310 and the drive handle 22 Once the components are assembled, the remaining components can be joined together.

[0114] The drive shaft 316 is an elongated rod with one or more protruding elements 602 , which are arranged at its proximal end, as in Fig. 6 shown. The preceding elements 602 are flexible extensions that grow from the surface of the drive shaft 316 are fanned out. This means that the preceding elements 602 are so deformable that they fit flush with the surface of the drive shaft 316 They can be pressed down, but return to their original position when relieved by a counterforce. This allows the drive shaft to be easily pushed through. 316 through all components of the clamping mechanism during assembly, as described below.

[0115] The collar ring molding 310 It has an inner cavity divided into two parts. The first part is a narrow channel or slot. 607 for mounting the drive shaft 316 , wherein the distal end of the collar ring molding 310 an opening 311 includes, as in Fig. 3 shown, which corresponds to the T-shaped cross-section of the drive shaft 316 It fits. The diameter of the channel 607 is only slightly further along than that of the drive shaft 316 to ensure a secure fit for improved stability. When inserting the drive shaft. 316 The preceding elements will 602 pressed flat to allow the drive shaft to be pushed through completely.

[0116] The second part is a chamber 608 , which is large enough to hold one end of the spring 312 to record the chamber 608 can extend over any suitable part of the length of the collar ring molding 310 extend. The length of the chamber 608 For example, approximately 25% of the length of the collar ring molded part can be used. 310 up to 75% of the length of the collar ring molded part 310 be.

[0117] The chamber 608is significantly larger than the collar ring molding channel 607 , so that the drive shaft 316 through the collar ring molding 310 is pushed, the preceding elements 602 extend outwards again into their original structure when they enter the chamber 608 to reach.

[0118] The collar ring mold part- 310 and drive handle 22 The arrangement is along the drive shaft. 316 pushed until the collar ring molding 310 a second set of the preceding elements 600 achieved. These preceding elements 600 have a greater width than the opening 311 on the collar ring molding 310 , to form an obstacle that prevents the collar ring molding 310 further along the drive shaft 316 moved. For this purpose, the preceding elements must be 600be sufficiently stiff so that the collar ring molded part 310 not by exerting force or pushing the foreground elements inwards 600 can be pushed past them.

[0119] The drive shaft 316 is then passed through the center of the spring 312 pushed. The spring 312 preferably has a diameter that is only slightly larger than that of the drive shaft 312 to ensure a tighter fit between the spring 312 and the drive shaft 316 to provide. The spring 312 it will then run along the drive shaft 316 pushed until the end of the spring 312 the collar ring forming chamber 608 fills.

[0120] The inner molded part 314 It is a cylindrical or barrel-shaped component with an inner cavity divided into two sections. The first section is a chamber. 610, in which one end of the spring 312 is recorded in such a way that the spring 312 partially through the collar ring molding 310 and the inner molded part 314 is enclosed. The second section is a narrow channel or slot. 603 to accommodate the proximal end of the drive shaft 316 The canal 603 is in two parts 604 , 606 subdivided. The first part of the canal 604 is shaped in such a way as to prevent the drive shaft from passing through. 316 enabled, whereby the flexible extensions 602 They are pressed flat. For this purpose, the diameter of the first channel section is 604 only slightly larger than that of the drive shaft 316 to ensure a secure fit. The secure fit of the drive shaft 316 both in the collar ring molding channel 607 as well as in the canal 603 of the inner molded part means that the drive shaft316 It is held firmly in place. This ensures the stability of the drive shaft. 316 in the case 20 increased, which is particularly important for ensuring maximum control of the end effector 14 is essential.

[0121] The second part of the canal 606 represents a shoulder 605 ready, into which the foregoing elements merge 602 can extend. The drive shaft engages 316 through the canal 604 through and into the second part of the canal 606 In a fan-shaped pattern, the flattened, protruding elements spread out. 602 consequently, they return to their original, uncompressed position. After the preceding elements 602 with the shoulder 605 of the second channel section 606 have come into play, the drive shaft 316 not through the first part of the channel 604 be withdrawn and is thus incorporated into the inner mold part314 held. For this, the diameter of the second channel section must be 606 be sufficiently wide so that the preceding elements 602 about the diameter of the first channel section 604 extend beyond. To create this snap connection, only one side of the drive shaft is required. 316 a protruding element 602 necessary.

[0122] This snap-fit ​​connection is designed so that any axial movement of the inner molded part 314 on the drive shaft 316 is transferred. Similarly, every rotational movement of the inner molded part is transmitted. 314 , for example by surrounding the inner molded part 314 trained rotary wheel 28 , also on the drive shaft 316 transmitted.

[0123] To complete the assembly of the clamping mechanism, the drive shaft is 316 simply through the collar ring mold 310 , the spring312 and finally the inner molded part 314 pushed until the preceding elements 602 into the second part of the channel 606 snap into place.

[0124] After arranging along the drive shaft 316 are the collar ring mold part 310 , the spring 312 and the inner molded part 314 arranged so that the spring 312 partially from the collar ring molding 310 and the inner molded part 314 is enclosed. By providing the collar ring forming chamber 608 and the chamber 610 of the inner molded part, in which an essential part of the spring 312 a longer spring can be absorbed 312 can be used without requiring additional space in the handle 10 is required. The larger the collar ring molding chamber 608 and the chamber 610 of the inner molded part, the longer the spring 312Furthermore, the distance between the preceding elements means 600 , 602 that the ends of the spring 312 through the end walls 612 , 614 the collar ring forming chamber 608 or the chamber 610 the inner molded part is compressed so that the spring 312 It undergoes an initial pre-compression during installation. This is important to ensure that when the handle is operated... 22 Apply the correct force to the clamping jaws to activate the clamping mechanism. 14 is exercised.

[0125] In addition, the inner molded part can 314 in another barrel-shaped molded part, such as the rotary wheel 28 , be recorded as in Fig. Figures 13a–b show the inner molded part rotating here. 314 with the rotary dial 28 , but is free to move axially within the inner cavity 1300 of the rotary dial 28between a first position, as in Fig. 13a shown, and a second position, as in Fig. As shown in 13b, to move. Consequently, the rotation of the wheel rotates. 28 the inner molded part 314 , which in turn controls the drive shaft 316 and the clamping jaws 14 turns.

[0126] After assembling all components, the drive handle can be 22 into the case 20 to be installed. For this purpose, the drive handle 22 at his joint 306 connected to the housing. At the joint 306 For example, it could be two pins extending outwards, which are connected to corresponding joint components. 308 , which are integrally formed with the shell mold parts 300 , 302 are designed to fit together. This provides an anchor point around which the drive handle can be attached. 22 can rotate.

[0127] Thus, the arrangement described above constitutes a mechanism for actuating the end effector arrangement. 14 ready-made, which can be easily and safely assembled without any additional components.

[0128] During use, the user presses the drive handle 22 towards the proximal end 328 of the case 20 , which causes the drive handle 22 around his joint 306 is rotated. The collar ring presses down during this process. 304 against the proximal flange 800 , whereby the collar ring molding 310 is moved in the longitudinal direction. This longitudinal movement displaces the spring. 312 , the inner molded part 314 and the drive shaft 316 back towards the proximal end of the handle section 10 , as from Fig. 5a emerges. Since the drive shaft 316 with the clamping jaws 14is connected, for example by an arrangement of pen 400 and cam slot 402 , the clamping jaws 14 moved from the open to the closed position. The force from the drive handle 22 This is achieved via the spring mechanism of the collar ring molding part 310 , Feather 312 and inner molded part 314 on the drive shaft 316 This spring mechanism is particularly important because it limits the movement that may occur between the clamping jaws. 14 The force acting on the trapped tissue causes it.

[0129] When pressing the drive handle 22 set the collar ring mold part 310 , the spring 312 and the inner molded part 314 their axial movement continues until either the inner molded part 314 its outermost proximal position, so that the clamping jaws 14 are completely closed, as in Fig. 5a shown, or the clamping jaws 14 due to tissue trapped between them 500 cannot be closed any further, as in Fig. 5b is shown, where in this case the drive handle 22 is not fully actuated, so that it passes through the locking element 324 is held in place. If the user presses the drive handle 22 further and the collar ring 304 further against the flange 800 , finally the threshold compression force of the spring 312 achieved, so that the spring 312 begins between the collar ring mold part 310 and the inner molded part 314 to be compressed, as in Fig. 5b can be seen.

[0130] Will the spring 312 If the drive handle is squeezed further, it can 22 can be moved into the locked position without applying further force to the trapped tissue.500 is exerted. This means that the force of the drive handle 22 no longer on the drive shaft 316 is transferred, but effectively through the spring 312 is absorbed. This causes the spring to... 312 Make sure the correct force is applied to the clamping jaws. 14 is transferred. Without the spring 312 This causes the operation of the drive handle. 22 continued increase in the drive shaft 316 and consequently onto the clamping jaws 14 and the tissue 500 The force exerted could lead to mechanical damage to the tissue. 500 lead to this if the user uses the drive handle 22 presses to engage it with the locking element 324 bring to.

[0131] For this reason, the pre-compression of the spring 312 important to ensure that the spring 312 the force of the grip 22absorbs as soon as the inner molded part 314 its axial end position is reached. Similarly, a longer spring enables 312 a larger spring stroke, so that the spring 312 during use, it is not fully compressed to its block length. When the spring reaches... 312 its block length, it would no longer be able to withstand the force exerted by the drive handle. 22 absorb the exerted force and the force would be applied again to the clamping jaws. 14 be transferred.

[0132] To the clamping jaws 14 To keep it in its closed position, the locking element must 324 on the drive handle 22 with the snap-in part 326 inside the proximal end 328 of the case 20 be intervened, as in Fig. 26a–f is shown.

[0133] Fig. 11 shows that the snap-fit ​​mold part 326a single, one-piece molded component that forms a body section 1108 , a spring element 1104 and a cam path 1106 includes the proximal end. 328 of the case 20 features parallel walls 1100 up, which has a channel 1110 define in which the body section 1108 is recorded. The width of the channel 1110 is chosen in such a way that the body section 1108 in the canal 1110 is held, but is nevertheless able to operate in the channel during application. 1110 to slide up and down as described below. The snap-fit ​​component is designed for this purpose. 326 preferably made of a low-friction material, such as polytetrafluoroethylene (PTFE), to allow the body section 1108 easily in the canal 1110 It glides without sticking. For added stability in the channel. 1112 can a shaped pen 330in the case 20 It is provided that it has a cam slot 331 the procedure is performed on the body part 1108 is provided as in Fig. 46 shown.

[0134] The spring 1104 is at the end of the body section 1108 placed and arranged to cover the body section 1108 in the canal 1110 upwards towards the distal end of the housing 20 to pre-tension the spring. 1104 can have any suitable design; for example, the spring can 1104 have a curved shape or a loop shape, as in Fig. 11 shown. The cam path 1106 is located on the body section 1108 Molded, protruding part. The cam path 1106 includes a first cam surface 1112 , a groove 1114 and a second cam surface 1116 , to form a V-shaped molded part.

[0135] The locking element 324 consists of an arm 1118 , which extends from the base of the drive handle 22 extends. The arm 1118 points a pen 1120 on, which is located at its end and is suitable to move along the cam path 1106 to move.

[0136] During application, the locking element 324 via an opening 1102 into the case 20 introduced. The pen 1120 achieved with the snap-in mold part 326 in intervention, so that the body section 1108 in the canal 1110 is pulled downwards, causing the spring 1104 is pulled apart. As in Fig. As shown in 26b–c, the pen moves 1120 along the side of the first cam surface 1112 , until it reaches the upper part of the "V". At this point, the drive handle can be 22 not be pressed down further and the spring 1104pulls the body section 1108 in the canal 1110 back up, so that the pen 1110 into the groove 1114 impacts, causing the drive handle 22 held in the pressed position and the clamping jaws 14 held in the closed position, as in Fig. 26d shown.

[0137] To the drive handle 22 To bring it into lock, the user simply needs to activate the drive handle in the fully depressed position and wait until the pin... 1110 into the groove 1114 engages, and then the drive handle 22 Release. In this locked position, the user's hand is free to use other functions of the instrument. 1 to perform actions such as activating the cutting mechanism using the trigger 24 , Rotating the clamping jaws 14 using the rotary dial 28or actuating the electrodes in the clamping jaws 14 using the switch 26 .

[0138] To the locking element 324 from the case 20 to release and the clamping jaws 14 To open it, the user must use the drive handle. 22 once again towards the case 20 Press. This will make the pen 1120 out of the groove 1114 released as in Fig. 26e shown. If the pen 1120 out of the groove 1114 When it steps, the force of the pre-tensioned spring pulls 1104 the body part 1108 in the canal 1110 back upwards, so that the pin moves along the side of the second cam surface 1116 moved, as in Fig. shown in 26e–f. When the pen 1120 the bottom of the second cam surface 1116 Once reached, he presses the body section 1108 further in the canal 1110 upwards, so that the pen 1120back from the opening 1102 can occur. The body section 1108 can then return to its original position in the canal 1110 return.

[0139] To the drive handle 22 To solve, the user simply needs to use the drive handle. 22 towards the proximal end of the housing 20 press and then the drive handle 22 to return to its original open position.

[0140] Furthermore, the snap-fit ​​part 324 one on an override button 4600 include the area of ​​the body 1108 is formed in one piece, as in Fig. 46 shown, with the override button 4600 is intervened in such a way that the position of the cam path changes. 1106 changes in such a way that the pen 1120 automatically out of the groove 1114 steps and the drive handle 22releases. Consequently, if the locking mechanism were to fail for any reason, the user would be able to release the drive handle. 22 to release the clamping jaws 14 to open.

[0141] The body section 1108 can also be equipped with an integrated locking bar 4602 must be provided to allow the user to release the entire locking mechanism, with the locking bar 4602 is movable between a first and a second position to move the body section 1108 in the canal 1110 to move manually. If the locking bar 4602 The body section is located in the first position. 1108 in its normal position, so that the locking mechanism works as described above. The user can then adjust the locking bar. 4602 move into their second position, thereby the body section 1108 in the canal 1110 is moved upwards, so that the pen 1120only the second cam surface 1116 can pass through and is thereby prevented from coming into contact with the groove 1114 intervention has begun.

[0142] Such a locking mechanism is also suitable for many end effector arrangements. For example, such a locking element can be used on the trigger. 24 be provided for the cutting mechanism to engage the cutting blade 340 to hold in the activated position.

[0143] When releasing the locking element 324 can the drive handle 22 to be moved back to its original position. The collar ring does this. 304 the load is released, which is placed on the proximal flange 800 is exerted, and presses against the distal flange 802 , whereby the collar ring molding 310 is pulled back into its original axial position. Consequently, the spring is also pulled back. 312 , the inner molded part 314 and the drive shaft316 axially withdrawn, which in turn reduces the clamping jaws 14 reset to the open configuration. 4. Arrangement and operation of the cutting mechanism

[0144] Various features and aspects relating to the structure and operation of the cutting mechanism will now be described. As described above, the proximal handle section includes 10 of the electrosurgical instrument 1 a second mechanism for actuating another aspect of a distal end-effector arrangement 14 For example, the end effector arrangement 14 a set of opposing clamping jaws 14 and a blade 340 be, with the distal end of the blade 340 is arranged to fit between the clamping jaws 14 to slide between these clamping jaws 14 To cut clamped fabric. The mechanism used to move the blade. 340, which are in a central railway 341 of the drive shaft 316 The mechanism designed to trigger the cutting action is called the cutting mechanism. The cutting mechanism includes a drive arm. 2000 , a blade drive component 346 , a blade collar ring molded part 348 , a blade shape 352 and a tension spring 350 , all of which are coupled together to form a 3-pivot thrust crank mechanism, as in Fig. 20a–b as well as Fig. 31 and Fig. 32 shown.

[0145] The drive arm 2000 is from a trigger 24 and the trigger mold 344 formed, whereby the trigger 24 a finger gripping element for triggering the cutting mechanism and the trigger mold part 344 a collar ring with a C-shaped side profile and an opening 364 is through which the drive shaft 316 is inserted. The point at which the trigger24 and the trigger mold 344 meeting, forms a pivot point A around which the drive arm 2000 is rotated. This first pivot point A is on the housing. 20 anchored, for example by means of outward-facing pins 358 , which with corresponding molded parts 356 , which are connected to the shell moldings 300 , 302 are formed in one piece, are connected.

[0146] The distal end of the drive arm 2000 , that is, the end of the trigger mold part 344 , is with the blade drive component 346 pivotally connected to form a second pivot point B. The blade drive component 346 It is an H-shaped frame with two parallel arms and an intermediate strut. Thus, the parallel arms of the blade drive component are 346 at one end with the trigger mold 344connected in a pivotable manner, for example by means of outward-facing pins 366 and mating connector 368 At the opposite end are the parallel arms of the blade drive component. 346 also with the blade collar ring molding 348 pivotably connected to form a third pivot point C, for example by means of outward-facing pins 372 and suitable connector 370 .

[0147] As in Fig. 21 to Fig. Shown in 23 is the blade collar ring molded part. 348 a cylindrical or barrel-shaped component with a chamber 2104 , in which the blade shape 352 sits, whereby the blade shape 352 a cylindrical or barrel-shaped component with a body 362 is the one who enters the chamber 2104 of the blade collar ring molding 348 It is fitted. The blade shape 352 also includes a flange 360with a diameter larger than that of the chamber 2104 , so that the flange 360 against the distal lip margin 2200 of the blade collar ring molding 348 in the facility, as in Fig. 22 shown. Consequently, the flange ensures 360 that the correct end of the blade shape 352 is incorporated into the blade collar ring molding.

[0148] The body 362 is with a small groove 2202 to provide its circumference in order to form a shoulder that aligns with the distal nose 2200 is engaged so that the blade shape 352 and the blade collar ring molding 348 are connected to each other via a snap-fit ​​connection. The distal lip margin 2200 fits with the groove 2202 together to form the blade part 352 in the blade collar ring molding 348 to hold while the blade mold 352in the chamber 2104 can rotate freely. Thus, the blade shape 352 and the blade collar ring molding 348 free to rotate concentrically.

[0149] As soon as the blade collar ring molding 348 and the blade shape 352 are composed of different materials, the blade can 340 as in Fig. 24a–c are shown to be connected. In this respect, the blade component includes 352 a T-shaped opening 2300 , which extends along its length and is shaped in such a way that it both protects the blade 340 as well as the drive shaft 316 records, as in Fig. 23 shown.

[0150] The proximal end of the blade 340 includes an intervention element 2102 , which extends further than the general profile of the rest of the blade 340 , that is, it does not lie in the same axial plane. As in Fig. As shown in 24c, the body comprises 362 furthermore, a recess 2100 , in which the intervention element 2102 is held. To allow for arrangement, the proximal end of the blade is 340 in a first point, which relates to the intervention element 2102 opposite, cut off, to create a slanted edge 2400 to provide, and is adjacent to the intervention element in a second respect. 2102 cut out to create a recessed section 2402 to provide. Thus, the proximal end of the blade 340 an L-shaped profile.

[0151] To the blade 340 in the arrangement of blade shape 352 and blade collar ring molding 348 to arrange the blade 340 at an angle to the longitudinal axis of the instrument 1 opposite the T-shaped opening 2300 oriented in such a way that the intervention element 2102 and the slanted edge2400 into the inner cavity 2404 of the blade shape 352 can be introduced, as in Fig. 24a–b shown. Then the blade 340 pulled downwards in a line with the longitudinal axis to engage the element 2102 into the recess 2100 to press, as in Fig. shown in 24c. Thus, the intervention element is 2102 effective with the shoulder 2406 of the blade shape 352 jammed, causing the proximal end of the blade to jam. 340 in the inner cavity 2404 is held.

[0152] The drive shaft 316 can then pass through the T-shaped opening 2300 be inserted, whereby the blade 340 in the central railway 342 recorded as by Fig. 22 and Fig. 23 shown. Thus, a longitudinal movement of the arrangement of blade collar ring components results in 348 and blade shape 352along the drive shaft 316 the blade 340 along the railway 342 delay.

[0153] To complete the blade-trigger assembly, a tension spring extends 350 between the blade collar ring molding 348 and the drive arm 2000 , for example by means of hooks 2002 , 2004 .

[0154] During application, the user pulls the trigger. 24 back to the case 20 , as in Fig. 25b–c shown, so that the drive arm 2000 The first pivot point A is pivoted. This pushes the second pivot point B forward in the distal direction, causing the drive component to... 346 the arrangement of blade collar ring molding 348 and blade shape 352 presses along the drive shaft. The trigger 24 The applied load is therefore transmitted via the trigger fitting 344and the drive component 346 on the blade collar ring molding 348 and the blade shape 352 transferred. Since the proximal end of the blade 340 in the blade shape 352 When held as described above, the blade slides 340 with the arrangement of blade collar ring molding 348 and blade shape 352 along the central railway 342 Since the blade shape 352 in the blade collar ring molding 348 The drive shaft can be rotated independently. 316 can be rotated without affecting the operation of the cutting mechanism.

[0155] The mechanism's operation is optimized to ensure good force transmission at the beginning of the blade's travel. 340 , when the user's finger is stretched and less strong, and also at the end of the blade's path 340 to provide where more forces oppose the path of the blade 340work, such as the force of the spring 350 , friction within the track 342 and the force required to penetrate thick tissue. As demonstrated by Fig. As can be seen in section 27, the user applies a constant force to the trigger. 24 exerted. The mechanism transforms this trigger force into a high initial force of the blade. 340 , which decreases when the blade 340 along the railway 342 is shifted, and increases again when the blade 340 the clamping jaws 14 achieved. When pivot point B moves from its retracted position to its advanced position, as in Fig. 28a–b shown, such that β > 90°, therefore the speed at which the blade collar ring 348 and the blade shape 352 along the drive shaft 316 being displaced, thereby increasing the power of the blade 340 is increased.

[0156] Thus, the mechanism is able to... 340 to drive on with sufficient force to push the material between the clamping jaws 14 to effectively cut trapped tissue without the user having to press the trigger. 24 would have to be subjected to additional force.

[0157] Furthermore, it may be necessary for the cutting mechanism to... 340 around a curved set of clamping jaws 14 along, which reduces the frictional forces that cause the blade to move 340 counteracting it, it increases. The frictional force is a product of the coefficient of friction of the blade. 340 within the railway 342 and the force that the blade 340 as a result of the bending onto the walls of the track 342 exercises.

[0158] To reduce this frictional force, the lateral flexibility of the distal end of the blade can be graduated. Such graduated flexibility can be achieved, for example, by preferably designing the blade with a specific shape. 340 is weakened to such an extent that it is able to move along the track 342 to bend while remaining rigid in the direction of the cutting force. A preferred weakening effect can be achieved, for example, by providing one or more openings or one or more slots. 354 at the distal end, as in Fig. 47a. Such openings can be of constant or varying size or shape, depending on the required degree of flexibility. For example, in Fig. 47b two adjacent openings 4702 , 4704 designed with different sizes, with the larger opening 4702 a higher degree of flexibility is achieved than the smaller opening 4704. Another example is in Fig. 47c three openings 4706 , 4708 , 4710 provided in varying sizes and shapes, with the largest opening 4706 The weakening point is located furthest distally to create increased flexibility in that region. A further preferential weakening effect can be achieved by varying the thickness of the blade. 340 can be reached so that the distal end of the blade 340 beveled 4700 is as in Fig. 47d shown.

[0159] Alternatively, patterned laser cuts can be used. 4702 or chemical etching can be applied to the distal end to increase the flexural strength along a length of the blade. 340 to control, as in Fig. 47e shows that the distance between such sections can be constant or can increase gradually from the distal to the proximal end.

[0160] Preferably the blade 340divided into at least three areas of varying flexibility, for example a distal area, a middle area, and a proximal area, wherein the distal area has greater lateral flexibility than the middle area, and the middle area has greater flexibility than the proximal area. For example, the distal area may have a beveled end. 4700 be designed to offer the greatest degree of flexibility; the central area can have an opening 354 be formed to provide a relatively lower degree of flexibility; and the proximal area may be formed from a rigid rod to offer even less flexibility, as in Fig. 47a shown. In another, in Fig. In the example shown in 47b, the distal area has a large opening. 4702 to offer the greatest degree of flexibility; the middle section includes a smaller opening. 4704, to provide reduced flexibility; and the proximal region is again a rigid bar with the least degree of flexibility. The distal, middle, and proximal regions can be obtained using any suitable combination of the preferred weakening described above.

[0161] Another way to reduce the frictional force resulting from the curved path is to apply a low-friction coating to at least one side of the distal end of the blade. 340 to apply. For example, the blade can be coated, for example using physical vapor deposition (PVD) or chemical vapor deposition (CVD) processes with a low-friction or non-adherent material, such as a PTFE composite or other low-friction polymer composite. 5. Drainage openings

[0162] Several further features and aspects regarding the structure of the drive shaft will now be discussed. 316 described. As described above, the drive shaft 316 an elongated rod with a T-shaped cross-section, as in Fig. Shown in 10a. The drive shaft 316 includes a slot or track 342 along its length, which is suitable to accommodate another elongated element, such as the cutting blade 340 , which is used in the cutting mechanism described above. In one application, a sliding of the cutting blade occurs. 340 along the length of the drive shaft 316 caused to the distal end of the cutting blade 340 between the clamping jaws 14 to move in order to cut the tissue that is wedged in between.

[0163] Over time, blood and tissue can accumulate at the distal end of the instrument. 1 collect, especially along the outer shaft12 and the drive shaft 316 This accumulation of blood and tissue can cause the blade to... 340 in the drive shaft 316 what remains is the functioning of the instrument. 1 , especially of the cutting mechanism, is reduced. To prevent this, sections of the distal end of the drive shaft are 316 cut out so that the contact surface between the drive shaft 316 and the blade 340 and thus the surface area to which blood and tissue can adhere is reduced.

[0164] These cut-out sections can create openings, such as those in Fig. elongated windows shown in 10b–c 1000 , 1002 , so that the distal end of the drive shaft 316 It comprises a supporting base with forked side walls. The cut-out sections can also form the base of the drive shaft. 316extend so that the distal end comprises forked side walls and an open bottom. To determine the extent through these openings 1000 , 1002 To maximize the provided drainage, the openings preferably extend more than 50% of the depth of the drive shaft. 316 out of.

[0165] Thus, these openings represent 1000 , 1002 Drainage openings between the central track 342 and the exterior of the drive shaft 316 ready. 6. Rotary knob and switch

[0166] Several other features and aspects regarding the operation of the adjustment wheel will now be discussed. 28 (also referred to here as a rotary knob), described. The adjusting knob 28 is intended to allow the user to access the external area 12 , on which the end effector assembly 14It is appropriate to rotate it. In order to reduce the required space and thus create a more compact instrument, the internal volume is 1300 of the adjustment wheel 28 also used to create a space for movement of the inner molded part 314 to provide a component that forms part of the clamping mechanism described above. Such an arrangement allows for a more compact mechanism.

[0167] In detail, the rotary dial includes 28 (also referred to here as a dial), a tooth-like plastic wheel with a multitude of notched sections. 336 , which are arranged around its outer diameter. The adjusting wheel 28 It has the appearance of a gear, with the notched cutout sections arranged to ergonomically accommodate a user's thumb. In this regard, and as in Fig. 13a, Fig. 13b, especially in Fig. 14a, shown in more detail, the notched sections lie at an angle to the plane of rotation of the adjusting wheel when used, so that in general the adjusting wheel or rotary wheel 28 It has a slightly truncated conical shape, wider at the end furthest from the user than at the end closest to the user. The notched sections 336 They extend from the distal edge of the adjustment wheel to the proximal edge and are curved or saddle-shaped to accommodate a user's thumb during operation. As detailed in Fig. As shown in Figure 14a, the angle shape of the notched sections fits. 336 to achieve the truncated cone shape of the rotary wheel 28 , generally to the angle of the instrument's body. In Fig. 14a The dashed lines illustrate the angular shape of the notches. 336 around the edge of the wheel 28, which can be viewed as distally tangential to the angle of the instrument's outer walls at the point around the wheel, and in particular to the section of the instrument's outer walls immediately in front of the wheel. Such an arrangement, in which the angled notches of the outer edge of the rotating wheel fit the angle of the instrument wall around the wheel, provides a comfortable and ergonomic shape that is easy for the surgeon to use.

[0168] Regarding the number of notched sections 336 around the outer diameter of the wheel 28 As shown in one embodiment, eight notched sections are evenly spaced around the outer diameter of the wheel. In other embodiments, a smaller or larger number of notched sections can be used, for example, only six or seven, or even nine or ten. If a larger wheel 28If it is to be used, a larger number of notched sections can be used. 336 It may be intended that a smaller wheel is used, and conversely, if a smaller wheel is to be used, the number of sections may be lower. In this respect, the actual size of each slotted section should be considered. 336 They typically remain the same, as the notched sections were ergonomically chosen to comfortably accommodate a user's thumb.

[0169] Regarding the positioning of the adjustment wheel 28 within the instrument, as in Fig. Shown in 2 is the rotary or adjusting wheel. 28 vertically aligned below the switch 26 positioned and spaced from the adjusting wheel in a direction orthogonal to a longitudinal axis, which is defined, for example, by the longitudinal direction of the drive shaft 316 is defined. In particular, the manual switch is located 26directly on an axis orthogonal to this longitudinal axis and which is also through the adjustment wheel 28 through. Furthermore, as in Fig. 14a and Fig. 14b shown, the switch 26 It is relatively large and extends across the adjustment wheel from one side of the instrument's upper surface to the other. The switch 26 It is curved in nature to generally fit the curved upper surface of the instrument's outer wall and has ridges, grooves, or other raised projections on its outer surface to assist the user in gripping the switch for pressing with their thumb. The surface of the switch 26 is relatively large, namely more than 3cm 2 or even 5cm 2 This provides a large surface area to allow for ergonomic activation by the user. The vertical orientation of the switch 26 directly above the adjustment wheel28 It also allows for ergonomic activation. As explained elsewhere, the switch serves this purpose. 26 When used, it is intended to cause the end effector to receive an RF coagulation signal to coagulate tissue located within it.

[0170] Regarding the ergonomics of the switch and the dial, Fig. 35a and Fig. 35b Two corresponding illustrations of different users with hands of different sizes. As shown, the switch 26 , because it has a relatively large surface area, making it easy for users with hands of different sizes to operate, while at the same time the clamping handle 22 (and the blade trigger) 24 , if desired) is served.

[0171] Back to Fig. 12, as previously described, the dial 28 an inner cavity 1300 on, which when used in the inner mold part 314is included. As previously described, the inner molded part comprises 314 an inner molding chamber 610 and has a T-shaped severed section 1208 therein, through which the drive shaft 316 It is mounted and attached as previously described. The inner molded part 314 is inside the inner cavity of the wheel 28 snapped in, and they are flanges 1206 , as in Fig. 12 as well Fig. 29a and Fig. 29b shown to the outer edge of the cylindrical inner cavity 1300 of the adjustment wheel 28 designed around the inner molded part 314 to hold it in place within the cavity once it has been inserted. The inner cavity 1300 of the adjustment wheel 28 is also equipped with locking elements 1200 equipped with appropriate locking elements 1202 interacting around the outer circumference of the inner cylindrical molded part314 are provided. The respective locking elements 1200 and 1202 include corresponding raised step sections that extend side by side circumferentially around the inner surface of the cavity. 1300 fit if the adjustment wheel 28 and the inner cylindrical molded part 314 are in the correct rotational alignment relative to each other. The respective locking elements 1200 and 1202 are provided in such a way that during application the inner cylindrical molded part 314 from side to side within the inner cavity of the wheel 28 glide, but not in the wheel 28 can rotate. Instead, the interacting locking elements act. 1202 and 1200 such that the inner molded part 314 with the rotary dial 28 rotates when it is rotated. In this way, any torque applied to the rotating wheel is transferred. 28is loaned by user 28, to the inner molded part 314 and then onto the drive shaft 316 transferred to rotate the drive shaft that carries the end effector. Fig. 29a and Fig. 29b shows the inner molded part 314 , which is located in the inner cavity of the adjusting wheel 28 is incorporated, and illustrate how the inner molded part 314 inside the inner cavity 1300 of the wheel 28 It can slide axially.

[0172] Fig. 13a and Fig. 13b further shows in more detail how the inner molded part 314 is able to move within the inner cavity 1300 of the wheel 28 to move. As described above, the drive shaft 316 through the T-shaped opening 1208 in the inner molded part 314 through and is secured therein by means of protruding snap-lock or locking elements. 602, which are provided at the end of the drive shaft, secured. The locking or latching elements 602 They are in the form of spring metal tabs, which are also able to pass through the T-shaped opening. 1208 in the inner molded part 314 to pass through, and then into a second part of the canal 606 The inner molded part is received, forming a cavity that allows the spring tabs to spring apart, thereby securing the drive shaft within the inner molded part. The inner molded part 314 is then placed in the inner cavity of the adjusting wheel. 1208 pressed and through the locking tabs 1206 held in place as described above. The inner molded part can move within the inner cavity. 1300 move axially to come into contact with the inner surface of the distal wall of the wheel. 28 to come, as in Fig. 13a shown, or, at its opposite end, in conjunction with the intervention elements 1206 to reach the distal edge of the wheel. Thus, the inner molded part 314 with a degree of axial sliding movement within the cavity of the adjusting wheel 28 provided which is required as part of the mechanism to control the force exerted by the user on material contained within the clamping jaws, as described above.

[0173] The grid shaft of the inner molded part 314 in the inner cavity of the adjusting wheel 28 This greatly improves the assembly of the device, making it significantly easier and therefore cheaper. To position the adjusting wheel in the housing, as shown in... Fig. As shown in 33, the outer distal wall 1310 of the adjustment wheel 28 with an internal retaining wall 1320The projection provided by the device housing is concentric and therefore aligned. This also allows for easy and precise assembly and positioning of the wheel. 28 inside the case. 7. Rotation control of the drive shaft

[0174] As explained above, the shaft 12 with the end effector 14 The shaft is rotatable to allow the end effector to be moved into desired rotational positions for cutting and coagulating tissue. However, to prevent excessive stress on the cable connections to the end effector from excessive rotation of the shaft in one direction, which could cause the wiring to become coiled, twisted, or subjected to excessive strain, a mechanism for controlling the shaft's rotation is required. 12This is necessary, in particular to limit the degree of rotation and thus prevent excessive stress on the wiring. Furthermore, positive control of the shaft's rotation is achieved. 12 The ergonomic experience of the instrument during use and the user's perception of quality are improved.

[0175] To provide rotational control of the shaft, one embodiment uses an arrangement which is Fig. 15a and Fig. 15b as well Fig. 16a to Fig. As shown in 16d, it is used. Regarding Fig. 15 is the dial here 28 with notched sections 36 on its proximal surface (i.e., the rear surface facing the user) with a ring 1506 provided by the proximal surface, which is concentric with the axis of the wheel 28 The ring is aligned, protruding slightly. 1506rests on guide stop elements during application 1502 and 1504 , the projections on the inner surface of the outer casing that protrude to align with the outer circumference of the ring 1506 to be able to make contact. Because of their positioning on the housing in relation to the axis of the ring, the stop part 1502 smaller than the stop part 1504 , but both stop parts 1502 and 1504 Each has angled upper guide surfaces 1510 and 1512 on (see Fig. 15a), which is connected to the outer circumferential surface of the ring 1506 , which forms part of the adjusting wheel, are in contact and help to support and guide the adjusting wheel during its rotation.

[0176] In addition to providing a guiding function, the stop parts also function 1502 and 1504It also serves as a stop to prevent the adjustment wheel from rotating beyond the angular position of the stop pieces. In this respect, the ring... 1506 with a rectangular stop projection extending radially from it 1500 equipped. If the adjustment wheel 28 As it is rotated, the stop projection comes into play. 1500 against corresponding contact surfaces 1514 and 1516 the stop parts 1502 and 1504 in the attachment. The stop surfaces run at an angle to be parallel to the rectangular stop projection. 1500 to be, if the stop position is positioned at an angle to rest against it.

[0177] The stop parts arranged as described above 1502 and 1504 are positioned and of such length that they provide a known rotational measure of the wheel 28 from the stop part 1500 to the stop element 1502provide. In the currently described and in Fig. 15a and Fig. The arrangement shown in 15b consists of the stop parts. 1502 and 1504 The stops are positioned on the housing at a distance from each other to allow the adjusting wheel to rotate 270° from stop to stop. The degree of rotation can be easily varied by increasing or decreasing the distance between the stops, adjusting the length and angle of the guide and stop surfaces accordingly to ensure they are essentially perpendicular to the wheel and the stops themselves. For example, the stops can be positioned and shaped to provide an angular rotation of the wheel between 250° and 300°.

[0178] The above describes the rotational control applied to the adjusting wheel (and then, via the adjusting wheel, the shaft). Fig. 16a to Fig. Figure 16d shows a further rotation control mechanism that is applied to the shaft at the opposite end of the shaft using the shaft molding. 320 is applied here. The shaft-shaped part has a rectangular stop element protruding from it. 1600 The inner surface of the outer housing is further equipped with appropriately shaped stop elements. 1602 and 1604 provided, which are shown in the form of a part with steps that provide corresponding stop surfaces for the rectangular stop element 1600 corresponding parallel stop surfaces in corresponding angular positions of the shaft component 320 offer. In the example shown, the shaped stop parts are positioned on the housing and offer the stop element 1600 corresponding stop surfaces to allow a 270° rotation of the shaft 12to allow the end effector to move from stop to stop. In further embodiments, the shaped stop parts can 1602 and 1604 be positioned to engage the stop element 1600 in other rotational angle positions of the molded part 320 to provide stop surfaces to offer a larger or smaller degree of rotation, for example from 180° to 360°, or preferably from 250° to 300°, or most preferably 270°.

[0179] The corresponding ones, in the adjustment wheel 28 and in the shaft molding 320The provided rotation control mechanisms can be independent of each other; that is, they do not both need to be provided in a given embodiment, but only one or the other can be provided to provide rotation control of the shaft. However, it is advantageous with regard to the operation and perceived quality of the device if both rotation control mechanisms are provided in a device and oriented such that they provide a stop for the rotation at the same points in both directions. Such an arrangement means that the rotation of the shaft is stopped at both ends of the handle section. 10 independently stops, and it becomes very difficult for a user to force any further unwanted rotation of the shaft beyond the permitted limits given by the stops.

[0180] An alternative rotation control mechanism is in Fig. 36 and Fig. 37 shown. Fig. Figure 36 again shows the shaft molding part 320 , but here is the molded part with a ring 3220 provided with a primary rectangular stop element extending radially from it 3202 and secondary position marker elements 3204 , 3206 and 3208 are attached, which are essentially, preferably in orthogonal positions, arranged at equal angles around the ring. The secondary position marker elements 3204 , 3206 and 3208 form small raised protrusions that are not large enough to align with the contact surfaces 3212 and 3214 to come.

[0181] The contact surfaces 3212 and 3214are provided as one-piece molded parts with the outer casing and are positioned here to prevent rotation of the shaft molded part. 320 to allow 180° rotation. In this respect, the stop element 320 at the ends of the rotation range against the stop surfaces 3212 and 3214 in the system to prevent further rotation of the shaft component. Thus, as in Fig. 36a to Fig. shown in 36c, the shaft molding 320 , which the shaft 12 carries, rotates over 180° to allow rotational positioning of the end effector as desired.

[0182] A springy lead is also provided. 3216 , which includes a plastic projection with an essentially triangular cross-section, extending from the part-forming stop surface 3214 extends upwards, so that its tip forms an outer circumferential surface of the ring 3220The secondary position markings, in the form of small, raised protrusions, press against the tip of the spring-loaded protrusion when the shaft molding is touched. 320This rotation causes the tip of the spring-loaded projection to move from its rest position, allowing the corresponding projection to move past it. The effect of this process is to provide user feedback, as the user must apply more force to move the mechanism beyond the rotational positions where the raised projections contact the tip of the spring-loaded projection. Sufficient force must be applied to bend the tip of the spring-loaded projection, allowing the projection to move past it. As a result, the user perceives an increase in the force required to rotate the shaft beyond the rotational positions of the raised projections, thus providing an intuitive indication of the shaft's rotational position and, consequently, the end effector's position.Such a haptic feedback mechanism therefore allows for user-friendly and simple operation of the device.

[0183] Fig. 37 shows the corresponding adjustment wheel 28 for the mechanism in Fig. 36. Here the adjustment wheel also has small stops. 3222 provided with features arranged orthogonally at 90° intervals around the adjusting wheel. A similar mechanism can be used for the spring-loaded projection. 3216 It is intended to extend from the housing to provide similar haptic feedback as in the case of the shaft molding. 320 to provide. In such an arrangement, haptic feedback on the rotational position of the shaft is provided from both ends of the handle, thus improving the user's perception of the device. 8. Cabling

[0184] At this point, further features and aspects relating to the wiring within the handle will be discussed. 2 can be described. As described above, the switch button 26 provided to supply the RF signal for operating the electrodes in the end-effector assembly 14 to activate and deactivate via a suitable circuit, for example via two ingress-proof switches on a small circuit board (PCB) 338 As in Fig. Shown in 17 is the PCB 338 with a connecting cable 1700 for receiving the RF output from a generator (not shown) and electrical wiring. 1702 , 1704 to provide the RF current for the electrodes in the clamping jaws 14 connected, for example, a cable for the active electrode and one for the counter electrode.

[0185] The wiring is included in the arrangement. 1702 , 1704from the electrodes the outer shaft 12 down, the drive shaft 316 along and up to the shaft molding 320 guided, as by Fig. 17 shown. As in Fig. Shown in 9b is the shaft molding part. 320 a cylindrical or barrel-shaped component with an opening 912 at the distal end, around the outer shaft 12 to take up. The outside 12 is on the shaft molding 320 fastened, for example by locking lugs 900 , which have corresponding grooves 902 in the shaft molding 320 cooperate. If the shaft molding 320 As it rotates, the outer shaft consequently rotates. 12 with him. The shaft molding 320 also includes a further opening 914 at the proximal end, with the opening 914 has a T-shape to accommodate the drive shaft 316 to include the drive shaft 316 through the inner cavity1802 of the shaft molding 320 through and the length of the outer shaft 12 extends downwards. Thus, the drive shaft 316 able to within the shaft mold 320 and the outer reaches 12 to glide, but every rotational movement of the drive shaft 316 is applied to the shaft molding 320 and then the outer shaft 12 transmitted.

[0186] As in Fig. As shown in 18a, the electrode cables 1702 , 1704 from the inner cavity 1802 through an opening 1800 in the wall of the shaft molding 320 guided before spreading over and around the body 1804 of the shaft molding 320 are wound up. This kind of winding of the cables 1702 , 1704 around the shaft molding 320 holds the cables 1702 , 1704 in a compact arrangement to prevent the cables from 1702 , 1704during the assembly of the rest of the instrument 1 are a hindrance. Furthermore, winding the cables means 1702 , 1704 around the shaft molding 320 that, if the shaft molding 320 with the drive shaft 316 rotates the cables 1702 , 1604 unwind and rewind with the rotation without the cables 1702 , 1702 Over-tensioning can lead to short circuits. In particular, winding the cables allows 1702 , 1704 in this special way up to 270° rotation, as in relation to Fig. 15a–b and Fig. described in sections 16a–d.

[0187] The electrical wiring 1702 , 1704 is then applied along the top of the case 20 guided. In this respect, one of the shell mold components is 300 with two compartments 1900 , 1902 provided, which are arranged side by side to connect the cable contacts1904 , 1906 to record the active and return cables 1702 , 1704 with the wiring 1908 , 1910 the intrusion-protected switches 338 connect all electrical cables 1702 , 1704 , 1908 , 1910 are in the subjects 1900 , 1902 led inwards and around them, so that only contact 1904 , 1096 in every subject 1900 , 1902 The cables are guided by guide sections. 1912 , 1014 , 1916 will be made easier, which includes a set of cables 1702 , 1910 around the exterior of the fans 1900 , 1902 route around each compartment. 1702 with the cable 1908 aligned in the longitudinal direction, and the return cable 1704 is connected to the cable 1910 aligned lengthwise.

[0188] Consequently, the two cable contacts 1904 , 1906 separated lengthwise, so that there is only one contact through each compartment 1900 , 1902 can pass through, creating a physical barrier between each contact 1904 , 1906 and is provided for the wiring. This eliminates the risk of damage to the insulation of one of the cables by the contacts. 1904 , 1906 himself.

[0189] The cables 1702 , 1704 , 1908 , 1708 are all through small openings 1918 , 1920 , 1922 , 1924 in the walls of the compartments into their respective compartments 1900 , 1902 introduced. Preferably the dimensions of the openings are 1918 , 1920 , 1922 , 1924 such that only one electrical cable can pass through. The opposite shell shape 302It also includes corresponding rib elements (not shown) to secure the contacts. 1904 , 1906 in the subjects 1900 , 1902 to maintain a substantially sealed enclosure. This is important to prevent air leakage through the compartments. 1900 , 1920 to minimize contacts 1904 , 1906 to protect against any fluid that may damage the outer shaft 12 along and into the housing 20 This could cause a short circuit of the contacts 1904 , 1906 would cause. 9. End effector arrangements

[0190] Exemplary end-effector configurations that can be used with the device are now described. The examples described are mentioned only for the sake of completeness, and it is clear that other end-effector configurations can be used with the instrument, provided they are capable of being driven from the drive shaft. 316to be driven. This means that embodiments of the invention are not limited to the specific end effectors described here, but other end effector designs can also be used.

[0191] Fig. 38 to Fig. Figure 44 shows exemplary instruments in which electrically conductive stop elements are arranged on one or both of the sealing electrodes. With regard to Fig. 38 includes an end effector, which is generally connected to 3801 is characterized by an upper clamping jaw 3802 , which have a lower clamping jaw 3803 around a pivot point 3804 It is connected in a way that allows it to pivot around. Flanges. 3805 are at the proximal end of the upper clamping jaw 3802 present, while flanges 3806 at the proximal end of the lower clamping jaw 3803 are present. The flanges 3805 and 3806 Each has slots 3807on, through which a drive pin 3808 extends, so that a proximal and distal movement of the drive pin 3808 (by means of a drive mechanism (not shown)) a pivoting of the clamping jaws 3802 , 3803 between an open and a closed position.

[0192] A metallic clamping piece 3809 is on the inner surface of the upper clamping jaw 3802 present, while on the inner surface of the lower clamping jaw 3803 a metallic clamping piece 3810 is present. If the clamping jaws 3802 , 3803 When the metal clamping pieces swivel into their closed position, they reach the 3809 , 3810 close together to capture tissue (not shown) between each other.

[0193] The upper clamping piece 3809 has a generally planar surface, with the exception of an elongated depression (in Fig. 38 (not visible), which runs along its length. The lower clamping piece 3810 has a corresponding indentation 3811 on, whereby the recesses in the clamping pieces 3809 , 3810 To capture the longitudinal movement of a cutting blade (not shown). The lower clamping piece 3810 is also equipped with a variety of metallic stop elements 3812 provided, which run along the length of the clamping piece and on both sides of the recess 3811 are arranged. The stop elements 3812 should now, with reference to Fig. 39 and Fig. 40 will be described in more detail.

[0194] Each metallic stop element 3812 consists of the upper bulge of a stop element 3813 , which is in an insulating element 3814 is incorporated in such a way that it encloses the stop element, separating it from the rest of the clamping piece. 3810 insulated. Each insulating element 3814and stop element 3813 is in a corresponding opening 3851 , which are in the clamping piece 3810 is present, arranged so that the upper section of the insulating element forms an insulating ring 3816 to each stop element 3812 trains.

[0195] If the clamping jaws 3802 , 3803 be moved into their closed position (as in Fig. 40 shown), the stop elements touch 3812 the upper clamping piece 3809 , maintaining a distance between the upper and lower clamping pieces of between 20 µm and approximately 350 µm (0.00079 in to approximately 0.014 in). During application, an electrosurgical coagulation voltage is applied between the clamping pieces. 3809 , 3810 applied, and the distance between the clamping pieces ensures an effective seal between the clamping jaws 3802 , 3803captured tissue. At the same time, an electrical short circuit between the clamping pieces is prevented, since the stop elements 3812 They are electrically insulated so that they do not have the same electrical potential as the rest of the clamping piece. 3810 wear. The metallic stop elements 3812 are rigid, which allows a consistent separation of the surfaces of the clamping pieces, while it is feasible for the electrical potential of the stop elements to 3813 It is monitored to detect when it reaches the upper clamping piece. 3809 Touch to indicate that the clamping jaws are closing.

[0196] Fig. 41 to Fig. Figure 43 shows an alternative arrangement in which the metallic stop elements 3812 directly on the lower clamping piece 3810 are attached without the insulating elements surrounding the stop elements. In this arrangement, insulating elements are 3817 on the upper clamping piece3809 , provided in appropriate relation to each of the stop elements. In this way, the insulating elements ensure 3817 , when the clamping jaws 3802 , 3803 are closed so that there is no electrical short circuit between the upper clamping piece 3809 and the lower clamping piece 3810 It's coming. The metallic stop elements. 3812 to ensure that the appropriate separation of the clamping jaws is maintained during the application of electrosurgical energy in order to seal tissue captured between the clamping jaws.

[0197] Fig. Figure 44 finally shows another alternative, in which the metallic stop elements 3812 directly back onto the lower clamping piece 3810 are attached. In this arrangement, a metallic counter-holder is used. 3818 arranged opposite each stop element, with each metallic counter-holder 3818from an insulating element 3819 is surrounded in order to be separated from the rest of the upper clamping piece 3809 to be insulated. When the clamping jaws are closed, there is metal-to-metal contact between the stop elements. 3812 and the metallic counterholds 3818 , whereby the insulation of the counter-holders ensures that an electrical short circuit between the clamping pieces is prevented. 3809 , 3810 This is prevented again. Here too, the electrical potential of each of the metallic counterholders can be monitored to detect when they assume the potential of the lower clamping piece, which indicates the closing of the clamping jaws. 10. Electrosurgical System

[0198] With reference to Fig. 45 is intended to be the instrument 1 when used with an electrosurgical generator 4500connected to a controllable radio frequency (RF) source (not shown) which, when applied, generates an RF coagulation signal that coagulates or seals tissue when applied via the electrodes of the instrument's end effector. 1 it is attached to. The electrosurgical generator 4500 includes control input switch 4504 and 4502 , to allow the generator to be switched on and off as needed, and to control the power of the RF coagulation signal supplied to the instrument 1 to allow it to be supplied. In this respect, the electrosurgical generator 4500 a conventional one.

[0199] The instrument 1 is when using the generator 4500 through a tax and service supply line 4506 connected, which contains separate electrical lines to supply an RF signal to the instrument's end effector 1to allow the previously described internal wiring, and furthermore to receive a control signal from the switch 26 of the instrument 1 to allow the electrosurgical generator to send an RF coagulation signal to the instrument 1 to be output. During use, the surgeon activates the generator via an on / off switch. 4504 and selects the coagulation or sealing signal strength to be generated by the internal RF source using knobs. 4502 During a surgical procedure with the instrument, if a sealing or coagulation RF signal is required at the end effector, the surgeon activates the generator to produce such a signal by flipping the switch. 26 When the instrument's button is pressed, the generated RF signal is transmitted via the electrical lines. 4506 The signal is relayed to the end effector. That is, pressing the switch... 26In application, this results in the application of an RF coagulation or sealing signal to the appropriate electrodes contained in the end effector. 11. Summary

[0200] In light of the above, embodiments of the invention provide an advanced electrosurgical forceps instrument that allows for simple and ergonomic one-handed operation by the user, offers rotational flexibility of the end effector, controls the force applied by the end effector to the grasped tissue to prevent excessive force, and allows for convenient mechanical cutting of the grasped tissue while simultaneously providing electrosurgical coagulation or sealing of the tissue. Furthermore, the instrument was designed for easy and cost-effective assembly, while also being compact thanks to the efficient use of available space in the internal activation mechanism.

[0201] Various further modifications of the embodiments described above, whether by adding, eliminating or replacing, will be apparent to those skilled in the art in order to provide additional embodiments, each and in their entirety within the scope of protection of the attached claims. QUOTES INCLUDED IN THE DESCRIPTION

[0202] This list of documents cited by the applicant was automatically generated and is included solely for the reader's convenience. The list is not part of the German patent or utility model application. The DPMA accepts no liability for any errors or omissions. Cited patent literature

[0203] US 2015 / 223870 A1

[0002] US 5730740

[0003] US 5104397

[0003] US 4800880

[0003] WO 98 / 14124

[0003] US 2012 / 0109186

[0003] US 5352235

[0003] WO 2014 / 074807

[0003] US 7846161

[0003] WO 2008 / 024911

[0003] US 5776130

[0003] US 6039733

[0003] US 6179834

[0003] US 7131971

[0003] US 7766910

[0003] EP 2628459

[0003] US 2014 / 0221999

[0003] US 7083618

[0003] US 2009 / 0248020

[0003] US 2015 / 0209103

[0003] US 5797938

[0003] US 7101373

[0003]

Claims

[1] Surgical instrument which comprising a body section having a handle arranged at its proximal end and a shaft extending at least partially through and out of the body section in a distal direction, the shaft being rotatably attached to the body section to allow the shaft carrying the end effector to be rotated relative to the body section during use; wherein the shaft and the body section are provided with a plurality of sets of corresponding interacting rotation control elements which, in application, are arranged to limit the angular rotation of the shaft relative to the body section to within a predetermined angle, wherein the plurality of sets of corresponding interacting rotation control elements are spatially distributed at a plurality of corresponding positions in the longitudinal direction along the shaft, thereby providing, in use, control of the angular rotation of the shaft relative to the body at said plurality of corresponding positions in the longitudinal direction. [2] Surgical instrument according to claim 1, wherein at least one of the plurality of positions is arranged longitudinally at or near the proximal end of the body segment. [3] Surgical instrument according to claim 2, wherein the set of interacting rotation control elements arranged at or near the proximal end of the body section comprises a rotatable adjusting wheel, wherein a rotation of the adjusting wheel causes a corresponding rotation of the elongated shaft and the adjusting wheel comprises one or more stop elements suitable for engaging with complementary stop elements on the body section. [4] Surgical instrument according to any one of claims 1 to 3, wherein at least one of the plurality of positions is arranged longitudinally at or near the distal end of the body segment. [5] Surgical instrument according to claim 4, wherein the set of interacting rotation control elements arranged at or near the distal end of the body section comprises a rotatable shaft support element suitable for allowing the shaft to extend from the interior of the body section to the exterior and to rotate with the shaft when the latter is rotated relative to the body section, wherein the rotatable shaft support element comprises one or more stop elements suitable for engaging with complementary stop elements on the body section. [6] Surgical instrument according to any one of claims 1 to 5, wherein the plurality of spatially distributed sets of corresponding interacting rotation control elements along the shaft are rotationally aligned to prevent further rotation of the shaft at the same angular position(s) of the shaft. [7] Surgical instrument according to any one of claims 1 to 6, wherein the predetermined rotation angle of the shaft is between 180 and 360 degrees, or more preferably between 250 and 300 degrees, or most preferably at approximately 270 degrees. [8] Surgical instrument which a handle that has a longitudinal axis defining a generally front and a rear direction, as well as an elongated shaft extending from inside the handle through the front end of the handle, an end effector arranged at the distal end of the elongated shaft and a rotatable shaft support element suitable for allowing the elongated shaft to extend from the inside of the handle to the outside and to rotate with the shaft when the latter is rotated relative to the handle, wherein the rotatable shaft support element has one or more stop elements suitable for engaging with complementary stop elements on the handle. [9] Surgical instrument according to claim 8, wherein the rotatable shaft support element is provided with a plurality of stop elements. [10] Surgical instrument according to claim 8 or 9, wherein one or more stop elements have the form of projections. [11] Surgical instrument according to claim 10, wherein the one or more stop elements have the form of projections formed on the rotatable shaft support element. [12] Surgical instrument according to one of claims 8 to 11, wherein the handle is provided with one or more shoulders which form the features with which the one or more stop elements are designed to engage. [13] Surgical instrument according to any one of claims 8 to 12, wherein the predetermined angular rotation is between 180 and 360 degrees, more preferably between 250 and 300 degrees and most preferably at approximately 270 degrees.

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