Device for measuring tissue elasticity

Abstract

Device (1) for measuring tissue elasticity comprising a housing (3) with a housing longitudinal axis (31) and a proximal and a distal housing end (33, 35), wherein a contact detection device (37) is arranged in the housing (3), wherein a displacement measuring device (39) is received in the housing (3) and is slidably guided relative to the housing (3) and the first contact detection device (37) in the direction of the housing longitudinal axis (31), wherein a probe (4) is arranged at the proximal housing end (33), the probe (4) has a tubular probe body (42) with a probe longitudinal axis (41) and a distal and a proximal probe end (43, 45), wherein a first and second transmission element (47, 49) are arranged longitudinally slidably in the probe body (42).- wherein at the proximal probe end (43) the first transmission element (47) is designed as a reference support surface (471) and the first transmission element (47) transmits a displacement of the reference support surface (471) to the contact detection device (37),- wherein at the proximal probe end (43) the second transmission element (49) is designed as a probe tip (491) for measuring tissue elasticity and the second transmission element (49) transmits a displacement of the probe tip (491) in the longitudinal direction (40) to the displacement measuring device (39),- wherein the reference support surface (471) projects laterally from the tubular probe body (42) in a direction (48) which lies in a plane (46) extending substantially orthogonally to the probe longitudinal axis (41) and the deflection of the reference support surface (471) transversely to the probe longitudinal axis (41) can be transferred to the first transmission element (47) via a deflection device (481).

Description

The present invention relates to a device for measuring tissue elasticity according to claim 1. It is known from the state of the art that conclusions about potentially imminent pregnancy complications can be drawn from the tissue elasticity of the cervix of a pregnant woman. It is known that a gynecologist regularly palpates the cervix of a pregnant woman with his finger in order to detect possible changes in tissue elasticity. Furthermore, methods and devices for determining the mechanical properties of an elastic material, and in particular of human tissues such as the cervix or liver, are known from the prior art, for example, DE 196 50 992 A1. In these methods, the tissue to be examined is drawn into the opening of a hollow measuring probe by means of a defined negative pressure, whereby the penetration depth measured by optical or acoustic sensors allows conclusions to be drawn about the mechanical properties of the tissue under investigation. The aforementioned devices have the disadvantage that the negative pressure during the measurement also draws body fluids, particles, or bacteria into the hollow measuring probe, which can influence the optical and acoustic sensor devices and thus distort the measurement result. Furthermore, suitable measures are required to remove the drawn-in fluids, etc.to separate the particles in order to prevent further penetration into the area of ​​the measuring device, which must be laboriously cleaned or sterilized after each measurement process. US Patent 2010 / 0174208 A1 discloses a measuring device. The measuring device comprises a contact section having a first contact surface that comes into contact with the living body and exerts pressure on the living body. The device further comprises an auxiliary section having a second contact surface that comes into contact with the living body and supporting the second contact surface in such a way that it can perform a reciprocating motion between a coplanar position, in which the second contact surface is arranged substantially in the same plane as the first contact surface, and a retracted position, in which the second contact surface is set back relative to the first contact surface. A locking mechanism is also provided that locks the auxiliary section in a state in which the second contact surface is arranged in the retracted position. US Patent 2006 / 0051734 A1 relates to a device for examining the histology of multiphase biological tissues, which can be used both to measure the stiffness of muscle tissue and to determine the pain sensitivity of a living body. The device comprises a probe insertable through a body channel, equipped with at least one tactile sensor element whose periodically movable body exerts pressure on biological tissue. The movable body operates within an excitation frequency range of 1 Hz to 500 kHz, has a maximum stroke length of less than 1 mm, and generates a displacement force of 0.01 N to 1 N. An integrated displacement mechanism with a controller primarily regulates the excitation frequency. Additionally, sensors monitor both the movement and the applied force to record the viscoelastic response of the tissue to the periodic compression.The device can further comprise contact and auxiliary sections with multiple contact surfaces that are movable between a coplanar and a retracted position and can be fixed via a locking mechanism. The invention also includes methods for generating histological profiles of biological tissues near body channels, as well as diagnostic methods using the described device. US Patent 5,879,312 A relates to a hardness tester for determining the tissue hardness of a body part of a living person. The device comprises a spring-loaded indentor that moves against the spring force when pressed against the body part. The indentor is mounted in a sleeve, which is also spring-loaded but uses a weaker auxiliary spring and also moves upon contact with the body part. The movement of the indentor is converted into an electrical signal by a transducer. As soon as the sleeve reaches a predetermined displacement, a trigger generates a signal, whereupon a control unit performs various processing steps. These include detecting and displaying the movement of the indentor, storing the measured values, and calculating and displaying the difference in hardness of the body part between a relaxed and a compressed state.This allows the device to provide a precise and reproducible analysis of tissue hardness and muscle tension. The aforementioned measurement methods known from the prior art for determining tissue elasticity have the disadvantage that they are either highly subjective or the measuring devices used are highly complex. In particular, when determining tissue elasticity by manual palpation by a gynecologist, the measurements depend on the assessment of the specialist personnel performing the measurement. While the aforementioned measuring devices eliminate the disadvantages of a subjective assessment of tissue elasticity, the aspiration device is highly complex and requires specially trained personnel to perform the measurement. To measure tissue elasticity, a precisely defined pressure must be generated within the area of ​​the aspiration device, and particular attention must be paid to ensuring that there is no pressure loss between the measuring device and the cervix being examined. Therefore, there is a current need for a device for the objective measurement of tissue elasticity that has a simplified design with high measurement accuracy and at the same time exhibits a lower sensitivity of the measurement method to external disturbances. The device according to the invention is defined by the features of claim 1. The invention is characterized in that a probe is arranged at the proximal housing end of a device for measuring tissue elasticity, the probe having a tubular body with a probe longitudinal axis and a proximal and a distal probe end, wherein a first and second transmission element are arranged longitudinally displaceable in the probe body, wherein at the proximal probe end the first transmission element is designed as a reference support surface and the first transmission element transmits a displacement of the reference support surface to the contact detection device, and wherein at the proximal probe end the second transmission element is designed as a probe tip for measuring tissue elasticity and the second transmission element transmits a displacement of the probe tip in the longitudinal direction to the displacement measuring device, wherein the reference support surface (471) is in a direction (48),which lies in a plane (46) extending essentially orthogonally to the probe longitudinal axis (41), projects laterally from the tubular probe body (42) and the deflection of the reference support surface (471) transversely to the probe longitudinal axis (41) can be transmitted to the first transmission element (47) via a deflection device (481). The tissue to be examined using the probe is biological tissue, in particular human tissue, for example, cervical tissue. Measuring tissue elasticity by measuring the displacement of a probe tip relative to a reference surface has the advantage that the measurement is not dependent on optical or acoustic measuring or detection devices in the area of ​​the proximal probe end facing the tissue. Furthermore, the measurement is significantly simpler to perform, since, unlike in the prior art, a vacuum does not need to be created for the measurement. Rather, in the described device according to the invention, the tissue elasticity can be directly determined by measuring the displacement of the probe tip relative to the reference surface using a displacement measuring device. The longitudinal axis of the housing and the longitudinal axis of the probe preferably extend parallel to each other, and particularly preferably the axes extend essentially coaxially to each other. Preferably, it can be provided that a first spring device is arranged in the housing of the displacement measuring device and that the second transmission element together with the displacement measuring device can be displaced from a first starting position against the spring force of the first spring device in the direction of the proximal housing end or the distal probe end into a second deflection position. The inclusion of a first spring mechanism on the displacement measuring device offers the advantage that the second transmission element, and thus also the probe tip, can be deflected together with the displacement measuring device against the spring force of the first spring mechanism. When measuring tissue elasticity, the proximal end of the probe is brought into the area of ​​the tissue under investigation, so that initially the probe tip comes into contact with the tissue. As the proximal end of the probe is moved further towards the tissue under investigation, the probe tip, together with the second transmission element and the spring-loaded displacement measuring device, is deflected depending on the tissue elasticity or can partially penetrate the tissue.By measuring the deflection of the probe tip relative to the reference contact surface, which is placed on the tissue under investigation during the measurement, the tissue elasticity can be calculated directly, taking into account the spring elasticity of the first spring device in combination with the geometric dimensions of the probe tip. Preferably, a second spring device may be arranged on the contact detection device, and the first transmission element together with the contact detection device may be deflected from a first contact detection position against the spring force of the second spring device towards the proximal end of the housing into a second deflected contact position. The design of a second spring mechanism on the first transmission element allows the reference support surface to also deflect against the spring force of the second spring mechanism during measurement. This increases both the comfort of the patient being examined and the accuracy of the measurement. In particular, the spring-loaded reference support surface can conform to the tissue being examined during the measurement, and the deflection of the probe tip relative to the reference support surface can be used to determine tissue elasticity. According to the invention, the probe tip can be designed so that it projects a defined distance from the reference support surface in the proximal direction of the probe's longitudinal axis. The proximal direction is defined as extending from the distal probe end towards the proximal probe end. The proximal end of the probe tip or the second transmission element, viewed in the proximal direction of the probe's longitudinal axis, has a defined distance in the first undisplaced starting position relative to the distal end of the reference support surface or the first transmission element in the first undisplaced contact detection position. The probe tip thus projects a defined distance beyond the reference support surface in the proximal direction. In a preferred embodiment, the probe is designed for insertion into a vagina and the probe body has a length such that the reference contact surface and the probe tip can be brought into contact with the tissue of the cervix. The vagina in question is the vaginal opening of a patient being examined, particularly a pregnant woman. The probe can be used specifically to determine the elasticity of the cervical tissue. The dimensions of the probe, and especially its body, are adapted to the average dimensions of the human vagina and cervix being examined. Preferably, the probe body may have a length in the range of 10 cm to 30 cm in the direction of the probe's longitudinal axis. Furthermore, according to the invention, the probe body may have a diameter in the range between 2 mm and 25 mm. It is particularly preferred that the probe be detachably connected to the proximal end of the housing. The detachable connection between the housing and the probe offers the advantage that the probe can be separated from the housing of the actual measuring device at any time for cleaning, sterilization, or autoclaving. Only mechanical elements, such as the first and second transmission elements with probe tip and reference contact surface, need be provided within the probe body, allowing the electronic measuring devices, such as the contact detection device and / or the displacement measuring device, to be located within the housing. This design has the advantage that the actual electronic measuring devices do not come into contact with biological tissue and, in particular, do not need to be inserted into the vagina. Only the probe comes into contact with the tissue being examined or with the vagina of the patient being examined.Any bodily secretions can only enter or penetrate the area of ​​the probe and do not reach the area of ​​the housing containing the electronic measuring devices. This offers the advantage that the housing of the device for measuring tissue elasticity for patient examination and the probe form separate units that can be coupled via a mechanical interface. The probe can be designed for single use only, allowing it to be disposed of immediately after the examination. The probe components, particularly the probe body and the first and second transmission elements, can be made of a biocompatible plastic. Because the electronic measuring devices are housed within the device's casing and the probe is designed with only mechanical elements, the cost and complexity of the probe can be kept low, enabling it to be designed as a single-use, consumable item. Alternatively, the vaginal probe can also be designed for multiple uses. In this case, it is advantageous to provide only a first and second transmission element within the probe and to omit any measuring devices in the probe area. This allows the probe to be easily sterilized or autoclaved for multiple uses. The components of the probe can be manufactured as injection molded parts and / or as vacuum cast parts and / or 3D printed parts, whereby the components of the probe can be made of plastic and / or metal. In particular, it is provided that the distal end of the probe body can be coupled to the proximal end of the housing by means of a coupling device. The first transmission element can be designed in such a tubular shape that the second transmission element is guided longitudinally displaceable within the first transmission element. The tubular design of the first transmission element in combination with the guiding of the second transmission element within the tubular body of the first transmission element has the advantage that the diameter of the probe can be reduced. In a further preferred embodiment, stop elements adapted to one another can be formed on the first and the second transmission element such that, when the reference support surface is displaced in the distal direction of the probe's longitudinal axis, the first and second transmission elements are coupled to each other in the probe's longitudinal direction, allowing the probe tip to be displaced in the distal direction relative to the first transmission element and the reference support surface. The design of matching stop elements on the first and second transmission elements offers the advantage that a distal displacement of the reference support surface in the coupled state is transmitted to the second transmission element and thus also to the probe tip. The stop elements can, for example, be arranged as an annular stop collar on opposite surfaces of the first and second transmission elements. Furthermore, it may be provided that the reference support surface is designed in a ring shape, wherein the probe tip and the second transmission element are arranged within the ring-shaped reference support surface and the probe tip protrudes from the reference support surface in the first starting position in a distal direction by a defined distance. The reference contact surface can be designed with a flat end face, which can be chamfered at the edges. The ring-shaped design of the reference contact surface, in conjunction with the placement of the probe tip within this ring, offers the advantage that the proximal end of the probe, and thus the probe's measuring range, can have a small diameter. This allows the reference contact surface and the probe tip to be precisely positioned against the area of ​​the cervix being measured for tissue elasticity assessment. According to the invention, it can further be provided that the probe tip is essentially cylindrical in the direction of the probe's longitudinal axis with a flat end face. The cylindrical probe tip can have a constant, defined diameter. For example, the diameter of the cylindrical probe tip can be in the range of 1 mm to 10 mm, particularly preferably 2 mm, 3 mm, or 5 mm. The flat end face of the probe tip can have a chamfer around its circumference, the chamfer preferably extending at an angle of 45° to the end face. The cylindrical design of the probe tip offers the advantage that the spring-loaded tip exerts a constant pressure on the tissue being examined, even as the penetration depth increases. The flat end face ensures that the measurement is not perceived as uncomfortable by the patient. Furthermore, it may be provided that the first and / or the second transmission element are each formed from a base body, the base body extending essentially from the proximal probe end to the distal probe end. The basic bodies of the first and / or the second transmission element can be designed as one or more parts. Designing the first and / or second transmission element as a continuous base body offers the advantage that the transmission of the deflection or displacement of the reference support surface and / or probe tip is purely mechanical. Consequently, the probe can be designed with fewer elements. In particular, the need for electronic components in the probe area can be completely eliminated. In an alternative embodiment, it is provided that the probe tip protrudes laterally from the tubular probe body in the direction of a plane extending substantially orthogonally to the probe's longitudinal axis, and that the deflection of the probe tip transversely to the probe's longitudinal axis can be transmitted to the second transmission element via a deflection device. In this alternative configuration, the tissue elasticity of the patient's vaginal wall can be measured. When the probe is inserted into the vaginal area, the tissue is stretched by the penetrating probe in such a way that the vaginal tissue preferably lies against the tubular probe on all sides. This eliminates the need for a reference contact surface for detecting contact with the surrounding tissue, since, as previously described, the vaginal wall tissue lies against the surface of the probe body. The design of the lateral reference contact surface also enables measurement of tissue elasticity perpendicular to the probe's longitudinal axis, in the event that the tissue to be measured is not in contact with the probe body on all sides. In an alternative embodiment of a device for measuring tissue elasticity, the device comprises a tubular housing with a longitudinal axis and distal and proximal ends, wherein a displacement measuring device is housed within the housing and guided so as to be displaceable relative to the housing in the direction of the longitudinal axis. The device is characterized in that a probe tip projects laterally from the tubular housing in the direction of a plane extending substantially orthogonally to the longitudinal axis of the housing, wherein the probe tip is deflectable in the direction of a plane extending substantially orthogonally to the longitudinal axis of the housing, and wherein the deflection of the probe tip transversely to the longitudinal axis of the housing can be transmitted to the displacement measuring device via a deflection device. According to the invention, a lighting device can be arranged in the region of the proximal end of the housing, wherein the light waves generated by the lighting device are guided by at least one light guide arranged within the probe body to the region of the probe tip or to the region in which the tissue elasticity is measured. The light guide can be embedded in the probe body, with the light guide extending substantially from the distal end of the probe to the region of the probe tip. The light-guiding device has the advantage that, at the distal end of the probe (which can be coupled to the proximal end of the housing with an illumination device), it couples the light waves emitted by the illumination device into the probe tip, transmits them there, and couples them out again. This makes it possible to illuminate the tissue measurement site at the probe tip. Furthermore, the design with a light-guiding device eliminates the need for active elements in the probe, which has the advantage that the probe can be manufactured cost-effectively and as a single-use item. The probe body can have at least one receiving device for coupling an endoscope. This receiving device can be located inside and / or outside the probe body. The receiving device can be designed as a channel within the probe body. By inserting a standard rigid or flexible endoscope into the probe, the probe tip, and thus the area where the measurement is taken, can be observed. This has the advantage that the area where the tissue measurement is to be performed can be observed even when the probe has been inserted into the vagina of the patient being examined. Observing the probe tip with the endoscope allows the examiner to precisely align the probe tip with the tissue to be examined, such as the cervix or a section thereof. In a preferred embodiment, the light guiding device is an optical waveguide. In the following, exemplary embodiments of the invention are explained in more detail with reference to the drawings. Figure 1 shows a perspective view of a device for measuring tissue elasticity. Figure 2 shows a section through the proximal end of a first embodiment of the probe. Figure 3 shows a perspective sectional view of the proximal end of the probe in a second alternative embodiment. Figure 4 shows a sectional view of the proximal housing end with the distal end of an attached probe. Fig. 1 shows a first embodiment of a device 1 for measuring tissue elasticity, comprising a housing 3 with a longitudinal axis 31 and proximal and distal housing ends 33, 35. A contact detection device 37 (not shown) is arranged in the housing 3, and a displacement measuring device 39 (also not shown) is received in the housing and is slidably guided relative to the housing 3 and the first contact detection device 37 in the direction of the longitudinal axis 31. A probe 4 is arranged at the proximal housing end 33. The probe 4 has a probe body 42 with a longitudinal axis 41 and a distal end 45 and a proximal end 43. In the area of ​​the proximal probe end 43, the first transmission element 47 is designed as a reference support surface 471, furthermore, at the proximal probe end 43, the second transmission element 49 is designed as a probe tip 491 for measuring tissue elasticity.The probe 4 has a tubular probe body 42 with a length 421 along the probe axis 41, wherein the probe 4 has such a length 421 that the probe tip 491 with the reference contact surface 471 can be inserted through the vagina into the region of the cervix. The housing 3 with the contact detection device 37 and the displacement measuring device 39 located inside the housing does not penetrate the vagina of the patient being examined during the measurement process. When measuring tissue elasticity using the device 1 shown in Fig. 1, only the probe 4 with the probe body 42 comes into contact with the tissue of the patient being examined. This prevents contamination of the housing by bodily secretions. Fig. 2 shows a section through the proximal probe end of a first embodiment of the probe 4 for measuring tissue elasticity with a tubular probe body 42. The tubular probe body 42 has rounded edges at its proximal end, facilitating insertion of the probe into the vagina of the patient under examination. A first and second transmission element 47, 49 are slidably mounted along the longitudinal axis 41 of the probe. The first transmission element 47 is designed as a reference contact surface 471 in the region of the proximal probe end 43. The second transmission element 49 is designed as a probe tip 491 in the region of the proximal probe end 43. In the illustrated embodiment, the probe tip 491 has a flat end face 491a with a circumferential chamfer 491b and a substantially cylindrical body.The diameter of the cylindrical body remains constant in the region of the proximal end of the second transmission element 49. In the illustrated embodiment, the first transmission element 47 is tubular and surrounds the second transmission element 49, which is slidably arranged within the second transmission element. In the illustrated embodiment, the reference support surface 471 is annular around the probe tip 491. Furthermore, a stop element 477 is formed on the first transmission element 47, and a corresponding stop element 497 is formed on the second transmission element 49. The formation of the corresponding stop elements 477 and 497 prevents displacement of the reference support surface 471 or 491.As a result of a displacement of the first transmission element 47, the aforementioned displacement towards the distal probe end 45 is transmitted to the second transmission element 49 and thus also to the probe tip 491. It is therefore evident that when the reference support 471 is displaced towards the distal probe end, and thus to the right in the drawing, the second transmission element, together with the probe tip 491, is also displaced distally. In the illustrated embodiment of Fig. 2, both the first and the second transmission elements 47, 49 each have a base body 479, 499. Due to the one-piece design of the first transmission element 47, a displacement of the reference support surface 471 in the direction of the probe's longitudinal axis 41 is transmitted to the contact detection device located in the housing 3, which is not shown in Fig. 2.Furthermore, due to the one-piece design of the second transmission element 49, a displacement of the probe tip 491 in the direction of the probe's longitudinal axis 41 is transmitted to the displacement measuring device (not shown) located in the housing 3. The first transmission element 47 also has a second stop element 477a, by means of which the maximum displacement of the first transmission element 47 is limited by its interaction with the probe body 42. In alternative embodiments, the first and second transmission elements 47 and 49 can also be designed in multiple parts, but in these cases, a displacement of the probe tip or the reference surface to the contact detection device or the displacement measuring device is ensured. Fig. 2 shows the probe 4 with the reference contact surface 471 and the probe tip 491 in the unloaded initial state. In this initial state, the first transmission element 47 with the reference contact surface 471 is in the first contact detection position 473, and the probe tip 491 is in a first starting position 493. The probe tip 491 projects distally 40 towards the longitudinal axis 41 of the probe by a defined distance 500. Figure 3 shows a perspective view of a second alternative embodiment of the probe 4 with a substantially tubular probe body 42, wherein the probe body 42 has a hemispherical shape in the region of the distal probe end 43, so that the probe can be inserted more easily into the vagina of the patient being examined. As an alternative to the hemispherical shape of the distal probe end 43 shown, other continuously expanding geometries of the probe 4 are conceivable, which would also simplify insertion into the vagina. In the illustrated embodiment, the probe 4 has a second transmission element 49 that is longitudinally displaceable along the probe's longitudinal axis 41, wherein the probe tip 491 projects laterally from the tubular probe body 42 in the direction 48 of a plane 46 extending substantially orthogonally to the probe's longitudinal axis 41, and the deflection of the probe tip 491 transversely to the probe's longitudinal axis 41 is transmitted to the second transmission element 49 via a deflection device 483. In the illustrated embodiment, the first transmission element 47 with the reference support surface 471 (both not shown) is not extended outwards. Rather, the first transmission element 47 with the reference support surface 471 in the area of ​​the distal probe end 45 is designed such that when the probe 4 shown is inserted into the vagina of the patient being examined, a signal is transmitted via the first transmission element to the contact detection device 37.Figure 4 shows the proximal housing end 33 of a housing 3 with a displacement measuring device 39 and a contact detection device 37. The sectional drawing in Figure 4 shows that, in the illustrated embodiment, both the contact detection device 37 and the displacement measuring device 39 are slidably mounted relative to the housing 3 in the direction of the housing's longitudinal axis 31. Furthermore, Figure 4 shows that the probe 4, with its distal probe end 45, is placed on the proximal housing end 33 of the housing 3 and is thus detachably coupled to it.In the illustrated embodiment, the probe 4 has a tubular probe body 42 within which the first transmission element 47, which is also annular, and the second transmission element 49 are guided for longitudinal displacement. The distal end of the second transmission element 49 abuts the proximal end of the displacement measuring device 39 and thus transmits a displacement in the longitudinal direction 40 of the probe to the displacement measuring device 39. Furthermore, the distal end of the first transmission element 47 rests against the proximal end of the contact detection device 37 and thus also transmits a displacement in the longitudinal direction of the probe to the contact detection device. The contact detection device is therefore in mechanical contact with the first transmission element 47, and the displacement measuring device 39 is in mechanical contact with the second transmission element 49.

Claims

Device (1) for measuring tissue elasticity comprising a housing (3) with a housing longitudinal axis (31) and a proximal and a distal housing end (33, 35), wherein a contact detection device (37) is arranged in the housing (3), wherein a displacement measuring device (39) is received in the housing (3) and is slidably guided relative to the housing (3) and the first contact detection device (37) in the direction of the housing longitudinal axis (31), wherein a probe (4) is arranged at the proximal housing end (33), the probe (4) has a tubular probe body (42) with a probe longitudinal axis (41) and a distal and a proximal probe end (43, 45), wherein a first and second transmission element (47, 49) are arranged longitudinally slidably in the probe body (42).- wherein at the proximal probe end (43) the first transmission element (47) is designed as a reference support surface (471) and the first transmission element (47) transmits a displacement of the reference support surface (471) to the contact detection device (37),- wherein at the proximal probe end (43) the second transmission element (49) is designed as a probe tip (491) for measuring tissue elasticity and the second transmission element (49) transmits a displacement of the probe tip (491) in the longitudinal direction (40) to the displacement measuring device (39),- wherein the reference support surface (471) projects laterally from the tubular probe body (42) in a direction (48) which lies in a plane (46) extending substantially orthogonally to the probe longitudinal axis (41) and the deflection of the reference support surface (471) transversely to the probe longitudinal axis (41) can be transferred to the first transmission element (47) via a deflection device (481). Device (1) according to claim 1, characterized in that a first spring device (391) is arranged in the housing (3) on the displacement measuring device (39) and the second transmission element (49) together with the displacement measuring device (39) is displaceable from a first starting position (493) against the spring force of the first spring device (391) in the direction of the proximal housing end (35) to a second deflection position (495). Device (1) according to claim 1 or 2, characterized in that a second spring device (371) is arranged on the contact detection device (37) and the first transmission element (47) together with the contact detection device (37) can be deflected from a first contact detection position (473) against the spring force of the second spring device (371) in the direction of the proximal housing end (35) into a second deflected contact position (475). Device (1) according to one of the preceding claims, characterized in that the probe (4) is designed for insertion into a vagina and the probe body (42) has a length (421) such that the reference support surface (471) and the probe tip (491) can be brought into contact with the tissue of the cervix. Device (1) according to one of the preceding claims, characterized in that the probe body (42) has a length in the range of 10 cm to 30 cm in the direction (40) of the probe longitudinal axis (41). Device (1) according to one of the preceding claims, characterized in that the probe body (42) has a diameter (423) in the range between 2 mm and 25 mm. Device (1) according to one of the preceding claims, characterized in that the probe (4) is detachably connected to the proximal housing end (33). Device (1) according to one of the preceding claims, characterized in that the distal end (45) of the probe body (42) can be coupled to the proximal end (33) of the housing (3) by means of a coupling device (44). Device (1) according to one of the preceding claims, characterized in that stop elements (477,497) adapted to one another are formed on the first and the second transmission element (47,49) such that when the reference support surface (471) is displaced in a distal direction, the first and second transmission element (47,49) are coupled to each other in the probe longitudinal direction (40), whereby a displacement of the probe tip (491) in a distal direction relative to the first transmission element (47) and the reference support surface (471) is possible. Device (1) according to one of the preceding claims, characterized in that the reference support surface (471) is designed in an annular shape, wherein the probe tip (491) and the second transmission element (49) are arranged within the annular reference support surface (471) and the probe tip (491) projects distally (40) from the reference support surface (471) in the first starting position (493) by a defined distance (500). Device (1) according to one of the preceding claims, characterized in that the first and / or the second transmission element (47, 49) are each formed from a base body (479, 499), wherein the base bodies (479, 499) extend substantially from the distal probe end (45) to the proximal probe end (43). Device (1) according to one of the preceding claims, characterized in that the probe tip (491) extends laterally from the tubular probe body (42) in a direction (48) which lies in a plane (46) extending substantially orthogonally to the probe longitudinal axis (41) and the deflection of the probe tip (491) transversely to the probe longitudinal axis (41) can be transmitted to the second transmission element (49) via a deflection device (483). Device (1) according to one of the preceding claims, characterized in that a lighting device (36) is arranged in the region of the proximal housing end (33), wherein the light waves generated by the lighting device (36) can be guided into the region of the probe tip (491) by at least one light guiding device (50) arranged within the probe body (42). Device (1) according to one of the preceding claims, characterized in that the probe body (42) has at least one receiving device (425) for coupling an endoscope.

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