Surgical cutting device for otology and methods for its operation

Abstract

Surgical cutting device (10; 20) with an elongated device body (11) aligned along a longitudinal axis (z), comprising at a first end a handle-like grip (12) and at the opposite second end a cutting head (13) with a cutting blade (14) having a blade body (14') with a sharp cutting edge (14''), wherein the cutting blade (14) is arranged within a cutting window (15) open throughout in a direction (x') transverse to the direction of the longitudinal axis (z), wherein the cutting blade (14) is positioned in the cutting window (15) such that its sharp cutting edge (14'') is aligned parallel to a transverse axis (y) which is perpendicular to the longitudinal axis (z) and oblique to the direction (x'), and wherein the cutting blade (14) is connected to the device body (11) either rigidly or movably about the transverse axis (y), characterized by that the surgical cutting device (10; 20) is an otological instrument for producing a thin tissue or cartilage disc (19') from a patient's own material (19) for otological applications, and that the sharp cutting edge (14'') of the cutting blade (14) is positioned axially away from the blade body (14') in the direction of the longitudinal axis (z) towards the handle-like grip (12).

Description

[0001] The invention relates to a medical cutting device with an elongated device body aligned along a longitudinal axis, comprising at a first end a handle-like grip and at the opposite second end a cutting head with a cutting blade which has a blade body with a sharp cutting edge, wherein the cutting blade is arranged within a cutting window which is continuously open in a direction x' transverse to the direction of the longitudinal axis, wherein the cutting blade is positioned in the cutting window such that its sharp cutting edge is aligned parallel to a transverse axis which is perpendicular to the longitudinal axis and oblique to the direction x', and wherein the cutting blade is either rigidly or movably connected to the device body about the transverse axis.

[0002] Such a device for scraping thin bone parts, but not for tissue or cartilage, with a cutting blade rigidly connected to the device body, is known from US 2007 / 0 208 348 A1 (= Reference [0]).

[0003] Dietrich Plester et al. “Atlas of Ear Surgery”, page 79, Kohlhammer Publishing (1989) ISBN 3170084887 (= Reference [1]) describes a similar medical cutting device for the field of otology for the production of thin tissue or cartilage discs. Background of the invention

[0004] The removal of thin autologous tissue, particularly cartilage discs of uniform thickness, from a larger piece of cartilage—for example, taken from the auricle, tragus, the cartilaginous portion of the upper rib bones, or the nasal septum—is a frequently required procedure for various medical purposes. For instance, it may be necessary to examine specific properties of the underlying tissue more closely, especially under a microscope. In otolaryngology (ENT), such thin cartilage discs are also needed for many surgical procedures, such as covering a middle ear prosthesis, reconstructing the posterior wall of the ear canal, or repairing a perforated eardrum. These thin cartilage discs are also used in many nasal surgeries to perform functional or aesthetic corrections to the nose. Devices for processing tissue or cartilage discs made from a patient's own body material

[0005] EP 0 483 567 B1 (= Reference [2]) describes a cutting device with which thin cartilage discs of a predefinable thickness (within certain limits) can be quickly, safely, and with consistent quality cut from a larger piece of cartilage. However, to achieve different thicknesses of the produced cartilage discs, special spacer plates of known thickness must be inserted into the cutting device. These spacer plates—as well as the cutting device itself—must be kept strictly clean and sterile and treated accordingly before each operation, which is both time-consuming and prone to errors. Considering that an average ENT clinic has three to four operating rooms and that fifteen to twenty patients are operated on in a single day during peak times, it may be necessary to prepare a cartilage cutter up to fifteen times a day.This poses a significant logistical challenge for sterile supply. Furthermore, handling the spacer discs is not entirely straightforward. For example, their small size makes it difficult to label them clearly and adequately, which is essential to ensure that the correct size spacer disc is readily available during the operation. Correctly inserting and securing these rather small spacer discs in the cutting device also requires some dexterity.

[0006] In order to be able to produce thin cartilage discs of certain different thicknesses in uniform quality even without the use of the known spacer plates, US 2010 / 0286693 A1 (= Reference [3]) proposes that - as in the known cutting device according to Reference [2] - the first recess arranged on the top of the device body in the first working section can be closed by a first projection arranged on the top of the cover, wherein the first lateral limiting web has a first guide slot for inserting a cutting blade, which is led from an end face of the first section and runs parallel to the base of the first recess at a predetermined first distance.Furthermore, the device according to reference [3] shall have at least one second holding device which has a second section with a second recess arranged on the top of the device body, which is completely or partially surrounded by a second limiting web and can be closed by a second projection arranged on the top of the cover, wherein the second lateral limiting web has a second guide slot for inserting a cutting blade, which is led from an end face of the second section and runs parallel to the base of the second recess at a predetermined second distance.

[0007] Since the distances between the respective guide slot and the corresponding base of the respective recess can be selected differently for various holding devices, this known cutting device, with its different holding devices, allows the production of cartilage discs of specific thicknesses without the need for the spacer plates that were indispensable in previous state-of-the-art technology. Furthermore, handling this cutting device between the thumb and forefinger provides the surgeon with greater safety during the actual cutting process, because all parts can be moved safely and in a controlled manner relative to each other due to their geometry and design. However, a disadvantage of this known cutting device is that parts can only be manufactured with considerable effort. Injection-molded products, in particular, are prone to significant problems with very thin walls.As a result, the products are generally not economically viable due to the financial expenditure.

[0008] DE 10 2013 105 857 B4 (=reference [4]) improves upon this prior art by proposing a modified cutting device. However, this device also presents a certain risk of injury to the user, as the cutting blade is freely accessible before being inserted into the guide slot and could therefore cut the user's finger with an awkward movement. A further disadvantage of this known device (as well as of the prior art discussed above) is that the knife must be handled with sawing or chopping motions to cut the desired cartilage disc, which often leads to uneven cutting results.

[0009] A cutting device with a rotating cutting blade is known from DE 10 2017 111 634 B3 ≈ EP 3 409 233 B1 ≈ US 10 663 375 B2 (= Reference [5]).

[0010] A relatively simple, early cutting device in the form of a disposable cartilage cutter is described in EP 2 249 139 B1 ≈ US 8 563 614 B2 (= Reference [6]).

[0011] An improved embodiment of a disposable cartilage cutter compared to reference [6] is shown in DE 10 2013 105 857 B4 ≈ EP 2 810 628 B1 ≈ US 9 532 790 B2 (= reference [7]).

[0012] For longer-lasting and repeated use, the applicant shows a precision cartilage cutter on her homepage at https: / / www.kurzmed.com / de / produkte / otologie / instrumente-und-zubehoer.html, the use of which is explained, for example, in https: / / www.youtube.com / watch?v=NrStxT4JOtU (= reference [8]).

[0013] However, all cutting devices according to references [2] to [8] have in common that they deal only with the further processing, in particular the precise cutting of already existing pieces of tissue or cartilage, but not with the “obtaining” them from the patient’s own body material by means of a surgical procedure. Re-implantations in ophthalmology

[0014] From the field of ophthalmology – which is conceptually quite distant with regard to the generic otology of the present invention – where not cartilage tissue, but rather entirely different, very soft or gelatinous corneal or macula tissue can be harvested and reinserted, surgical microkeratomes are known, for example, from DE 698 18 043 T2 (= Reference [9]). In this process, small portions of the cornea are used for the surgical correction of refractive errors of the eye's lens, which can be harvested using a special cutting tool.

[0015] The company Gebauer Medizintechnik GmbH in D-75242 Neuhausen also describes on its website www.gebauermedical.com (= reference

[10] ) cutting devices for removing cornea material by means of a planing-like forward movement by applying pressure from the handle of the device towards a cutting head. Invention-specific prior art from otology

[0016] Singh SP et al., in their publication “A Comparative Evaluation of Audiological and Graft Uptake Results of Reinforced Sliced ​​Conchal Cartilage Versus Temporalis Muscle Fascia Graft In Type I Tympoplasty”, International Journal of Clinical & Experimental Otolaryngology (IJCEO), 2018; 4(1): 96-100 (= Reference

[11] ), also describe the harvesting and reimplantation of cartilage tissue in otology. They show and describe special cartilage cutters for this purpose.

[0017] Finally, the reference already mentioned at the beginning [1] describes a generic surgical cutting device for otology used in the present invention for producing a thin tissue or cartilage disc from a patient's own tissue for otological applications. According to reference [1], this device consists of a surgical scalpel with an elongated body aligned along a longitudinal axis, comprising a handle-like grip at one end and a cutting head with a cutting blade at the opposite end, the cutting blade having a blade body with a sharp cutting edge.

[0018] A disadvantage of this method is the necessarily freehand use of the scalpel when removing tissue or cartilage. The quality of the cutting result is therefore highly dependent on the surgeon's skill and experience on that particular day. Object of the invention

[0019] In contrast, the present invention is based on the objective of improving a generic otological cutting device of the type described above in a cost-effective and efficient manner using the simplest possible technical means, such that the advantages of the known cutting devices described above are largely retained, while avoiding the aforementioned disadvantages. In particular, the invention aims to ensure that the cutting process can be carried out simply and safely, and that particularly uniform cutting results can be achieved with high-quality cutting products, especially corticomedia or tissue chips with a defined, predeterminable thickness. Brief description of the invention

[0020] Starting from the features specified in the preamble of claim 1, this relatively complex problem is solved according to the invention in a surprisingly simple, effective and cost-effective manner by positioning the sharp cutting edge of the cutting blade axially away from the blade body in the direction of the longitudinal axis z towards the handle-like grip.

[0021] This allows the device to be used under tension, unlike the methods used in ophthalmology, which operate under compression. Such an operating mode is particularly gentle during the surgical "processing" of delicate living tissue and leads to geometrically more precise results.

[0022] This design and its inherent functionality ensure that the sharp cutting blade always remains hidden within the guide slot of the cutting window during use, thus minimizing the risk of injury to the operator.

[0023] The alignment of the sharp cutting edge parallel to the transverse axis of the device enables a uniform, planar pulling motion of the cutting blade over the site of tissue removal in the patient, unlike a simple scalpel. This results in significantly improved working results compared to the prior art devices described above, particularly with regard to exceptionally uniform, reproducible cuts of the tissue or cartilage sample and the extraction of slices or layers of precisely defined thickness. Ultimately, the inventive design of the cutting device leads to considerably better, finer, and more uniform cutting results.

[0024] Particular advantages of the device according to the invention compared to the prior art include: Simplicity of the device: In its simplest embodiments, the cutting device according to the invention comprises only the handle and the cutting head. Both parts of the device can be manufactured with high precision, yet without significant technical effort. Precision: The ability to adjust the cutting depth allows for a cut through the patient's tissue that is characterized by a particularly uniform cutting thickness and surface quality. Safety: The blade is not directly accessible to the user, making a cut extremely unlikely. - Simple removal of cartilage layer ◯ low effort ▪ A pulling motion results in an easier pulling motion (for this application) due to the upward force component, compared to pushing with the downward force component. - Defined layer thickness ◯ No additional work step is necessary. Up to now, a part is cut out and then adjusted to the layer thickness again with an additional instrument (see references [2] to [8]). - Less cartilage material is removed than with the previous procedure, or only to the extent necessary. • Gentler procedure for the patient, gentler surgery and better healing process ◯ Only a “chip” is peeled / harvested, so to speak, without having to cut out a larger piece of tissue or cartilage. ◯ This procedure is also faster in terms of time, as the peeled (“harvested”) chip does not need to be further processed in terms of its thickness. - The cutting device according to the invention can be designed as a sterile, disposable product. ◯ This eliminates the need for time-consuming preparation. Preferred embodiments of the invention

[0025] Advantageously, a class of embodiments of the cutting device according to the invention includes a cutting element in which the cutting window and the cutting blade are rigidly, and in particular integrally, connected to the device body. This enables precise metering and transmission of the force applied when removing a piece of tissue or cartilage. Furthermore, this simple design also simplifies manufacturing.

[0026] Particularly preferred are further developments of this class of embodiments which are characterized by the fact that the cutting body has a spacer which defines the penetration depth of the sharp cutting edge into the patient's own body material and thus the thickness of the peeled-out thin tissue or cartilage disc.

[0027] This allows for the harvesting of particularly precise chips of a desired layer thickness, which can usually be used for re-implantation in the patient without further processing.

[0028] In order to be able to adjust the layer thickness required in each individual case particularly precisely and finely, in preferred further developments the spacer is designed to be adjustable, for example with one or more spacer discs which in particular have a thickness between 0.1mm and 1mm, preferably between 0.3mm and 0.4mm, which normally satisfies the most common requirements.

[0029] Further developments of this embodiment of the invention are also of particular practical advantage, in which the cutting head, following the cutting body, has a viewing window axially offset towards the handle-like grip in the direction of a vertical axis x perpendicular to the longitudinal axis z and perpendicular to the transverse axis y, as is known per se from German publication DE 101 38 235 C1 (= Reference

[12] ). This viewing window enables the surgeon to visually assess and control the donor site during tissue or cartilage removal from the patient.

[0030] Particularly preferred are embodiments of the invention which are characterized in that a cartilage punching device is arranged at the free end of the handle opposite the cutting head. This device, for example, is integrated into the cutting unit for the standardized fabrication of a stabilizer for total dentures. It allows small cartilage discs to be produced quickly and in a single step intraoperatively. Such grafts are suitable, for instance, for covering a tympanoplasty prosthesis.

[0031] The design of embodiments of the invention is particularly ergonomically advantageous in which the cutting blade is arranged in the cutting body with the side of its sharp cutting edge tilted at an angle of inclination between 10° and 40°, preferably about 25°, against the zy-plane.

[0032] Particularly cost-effective to manufacture, but also sufficiently reproducible and consistent in quality are embodiments of the surgical cutting device according to the invention in which the cutting blade is made from a commercially available razor blade.

[0033] Another class of advantageous embodiments of the cutting device according to the invention is characterized in that the cutting blade is made of stainless steel, preferably surgical steel. This means that the cutting device meets even the highest requirements for clinical hygiene, especially in the field of surgery.

[0034] To further increase the quality of the cutting device according to the invention, in preferred further developments of this class of embodiments the sharp cutting edge of the cutting blade has a double-sided grind and is preferably specially hardened.

[0035] Another class of embodiments of the invention, which are somewhat more expensive in terms of material costs, is characterized by the fact that the entire device body of the cutting device is made of stainless steel, preferably surgical steel. However, such surgical cutting devices can be sterilized as often as desired and repeatedly according to the highest clinical hygiene standards and can be reused for virtually any length of time.

[0036] In an alternative class of embodiments of the invention that are generally somewhat less expensive to manufacture and somewhat lighter in weight, parts of the cutting device, in particular the handle-like grip, are made of plastic.

[0037] The cutting device according to the invention can also be designed as a cost-effective, disposable product that is discarded after a single use. This eliminates the need for cleaning and re-sterilization. This is becoming increasingly important, as the contamination of surgical instruments is a growing hygiene problem in everyday clinical practice. Therefore, the cutting device according to the invention is particularly preferably made, at least in part, of a sterilizable plastic. This allows the cutting device to be manufactured considerably more cost-effectively than conventional devices made entirely of metal. Delivery to the operating room is then in sterile packaging, and the used cutting device can simply be disposed of.Such a sterilely packaged, single-use product also has the advantage that the cutting device does not require time-consuming cleaning and sterilization before each operation, and it also minimizes the risk of infection, which cannot be completely ruled out with sterile supply systems. Preferably, the corresponding parts of the cutting device are manufactured using an injection molding or 3D printing process.

[0038] To further reduce material and weight, in preferred embodiments of the surgical cutting device according to the invention, the handle-like grip can have a hollow or concave structure.

[0039] In practice, embodiments of the surgical cutting device according to the invention have proven effective in which the sharp cutting edge of the cutting blade has a beam-like, saw-tooth-like, sickle-like, oval, or round, concave or convex shape, particularly on a circular segment, preferably on a quarter or half circle.

[0040] The present invention also encompasses a method for operating a surgical cutting device of the type described above for producing a thin tissue or cartilage disc, characterized in that the sharp cutting edge of the cutting device is placed on a suitable area of ​​the patient's body under slight pressure, and that by pulling the cutting device towards the handle, a desired tissue or cartilage disc is peeled away from the patient's own tissue with particular sensitivity. The application of the surgical cutting device according to the invention under tension (instead of pressure) is therefore particularly gentle on the patient, and the result is also much more precise chips.

[0041] Further features and advantages of the invention will become apparent from the following detailed description of embodiments of the invention with reference to the figures of the drawing, which show details essential to the invention, as well as from the claims.

[0042] The individual features can be implemented individually or in any combination in various versions of the invention. The embodiments shown and described are not to be understood as an exhaustive list, but rather as examples illustrating the invention. Detailed description of the invention and drawing

[0043] The schematic drawing shows embodiments of the invention, which are explained in more detail in the following description.

[0044] In detail: Fig. 1a a schematic spatial representation obliquely on the underside of the device body of an embodiment of the cutting device according to the invention; Fig. 1b how Fig. 1a, however, with a view obliquely from above onto the cutting device; Fig. 2a the embodiment of Fig. 1b in a side view in the direction of the transverse axis y; Fig. 2b how Fig. 2a, however, in a view from above along the vertical axis x; Fig. 2c how Fig. 2b, however, in a view from below along the vertical axis x; Fig. 2D like Fig. 2a, however, in a rear view in the opposite direction to the longitudinal axis z; Fig. 2e like Fig. 2d, but in a front view in the direction of the longitudinal axis z; Fig. 3a how Fig. 2a, however, in a sectional view along the section line AA looking in the direction of the transverse axis y; Fig. 3b Detail B of the embodiment of Fig. 3a; Fig. 3c how Fig. 2b, however with the section line AA in the direction of the longitudinal axis z for the section view in Fig. 3a; Fig. 3D enlarged detail C of the embodiment of Fig. 3a; Fig. 4a a schematic spatial representation obliquely on the underside of the device body of an embodiment of the cutting device according to the invention without cartilage punching device in peeling position with indicated autologous cartilage material of a patient; Fig. 4b how Fig. 3a, however, in a sectional view along the section line DD looking in the direction of the transverse axis y in peeling position with indicated autologous cartilage material of a patient; Fig. 4c enlarged detail E of the embodiment of Fig. 4b with an indicated tissue or cartilage disc peeled from the patient's own cartilage material; and Fig. 4D like Fig. 3c, however with the section line DD in the direction of the longitudinal axis z for the section view in Fig. 4b.

[0045] The embodiments of the surgical cutting device 10; 20 according to the invention, schematically depicted in the figures of the drawing, serve to produce thin tissue or cartilage discs 19' from the patient's own tissue 19. The cutting device 10; 20 is designed for otological applications and comprises an elongated device body 11 aligned along a longitudinal axis z, which has a handle-like grip 12 at one first end and a cutting head 13 with a cutting blade 14 at the opposite second end. The cutting head 13 has a blade body 14' with a sharp cutting edge 14''.

[0046] The cutting device 10; 20 according to the invention is characterized in that the cutting blade 14 is arranged within a cutting window 15 which is continuously open in a direction x' transverse to the direction of the longitudinal axis z; that the cutting blade 14 is positioned in the cutting window 15 such that its sharp cutting edge 14'' is aligned parallel to a transverse axis y which is perpendicular to the longitudinal axis z and oblique to the direction x'; and that the cutting blade 14 is connected to the device body 11 either rigidly or movably about the transverse axis y.

[0047] The cutting window 15 and the cutting blade 14 are housed in a cutting body 13' which is rigidly, and in particular integrally, connected to the device body 11. This cutting body has a spacer 16 which defines the penetration depth of the sharp cutting edge 14'' into the patient's own tissue 19 and thus the thickness of the excised thin tissue or cartilage disc 19'. The spacer 16 is adjustable, in the embodiments shown in the drawing with one or more spacer discs 16'.

[0048] The cutting head 13 has a viewing window 17 axially offset in the direction of the longitudinal axis z towards the handle-like grip 12, extending in the direction of a vertical axis x perpendicular to the longitudinal axis z and perpendicular to the transverse axis y.

[0049] At the free end of the handle-like grip 12, opposite the cutting head 13, a cartilage punching device 18 can additionally be integrated into the cutting device 10. This serves, for example, for the rapid production of a standardized stabilizer for total dentures from the thin tissue or cartilage disc 19' that has been peeled from the patient's own tissue 19 using the cutting device 10 according to the invention.

[0050] In particularly durable embodiments of the cutting device 10; 20 according to the invention, the entire device body 11 is made of stainless steel, preferably surgical steel.

[0051] Alternatively, in other embodiments, which are also suitable as more affordable and lighter disposable products, parts of the cutting device 10; 20, in particular the handle-like grip 12, may be made of plastic.

[0052] As especially in the Fig. 1a, Fig. 3a, Fig. 4a and Fig. As can be clearly seen in 4b, the stem-like handle 12 may also have a hollow or concave structure for reasons of weight saving.

[0053] In all embodiments of the cutting device 10; 20 shown in the present drawing, the sharp cutting edge 14'' of the cutting blade 14 has a beam-like structure running parallel to the transverse axis y, as can be seen in particular from the Fig. 1a and Fig. 2c clearly shows. However, in embodiments of the invention not specifically shown in the drawing, the sharp cutting edge 14'' can also be shaped differently, for example, having a sawtooth-like or sickle-like or oval or round, concave or convex shape, in particular on a circular segment, preferably on a quarter or half circle.

[0054] The cutting blade 14 is usually made of stainless steel, particularly surgical steel. Especially in less expensive disposable products, the cutting blade 14 may also be made from a standard razor blade. Preferably, the sharp cutting edge 14'' of the cutting blade 14 is specially hardened.

[0055] As seen especially in the enlarged detail- Fig. 3b, Fig. 3D and Fig. As can be clearly seen in Figure 4c, the sharp cutting edge 14'' of the cutting blade 14 can have a single-sided bevel. However, in embodiments of the invention not specifically shown in the drawing, the bevel of the cutting edge can also be on both sides.

[0056] From the Fig. 1b, Fig. 2a, Fig. 3a, Fig. 3b, Fig. 4b and Fig. Figure 4c clearly shows how, in particularly preferred embodiments of the cutting device 10; 20 according to the invention, the cutting blade 14 is arranged in the cutting body 13' with the side of its sharp cutting edge 14'' tilted at an angle of inclination between 10° and 40°, preferably about 25°, relative to the zy-plane. In the end region of the cutting head 13 with the cutting body 13', the inclined profile then transitions, at least on the underside, into an end section running parallel to the zy-plane, which, when peeling off a thin tissue or cartilage disc 19', rests on the corresponding area of ​​the patient's own tissue material 19 used to obtain it.

[0057] Above all, the Fig. 2a, Fig. 3a, Fig. 3b, Fig. 3D, Fig. 4b and Fig. Figure 4c illustrates how the sharp cutting edge 14'' of the cutting blade 14 is positioned axially away from the blade body 14' in the direction of the longitudinal axis z towards the handle-like grip 12. This makes it particularly easy to carry out a method for operating the surgical cutting device 10; 20 according to the invention for producing a thin tissue or cartilage disc 19'. This method is characterized in that the sharp cutting edge 14'' of the cutting device 10; 20 is placed on a suitable area of ​​the patient's body with slight pressure, and that by pulling the cutting device 10; 20 towards the grip 12, a desired tissue or cartilage disc 19' is peeled out of the patient's own tissue 19, as shown in the Fig. 4a to 4d indicated. List of reference symbols: 10; 20 surgical cutting device 11 Device bodies 12 stem-like handle 13 Cutting head 13' cutting body 14 cutting blade 14' blade body 14''; sharp cutting edge 15 cutting windows 16 spacers 16' spacer 17 viewing windows 18 Cartilage punch device 19. Patient's own body material 19' excised thin disc of tissue or cartilage x' direction perpendicular to the longitudinal axis x vertical axis y transverse axis z Longitudinal axis Reference list

[0058] Publications considered for the assessment of patentability: [0] US 2007 / 0 208 438 A1 [1] Dietrich Plester et al. “Atlas of Ear Surgery”, page 79, Kohlhammer Publishing (1989) ISBN 3170084887 [2] EP 0 483 567 B1 [3] US 2010 / 0286693 A1 [4] DE 10 2013 105 857 B4 [5] DE 10 2017 111 634 B3 ≈ EP 3 409 233 B1 ≈ US 10,663,375 B2 [6] EP 2 249 139 B1 ≈ US 8,563,614 B2 [7] DE 10 2013 105 857 B4 ≈ EP 2 810 628 B1 ≈ US 9,532,790 B2 [8] Internet presence of the applicant with precision cartilage cutter https: / / www.kurzmed.com / de / produkte / otologie / instrumente-und-zubehoer.html and https: / / www.youtube.com / watch?v=NrStxT4JOtU [9] DE 698 18 043 T2

[10] Website of Gebauer Medizintechnik GmbH in D-75242 Neuhausen: www.gebauermedical.com

[11] Singh SP et al. “A Comparative Evaluation of Audiological and Graft Uptake Results of Reinforced Sliced ​​Conchal Cartilage Versus Temporalis Muscle Fascia Graft In Type I Tympoplasty,” International Journal of Clinical & Experimental Otolaryngology (IJCEO), 2018; 4(1):96-100

[12] DE 101 38 235 C1

Claims

[1] Surgical cutting device (10; 20) with an elongated device body (11) aligned along a longitudinal axis (z), which comprises a stem-like handle (12) at a first end and a cutting head (13) with a cutting blade (14) at the opposite second end, which has a blade body (14') with a sharp cutting edge (14"), wherein the cutting blade (14) is arranged within a cutting window (15) which is continuously open in a direction (x') transverse to the direction of the longitudinal axis (z), wherein the cutting blade (14) is positioned in the cutting window (15) such that its sharp cutting edge (14") is aligned parallel to a transverse axis (y) which runs perpendicular to the longitudinal axis (z) and oblique to the direction (x'), and wherein the cutting blade (14) is connected to the device body (11) either rigidly or movably about the transverse axis (y). is, characterized by , that the surgical cutting device (10; 20) is an otological instrument for producing a thin tissue or cartilage disc (19') from a patient's own body material (19) for otological applications, and that the sharp cutting edge (14'') of the cutting blade (14) is positioned axially away from the blade body (14') in the direction of the longitudinal axis (z) towards the handle-like handle (12). [2] Cutting device according to claim 1, characterized by that the cutting window (15) and the cutting blade (14) are accommodated in a cutting body (13') which is rigidly, in particular integrally, connected to the device body (11), and that the cutting body (13') preferably has a spacer (16) which defines the penetration depth of the sharp cutting edge (14'') into the patient's own body material (19) and thus the thickness of the peeled-out thin tissue or cartilage slice (19'). [3] Cutting device according to claim 2, characterized by that the spacer (16) is designed to be adjustable, for example with one or more spacer discs (16'), which in particular have a thickness between 0.1 mm and 1 mm, preferably between 0.3 mm and 0.4 mm. [4] Cutting device according to one of claims 2 or 3, characterized by that the cutting head (13) has, adjacent to the cutting body (13'), a viewing window (17) axially offset in the direction of the longitudinal axis (z) towards the handle-like handle (12) which is continuous in the direction of a vertical axis (x) perpendicular to the longitudinal axis (z) and perpendicular to the transverse axis (y). [5] Cutting device according to one of the preceding claims, characterized by that a cartilage punching device (18) is arranged at the free end of the stem-like handle (12) opposite the cutting head (13). [6] Cutting device according to one of the preceding claims, characterized bythat the cutting blade (14) is arranged in the cutting body (13') with the side of its sharp cutting edge (14'') tilted against the zy-plane by an angle of attack between 10° and 40°, preferably by approximately 25°. [7] Cutting device according to one of the preceding claims, characterized by that the cutting blade (14) is made of a razor blade. [8] Cutting device according to one of the preceding claims, characterized by that the cutting blade (14) is made of stainless steel, preferably surgical steel. [9] Cutting device according to claim 7 or 8, characterized by that the sharp cutting edge (14'') of the cutting blade (14) has a double-sided grind and is preferably hardened. [10] Cutting device according to one of claims 1 to 9, characterized by that the entire device body (11) of the cutting device (10; 20) is made of stainless steel, preferably surgical steel. [11] Cutting device according to one of claims 1 to 9, characterized by that parts of the cutting device (10; 20), in particular the handle-like grip (12), are made of plastic. [12] Cutting device according to one of the preceding claims, characterized by that the handle-like grip (12) has a hollow or concave structure. [13] Cutting device according to one of the preceding claims, characterized by that the sharp cutting edge (14'') of the cutting blade (14) has a bar-like or a sawtooth-like or a sickle-like or an oval or a round, concave or convex shape, in particular on a circular segment, preferably on a quarter or semicircle.

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