Surgical Instrument

Abstract

The invention relates to a surgical instrument (10) with a handle (20) and a blade carrier (50) arranged thereon, the blade (30) being arranged in a plane (EK), wherein the blade (30) has a concave cutting edge (32), wherein the blade carrier (50) has a width (bK) in a direction transverse to a longitudinal axis (lK) of the blade carrier (50), wherein the blade carrier (50) has a top surface (51) and a bottom surface (52), wherein the plane (EK) extends transversely to the top surface (51) and the bottom surface (52), and wherein the top surface (51) has at least one recess (40) with a side wall (41), a bottom surface (52), a length (lA) in the direction of the longitudinal axis (lK) of the blade carrier (50) and a width (bA) in a direction transverse to the plane (EK) of the blade (30), wherein the width (bA) of the recess (40) is greater than 75% of the width (bK) of the blade carrier (50).

Description

[0001] The invention relates to a surgical instrument.

[0002] The median nerve of the hand, which supplies the muscles of the thumb and metacarpal, runs through a tunnel-like tube called the carpal tunnel. At the level of the wrist, a broad band stretches between the thumb and little finger muscles. This band, also called the flexor retinaculum, forms the roof of the carpal tunnel, which contains the median nerve and the flexor tendons of the fingers. In carpal tunnel syndrome, this canal becomes too narrow, placing pressure on the median nerve. This can lead to symptoms such as tingling or numb hands.

[0003] In some cases, surgery is necessary to treat carpal tunnel syndrome. During the operation, the nerve canal is widened by severing the flexor retinaculum, which spans the carpal bones and borders the carpal tunnel toward the palm. This procedure can be performed using either an open or minimally invasive approach. One possible procedure for minimally invasive carpal roof release involves making an approximately two-centimeter-long incision in the flexor side of the wrist, through which a small probe with a small knife is inserted into the carpal tunnel, between the metacarpal nerve and the carpal roof. Once the probe is in the carpal tunnel, the carpal roof can be split from the inside.

[0004] For minimally invasive procedures, a surgical instrument with a handle and a blade arranged thereon with a concave cutting edge is known, the blade having a plane. DE 10 2019 120 671 A1 discloses such a surgical instrument, which comprises means for enhancing ultrasound visibility in the form of a plurality of recesses, each of which has exactly three side surfaces aligned perpendicular to each other. Even though such recesses enable a certain degree of ultrasound visibility, it is evident that the ultrasound visibility of this instrument is in need of improvement.

[0005] The object of the invention is therefore to provide a surgical instrument with which the safety of minimally invasive surgery on the carpal tunnel of a hand can be further increased.

[0006] The object of the invention is achieved by a surgical instrument having the features of patent claim 1.

[0007] Advantageous embodiments and further developments of the invention are specified in the dependent claims.

[0008] The surgical instrument according to the invention with a handle and a blade carrier arranged thereon with a blade arranged in a plane, wherein the blade has a concave cutting edge, wherein the blade carrier has a width in the direction transverse to a longitudinal axis of the blade carrier, is characterized in that the blade carrier has an upper side and a lower side, wherein the plane runs transversely, in particular perpendicularly, to the upper side and to the lower side, and wherein the upper side has at least one recess with a side wall, a bottom surface, a length in the direction of the longitudinal axis of the blade carrier and a width in the direction transverse to the plane of the blade, wherein the width of the recess is greater than 75%, preferably greater than 80%, particularly preferably greater than 85%, of the width of the blade carrier.Surprisingly, it has been found that such a large recess is particularly clearly visible in ultrasound and can thus significantly increase ultrasound visibility.

[0009] Advantageously, the base surface is oriented perpendicular to the plane of the blade. Such an arrangement can enable good blade location, as the relative alignment between the base surface and the blade is fixed.

[0010] According to a particularly preferred embodiment, the bottom surface is arranged parallel to the top surface. Since the ultrasound is usually directed perpendicularly to the top surface of the blade carrier during the specific surgery for treating carpal tunnel syndrome, such an arrangement can further increase ultrasound visibility.

[0011] Particularly preferably, the side wall is arranged perpendicular to the top surface. Since the ultrasound beam is typically directed perpendicularly to the top surface of the blade carrier during the specific surgery for treating carpal tunnel syndrome, such an arrangement can further improve ultrasound visibility.

[0012] Advantageously, the length of the recess is greater than its width. The resulting design of the recess can enable good visibility in the ultrasound image.

[0013] An advantageous development of the invention provides that the at least one recess has a rectangular cross-section parallel to the upper side with a front edge, a rear edge, and two side edges. Such a recess can enable particularly good visibility in the ultrasound image.

[0014] According to a particularly preferred embodiment of the invention, one of the at least one recess is arranged such that the front edge is arranged in the same sectional plane perpendicular to the longitudinal axis of the blade carrier as the cutting edge, in particular the base of the concave cutting edge. In other words, the base or deepest point of the cutting edge lies below the front edge of the recess in a plan view. Such a configuration can enable particularly good localization of the blade, since the relative alignment between the recess and the blade is fixed.

[0015] The ultrasound visibility can be further improved if, according to an advantageous development, several recesses, preferably three recesses, are arranged one behind the other in the upper side of the blade holder in the direction of the longitudinal axis of the blade holder, since such a structure can also produce a clearly recognizable structure in the ultrasound image.

[0016] Preferably, the front edges of the recesses are arranged equidistant from each other. In this way, the recesses can be used to form a kind of scale, which can provide the user with information about the penetration depth of the instrument or distances to the components of the hand surrounding the instrument.

[0017] The deeper the recess, the better the ultrasonic visibility. Therefore, the side wall is advantageously as high as possible, for example, up to 50% of the height of the blade holder.

[0018] In order to further improve the ultrasound visibility, a plurality of ultrasound reflectors are preferably arranged in the base surface, which reflectors are designed in particular as depressions, wherein the depressions particularly preferably each have two, preferably exactly three, side walls aligned perpendicular to one another.

[0019] The blade is preferably made of metal, especially stainless steel. A metal blade can be particularly well crafted to the desired sharpness.

[0020] Preferably, the blade holder and / or the handle are made of plastic, particularly by injection molding or 3D printing. This allows for a simple and cost-effective manufacturing process. Furthermore, the surgical instrument can be manufactured with less weight than, for example, if it were made of metal.

[0021] According to an advantageous embodiment of the invention, the blade is permanently arranged in the blade holder, in particular by being overmolded therein using an injection molding process or encased in a 3D printing process. This allows for reliable fixation of the blade in the surgical instrument.

[0022] A preferred embodiment of the invention provides for the blade holder to be detachably connected to the handle. This allows the blade holder to be designed as a disposable component, while the handle can be reused multiple times.

[0023] Advantageously, the handle has openings through which the weight of the handle can be reduced.

[0024] An embodiment of the invention is explained in detail with reference to the following figures. Fig. 1 a perspective view of an embodiment of a surgical instrument according to the invention, Fig. 2 an enlarged detail of the distal end of the surgical instrument according to Fig. 1, Fig. 3 a top view of the surgical instrument according to Fig. 1, Fig. 4 a section along the line AA in Fig. 3, Fig. 5 an enlarged detail from Fig. 4 and Fig. 6 an enlarged detail from Fig. 2.

[0025] The Fig. 1 to 6 show different views of an embodiment of a surgical instrument 10 according to the invention.

[0026] The instrument 10 has a handle 20 and a blade carrier 50 arranged thereon with a blade 30. The blade 30 has a concave cutting edge 32. The blade 30 can be used as shown in particular in Fig. 5 can be recognizably formed in a leaf-like manner and has a plane EK which runs parallel to a surface. The plane EK of the blade 30 is in Fig. 5 the paper plane and is in Fig. 3 perpendicular to the paper plane. The thickness of the leaf-like blade 30 should be sufficient to ensure sufficient stability. In particular, the blade 30 is made of metal, for example, stainless steel. The cutting edge 32 can be U-shaped or V-shaped, for example. The cutting edge 32 lies in particular in the plane EK of the blade 30. The cutting edge 32 is formed, for example, as a concave recess starting from one of the side edges of the leaf-like blade 30.

[0027] The blade 30 is secured in the blade holder 50, which is arranged on the handle 20. The blade holder 50 can be integrally connected to the handle 20 or, preferably, can be detachably arranged on the handle 20 via a detachable connection, for example, a screw connection or a bayonet connection. This allows for easy replacement of the blade 30, as the blade 30 can be replaced together with the blade holder 50.

[0028] The instrument 10 can have a first section 14, which is formed, for example, largely by the handle 20, with a first longitudinal axis l1, and a second section 15, which is formed, for example, largely by the blade carrier 50, with a second longitudinal axis l2. The longitudinal axes l1 and l2 can be aligned. Advantageously, however, the second longitudinal axis l2 is angled by an angle α relative to the first longitudinal axis l1, wherein the angle α is in the range of 10° to 40°, preferably in the range of 20° to 30° and is, for example, 25°. The angle α by which the second longitudinal axis l2 is angled relative to the first longitudinal axis l1 lies in particular in the plane EK of the blade 30 (cf. Fig. 4).

[0029] The instrument 10 can be pin-shaped with a distal end 11 and a proximal end 12, wherein the blade 30 is arranged at the distal end 11, in particular at the front side of the distal end 11. The blade 30 is oriented in particular such that the longitudinal axis l2 of the first section 14, in particular of the handle 20, lies in the plane of the blade 30.

[0030] The blade carrier 50 has a longitudinal axis lK, which can in particular coincide with the second longitudinal axis l2, a width bK and an upper side 51 and a lower side 52, wherein the plane EK of the blade 30 runs transversely, in particular perpendicularly, to the upper side 51 and the lower side 52. The upper side 51 has at least one recess 40 with a side wall 41, a bottom surface 42, a length lA in the direction of the longitudinal axis lK of the blade carrier 50 and a width bA in the direction transverse to the plane EK of the blade 30. The width bA of the recess 40 is greater than 75%, preferably greater than 80%, particularly preferably greater than 85%, of the width bK of the blade carrier. The recess 40 extends, in particular, almost over the entire width bK of the blade carrier 50 to such an extent that the side wall 41 of the recess 40 can still be formed stably in the blade carrier 50. The length lA of the recess 40 is preferably greater than the width bA of the recess 40.The bottom surface 42 can be oriented perpendicular to the plane EK of the blade 30. In particular, the bottom surface 42 can be arranged parallel to the top surface 51. The side wall 51 can be arranged perpendicular to the top surface 51.

[0031] The at least one recess 40 is particularly designed such that it has a rectangular cross-section parallel to the upper side 51, with a front edge 46, a rear edge 47, and two side edges 48a, 48b, which are particularly aligned parallel to one another. In particular, the recess 40 can be substantially cuboid-shaped.

[0032] The embodiment of the surgical instrument 10 shown in the figures has three recesses 40, which are arranged one behind the other in the upper side 51 of the blade holder 50 in the direction of the longitudinal axis lK of the blade holder 50. The recess 40a, which is arranged closest to the distal end 11 of the instrument 10, is arranged in particular such that the front edge 46 is arranged above the blade 30, in particular above the most proximal point of the cutting edge 32 or in other words in the same cutting plane S perpendicular to the longitudinal axis lK of the blade holder 50 as the cutting edge 32, in particular the base of the concave cutting edge 32 or the most proximal point of the cutting edge 32 (cf. in particular Fig. 5).

[0033] The three recesses 40 are arranged in particular such that the front edges 46 of the recesses 40 are arranged equidistantly at a distance a from each other (cf. in particular Fig. 3), which can form a kind of scale. The distance a can be, for example, 1 cm.

[0034] The side wall 41 of the recess can have a height hA that is up to 50% of the height hK of the blade holder 50. The recess 40a, which is arranged closest to the distal end 11 of the instrument 10 and in particular is arranged above the blade 30, can have a smaller depth than the following recesses 40, since this recess is located above the blade 30.

[0035] Ultrasonic reflectors, which can be designed as depressions 44, can be arranged in the bottom surface 42. The depressions 44 are designed in particular such that they reflect the ultrasound, in particular regardless of the direction from which the ultrasound impinges on the depressions 44. For this purpose, the depressions 44 can, for example, have exactly three side surfaces 44a, 44b, 44c that are aligned perpendicular to one another (cf. in particular Fig. 2). This creates a depression 44 such that it appears as if a corner of a cube had been pressed into a surface. Such depressions 44 reflect an incident ultrasonic beam back parallel to the direction of incidence, regardless of the direction of incidence.

[0036] A first side surface 44a of the recess 44 can form an angle of approximately 35° with the bottom surface 42. A second side surface 44b and a third side surface 44c can be arranged symmetrically to a longitudinal axis 1K of the blade carrier 1K. For example, the recess 44 can have a triangular base surface 44d in the bottom surface 42, with the apex of the triangle pointing toward the distal end 11 of the surgical instrument (see FIG. Fig. 2 and Fig. 6).

[0037] The blade carrier 50 and / or the handle 20 can be made of plastic, for example, by injection molding or 3D printing, whereby, in particular, the blade carrier 50 and the handle 20 can be formed as two parts or connected to one another in one piece. In particular, the blade 30 can be arranged indetachably in the blade carrier 50, for example, by directly overmolding the blade 30 in the injection molding process or directly encasing it in the 3D printing process. The handle 20 can have openings 22, by means of which the weight of the handle 20 can be reduced. List of reference symbols 10 instruments 11 distal end 12 proximal end 14 first section 15 second section 20 Handle 22 Breakthrough 30 blade 32 cutting edge 40 recess 41 Side wall 42 floor area 44 Deepening 44a first side surface 44b second side surface 44c third side surface 44d floor area 45 cross section 46 leading edge 47 rear edge 48a side edge 48b side edge 50 blade carriers 51 Top 52 bottom EK plane of the blade lK Longitudinal axis of the blade carrier l1 first longitudinal axis l2 second longitudinal axis α angle lA Length of the recess bA Width of the recess hA height of the recess bK Width of the blade carrier hK Height of the blade carrier S cutting plane a distance QUOTES CONTAINED IN THE DESCRIPTION

[0000] This list of documents submitted by the applicant was generated automatically and is included solely for the convenience of the reader. This list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions. Cited patent literature

[0000] DE 10 2019 120 671 A1

[0004]

Claims

[1] Surgical instrument (10) with a handle (20) and a blade carrier (50) arranged thereon with a blade (30) arranged in a plane (EK), wherein the blade (30) has a concave cutting edge (32), wherein the blade carrier (50) has a width (bK) in the direction transverse to a longitudinal axis (lK) of the blade carrier (50), characterized by in that the blade carrier (50) has an upper side (51) and a lower side (52), wherein the plane (EK) runs transversely to the upper side (51) and to the lower side (51), and wherein the upper side (51) has at least one recess (40) with a side wall (41), a bottom surface (52), a length (lA) in the direction of the longitudinal axis (lK) of the blade carrier (50) and a width (bA) in the direction transversely to the plane (EK) of the blade (30), wherein the width (bA) of the recess (40) is greater than 75% of the width (bK) of the blade carrier (50). [2] Surgical instrument according to one of the preceding claims, characterized by that the bottom surface (42) is aligned perpendicular to the plane (EK) of the blade (30). [3] Surgical instrument according to one of the preceding claims, characterized by that the bottom surface (42) is arranged parallel to the top surface (51). [4] Surgical instrument according to one of the preceding claims, characterized by that the side wall (41) is arranged perpendicular to the top side (51). [5] Surgical instrument according to one of the preceding claims, characterized by that the length (lA) of the recess (40) is greater than the width (bA) of the recess (40). [6] Surgical instrument according to one of the preceding claims, characterized by that the at least one recess (40) has a rectangular cross-section (45) parallel to the upper side (51) with a front edge (46), a rear edge (47) and two side edges (48a, 48b). [7] Surgical instrument according to one of the preceding claims, characterized by that one of the at least one recess (40) is arranged such that the front edge (46) is arranged in the same cutting plane (S) perpendicular to the longitudinal axis (lK) of the blade carrier (50) as the cutting edge (32), in particular the base of the concave cutting edge (32). [8] Surgical instrument according to one of the preceding claims, characterized by that several recesses (40), preferably three recesses (40), are arranged one behind the other in the upper side (51) of the blade holder (50) in the direction of the longitudinal axis (lK) of the blade holder (50). [9] Surgical instrument according to claim 7, characterized by that the front edges (46) of the recesses (40) are arranged equidistant from one another. [10] Surgical instrument according to one of the preceding claims, characterized bythat the side wall (41) has a height (hA) which is up to 50% of the height (hK) of the blade holder (50). [11] Surgical instrument according to one of the preceding claims, characterized by in that a plurality of ultrasonic reflectors are arranged in the base surface (42), which reflectors are designed in particular as depressions (44), wherein the depressions (44) particularly preferably each have two, preferably exactly three, side walls (44a, 44b, 44c) which are each aligned perpendicular to one another. [12] Surgical instrument according to one of the preceding claims, characterized by that the blade (30) is made of metal, in particular of stainless steel. [13] Surgical instrument according to one of the preceding claims, characterized by that the blade holder (50) and / or the handle (20) are made of plastic, in particular by injection molding or 3D printing. [14] Surgical instrument according to one of the preceding claims, characterized by that the blade (30) is arranged in the blade holder (50) in a non-detachable manner, in particular is encapsulated therein in an injection-molding process or is arranged encased in a 3D printing process. [15] Surgical instrument according to one of the preceding claims, characterized by that the blade holder (50) is detachably connected to the handle (20). [16] Surgical instrument according to one of the preceding claims, characterized by that the handle (20) has openings (22).

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