Hand surgical instrument and bridge for a hand surgical instrument

Abstract

The invention provides a hand surgical instrument and a bridge for a hand surgical instrument through which a variety of working instruments can be ideally inserted into a shaft of the hand surgical instrument. This is achieved by a bridge (12) for a hand surgical instrument (10) having a channel-like guide bore (19) for an optic. This bore (19) extends through the entire bridge (12), from a proximal end (15) to a distal end (14). The present invention provides that the guide bore (19) is segmented from the proximal end (15) to the distal end (14) of the bridge (12), and the segments (24, 25, 26) have longitudinal axes (30, 31, 32) that are offset from each other.

Description

[0001] The invention relates to a bridge for a hand surgical instrument according to the preamble of claim 1. Furthermore, the invention relates to a hand surgical instrument according to claim 12.

[0002] Hand surgical instruments such as endoscopes, cystoscopes, resectoscopes, and the like are commonly used for urological applications. These instruments are guided through an opening in the body of the patient using a tubular shaft and positioned for use. Depending on the application or instrument, various instruments are guided through the shaft, such as forceps, scissors, clamps, or, as in high-frequency surgery, electrical electrodes. In addition, a telescope is guided through the shaft into the body along with the aforementioned instruments to provide visual control of the treatment.

[0003] Outside the body, namely at the proximal end of the shaft, there is usually a main body or bridge of the instrument. Such a bridge generally serves to attach the various working instruments and the optics that are to be guided into the shaft. For this purpose, valves or other closure or connection means are provided on the bridge. It is also conceivable that the bridge has connections for a fluid drain or supply. Furthermore, embodiments are known in which additional electrical or optical instruments can be connected to this bridge. To make the instrument, including the bridge and shaft, easier to operate, it can also have handles.

[0004] In these minimally invasive applications, it is of paramount importance that the cross-section of the shaft to be inserted into the body is just large enough to accommodate all of the necessary instruments. Accordingly, the available volume within the shaft must be used optimally. Not only the type and shape of the instruments to be guided through the shaft plays a role, but also their relative position to one another, across the entire length of the shaft. It can happen that very long and very thin instruments, such as a rod optic that is attached to the bridge and runs through the entire shaft, tilt when the bridge is coupled to the shaft, thereby disrupting the space available for the other instruments. A tilted optic can be very cumbersome, especially when wires are used to manipulate levers or forceps.In the worst case, the functionality of the working instruments is impaired by the tilted optics, particularly in the distal area of ​​the shaft, which can have a negative impact on the result of the application.

[0005] Based on this, the object of the present invention is to create a bridge for a hand surgical instrument, by the use of which all working instruments and the optics can be guided in an ideal manner into the shaft of the hand surgical instrument.

[0006] A bridge for solving this problem has the features of claim 1. Accordingly, it is provided that a bridge for a hand surgical instrument, which can be, for example, an endoscope, a cystoscope, or a resectoscope, has a channel-like guide bore for an optic. This bore extends through the entire bridge, from a proximal end to a distal end. An optic, which can be, for example, a rod lens system or a fiber optic, can be guided and, if necessary, also fastened through this bore. In addition to this guide bore, the bridge has at least one working channel through which working instruments can be guided. These working instruments can be, for example, wires, rods, or tubes that lead to tools arranged in a distal end of the instrument.This at least one working channel can be arranged parallel or at an angle to the guide bore. Embodiments are conceivable in which the bridge has two or more working channels. At a distal end, the bridge can be coupled to a shaft. This coupling can be achieved, for example, via a bayonet-like rotary clamping ring or an automatic clamping ring. In a generic instrument, the shaft that is coupled to the bridge is designed such that it accommodates both the optics and the at least one working instrument, which are guided through the bridge. The instruments or the optics are guided within the shaft to the distal end in order to be inserted at the treatment site within the body. At a proximal end of the bridge, for example, a telescope for the optics can be attached.

[0007] The present invention provides that the guide bore is segmented from the proximal end to the distal end of the bridge, and the segments have longitudinal axes that are offset from one another. Due to this segmentation and the offset of the longitudinal axis, the optics are not guided coaxially within the bridge. This means that the optics can be fastened within the bridge in such a way that they are guided into the shaft at an angle to the longitudinal axis of the shaft. This compensates for any tilting that occurs when the shaft and bridge are coupled, so that the distal end region of the shaft, in particular, remains free for the other working instruments. The correction of the relative positioning of the optics within the shaft, which takes place in the bridge, results in both the optics and the working instruments at the distal end of the hand surgical instrument being usable without restriction.

[0008] The invention preferably provides that at least one segment of the guide bore has a different diameter than at least one other segment. The offset of the longitudinal axis of the various segments results in a shift in the relative alignment of the optics within the segments. As a result, the optics may require more space, at least locally, to avoid hitting the wall of the guide bore.

[0009] In particular, the invention provides that the guide bore has at least two segments. A special embodiment can provide that the guide bore has three segments, namely a distal first segment, a middle second segment and a proximal third segment. These segments are all designed such that the optic can be guided through the bridge. Likewise, these segments are designed such that they disrupt the coaxial guidance of the optic within the guide bore and thereby compensate for the tilting of the optic. Likewise, it is also conceivable that further segments are introduced into the guide bore in order to achieve the aforementioned effect. These segments can be sections within the bore with a length of a few millimeters to centimeters or rings that are arranged within the bore and act on the rod-like optic.For example, it is conceivable that the guide bore has two or three rings which have a different inner diameter and are shifted relative to a longitudinal axis of the guide bore.

[0010] A preferred embodiment of the invention can provide for the second segment to have a larger diameter than the first and third segments. The displacement of the longitudinal axes of the segments results in a local tilting or bending of the rod-like optic. Due to this bending, the optic requires an adapted cross-section in the guide bore in some areas to prevent the optic from colliding with an inner wall of the bore and altering the correction made. Alternatively, it is also conceivable for the second segment to have a greater axial offset than the first and third segments.

[0011] A particularly advantageous embodiment of the invention can provide that the diameter of the second segment is 4.0 mm to 5.0 mm, preferably 4.5 mm, the diameter of the first segment is 3.8 mm to 4.4 mm, preferably 4.22 mm, and the diameter of the third segment is 3.8 mm to 4.2 mm, preferably 4.13 mm. These dimensions are dimensioned such that the third segment encloses the rod-like optic in a form-fitting manner, preferably over its entire length in the third segment. Accordingly, the optic is fixed in this segment and has a defined holding point. The diameter of the first segment, in turn, is dimensioned such that, in conjunction with the offset, a section of the inner wall serves as a support for the optic. This means that in this segment, the longitudinal axis of the optic does not coincide with the longitudinal axis of the segment. Ultimately, the optic experiences tilting relative to the longitudinal axis of the shaft in this first segment.In addition, a support defines a second holding point to hold the distal end of the optic in a defined position.

[0012] Furthermore, it can be provided that the longitudinal axis of the first segment is shifted relative to the longitudinal axis of the optical guide of an optical plate, in particular parallel.

[0013] A special embodiment of the invention provides that the longitudinal axis of the first segment is offset relative to the longitudinal axis of the third and / or the second segment, in particular parallel, by 0.1 mm to 0.3 mm, in particular 0.21 mm. This offset of the longitudinal axis of the first segment relative to the longitudinal axes of the third and / or the second segment can be directed away from the working channel or towards the working channel. The interaction of the offset of the longitudinal axes and the different diameters of the segments allows the optics to be tilted relative to the longitudinal axis of the shaft. This tilting ensures that all working instruments and the optics can be used without restricting their functionality.

[0014] The invention can also provide for the second segment and the third segment to be coaxially aligned. Depending on the application or design, as well as the size and shape of the instrument, the segments can be designed in various ways. Thus, it is ultimately conceivable that there is an offset between almost every segment, and the diameters of the segments are selected such that the optics are optimally tilted.

[0015] A hand surgical instrument, in particular an endoscope, a cystoscope, a resectoscope or the like, for solving the above-mentioned problem has the features of claim 12. Accordingly, it is provided that the hand surgical instrument has a main body according to at least one of claims 1 to 11.

[0016] A preferred embodiment of the invention is explained in more detail below with reference to the drawing, in which: Fig. 1 a schematic representation of a hand surgical instrument, and Fig. 2 a cross-sectional view of a bridge.

[0017] In the Fig. Figure 1 shows a highly schematic representation of a hand surgical instrument 10. This instrument 10 can be, for example, a cystoscope, a resectoscope, or a similar instrument for the minimally invasive treatment of a patient. The hand surgical instrument 10 described here essentially consists of a tubular shaft 11 and a bridge 12. To treat the patient, the instrument 10 is guided into a body orifice of the patient with a distal end 21 of the shaft 11. The bridge 12 is located outside the body. A wide variety of working instruments can be inserted into the body through the shaft 11 via the bridge 12. Furthermore, the treatment can be observed and controlled via the bridge 12 and the shaft 11 using appropriate optics.

[0018] The shaft 11 can be coupled with a proximal end 13 to a distal end 14 of the bridge 12. This can be done using, for example, a screw cap, a click cap, a bayonet cap, or a clamping ring. A telescope 22 with an optical system can be arranged at a proximal end 15 of the bridge 12. Furthermore, in the embodiment of the instrument 10 shown here, a connector 16 is located on the side of the bridge 12, pointing diagonally downwards. This connector 16 is tubular and can have a valve 17 at a free end.

[0019] Within the bridge 12, there are at least two channel-like passages which run at least largely parallel to a longitudinal axis 18 of the hand surgical instrument 10 or the shaft 11, namely a guide bore 19 and at least one working channel 20. The guide bore 19 and the working channel 20 also run largely parallel to each other and to the longitudinal axis 18 and extend from the proximal end 15 to the distal end 14 of the bridge 12.

[0020] The connection 16 represents an extension of the working channel 20. When the valve 17 is open, various working instruments, such as wires, probes, clamps, or the like, can be inserted into the hand surgical instrument 10 through this tubular channel 20. The working instrument (not shown) is guided through the bridge 12 and through the shaft 11 to a distal end 21 of the shaft 11. Treatment of the patient takes place in front of the distal end 21 of the shaft.

[0021] The guide bore 19 serves to accommodate an optical system (not shown). This optical system can be, for example, a rod lens system (not shown). This rod lens system extends from the proximal end 15 to the distal end 14 of the bridge 12 and is further guided through the entire shaft 11 to the distal end 21 of the shaft 11, where it is directed onto the area to be treated. At the proximal end 15 of the bridge 12, the optical system or rod lens system can be connected to the telescope 22. The telescope 22 and / or the rod lens system can be attached to an optical plate 23 of the bridge 12. An eyepiece or a camera can be attached to the telescope 22 so that the surgeon can view the area to be operated on through the rod lens system. As an alternative to the rod lens system, a fiber optic system can also be used as an imaging medium.

[0022] In the invention described here, the guide bore 19 is formed in segments. According to the Fig. 2, the guide bore 19 has three segments, namely a first segment 24, a second segment 25 and a third segment 26. While the first segment 24 is aligned with the distal end 14 of the bridge 12, the third segment 26 borders on the proximal end 15 of the bridge 12. The second segment 25 is located between the first and the third segment 24, 26. As an alternative to the embodiment of the bridge 12 shown here, it is also conceivable that the guide bore 19 is divided into two segments or into more than three segments.

[0023] The diameters 27, 28, 29 of the three segments 24, 25, 26, represented here by double arrows, differ from one another. While the diameter 28 of the second segment 25 is the largest, the diameter 29 of the third segment 26 is precisely dimensioned such that the optics can be passed through with a form-fitting fit. In the exemplary embodiment illustrated here, the diameter 27 of the first segment 24 is smaller than the diameter 28, but larger than the diameter 29. In a preferred exemplary embodiment, the diameter 28 of the second segment 25 is 4 mm to 5 mm, preferably 4.5 mm. The diameter 27 of the first segment 24 is 3.8 mm to 4.4 mm, preferably 4.22 mm, and the diameter 29 of the third segment 26 is 3.8 mm to 4.2 mm, preferably 4.13 mm. However, it should be expressly pointed out that the sizes of the diameters can also assume other values.

[0024] The longitudinal axes 30, 31 and 32 of the segments 24, 25, 26 are aligned parallel to each other and parallel to the longitudinal axis 18 of the bridge 12 or the shaft 11 or the instrument 10. However, the longitudinal axis 30 of the first segment 24 is offset relative to the longitudinal axis 32 of the third segment 26 and / or relative to the longitudinal axis 31 of the second segment 25. The Fig.2 The offset 33 between the longitudinal axis 30 and the longitudinal axis 32, shown by arrows, can be 0.1 mm to 0.3 mm, in particular 0.21 mm. However, it is also conceivable that the offset 33 between the axes mentioned is greater or smaller. The decisive factor for the exemplary embodiment shown here is that the longitudinal axis 30 of the first segment 24 is shifted upwards relative to the longitudinal axis 32 of the third segment 26, i.e. away from the working channel 20. The offset 33 and the positive connection between the third segment 26 and the optics mean that the optics rests within the first segment 24 on a lower section, a support 34, of the inner wall and as a result a distal end of the optics, which is located at the distal end of the shaft 11, is pressed upwards, i.e. away from a working tool.The spacing of the optics and the working tool at the distal end ensures that the optics and the working tools do not interfere with each other's functionality. The widened second segment 25 serves to accommodate a slight bend in the optics without the optics touching an inner wall of the second segment 25. List of reference symbols: 10 hand surgical instruments 11 shaft 12 Bridge 13 proximal end 14 distal end 15 proximal end 16 connection 17 Valve 18 Longitudinal axis 19 Guide hole 20 working channels 21 distal end 22 telescope 23 Optical plate 24 first segment 25 second segment 26 third segment 27 diameters 28 diameter 29 diameters 30 Longitudinal axis 31 Longitudinal axis 32 Longitudinal axis 33 Offset 34 supports

Claims

[1] Bridge (12) for a hand surgical instrument (10), in particular an endoscope, a cystoscope or a resectoscope, with a channel-like guide bore (19) for an optic and at least one working channel (20) for receiving at least one working instrument, wherein a distal end (14) of the bridge (12) can be coupled to a shaft (11) for the optic and the at least one working instrument and a proximal end (15) can be coupled to a telescope (22), characterized by that the guide bore (19) is segmented from the proximal end (15) to the distal end (14) and the segments (24, 25, 26) have longitudinal axes (30, 31, 32) offset from one another. [2] Bridge (12) for a hand surgical instrument (10) according to claim 1, characterized by that at least one segment (24, 25, 26) has a different diameter (27, 28, 29) than at least one further segment (24, 25, 26). [3] Bridge (12) for a hand surgical instrument (10) according to claim 1 or 2, characterized by that the guide bore (19) has at least two segments (24, 25, 26). [4] Bridge (12) for a hand surgical instrument (10) according to one of the preceding claims, characterized by that the guide bore (19) has three segments (24, 25, 26), namely a distal first segment (24), a middle second segment (25) and a proximal third segment (26). [5] Bridge (12) for a hand surgical instrument (10) according to claim 4, characterized by that the second segment (25) has a larger diameter (28) than the first and third segments (24, 26). [6] Bridge (12) for a hand surgical instrument (10) according to claim 4 or 5, characterized bythat the diameter (28) of the second segment (25) is 4.0 mm to 5.0 mm, preferably 4.5 mm, the diameter (27) of the first segment (24) is 3.8 mm to 4.4 mm, preferably 4.22 mm, and the diameter (29) of the third segment (26) is 3.8 mm to 4.2 mm, preferably 4.13 mm. [7] Bridge (12) for a hand surgical instrument (10) according to one of claims 4 to 6, characterized by that the longitudinal axis (30) of the first segment (24) is displaced relative to the longitudinal axis of an optical guide in an optical plate (23), in particular parallel. [8] Bridge (12) for a hand surgical instrument (10) according to one of claims 4 to 7, characterized by that the longitudinal axis (30) of the first segment (24) is shifted relative to the longitudinal axes (32, 31) of the third and / or the second segment (26, 25), in particular parallel, by 0.1 mm to 0.3 mm, in particular 0.21 mm. [9] Bridge (12) for a hand surgical instrument (10) according to one of claims 4 to 8, characterized by that the second segment (25) and the third segment (26) are coaxially aligned. [10] Bridge (12) for a hand surgical instrument (10) according to one of claims 7 to 9, characterized by that the longitudinal axis (30) of the first segment (24) is shifted away from the working channel (20) relative to the longitudinal axes (32, 31) of the third and / or the second segment (26, 25). [11] Bridge (12) for a hand surgical instrument (10) according to one of the preceding claims, characterized by that a section of an inner wall of a distal section of the guide bore (19), in particular of the first segment (24), serves as a support (34) of the rod-like optic and an inner wall of a proximal section of the guide bore (19), in particular of the third segment (26), encloses the rod-like optic in a form-fitting manner. [12] Hand surgical instrument (10), in particular an endoscope, a cystoscope, a resectoscope or the like, with a bridge (12) according to one of claims 1 to 11.

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