Hand surgical instrument and bridge for a hand surgical instrument

Abstract

The invention provides a bridge for a hand surgical instrument, enabling all working instruments and optics to be inserted and removed from the instrument in a simple and clear manner. This is achieved by a bridge (12) for a hand surgical instrument (10) comprising a main body (20) in which a channel-like bore (19) for optics and at least one working channel (26, 28) for receiving at least one working instrument are arranged. A longitudinal axis (18) defines a plane (24) that divides the space around the bridge (12) into an upper half-space (25) and a lower half-space (26). The at least one working channel (26, 28) extends from the main body (20) towards the upper half-space (25).

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 10.

[0002] Urological procedures typically employ hand-operated surgical instruments such as endoscopes, cystoscopes, resectoscopes, and similar devices. These instruments, with their tubular shafts, are inserted through an opening in the patient's body and positioned for the procedure. Depending on the application and the specific instrument, various working tools are guided through the shaft, such as forceps, scissors, clamps, or, as in high-frequency surgery, electrical electrodes. Additionally, an optical system is inserted through the shaft along with these working tools to provide visual control during the procedure.

[0003] Outside the instrument body, at the proximal end of the shaft, there is typically a bridge. This bridge serves to attach the various working instruments and the optics that are to be inserted into the shaft. For this purpose, the main body of the bridge is provided with bores, valves, or other closures or connection elements. It is also conceivable that the main body has connections for, for example, fluid drainage or supply. Furthermore, embodiments are known in which additional electrical or optical instruments can be connected to this main body of the bridge.

[0004] With conventional hand surgical instruments, the ports and working channels for receiving instruments are located on the underside or lower half of the bridge, so that the openings of the ports and working channels point downwards or away from the bridge. In practice, however, it often happens that the hand surgical instruments inserted into the patient's body are oriented in such a way that the openings of the ports and working channels also point downwards or towards the patient's body. Consequently, inserting the instruments into the working channels or connecting any tubing, etc., to the ports proves difficult. The surgeon performing the procedure must, more or less, connect the instruments to the ports without being able to see them directly.This leads to the surgeon either having to change position or to the instrument connection taking unnecessarily long. Once all instruments and other tubing are connected to the main body of the bridge, the situation becomes very confusing for the surgeon, as they cannot see at a glance which working channels or ports are occupied and which are not, or which instruments are used in those channels and ports.

[0005] Based on this, the object of the present invention is to create a bridge for a hand surgical instrument with which all working instruments and optics can be inserted into and removed from the bridge of the hand surgical instrument in a simple and clear manner.

[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 may be, for example, an endoscope, a cystoscope, or a resectoscope, has a main body in which a channel-like bore for an optic and at least one working channel for receiving at least one working instrument are arranged. A distal end of this bridge can be coupled to a shaft for the optic and the at least one working instrument. A proximal end of the bridge can be connected to a telescope of the optic. A longitudinal axis of the bridge can be drawn through the bore of the main body or bridge. A plane can be placed on or through this longitudinal axis, which divides the space around the bridge into two half-spaces, namely an upper half-space and a lower half-space.The upper half-space comprises the side of the bridge generally referred to as the top and includes, in particular, the connection for the telescope. The lower half-space typically comprises the connections or working channels. Preferably, bores or the connection for the optics are associated with the upper half-space, and the connections or working channels for receiving additional surgical instruments are associated with the lower half-space. A key feature of the invention is that the at least one working channel extends from the main body toward the upper half-space. This orientation of the at least one working channel for receiving a surgical instrument makes it easier for the surgeon to insert surgical instruments into the working channel during patient treatment, since these instruments point toward the surgeon and not downwards or toward the patient.Likewise, this orientation of the working channels makes the working environment clearer for the operator, as it is immediately apparent which instruments are located in which ports or channels.

[0007] Preferably, at least one working channel extends from the main body into the upper hemisphere. This extended design of the working channel moves the individual openings or connections further apart, thus providing the surgeon with more space to insert the instruments into the working channels.

[0008] In particular, it is conceivable that the at least one working channel is arranged in the lower half-space of the bridge on the main body and extends from the lower half-space towards or into the upper half-space. This embodiment of the bridge is particularly advantageous because the working channels are easily accessible for instrument installation and offer a high degree of clarity.

[0009] Furthermore, it may be preferably provided that the at least one working channel is arranged in the upper half-space of the bridge on the main body and extends into this upper half-space. Likewise, it is conceivable that the at least one working channel is arranged exactly in the plane or at least partially intersects the plane and extends into the upper half-space. Depending on the requirements of the treatment to be performed, various embodiments of the bridge may prove advantageous. In particular, the relative arrangement of the optics and the working instruments within the instrument may necessitate a corresponding arrangement of the working channels relative to the bore.

[0010] Another advantageous embodiment of the invention provides that a first working channel is arranged on one side of the bore and a second working channel on the other side of the bore. The two working channels are arranged symmetrically or parallel to the plane. If a left and a right side are defined with respect to the longitudinal axis of the bore or the instrument, the first working channel would be assigned to the left side and the second working channel to the right side. This relative arrangement of the working channels allows both to be equipped with an instrument in a very simple and clear manner, without the two instruments interfering with each other.

[0011] Preferably, the at least one working channel forms an acute angle with the bore, with the angle opening proximally. The diverging course of the bore and the at least one working channel creates sufficient space at the corresponding openings or access points of the bore and the working channel to allow access for the instruments.

[0012] Furthermore, it is conceivable that the at least one working channel has a radius such that one end of the working channel extends towards the upper hemisphere. This slight curvature of the at least one working channel guides it upwards from its orientation in the main body, or into the upper hemisphere, in such a way that the instrument can still be moved easily within the working channel.

[0013] Finally, it is conceivable that at least one working channel has a valve through which the channel can be closed. This valve prevents liquids or other media from unintentionally entering the instrument during treatment and thus causing contamination, or from an uncontrolled leakage of a medium from the instrument during treatment. This valve can then be designed as a manually operated valve. Similarly, it is conceivable that the proximal opening of the working channel can be closed by a plug or other cap.

[0014] A hand surgical instrument, in particular an endoscope, a cystoscope, a resectoscope or the like, for solving the aforementioned problem, has the features of claim 10. Accordingly, it is provided that the hand surgical instrument has a bridge according to at least one of claims 1 to 9.

[0015] A preferred embodiment of the invention is explained in more detail below with reference to the drawing. This shows: Fig. 1 a schematic representation of a hand surgical instrument, Fig. 2 a perspective view of a bridge, and Fig. 3 A side view of a bridge.

[0016] In the Fig. Figure 1 is a highly schematic representation of a hand surgical instrument 10. This instrument 10 could 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. For the treatment of the patient, the instrument 10 is inserted into a body orifice of the patient with a distal end 21 of the shaft 11. The bridge 12 is located outside the body. Various surgical 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.

[0017] The stem 11 can be coupled to a proximal end 13 and a distal end 14 of the bridge 12. This coupling can be achieved, for example, with a screw closure, a click closure, a bayonet closure, or a clamping ring. A telescope 22 with optics can be mounted at a proximal end 15 of the bridge 12. The bridge 12 essentially consists of a main body 20. In the Fig. Figure 1 shows a highly schematic representation of a working channel 16 associated with this main body 20. This working channel 16 is tubular in shape and may have a valve 17 at one free end.

[0018] Within the bridge 12 are at least two channel-like passages that run at least largely parallel to a longitudinal axis 18 of the hand surgical instrument 10 or the shaft 11, namely a bore 19 and at least one channel (not shown) that opens into the working channel 16. The bore 19 and the channel also run largely parallel to each other and to the longitudinal axis 18.

[0019] The working channel 16 represents an extension of the main channel. Through this tubular working channel 16, various surgical instruments, such as wires, probes, clamps, catheters, stents, electrodes, flexible instruments, or the like, can be inserted into the hand-surgical instrument 10 when the valve 17 is open. The surgical instrument (not shown) is guided through the main body 20 or the bridge 12 and through the shaft 11 to a distal end 21 of the shaft 11. The patient is treated in front of the distal end 21 of the shaft.

[0020] The bore 19 accommodates an optical system (not shown). This optical system could, for example, be 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 continues through the entire shaft 11 to the distal end 21 of the shaft 11, where it is directed towards the area to be treated. The optical system, or the rod lens system, can be connected to the telescope 22 at the proximal end 15 of the bridge 12. The telescope 22 and / or the rod lens system can be attached to an optical plate 23 of the bridge 12. An eyepiece or camera can be attached to the telescope 22, allowing the surgeon to view the area to be operated on through the rod lens system. Alternatively, a fiber optic system can be used as an imaging device instead of the rod lens system.

[0021] A plane 24, projecting perpendicularly from the plane of the drawing, can be defined by the longitudinal axis 18, which passes through the bore 19. This imaginary plane 24 divides the space around the bridge 12 into two half-spaces: an upper half-space 25 and a lower half-space 26. The upper half-space 25 represents the area that is generally referred to as the top of the instrument 10 or the bridge 12. At least the majority of the optics on the telescope 22 are located here. The lower half-space 26, on the other hand, is also understood as the underside of the instrument 10 or the bridge 12. In the embodiment shown here, the working channel 16 extends out of the main body 20. Locking means can also be assigned to the lower half-space 26 at the distal end 14 of the bridge 12.

[0022] The Fig. Figure 2 clearly shows that the working channel 16 leads out of the main body 20 in the lower half-space 26 and then has a slight curvature or radius, so that the working channel 16 leads into the upper half-space 25.

[0023] In this arrangement, an opening 27, or the valve 17 connected to the opening 27, is located completely or almost completely within the upper half-space 25. It is also conceivable that the opening 27 is located in the lower half-space 26, but oriented towards the upper half-space 25. The working channel 16 thus penetrates the plane 24 and points upwards, or into the upper half-space 25, and therefore towards the surgeon. Due to this orientation, it is particularly easy for the surgeon to insert instruments (not shown) into the working channel 16. Similarly, hoses or other connections can be coupled to the valve 17 in a very simple and clear manner. This upward positioning of the working channel 16 makes the entire surgical situation very clear for the surgeon. This is because no channels, hoses, instruments, or the like are obstructed by other instruments, etc.covered or arranged in such a way that it is not directly visible how the various openings of the instrument 10 are equipped.

[0024] Through the perspective representation of the Fig. Figure 3 shows that in the embodiment shown here, two working channels 16, 28 are assigned to the bridge 12 and the main body 20, respectively. These two working channels 16, 28 are arranged symmetrically to the longitudinal axis 18 and are oriented the same way with respect to the plane 24, thus both pointing into the upper half-space 25. Fig.Figure 3 also shows that the two working channels 16 and 28 form an acute angle 29 with the longitudinal axis 18, with this angle 29 opening towards the proximal end 15 of the bridge 12. This diverging relative arrangement of the two working channels 16, 28 further increases the space available to the surgeon for using the instrument 10, thereby simplifying and improving the handling of the instrument 10.

[0025] Likewise, embodiments are conceivable in which the bridge 12 has only one or more than two working channels 16. It is also conceivable that the working channels 16, 28 are led out of the main body 20 in the plane 24 or in the upper half-space 25. Reference symbol list: 10 Instrument 11 shaft 12 Bridge 13 proximal end 14 distal end 15 proximal end 16 working channel 17 valve 18 Longitudinal axis 19 bore 20 main bodies 21 distal end 22 Telescope 23 Optical plate 24 levels 25 upper hemisphere 26 lower half-space 27 Opening 28 working channel 29 angles

Claims

[1] Bridge (12) for a hand surgical instrument (10), in particular an endoscope, a cystoscope or a resectoscope, comprising a main body (20) having a channel-like bore (19) for optics and at least one working channel (16, 28) 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 optics and the at least one working instrument (16, 28) and a proximal end (15) can be coupled to a telescope (22), wherein a longitudinal axis (18) of the bridge (12) extends axially through the bore (19) and a plane (24) passes through this longitudinal axis (18), defining an upper half-space (25) and a lower half-space (26) around the bridge (12), characterized by , that the at least one working channel (16, 28) extends from the main body (20) in the direction of the upper hemisphere (25). [2] Bridge (12) for a hand surgical instrument (10) according to claim 1, characterized by, that the at least one working channel (16, 28) extends from the main body (20) into the upper hemisphere (25). [3] Bridge (12) for a hand surgical instrument (10) according to claim 1 or 2, characterized by , that the at least one working channel (16, 28) is arranged in the lower half-space (26) of the bridge (12) on the main body (20) and extends from the lower half-space (26) towards the upper half-space (25) or into the upper half-space (25). [4] Bridge (12) for a hand surgical instrument (10) according to one of the preceding claims, characterized by , that the at least one working channel (16, 28) is arranged in the upper half-space (25) of the bridge (12) on the main body (20) and extends into the upper half-space (25). [5] Bridge (12) for a hand surgical instrument (10) according to one of the preceding claims, characterized by, that the at least one working channel (16, 28) is arranged exactly in the plane (24) or at least partially intersects the plane (24) and extends into the upper half-space (25). [6] Bridge (12) for a hand surgical instrument (10) according to one of the preceding claims, characterized by a first working channel (16) and a second working channel (28) which are arranged on different sides of the bore (19). [7] Bridge (12) for a hand surgical instrument (10) according to one of the preceding claims, characterized by , that the at least one working channel (16, 28) forms an acute angle (29) with the bore (19), the angle (29) opening in a proximal direction. [8] Bridge (12) for a hand surgical instrument (10) according to one of the preceding claims, characterized by, that the at least one working channel (16, 28) has a radius such that one end of the working channel (16, 28) extends in the direction of the upper half-space (25). [9] Bridge (12) for a hand surgical instrument (10) according to one of the preceding claims, characterized by , that at least one working channel (16, 28) has a valve (17). [10] Hand surgical instrument (10), in particular an endoscope, a cystoscope, a resectoscope or the like, with a bridge (12) according to any one of claims 1 to 9.

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