MEDICAL INSTRUMENT

Description

[0001] The invention relates to a medical instrument.

[0002] From EP 2 959 854 A1, a surgical instrument is known which has two jaws between which tissue can be grasped and which has cutting and sealing electrodes with which the grasped tissue can be cut and sealed. Furthermore, from US 2007 / 0043352 A1, an instrument for sealing vessels is known, the tool part of which is designed to clamp a vessel between two sealing electrodes. The movement of at least one of the sealing electrodes is effected by a hand lever. An electrical switch is associated with the hand lever, which controls the current flowing to the sealing electrodes. The switch is only actuated by the operating lever when the sealing electrodes have firmly clamped the vessel between them. dh,when the relevant jaws are closed. US 2009 / 157074 A1 is also considered a relevant prior art.

[0003] The object of the present invention is to provide an improved concept for activating or deactivating functions of a medical instrument.

[0004] This problem is solved with a medical instrument according to claim 1:

[0005] The medical instrument according to the invention comprises a housing and a device for activating or deactivating at least one function of the medical instrument. The device can be referred to as a control or switching device. The device comprises a first part and a second part, which are movable relative to the housing, wherein the second part is arranged and configured to be moved into an operative position with respect to the first part and, at the same time, with respect to the housing, in order to activate or deactivate the at least one function of the medical instrument. In the operative position, the second part and the first part work together to activate or deactivate the at least one function.The at least one function can, for example, be the application of electrical power, in particular RF power, to the electrodes of the medical instrument, if the medical instrument has electrodes for sealing and / or cutting tissue. Conversely, the first part is arranged and configured to be moved into an operative position relative to the second part and the housing, thereby activating or deactivating the at least one function of the medical instrument. Here, too, the first and second parts work together to activate or deactivate the at least one function of the medical instrument. Preferably, the other part does not necessarily need to be moved to activate or deactivate the at least one function; rather, the other part can remain in a rest position.The medical instrument is preferably a surgical instrument, particularly preferably an RF surgical instrument, with which one or more of the functions "cutting", "sealing", "devitalizing" and / or "coagulating" can be performed using RF energy.

[0006] In the medical instrument according to the invention, a specific function can be triggered by selectively operating a control section, by means of which the second part is moved into the operative position relative to the first part, and a further control section, by means of which the first part is moved. The control section is preferably separate from the further control section, for example, a separate control element. The control section and the further control section, which are intended for operating the second part and the first part respectively, are preferably arranged on the housing. The control section and the further control section can, for example, be buttons or levers that are elements separate from the housing, or the control section and the further control section can, for example, be sections of the housing.The operating section for moving the second part into the operative position relative to the first part is preferably configured to be moved relative to the housing for the movement of the second part. The further operating section for moving the first part into the operative position relative to the second part is preferably configured to be moved relative to the housing for the movement of the first part. For example, only one push button is required to trigger the function selectively with either one operating section or another. In exemplary embodiments, to trigger the same function, an element for pressing the push button can be pressed against the push button, for example, by means of the operating section, and the push button can also be moved against the element for pressing the push button by means of the further operating section. Compared to a solution with two push buttons, the solution according to the invention requires less space.Furthermore, the electrical connections are simplified. In particular, the wiring can be simplified. The otherwise necessary additional cables, for example for another button, would pose a risk of damaging moving parts. e.g. This would hinder a handle mechanism, if present, and would lead to increased development effort to secure it safely. Compared to a solution with two buttons, the solution according to the invention saves the costs for the additional components such as buttons, circuit board, cables, fixings, and the additional assembly steps, thus achieving lower manufacturing costs.

[0007] The medical instrument according to the invention can be advantageously further developed with one or more of the features described below or according to one or more of the embodiments described below:

[0008] The medical instrument comprises a printed circuit board on which the first part or the second part is arranged, the printed circuit board being movably mounted within the medical instrument. The printed circuit board can be movably mounted, in particular, within a housing of the medical instrument, especially a handle housing. The printed circuit board can be pivotably and / or tiltably and / or articulatedly mounted or supported.

[0009] The first or second part can be arranged on the printed circuit board (PCB), which is populated on one side only. The other side of the PCB can be free of components, such as pushbuttons, apart from electrical traces. Compared to a double-sided PCB, this type can be manufactured at a lower cost. The PCB can also have a pushbutton on at least one side, which can constitute either the first or second part.

[0010] In other embodiments, both sides of the circuit board can be populated with components, but in these embodiments only one side of the circuit board is populated with a push button. is. The button forms be prefers the first part.

[0011] The second part can be attached to a control section, for example a control element, which is movably mounted. is. Alternatively or additionally, the first part can be attached to another operating section, for example another control element, which is movably mounted. is. This eliminates the need for separate movable storage of the first part and / or separate movable storage of the second part.

[0012] In embodiments of the medical instrument, the medical instrument has an operating section for controlling the second part, in particular for moving the second part into its operative position relative to the first part, whereby operating the operating section triggers a further function of the medical instrument. This further function of the medical instrument can, for example, be a mechanical action on tissue, such as grasping tissue between two jaws. The operating section can be purely mechanically coupled to the tool of the medical instrument for performing this further function.

[0013] The control section is preferably operable in such a way that the further function is executed without the function being activated or deactivated by the operation, in particular the movement, of the control section. The medical instrument can, in particular, be designed such that the control section is movable by the user, whereby the further function is executed as a result of a first part of the movement and is only activated or deactivated as a result of a further subsequent part of the movement.

[0014] The medical instrument is preferably designed to provide the user with haptic feedback indicating that further movement of the operating section will activate or deactivate at least one function. The feedback is perceptible to the user, e.g., audibly, visually, or by touch. Preferably, the feedback is perceptible to the hand with which the user operates the instrument.

[0015] Preferably, the medical instrument has a further control section for operating the first part, in particular for moving the first part into the working position relative to the second part. Particularly preferably, operating the further control section does not trigger any further function of the medical instrument.

[0016] A particularly simple design is achieved if the additional operating section is a section of an element that serves as a carrier for the first part or for a printed circuit board that includes the first part. The element or carrier is preferably movably mounted, in particular movably supported, for example, by pivoting.

[0017] Particularly easy operation of the medical instrument is achieved if the control section is movable in a proximal direction to activate or deactivate the function and / or to trigger the subsequent function, and if the subsequent control section is movable in a distal direction to activate or deactivate the function. Alternatively, it would also be possible, for example, if the control section is movable in a distal direction to activate or deactivate the function and / or to trigger the subsequent function, and the subsequent control section is movable in a proximal direction to activate or deactivate the function. The control section and the subsequent control section are preferably arranged on different sides of the instrument, in particular on the instrument's handle, and / or point in different directions, for example, distal and proximal.At the distal end of the instrument, it can have a working section with at least one tool capable of performing at least one function. The operating section is preferably movable away from the working section of the instrument to activate or deactivate the function and / or the further function.

[0018] In preferred embodiments, the operating section for the second part is a section of an element that is movable relative to the element holding the second part. During operation, the element whose section is the operating section for the second part can be pressed against the element containing the second part to move the second part into the operating position relative to the first part, in particular to press the second part against the first part. This allows the movement of the operating section to also serve to activate a further function, for which a different or additional operating movement is necessary than that required for operating the second part.Of course, at least one movable intermediate element can exist between the element whose section is the operating section and the element which holds the second part, which is pressed against the element which holds the second part by means of the element whose section is the operating section, in order to move the second part into the effective position with respect to the first part.

[0019] The medical instrument preferably has an additional device for activating one of the functions of the at least one function. This additional device is preferably operable via an additional control panel. In exemplary embodiments, the "sealing" and "cutting" functions can, for example, be activated by the device, and only the "sealing" function can be activated by the additional device. For example, the device for activating both the "sealing" and "cutting" functions can have a button, and the additional device can have a separate button for activating only the "sealing" function.

[0020] The operating section for moving the second part into the working position relative to the first part is preferably mechanically elastically coupled to a tool to perform the further function of the medical instrument.

[0021] Further advantageous embodiments and preferred features will become apparent from the dependent claims, the following description, and the figures. These show: Figure 1 - an embodiment of an instrument according to the invention in a schematic perspective overall view; Figure 2 - the distal section of the medical instrument according to Figure 1 with the group of tools in enlarged perspective, partially cutaway view; Figure 3 - a side view into the half-opened housing of the handle of the exemplary medical instrument according to Figure 1 .

[0022] The medical instrument according to the invention can in particular be a surgical instrument 10, for example one such as shown schematically and by way of example in the Figures 1, 2 and 3 depicted, act. That in the Figure 1, 2 , 3The illustrated medical instrument 10 has the functions of "grasping tissue," "cutting," and "sealing" tissue and can be referred to as a sealing instrument. Accordingly, the group 12 of tools of the instrument serves to seal and, if necessary, cut tissue, whereby vessels and lumens contained in the tissue are closed and thus sealed at the resulting tissue margin. Although the invention is explained below using a sealing instrument 10 as an example, other medical instruments that do not have the aforementioned functions and / or have other functions can also be further developed according to the invention.

[0023] The medical instrument 10 according to the invention can, as shown in Figure 1The instrument 10, as illustrated by example, has an elongated shaft 11 which carries a group 12 of tools at its distal end. Proximally, the shaft 11 is connected to a handle part 13, which has a housing 14. The instrument 10 includes operating elements 15, 16, 17 (these can also be referred to as actuating elements) for operating the tools of group 12. The medical instrument 10 according to the invention, for example, has a first operating element 15, a second operating element 16, and a third operating element 17, which are arranged, for example, as shown ( Figure 1 and 3 ) can be arranged on the handle part 13. The tools of group 12 for performing the functions can be arranged as in Figure 2The illustrated exemplary medical instrument 10 has a tool for grasping tissue by means of two branches 18, 19, at least one of which is movably mounted. As a further tool, each branch carries electrodes 20 or 21, 22 for sealing tissue, and one branch carries an electrode 23 for cutting tissue.

[0024] The tool with branches 18, 19 for grasping the fabric and the electrodes 20, 21, 22, 23 for cutting and sealing the grasped fabric can, for example, be designed and operate as explained in EP 2 959 854 A1.

[0025] At least one of the branches 18, 19 of the tool for grasping tissue provided on the instrument 10 is pivotably mounted about the pivot axis 24. Figure 2This is the upper branch 18. Depending on the application, the first branch 18 or the second branch 19 or both branches 18, 19 can be pivoted or otherwise mounted about a common or different pivot axes, so that branches 18, 19 can be moved towards and away from each other.

[0026] The first branch 18 has a base body 25 with a U-shaped cross-section. The base body 25 has two mutually parallel first sealing jaws 26, 27, which are preferably electrically connected to each other and which define a groove 28 between them. This groove preferably extends over most of the length of the first branch 18 and serves to receive a cutting electrode holder 29. The groove 28 is bounded by the edges of the sealing jaws 26, 27, on which the sealing electrodes 20 are formed. Based on the illustration in Figure 2Only the sealing electrodes of the first sealing jaw 27 are visible. The sealing electrodes 20 can be electrically connected to the base body 25. The sealing electrodes 20 of the two first sealing jaws 26, 27 form, as shown from Figure 2 emerges, preferably a series of spaced-apart conductive individual surfaces, which are separated from each other by insulating areas 30.

[0027] The cutting electrode holder 29 has a cutting electrode 23 arranged on its end face. The cutting electrode 23 sits in a groove or recess of the wall-like extension 32 of the cutting electrode holder 29. The cutting electrode 23 is exposed at one end face.

[0028] The length of the wall-like extension 32, measured from the base towards the cutting electrode 23, is preferably designed such that the free end face of the cutting electrode 23 facing the second branch 19 extends beyond the sealing jaws 26, 27.

[0029] The second branch 19 also has a base body 35, preferably made of electrically conductive material. The base body 35 again has a U-shaped cross-section in which a groove 38 is formed between two sealing jaws 36, 37. The sealing electrodes 21, 22 are arranged on the electrically preferably interconnected second sealing jaws 36, 37 of the second branch 19 between insulating areas 39, 40.

[0030] In the illustrated embodiment, the first control element 15 is a thumb-operated button (thumb button) or lever that protrudes laterally from the housing 14 of the handle part 13. The first control element 15 is pressed from proximal to distal direction and moved relative to the housing 14 to apply electrical power to an electrode—for example, the electrodes for cutting 23 and sealing 20, 21, 22 in the illustrated exemplary instrument according to the invention—in order to cut and seal tissue. The second control element 16, in the illustrated instrument 10 according to the invention, is located at the bottom of the housing 14 of the handle part 13 and is a finger-operated lever that is pivotally mounted on the housing by means of the pivot bearing 45b.The lever 16 is, for example, mechanically coupled to a tool of the medical instrument in order to mechanically transmit hand force to the corresponding tool. In the illustrated embodiment, the lever 16 is, for example, mechanically coupled to the at least one pivotally movable branch 18 in order to close the branches 18, 19 to grasp tissue by moving the lever 16 in a proximal direction. The second control element 16 can also trigger the same functions that can be triggered by the first control element 15, as described in detail below. The third control element 17, which the medical instrument 10 may have, is, in the illustrated embodiment, a button or lever arranged in front of the second control element 16 for operation with the index finger.When the third control element 17 is moved back in a proximal direction with the index finger, one of the functions that can be triggered by actuating the first control element 15 or by actuating the second control element 16 is preferably activated. For example, by actuating the third control element 17, the "Sealing" function can be triggered by applying electrical power to the sealing electrodes 20, 21, 22, while the cutting electrode 23 is not coupled to the third control element 17 in such a way that actuating the third control element 17 would apply electrical power to the cutting electrode 23.

[0031] Figure 3 Illustrates a partial side view of the embodiment of the instrument 10 according to the invention. Figure 1(The distal working section of the instrument 10 with the group 12 of tools is not shown), in which the interior of the housing 14 is visible through the laterally open housing 14. The instrument 10 has an activation device for activating the "cutting" and "sealing" functions, the first part of which is a push button 41, which is supported by a circuit board 42. The push button 41 is connected to a control unit (not shown) for supplying the electrodes 20, 21, 22, 23 with RF power for "cutting" and "sealing", so that when the contacts of the push button 41 are in the corresponding switching state, the corresponding electrodes 20, 21, 22, 23 are supplied with electrical power.

[0032] The circuit board 42 is preferably only populated with electrical components on one side; in particular, a push button 41 is arranged only on one side of the circuit board 42. The circuit board 42 is preferably mounted on the first control element 15. The first control element 15 has a retaining section 43 arranged in the housing 14 and a control section 44 arranged outside the housing (see figure). Figure 1The first control element 15 is movably, in particular pivotably, held in the housing 14. In the exemplary embodiment, the first control element 15 is pivotally mounted in the housing 14 on a pivot bearing 45a connected to the housing 14. In the illustrated embodiment, the circuit board 42 is attached to the first control element 15, for example, by means of a snap-lock section 46, which engages in an opening (not shown) in the circuit board 42. The circuit board 42 is therefore movably mounted in the housing 14 by means of the first control element 15. Movement of the first control element 15 in the proximal direction can be limited by a stop section (not shown). The stop section can, for example, be attached to or integrally formed with the housing 14. The first control element 15 can be spring-loaded against the stop section in the proximal direction. Figure 3The first control element 15 is shown in its unactivated rest position.

[0033] Opposite the circuit board 42 and the push button 41, a retaining element 47 is arranged, which has an actuating section 48. The actuating section 48 is formed by an actuating section 48 of the retaining element 47. The retaining element 47 is movably held in the housing 14. For this purpose, the retaining element 47 has a spring-loaded section 49, which is connected to the housing 14 at the same point where the first operating element 15 is also connected to the housing 14. The retaining element 47 is designed and arranged so that the actuating section 48 can be moved into an operative position relative to the push button 41. In the illustrated embodiment, the actuating section 48 can be forced against the push button 41 to open or close an electrical contact of the push button 41 in order to activate cutting by means of the cutting electrode 23 and sealing by means of the sealing electrodes 20, 21, 22.The actuating section 48 is pushed against the button 41 by moving the second operating element 16 in a proximal direction, which is thereby pushed against the holding element 47, which is in its rest position (this is in . Figure 3 The retaining element 47 can protrude from the housing 14 (as shown) by extending beyond the housing's contour. The distal movement of the retaining element 47 can be limited by a stop section 50, which may be attached to or integrally formed with the housing 14. In its rest position, the retaining element 47 can be spring-loaded against the stop section 50.

[0034] The second operating element 16 and the retaining element 47 are, as shown, preferably separate elements. The second operating element 16 is arranged, in particular spaced apart from the retaining element 47, such that operating the second operating element 16 from the distal rest position (the second operating element 16 may be biased against a stop in this position, e.g. by means of a compression spring, which is described below) in a proximal direction initially leads to a closing movement of the movable branch 18 without activating the "cutting" and "sealing" functions, and only in the further course of movement of the second operating element 16 does the activation of the "cutting" and "sealing" functions by pressing the button 41 via the retaining element 47 lead to the activation of the functions "cutting" and "sealing".

[0035] The instrument 10 according to the invention can be configured to provide the user with tactile feedback when operating the second control element 16, indicating that further movement of the second control element 16 will activate the "cutting" and "sealing" functions. This can be achieved, for example, by means of a device (not shown) that requires the user to exert noticeably more force by hand to move the second control element 16 towards the holding element 47 in a specific position of the second control element 16, in order to move the second control element 16 further towards the holding element 47 or in a proximal direction.

[0036] The second operating element 16 is preferably mechanically elastically coupled to a tool of the medical instrument, for example, to the pivotable arm 18 of the illustrated instrument 10 according to the invention, in particular by means of a spring element, such as a compression spring 51, in order to transmit the force to the tool, for example, to actuate the arm 18. The elastic coupling, for example, the spring element 51, is designed and intended to substantially determine the stiffness of the transmission path for transmitting the hand force to the at least one pivotable arm.The spring element 51 is characterized by having a smaller spring constant than the other transmission elements for transferring the movement of the second operating element 16 to the tool and is pre-tensioned to such an extent that the desired clamping force between the branches 18 and 19 is reached before it deforms. The movement of the second operating element 16 is converted into a proximal movement of the spring element 51, which in turn is converted into a movement of the tool, for example, branch 18. The elastic deformation of the spring element 51 after reaching the desired clamping force can be achieved, for example, by means of a tension and / or compression stiffening tension and / or compression rod. This leads to a force limitation or a limitation of the force transmission from the second operating element 16 to the tool.Conversely, the mechanical-elastic coupling decouples the tool from the control element 16 in such a way that the control element 16 can still be moved into the position for activating or deactivating the function by pressing the button 41 via the holding element 47, even if the movement of the tool, for example of the branch 18, is obstructed beyond a certain position, for example by fabric that is caught between branches 18 and 19, so that branches 18 and 19 can no longer close further when the second control element 16 is actuated. However, due to the elastic coupling, the control element 16 can be moved into the position for activating or deactivating the "cutting" and "sealing" functions by means of elastic deformation of the spring element 51.

[0037] According to the invention, the user has another way to activate the "Sealing" and "Cutting" functions. The button 41 can be pushed against the actuating section 48, in this example against the actuating section of the retaining element 47, by means of the first operating element 15. This moves the button 41 into an operative position with respect to the actuating section 48 in a direction opposite to the direction of movement of the actuating section 48 for moving it into an operative position with respect to the button 41. When the button 41 is pushed against the actuating section 48 by means of the first operating element 15, the retaining element 47 is supported against the stop section 50.While in the illustrated embodiment a mechanical contact between the button 41 and the actuating section 48 is necessary so that the button 41 establishes or breaks an electrical contact, the button 41 can also be, for example, a capacitive sensor or an inductive sensor, so that it is only necessary for the actuating section 48 to be moved into a specific position (active position) relative to the button 41, or for the button 41 to be moved into a specific position (active position) relative to the actuating section 48 in order to trigger the establishment or breaking of an electrical connection for activation or deactivation by the first part 41, for example capacitively or inductively, without a force acting by the actuating section 48 on the button 41 or a force acting by the button 41 on the holding element 47 being absolutely necessary, so that the button 41 establishes or breaks the electrical connection.

[0038] The instrument 10 preferably has a further activation device with which one of the functions, e.g., "Sealing," can be activated. These functions can be activated by means of the first and second control elements 15, 16. Preferably, activation of the at least one other function (e.g., "Cutting"), which can be activated by operating the first control element 15, is not possible by means of the further activation device. The further activation device can, for example, as shown, have a further circuit board 52 with a further push button 53, wherein the third control element 17 can be moved into an operative position with respect to the further push button 53 by moving the third control element 17 in a proximal direction in order to press the further push button 53, so that the further push button 53 triggers the function.

[0039] The medical instrument 10 according to the invention operates, for example, as follows: To seal and separate tissues, in particular hollow vessels or tissues containing hollow vessels, the tissue is grasped between the jaws 18 and 19. By actuating the second control element 16, the movable jaw 18 is moved towards the other jaw 19 so that biological tissue is grasped between the jaws 18 and 19. The user pulls the lever 16, which forms the second control element 16, towards themselves, i.e., in a proximal direction. The instrument 10 can provide the user with tactile feedback, perceptible to the hand holding the instrument 10, indicating that further retraction of the lever 16 activates the "sealing" and "cutting" functions.For tissue sealing, an electrical voltage, preferably a high-frequency alternating voltage, is applied between branches 18 and 19, so that an electric current flows through the biological tissue between the electrodes 20 of the first branch 18 and the electrodes 21 and 22 of the second branch 19 to heat it and induce fusion of the captured tissue. Simultaneously, the cutting electrode 23 is activated. An electrical voltage, preferably a high-frequency voltage, is also applied to this electrode, the reference potential of which is located on one of the branches 18 and 19, preferably on the second branch 19. dh the sealing electrodes 21, 22. The current density at the end face of the cutting electrode 23 is so high that the biological tissue is quickly cut through.

[0040] The user can also supply the electrodes 23, 20, 21, 22 with RF power for cutting and sealing without pulling the lever 16, which forms the second control element 16, in a proximal direction by pressing the first control element 15. This allows tissue cutting and / or coagulation to be performed even with open branches 18, 19. e.g. to cut large vessels. It is also possible to supply the electrodes 23, 20, 21, 22 with RF power for cutting and sealing by means of the first control element 15 when the branches 18, 19 are partially closed and the second control element 16 is in a position such that the holding element 47 is not yet pressed against the button 41 due to the distance between holding element 47 and second control element 16.

[0041] In addition, the user can activate the sealing of open or partially closed branches 18, 19 by means of the third control element 17, which acts on the further button 53 when pressed.

[0042] According to the invention, a medical instrument 10 is provided which has a device for activating or deactivating a function of the medical instrument. The device has a push button 41 and an actuating section 48, wherein the actuating section 48 is arranged and configured to be moved into an operative position relative to the push button 41 in order to activate or deactivate at least one function of the medical instrument 10, and wherein the push button 41 is arranged and configured to be moved into an operative position relative to the actuating section 48 in order to activate or deactivate the at least one function of the medical instrument 10.The medical instrument 10 preferably has a second control element 16 for moving the actuating section 48 into the operating position, which provides an operating section, and preferably has a first control element 15 for moving the button 41 into the operating position, which provides a further operating section. The first control element 15 is preferably movable in a direction opposite to that in which the second control element 16 is movable for activating the function. This allows the function to be activated, for example, by moving a control element 15 from back to front. dh in a distal direction, and by moving another control element 16 in the opposite direction, from front to back, dhcan be activated in the proximal direction. Therefore, redirecting the force from an actuating element 15, 16 to actuate the first part or the second part in the opposite direction is not absolutely necessary. Reference symbol list:

[0043] 10 instrument 11 shaft 12 group of tools 13 Handle part 14 Housing 15 first control element 16 second control element 17 third control element 18 First industry 19 Second industry 20, 21, 22 Sealing electrode 23 Cutting electrode 24 Swivel axis 25 basic body 26 Sealing jaw 27 Sealing jaw 28 Nut 29 Cutting electrode holder 30 insulating areas 32 extension 35 basic body 36 Sealing jaw 37 Sealing jaw 38 Nut 39 Insulating area 40 Insulating area 41 Button 42 circuit board / printed circuit board 43 Stop section 44 Control section 45a swivel bearing 45b swivel bearing 46 Snap-rest section 47 retaining element 48 Actuating section 49 spring section 50 Stop section 51 Compression spring 52 additional circuit board 53 additional button

Claims

1. A medical instrument (10) with a housing (14) and with a device for activating or deactivating a function of the medical instrument, wherein the device comprises a button (41) and an actuating portion (48), wherein the actuating portion (48) is arranged and configured to be moved into an operative position with respect to the button (41) and thereby with respect to the housing (14) in order to thereby activate or deactivate at least one function of the medical instrument (10), and wherein the button (41) is arranged and configured to be moved into an operative position with respect to the actuating portion (48) and thereby with respect to the housing (14) in order to thereby activate or deactivate the at least one function of the medical instrument (10), wherein a first control element (15) is provided with a holding portion (43) arranged in the housing (14) and a control portion (44) provided outside the housing, wherein the control element (15) is held movably in the housing (14), wherein the button (41) is arranged on a circuit board (42), which is held movably in the housing (14) by means of the first control element (15), wherein the circuit board (42) is equipped with the button (41) on one side, wherein a holding element (47) which is held movably on the housing (14) is arranged opposite the circuit board (42) and the button (41), which holding element (47) has the actuating portion (48).

2. The medical instrument (10) according to anyone of the preceding claims, wherein the medical instrument (10) has a control portion (16) for moving the actuating portion (48) into the operative position with respect to the button (41), wherein a further function of the medical instrument (10) is performed based on the control of the control portion (16).

3. The medical instrument (10) according to claim 2, wherein the control portion (16) is controllable so that the further function is performed without the function being activated or deactivated due to the control of the control portion (16).

4. The medical instrument (10) according to claim 3, wherein the medical instrument (10) is configured to convey to the user, for example perceptibly with the controlling hand, that upon further movement of the control portion (16) the at least one function is activated or deactivated.

5. The medical instrument (10) according to anyone of the preceding claims, wherein the medical instrument (10) comprises a further control portion (44) for moving the button (41) into the operative position with respect to the second part (48), wherein the control of the further control portion (44) does not trigger the execution of any further function of the medical instrument (10).

6. The medical instrument (10) according to anyone of the preceding claims 2 to 5, wherein the control portion (16) is movable in a proximal direction to activate or deactivate the function and / or to trigger the further function, and wherein the further control portion (44) is movable in a distal direction to activate or deactivate the function.

7. The medical instrument (10) according to claim 2, wherein the control portion (16) for controlling the second part (48) is a portion of an element (16) which is movable with respect to the holding member (47) which comprises the actuating element (48).

8. The medical instrument (10) according to anyone of the preceding claims, wherein the medical instrument (10) comprises a further device (53, 17) for activating a function of the at least one function.