CAIMAN RING FORCEPS - MANUAL HF ACTIVATION

Description

Technical area

[0001] The present disclosure relates to a (medical) bipolar HF instrument, preferably of the scissors or forceps type, having a first and a second (crossing in a hinge) instrument branches, which form or have a jaw part, for example for grasping tissue, at a distal instrument end section and holding / actuating geometries (handles, finger rings, etc.) at a proximal instrument end section, all of which are intended and designed to move away from one another when opening and towards one another when closing for manual cutting and (HF) sealing of tissue, in particular in open surgery. Background of the Revelation

[0002] Generally, surgical sealing and cutting instruments of the above type are known, which use a high-frequency (HF) current for sealing using bipolar technology and a mechanical blade for cutting (biological) tissue. These instruments feature automatic, continuous activation when the jaws are pressed together. A blade lock is often integrated into the instrument as a safety precaution when the jaws are open. A further HF button is provided, which generally provides tactile feedback in two stages (2-click button). The first click indicates to the user that a defined closing state has been reached, and a second click activates the HF current. This state-of-the-art surgical instrument enables rapid operation, particularly for experienced users.The surgical instrument has clearly separated functions for cutting and sealing and low manufacturing costs.

[0003] Alternatively, there is a surgical instrument that uses ultrasound for sealing and incision, with the sealing and incision being manually activated continuously. Furthermore, this surgical instrument offers the choice between a MIN or MAX mode on the instrument. This is advantageous because it prevents accidental activation during closing, especially since the user has a free choice, thus providing greater control and safety.

[0004] However, the known surgical instruments have the disadvantage that they require the RF button to be held continuously, which can be ergonomically unfriendly and tiring for the user over time, especially since multiple activations per operation are conceivable. Another disadvantage can be the variation in the applied pressure. The user can vary the actuation pressure on the instrument / its blades through their hand force, potentially negatively influencing the sealing result. Accidental RF activation due to excessively rapid compression, as well as a preferred orientation during handling due to the asymmetrical arrangement of the blade actuation element, are further disadvantages. State of the art

[0005] US 10 188 450 B2 describes a forceps having a first and a second shaft (branch), each having a jaw member disposed at a distal end thereof. At least one jaw member is movable from an open to a closed position to grasp tissue therebetween. At least one jaw member is configured to reciprocate a blade. A trigger assembly includes a trigger and at least one linkage connected to the trigger and the blade such that rotation of the trigger translates the blade between the retracted and extended positions. An engaging member movable between a locked position and an unlocked position is also provided. The engaging member is configured to engage the linkage(s) in the locked position to prevent translation of the blade from the retracted to the extended position.

[0006] US 10 660 694 B2 describes a switch assembly for an electrosurgical instrument comprising a switch housing, a switch, a first biasing element, and an additional biasing element. The switch is disposed within the switch housing and is movable between an activated position for initiating delivery of electrosurgical energy and a deactivated position for terminating delivery of electrosurgical energy. The first biasing element is selectively positionable adjacent to and in communication with the switch. The first biasing element includes a first thickness providing a first resistance to resist movement of the switch between the activated and deactivated positions when positioned within the switch housing. The additional biasing element is selectively interchangeable with the first biasing element.The additional biasing element has a different thickness that provides different resistance to resist movement of the switch between the activated and deactivated positions when positioned in the switch housing.

[0007] From EP 2 671 528 B1 and EP 2 436 330 B1, a bipolar electrosurgical instrument is known, comprising a first and a second shaft (branch), each having a jaw element extending from its distal end. Each jaw element is adapted to connect to a source of electrosurgical energy such that the jaw elements are capable of selectively conducting energy through the tissue held therebetween. A knife channel is configured to reciprocate a cutting mechanism therein. An actuator selectively advances the cutting mechanism. A switch is disposed on the first shaft and configured to be depressed between a first position and at least one subsequent position upon biasing engagement with a mechanical interface disposed on the second shaft.The first position of the switch provides information to the user corresponding to a desired pressure on the tissue, and the at least one subsequent position is configured to activate the source of electrosurgical energy to deliver electrosurgical energy to the jaw members.

[0008] US 7 253 667 B2, US 9 498 279 B2, US 2019 0356 952 A1, WO 2019 224 634 A1, EP 1 609 430 B1, US 2019 0357 969 A1, WO 2019 224 636 A3, US 2019 0357 967 A1 and WO 2019 224 637 A1 also describe generic electrosurgical instruments according to the introductory part of claim 1. The above-mentioned WO 2019 224 634 A1 discloses operating options on both sides. Brief description of the revelation

[0009] The present disclosure is based on the object of providing a bipolar RF instrument that enables simplified operation, especially over a longer period of time, and furthermore, the orientation of the instrument for use is irrelevant. Furthermore, it is a particular aim of the present disclosure to eliminate or at least improve the above-mentioned disadvantages of the prior art.

[0010] This object is achieved by a bipolar HF instrument having the features of claim 1.

[0011] Accordingly, the bipolar HF (hand-held) instrument has a jaw part (for grasping! holding! gripping tissue), as well as a first instrument branch and a second instrument branch (for manually actuating the jaw part), which are (all) intended and designed to move away from one another when opened and towards one another when closed. In addition, a blade actuating element / blade actuating lever or (sliding) button is provided for activating a mechanical blade mounted in the jaw part for cutting tissue, wherein the mechanical blade is intended and designed to be movable by means of the blade actuating element from a first position (parking / non-cutting position) to a second position (cutting position). Furthermore, an HF activation element or activation button / knob / switch is provided for activating / unlocking an HF current supply, in particular for sealing (coagulating) tissue and, if necessary.A locking device, preferably designed separately for this purpose and acting on the branches, is provided in order to (optionally) achieve a locked branch state when the instrument branches are closed.

[0012] The basic idea of ​​the present disclosure is that the RF activation element and preferably the blade actuation element are provided and designed such that they can be operated from two, preferably opposite (or opposite to each other) sides of the RF instrument in a more preferably identical or similar manner. This has the advantage that the mechanical blade can always be operated in the same way, regardless of which way or in which hand the instrument is held. Accordingly, there is no preferred orientation or position of the instrument. This also applies to handling by right- or left-handed persons. In other words, it is irrelevant how a user holds the bipolar RF instrument, since operation always functions in the same way due to the bilateral design of the blade actuation element and the RF activation element.

[0013] In other words, the present subject matter according to the disclosure is a surgical (hand-held) instrument of the scissors or forceps type with bipolar HF technology and a mechanical (tissue-cutting) blade. By opening and closing the instrument branches, the jaw part is also opened and closed. In the closed state, tissue can be grasped and sealed by means of HF (high-frequency energy supply) via electrodes arranged in the jaw part. The jaw part also enables preparation and manipulation of the tissue. In the closed state of the jaw part, the tissue can also be cut using the blade mounted in the jaw part. The actuating devices for the separate and individual manual actuation of the HF power supply and the blade are designed and arranged in such a way that on two respectively opposite oropposite sides of the instrument result in essentially the same actuation geometry with essentially the same function / effect on the HF power supply and the blade. In this regard, it is expressly pointed out that the mirroring of the actuation geometry described above does not necessarily only occur two-dimensionally, but can also occur three-dimensionally. In other words, both actuation devices for actuating the HF current and the blade, for example, on the left and right of the instrument, can be arranged essentially the same (mirror-image) (two-dimensional duplication), or only one actuation device (blade actuation if applicable) can be arranged on the left and right of the instrument and the other actuation device (HF power supply if applicable) above and below the instrument (each mirror-image) (three-dimensional duplication).

[0014] The mechanical blade is movable from a first position to a second position by means of the blade actuating element. The blade actuating element is moved linearly from its distal resting position to the proximal position. The mechanical blade moves linearly from its proximal resting position to the distal position, allowing it to cut tissue grasped in the jaws.

[0015] Furthermore, the instrument preferably has a permanently installed locking device in the form of a passage lock. With the help of the lock, the instrument branches can be locked in a defined state (relative position). To lock, the instrument branches are closed until the locked state is reached. To unlock, the branches are pressed together again slightly until the lock is released. The design of the locking device / lock / passage lock is sufficiently known from the prior art and therefore needs no further description. It has the significant advantage that it can be used to create a defined closed state in which fluctuations in the closing force are to be expected only to a small extent. This, in turn, has the advantage of increasing the sealing quality and ensuring consistent performance.In addition, the locking mechanism allows the user to securely hold tissue without triggering RF activation. Another advantage is that the user can relax their hand when the locking mechanism is closed. There's no need to constantly squeeze the instrument. This makes this invention particularly ergonomic.

[0016] Further aspects of the present disclosure are described below according to the subclaims.

[0017] It is advantageous if the locking device consists of a male and a female part. In other words, HF can be activated and cutting can take place when the device is closed and locked. Typically, HF is activated first, followed by sealing. For this purpose, the HF activation element is moved proximally. Tap activation is preferably provided so that the user only has to press the button once and does not have to hold it down continuously. An HF generator with its integrated algorithm takes over the logic and switches itself off after a successful seal. However, the user always has the option of stopping the sealing process by tapping the HF activation button again. Cutting can take place in a second step. For this purpose, the blade actuating element is pulled proximally.Both the RF activation element and the blade actuation element are automatically reset, preferably by springs.

[0018] It is preferred if the sealing and / or cutting functions can be used independently of each other. In other words, the user has the freedom to use the sealing and / or cutting functions independently of each other.

[0019] It is preferred if a first rack-and-pinion gear system is provided and arranged in the first instrument branch, in which an input rack is connected to the blade actuating element and an output rack is connected to the mechanical blade, wherein the blade actuating element is linearly movable from a distal rest position to the proximal position. In other words, the required deflection mechanism in the first instrument branch is a rack-and-pinion gear system, in which the input rack is attached to the blade actuating element and the output rack is attached to the mechanical blade.

[0020] It is advantageous if the input rack and the associated blade actuating element are arranged approximately on the plane of symmetry between the first instrument branch and the second instrument branch.

[0021] In other words, the rack-and-pinion mechanism represents a significant advantage for the symmetrical use of the instrument. The arrangement of the input rod and the associated blade actuation element, approximately on the plane of symmetry between the first and second instrument branches, offers the significant advantage that the blade can always be actuated in the same way, regardless of which way the instrument is held. There is no preferred orientation or position of the instrument in this regard. This also applies to right- or left-handed use.

[0022] It is preferred if the bipolar HF instrument also has a blade lock configured to block the actuation of the mechanical blade in an open state and to allow the mechanical blade to move in a defined closed state. Two different safety concepts are provided that can be implemented in the bipolar HF instrument.

[0023] An initial safety concept allows blade actuation as soon as the jaws are sufficiently closed, for example, when they touch. HF activation / actuation is always possible in principle. This means there is no locking of the HF activation element. Alternatively, it is provided that HF ​​can be activated when the instrument is not locked. This allows the user more application options, but also carries the risk of HF activation with insufficient closing force. The fixed locking mechanism enables a defined closing state.

[0024] In a second safety concept, both blade actuation and HF actuation are only possible when the instrument is in the locked position of the permanently installed locking device. This ensures that both a cut and HF sealing are only possible in a clearly defined closed state, thus guaranteeing maximum safety. However, this option limits the user's options. Experienced users in particular may perceive this safety concept as a significant limitation. Therefore, it is preferable to use the first safety concept for experienced users and the second safety concept for less experienced users.

[0025] Preferably, the RF activation element is designed and provided in such a way that it can be moved or pivoted or displaced proximally when sealing is carried out.

[0026] It is advantageous if the RF activation element is designed and provided in such a way as to activate the RF power supply after a first tap activation and to switch it off automatically, preferably by means of an integrated algorithm, after successful sealing or to manually stop the RF power supply after a second tap activation of the RF activation element before successful sealing.

[0027] According to the invention, the HF activation element has an inner part which is mounted in a rocking, sliding or pivoting manner on a rotational axis of the HF activation element in the second instrument branch orthogonal to the proximal-distal direction, wherein the side of the inner part facing in the direction proximal to the instrument has a contacting element with an activation surface which contacts a first HF activation button upon actuation of the HF activation element and activates the HF power supply.

[0028] In other words, the design and positioning of the RF actuation button also aims to enable fully symmetrical operation of the instrument and to avoid the need for a preferred orientation of the instrument.

[0029] According to a first preferred embodiment, the RF activation element is mounted in the second branch, rocking around an axis, and can be reached equally easily from both sides of the instrument. Furthermore, positioning the RF activation element in only one instrument branch offers the advantage that the RF activation cabling is also located in only one instrument branch. This significantly reduces the effort and costs compared to a concept with actuation buttons / RF activation knobs in both instrument branches.

[0030] According to the invention, the inner part of the RF activation element has a first wing and a second wing, wherein the first wing protrudes laterally on the second instrument branch and the second wing protrudes opposite the first wing on the other side of the second instrument branch.

[0031] In other words, the RF activation element consists of several parts: an inner part and a first and a second wing. Alternatively, a one-piece design is also conceivable under different installation conditions.

[0032] Alternatively, it is conceivable to design the RF activation element as a slider that can be moved linearly in the proximal and distal directions. For this purpose, it is advantageous if the RF activation element is movably guided, for example, in a slot in a housing of the second instrument branch. This has the advantage that exactly one electronic RF activation button is required.

[0033] The activation surface of the RF activation element according to the above embodiment is intended to press the first (electronic) RF activation button.

[0034] According to the invention, the contacting element is provided and designed in a cam-shaped manner in the direction towards the first HF activation button.

[0035] In an alternative example not belonging to the invention, a second rack and pinion gear is placed distally to the first RF activation button in such a way as to contact the activation surface upon actuation of the RF activation element.

[0036] In other words, an alternative embodiment with exactly one electronic RF activation button is possible. For this purpose, the inner part of the RF activation element has a type of cam or similar device that engages with the first RF activation button upon rotation / pivoting about the rotation axis of the RF activation element. An additional return spring is provided and may be necessary.

[0037] An alternative embodiment not belonging to the invention, using (exactly) a first RF activation button, is provided with a rack and pinion gear. The inner part of the RF activation element is also rotatably mounted and connected to a gear. Two racks are positioned on two sides of the gear, each of which can transmit its movement to a contacting element / activation element / pressure plate. The contacting element then actuates the first RF activation button. Depending on the design of the RF activation button, the contacting element may be superfluous, and the racks can press directly onto the RF activation button. To ensure reliable operation, it is advantageous if the racks are equipped with return springs.

[0038] It is advantageous if a second HF activation button is provided and arranged next to the first HF activation button, parallel to the inner part of the HF activation element. In other words, the activation surface of the contacting element exerts a force on one of the two HF activation buttons by twisting / pivoting / displacing the HF activation element, thereby triggering activation of the HF process. By twisting / pivoting / displacing the HF activation element again, the HF process can also be stopped manually if necessary. In addition to the fully symmetrical design, the above embodiment has the advantage that the HF activation element can be actuated by both pulling and pushing. This offers the user several ergonomic operating options.

[0039] It is preferred if a return to a non-actuated rest position is provided via an integrated spring in the RF activation buttons. Alternatively, an additional return spring in the form of a sheet / leaf spring, a torsion spring, or similar can be provided.

[0040] It is therefore advantageous if the inner part of the RF activation element is supported by a spring element, for example a compression spring. This has the advantage that the spring element causes the entire RF activation element to protrude slightly in the axial direction of its axis of rotation. As a result, the activation surface, which would press on the first and / or second RF activation button, is disengaged, and when the RF activation element is actuated in this position, no RF energy supply can be activated. In a closed state, the RF activation element is pressed in the second instrument branch. In this position, the activation surface is re-engaged with the first and / or second RF activation button by closing the first and second instrument branches and the resulting compression of the compression spring into the second instrument branch.It is advantageous if the RF activation element has a separate return spring that permanently forces it into a rest position where the wings of the RF activation element are perpendicular to the main plane of the instrument. The return spring can be a leaf spring, tension spring, torsion spring, or similar.

[0041] It is advantageous if a commercially available electronic button can be used for the first RF activation button and / or the second RF activation button.

[0042] It is preferred if the first RF activation button and / or the second RF activation button are arranged in the proximal direction away from the inner part of the RF activation element, but facing it, on a circuit board in the second instrument branch. In other words, it is preferred that the first RF activation button and / or the second RF activation button are located on a circuit board on which they are interconnected using an OR logic. This ensures that an action occurs regardless of which of the RF activation buttons is pressed.

[0043] Alternatively, it is preferred if the RF activation element is designed in the form of a lever. In this case, it is provided that the position of such a lever can be switched as soon as the bipolar RF instrument is rotated, so that fully symmetrical actuation of the instrument is also possible. The lever is therefore located on both sides of the instrument or the second instrument branch. In this regard, it is advantageous if a first and a second RF activation button are provided in the instrument branch or in the housing of the instrument branch, which are opposite one another in such a way that, when the lever is in a first position, the first RF activation button is pressed when actuated, and when the lever is in position 2, the second RF activation button is pressed when actuated.Switching from position 1 to position 2 is preferably achieved by a snap mechanism so that the lever can be noticeably locked into the defined positions.

[0044] It is preferred if, according to the second security concept, the installation of an RF activation element lock is provided. In other words, a locking element prevents the RF activation element from being activated in the open state. In a closed state, activation is enabled.

[0045] It is advantageous if the locking element has a plunger that protrudes from a handle shell of the second instrument branch and can be brought into contact with an opposite handle shell of the second instrument branch when the instrument is closed. A locking element, for example a pin, is provided next to the plunger. The pin is intended and designed to interact with a bore in the inner part of the RF activation element. In an open state, the pin is located in the bore and twisting / actuation of the RF activation element is not possible. In a closed state, the plunger pushes the pin out of the bore and twisting / actuation of the RF activation element is possible. In this case, it is preferred if the locking element is equipped / designed with guide elements on two sides in order to prevent twisting of the locking element.

[0046] It is preferred if the blade actuating element has a different shape than the RF activation element. Preferably, the blade actuating element is round and the RF activation element has a different shape, e.g., a rectangular shape. Furthermore, it is additionally or alternatively preferred if the RF activation element has a different color, preferably blue, than the rest of the instrument, particularly since blue is usually associated with RF activation in surgery. Furthermore, it is advantageous if the RF activation element is additionally or alternatively provided at a sufficient distance from the blade actuating element. These differences have the advantage that the risk of confusion between the blade actuating element and the RF activation element can be reduced as much as possible.

[0047] It is preferred if the distance of the blade actuating element to a handle of the first instrument branch is 76 ± 20 mm and the distance of the RF activation element to the handle of the first instrument branch is 42 ± 20 mm.

[0048] It is advantageous if the RF activation element is sealed against the ingress of liquids, in particular blood, water, saline solution, etc. It is preferred if the first and second handle shells of the first and / or second instrument branch are provided with a seal all the way around. Alternatively or additionally, a seal is only present in the area of ​​the RF activation element. In other words, due to the use of the instrument in open surgery, another important aspect for the RF activation element is its sealing against the ingress of liquids. It must therefore be ensured that the ingress of liquid does not lead to unwanted RF activation. For this purpose, the RF activation element is provided with an appropriate seal. Sealing the handle shells with seals, for example TPE, is preferred.The seals can be applied around the entire contour of the handle shells and / or only in the area of ​​the RF activation element. The seal can be molded into one of the handle shells or be a separate part that is inserted during assembly. The sealing effect is achieved by pressing or screwing it onto the second handle shell.

[0049] Alternatively or additionally, it is preferred if the first and / or second RF activation buttons used are already sealed at the factory. In other words, the use of sealed RF activation buttons that are already sealed at the factory is provided. In this case, the circuit board to which the RF activation buttons are applied / soldered must also be sealed to prevent a short circuit at the circuit board's terminals. For this purpose, it is preferred if the circuit board is encapsulated, for example, with a plastic material.

[0050] Alternatively or additionally, it is preferred if a seal is provided on an axis / shaft of the inner part of the RF activation element with an elastomer sealing ring (O-ring).

[0051] Alternatively, the present disclosure relates to a bipolar HF instrument that can be used alternatively. The bipolar HF instrument is provided with a jaw part having a first instrument branch and a second instrument branch for grasping tissue, which are provided and configured to move away from each other upon opening and toward each other upon closing, a blade actuating element for activating a mechanical blade in the jaw part for cutting tissue, which blade is provided and configured to be movable from a first position to a second position by means of the blade actuating element, precisely two HF activation buttons for activating an HF power supply for sealing tissue, and a preferably switchable locking device for achieving a locked state when the instrument branches are closed.wherein the blade actuating element and the RF activation element are provided and designed symmetrically so as to be equally operable from both sides of the RF instrument, wherein one RF activation element is mounted laterally on each of the first and second instrument branches.

[0052] In other words, to improve ergonomics, the HF activation element can be placed laterally on the first and second instrument jaws. This also makes the instrument fully symmetrical. This embodiment preferably has a switchable locking device, which can be rotated using a proximally mounted rotary lever. To ensure that the user applies sufficient closing force when the locking device is switched off, an additional control device, here in the form of a third button, is provided. The third button is connected to the HF activation buttons in an AND logic and must be permanently pressed so that the HF energy supply can be activated. Sensors such as pressure sensors, distance sensors, or similar are provided as additional or alternative control devices. This provides the user with as many application options as possible. Short description of the characters

[0053] Fig. 1 shows a bipolar HF instrument in the open and unlocked state. Fig. 2 shows the bipolar HF instrument in the closed and unlocked state. Fig. 3 shows the bipolar HF instrument in closed and locked state. Fig. 4 shows the bipolar RF instrument with open instrument branches. Fig. 5 shows the bipolar HF instrument with open instrument branches and the blade, with part of the first instrument branch and the jaws hidden. Fig. 6 shows an RF activation element according to a first embodiment. Fig. 7 shows a top view of an RF activation element with additionally shown electronic buttons and circuit board according to the first embodiment. Fig. 8 shows an RF activation element according to a second embodiment. Fig. 9 shows an RF activation element by means of a rack and pinion gear according to a third embodiment. Fig. 10 shows an RF activation element as a slider according to a fourth embodiment. Fign. 11A und 11 B show the HF instrument with a lever as the HF activation element. Fig. 12 shows the HF instrument from the direction from above. Fig. 13 shows the arrangement of the RF activation buttons and the lever as the RF activation button. Fign. 14 und 15 show the bipolar HF instrument with an HF activation element according to a second safety concept. Fign. 16 und 17 show the RF instrument with an RF activation element locking element. Fig. 18, 19 und 20 show the activation element locking element. Fig. 21 shows the inner part of the RF activation element. Fig. 22 shows the distances between the individual components of the HF instrument. Fig. 23 shows the RF activation element with a seal of the RF activation element. Fig. 24 shows an RF activation button. Fig. 25 shows the inner part of an RF activation element with sealing ring. Fig. 26 und 27 each show another alternative embodiment of the HF instrument. Fig. 28 shows the HF instrument according to Fig. 1 - Fig 5 in a top view. Description of the embodiments

[0054] Hereinafter, embodiments of the present disclosure will be described based on the accompanying figures.

[0055] Fig. 1 shows a bipolar HF instrument 1 of the scissors or forceps type in the open and disengaged state. The bipolar HF instrument 1 has a jaw part 2, a first instrument branch 3, and a second instrument branch 4, which are coupled to the jaw part via a gear or integrally. By opening and closing the first instrument branch 3 and the second instrument branch 4, they pivot by a not further Fig. 1 The hinge shown also opens and closes the jaw part 2 accordingly. When closed, the jaw part 2 can grasp / hold tissue and be sealed by applying RF energy to electrodes (not shown) in the jaw part 2. This RF technology is well known from the prior art, for example, according to the present applicant.

[0056] The first instrument branch 3 and the second instrument branch 4 each further have a ring-shaped instrument actuation eyelet 20 in the proximal half of the instrument branches 3 and 4, into which the fingers of an operating hand can be inserted. Other instrument actuation forms are of course also conceivable, such as open brackets or through-passage slots in the instrument branches 3, 4.

[0057] In the instrument 1, a mechanical blade 6 is provided, particularly in the area of ​​the jaw part 2, which is movable preferably in the longitudinal direction of the instrument by means of a blade actuating element / button / knob 5. The mechanical blade 6 is intended to cut the tissue grasped in the jaw part 2. The arrangement of the mechanical blade 6 is shown in Fig. 5 shown in more detail.

[0058] The blade actuating element 5 is arranged in the first instrument branch 3. The blade actuating element 5 is designed to be moved linearly from its distal rest position to the proximal direction (ie in the direction away from the jaw part 2 / away from the patient). Fig. 1 The blade actuating element 5 is mounted for longitudinal displacement within a slot 21 formed in an instrument branch 3. The blade actuating element 5 is arranged between the jaw part 2 and the annular instrument actuating eyelet 20 of the first instrument branch 3 on the side adjacent to the second instrument branch 4. The blade actuating element 5 is preferably according to Fig. 1 designed as a pin protruding laterally from the instrument branch 3.

[0059] The jaw part 2 of the bipolar HF instrument 1 further comprises HF stranded wires (not shown) that are supplied with HF energy upon activation of an HF activation element 7 and transmit this energy to the electrodes in the jaw part 2. The HF stranded wires are connected to the flat plugs 22. Each HF stranded wire is connected to an element of the jaw part 2. The elements of the jaw part 2 are electrically insulated from one another (insulation not shown).

[0060] The HF activation element 7 is arranged in / on the second instrument branch 4 on the side adjacent to the first instrument branch 3. Here, the HF activation element 7 is placed closer to the annular instrument actuation eyelet 20 than the blade actuation element 5 and its associated slot 21 in the first instrument branch 3. The HF activation element 7 is preferably according to Fig. 1 designed as a rectangular touch button.

[0061] Finally, the bipolar HF instrument 1 has a locking device 8 of generally known construction at the level of the ring-shaped instrument actuation eyelets 20. The locking device 8 has a male part 8A and a female part 8B, which Fig. 4 are shown in more detail. The locking device 8 is provided on the instrument branches 3 and 4 facing each other. In Fig. 1 the locking device 8 is shown in a disengaged state.

[0062] Fig. 2 shows the bipolar HF instrument 1 in the closed and (not yet) locked state of the locking device 8. In Fig. 2 the HF instrument 1 is according to Fig. 1 shown, with the first instrument branch 3 and the second instrument branch 4 still closed. However, the jaw part 2 is already closed, whereby the closing force has not yet reached a certain value. Fig. 2 In the closed and unlocked state shown, it may already be possible to cut and activate HF, depending on the safety concept used.

[0063] When the instrument branches 3 and 4 are closed further, the locking device 8 engages completely. Fig. 3 shows the bipolar HF instrument 1 in such a closed and locked state. In Fig. 3 the HF instrument 1 is according to Fig. 1 und Fig. 2 , wherein the first instrument branch 3 and the second instrument branch 4 are completely closed. The locking device 8 is engaged. In the engaged state, the blade actuating element 5 and the RF activation element 7 are located almost midway between the two instrument branches 3 and 4 (i.e., essentially on the plane of symmetry of the instrument 1).

[0064] In Fig. 3 A solid arrow pointing proximally from the blade actuating element 5 is shown. This arrow represents the direction of movement of the blade actuating element 5 to move the mechanical blade 6 for cutting. A dashed arrow pointing distally, parallel to the solid arrow, indicates the direction of the return path of the blade actuating element 5 to return the blade 6 to its rest position.

[0065] In Fig. 3 In addition, a short, solid arrow pointing proximally from the RF activation element 7 is shown. This arrow represents the direction of movement of the RF activation element 7 to activate the RF energy supply. A dashed arrow pointing distally, parallel to the short, solid arrow, indicates the direction of the return path of the RF activation element 7.

[0066] Fig. 4 shows the bipolar HF instrument 1 with open instrument branches 3 and 4 in longitudinal section. The first instrument branch 3 and the second instrument branch 4 each consist of two half-handle shells, each enclosing a hollow space, whereby Fig. 4 the inner workings of the first and second instrument branches 3 and 4 can be seen.

[0067] In Fig. 4 shows the handle shell of the first instrument branch 3 with a first rack and pinion gear 9 with an input rack 10 and an output rack 11. The input rack 10 is connected to the blade actuating element 5 (in Fig. 4 not shown). The output rack 11 is connected to the mechanical blade 6 (in Fig. 4 not shown). The input rack 10 and the output rack 11 are connected to one another via an intermediate gear 12 such that when the blade actuating element 5 is actuated by a user in the proximal direction, the mechanical blade 6 is moved distally from its proximal rest position in order to cut the tissue grasped in the jaw part 2. The rack and pinion gear 9 serves as a deflection mechanism in the first instrument branch 3. A return spring 5A is also provided for the protruding blade mechanism in such a way as to automatically force the blade actuating element 5 and thus the blade 6 back into their respective rest positions.

[0068] In Fig. 4 shows the handle shell of the second instrument branch 4 with the interior of the HF activation element 7. In detail, an inner part 7A of the HF activation element 7 is indicated, which is arranged distally to a first HF activation button 15. If a second HF activation button 16 is provided, this is arranged laterally next to the first HF activation button 15 shown and therefore in Fig. 4 not visible. The RF activation button 15 shown is arranged on a circuit board 17. If a first and a second RF activation button 15, 16 are provided, they are interconnected via the circuit board 17 using an OR logic. A flat plug 22 is also provided in both the first instrument branch 3 and the second instrument branch 4 to contact the RF strands of the jaw part 2.

[0069] Furthermore, Fig. 4 The locking device 8 in longitudinal section. The locking device 8 has a male part 8A on the side of the first instrument branch 3 and a female part 8B on the side of the second instrument branch 4. When pressed together, the two parts 8A and 8B engage with each other. By pressing them together again, the locked state can be released again by means of a built-in return spring 8C.

[0070] Fig. 5 shows the bipolar HF instrument 1 with open instrument branches 3 and 4 and the blade 6, whereby part of the first instrument branch 3 and the jaw part 2 are hidden. Fig. 5 shows the same components as already Fig. 4 explained. Also shown is the mechanical blade 6, which is arranged in the jaw part 2 and in the first instrument branch 3 and is connected to the output rack 10.

[0071] Fig. 6 shows an HF activation element 7 according to a first embodiment not belonging to the invention. The HF activation element 7 has an inner part in the form of a crossbar 7A, which connects a first actuating wing or button 7B and a second actuating wing or button 7C to one another. According to this embodiment, one end of the crossbar-shaped inner part 7A is glued and / or pressed into / on the first actuating wing 7B or the second actuating wing 7C. The first actuating wing 7B and the second actuating wing 7C are arranged outside and laterally, i.e. on the opposite or mutually remote sides of the second instrument branch 4. The inner part 7A is located in the interior of the second instrument branch 4. In the direction proximal to the HF instrument or in Fig. 4 A contacting element 13 with an activation surface 14 is attached to a central section of the inner part 7A in the downward direction. If the user activates the HF activation element 7, the contacting element 13 connected to the inner part 7A presses the activation surface 14 onto the HF activation button 15 (in Fig. 6 not shown) and the RF energy delivery is activated.

[0072] The contacting element 13 is formed and mounted on a central axis 19 of the HF activation element 7, i.e., centrally on the inner part 7A, in a T-shape relative to the latter, as already indicated above. The activation surface 14 is arranged on the side of the contacting element 13 facing the HF activation button 15. The HF activation element 7 is mounted in a rocking manner along the central axis 19 in the second instrument branch 4, such that the two actuation wings 7B and 7C protrude laterally from the second instrument branch and can thus be reached and actuated equally well from both sides of the instrument 1.

[0073] Fig. 7 shows the RF activation element 7 according to the first embodiment. According to Fig. 7 A cross-bar-shaped inner part 7A of the RF activation element 7 is shown, with a first actuating wing 7B and a second actuating wing 7C. A contacting element 13 with the activation surface 14 is attached or formed on the inner part 7A centrally on the inner part 7A of the RF activation element 7 in the direction of a first and a second RF activation button 15.

[0074] In this embodiment, a first and a second RF activation button 15, 16 are provided, which are arranged next to each other and in Fig. 7 below the activation surface 14, ie according to the Fig. 5 are arranged proximal to the activation surface 14. Both HF activation buttons 15, 16 are arranged on a (single) circuit board 17. Two connections 23 are provided on the circuit board 17, which serve for the power supply. By twisting / pivoting / rocking the HF activation element 7 in the longitudinal direction of the central axis 19, regardless of which actuation wing 7B, 7C on the opposite side of the instrument 1 the user uses, the activation surface 14 presses on one of the two HF activation buttons 15, 16, thereby enabling the HF current to the electrodes in the jaw part 2.

[0075] Fig. 8 shows an HF activation element 7 according to a second embodiment of the invention. The second embodiment corresponds almost to the first embodiment, with the difference that the contacting element 13 is formed with two cam-shaped projections arranged next to one another, which surround the HF activation switch 7 on the outside (without contact), so that the contacting element 13 or its projections come into contact with the HF activation button 15 when the HF activation element 7 is actuated with a corresponding rocker movement of the cross-bar-shaped inner part 7A. Due to the double cam-shaped contacting element 13, exactly one electronic HF activation button 15 is sufficient and contact of the activation surface 14 on the side facing the HF activation button 15 with the HF activation button 15 is ensured.

[0076] On the distal side of the inner part 7A opposite the contacting element 13 (in all embodiments of the RF activation element 7 described above), two return springs 7D are provided which are spaced apart in the transverse direction of the instrument and are supported on the one hand on the second instrument branch 4 and on the other hand on the cross-bar-shaped inner part 7A in order to force the RF activation element 7 back into the (contactless) starting position, regardless of which side of the instrument 1 the RF activation element 7 is actuated from.

[0077] Fig. 9 shows an RF activation element 7 with a second rack and pinion gear 18 according to a third embodiment not belonging to the invention. The second rack and pinion gear 18 has a first rack 24 and a second rack 25, which are opposite one another and are operatively connected to one another at distal end sections via a gear 26. At the distal ends, at which the gear 26 is located, a return spring 7D acting in the proximal direction is attached to both the first rack 24 and the second rack 25. At the other, proximal ends of the first rack 24 and the second rack 25, a contacting element 13 is provided with an activation surface 14 facing an RF activation button 15 arranged proximal to the RF activation element 7. The RF activation button 15 is arranged on a circuit board 17.This means that the protruding rack and pinion gear 18 is provided in the second instrument branch 4 such that the HF activation button 15 is arranged proximal to the rack and pinion gear 18. Finally, an actuating element 7A in the form of a crossbar is shown, which protrudes from one side of the second instrument branch and is connected to the pinion. Another actuating element of the same design (not shown further) is also connected to the pinion and protrudes from the opposite side of the second instrument branch.

[0078] If the illustrated actuating element 7A is now moved in the proximal direction, one rack 25 also moves in the proximal direction, while the other rack 24 is moved in the distal direction. This causes the contacting element 13 to undergo a tilting movement similar to the embodiments described above, thereby actuating the RF contacting button 15. When the actuating element 7A is released, the preload springs 7D cause the racks 24, 25 to return to their original position. In principle, however, it is also possible to couple actuating elements to the rotational axis of the gear 26 in order to trigger the opposing longitudinal movements of the racks 24, 25 via the manually induced rotation of the gear 26.

[0079] Fig. 10 shows an RF activation element 7 as a slider according to a fourth embodiment not belonging to the invention. The fourth embodiment is according to Fig. 8 formed, wherein the contacting element 13 with the activation surface 14 is formed flat instead of cam-shaped. Furthermore, in this case, the crossbar-shaped inner part 7A is not rocker-shaped as in the embodiment according to Fig. 8 , but is mounted longitudinally displaceably in the second instrument branch 4.

[0080] Fign. 11A und 11B und 12 show the HF instrument 1 with a lever 27 as the HF activation element 7 on the opposite sides of the instrument. This sixth embodiment of the HF activation element 7, which is not part of the invention, shows, according to the Fig 11A the one lever 27, which is pivotally guided parallel to the second instrument branch 4. In this case, Fig. 11A the HF instrument 1 is aligned in accordance with the above figures. In Fig. 11B In contrast, the orientation of the HF instrument 1 is reversed, i.e., the first instrument branch 3 is shown facing downwards and the second instrument branch 4 is shown facing upwards, so that both levers 27 can be shown on opposite sides of the instrument. Due to the almost central arrangement of the HF activation element 7 on the side of the second instrument branch 4 closest to the first instrument branch 3, the operation of the lever 27 is the same regardless of the orientation of the HF instrument 1.

[0081] Fig. 13 shows the arrangement of two RF activation buttons 15 and 16 and the lever 27 as RF activation element 7 according to the sixth embodiment in the context of a schematic diagram. According to Fig. 13 the levers 27 are connected in a rotationally fixed manner to a contact rod, which extends along the second instrument branch 4, preferably in the proximal direction. Furthermore, a first HF activation button 15 and a second HF activation button 16 are provided, which are arranged opposite one another in such a way as to initially receive the contact rod between them without contact. If the one lever 27, shown in solid line, is in a first position (1), in which the contact rod has no contact with the HF activation buttons 15 and 16, and is actuated counterclockwise from this position, then the first activation button 15 is pressed by the contact rod. In the event that the instrument 1 is rotated, as shown in the Fign. 11A und 11B As shown, the lever 27 shown in dashed lines in its second position (2) comes into the same spatial position as the lever 27 shown in solid line in Fig. 13 , whereby in this case the two RF activation buttons 15 and 16 are positioned logically above the lever 27. If this lever 27, represented by a dashed line, is now actuated counterclockwise, the contact rod comes into contact with the second RF activation button 16, and this is consequently pressed.

[0082] It is also possible for the two levers 27 to swap their respective positions shown. In this case, switching from position (1) to position (2) is preferably realized by a snap-action mechanism between lever 27 and the contact rod, so that the lever tactilely engages in the defined positions (not shown).

[0083] Fign. 14 und 15 show the bipolar HF instrument 1 with an HF activation element 7 according to a defined safety concept. The HF instrument 1 is in Fig. 14 closed and not locked. In Fig. 15 the HF instrument 1 is closed and locked.

[0084] The inner part 7A of the RF activation element 7 is supported by a spring element 7E, preferably a compression spring. The spring element 7E is arranged in such a way that the entire RF activation element 7 protrudes slightly in the axial direction of its rotation / rocking axis 19 from the instrument branch 4 or is displaced in the axial direction of its rotation / rocking axis 19. This has Fig. 14 This results in the activation surface 14, which is intended to press the first RF activation button 15, no longer being able to engage the RF activation button 15. Therefore, when the RF activation element 7 is actuated in this displaced position, no RF energy can be activated.

[0085] As soon as the HF instrument 1 is in a closed and locked state, the first instrument branch 3 pushes the HF activation element 7 back against the preload force of the spring element 7E, so that the activation surface 14 can engage with the first and / or second HF activation button 15 and / or 16. This securing or safety concept therefore fundamentally provides for a spring-force-induced displacement of the HF activation element 7 into a non-functional position, which is only canceled again when a completely closed position of the two instrument branches 3, 4 is reached, by the other, first instrument branch 3 pushing the HF activation element 7 back into its functional position.

[0086] Fign. 16 und 17 show the HF instrument 1 with an HF activation element locking element 28 as another security or safety concept. Here, an HF activation element locking element 28 is built into / integrated into the HF instrument 1. Consequently, the user is able to operate the device in a closed and locked state, provided they trigger the HF activation element locking element 28 accordingly.

[0087] The activation element locking element 28 according to Fign. 18 und 19 has a plunger 29, which protrudes from the handle shell of the second instrument branch 4 and can be brought into contact with the opposite handle shell of the first instrument branch 3 when the HF instrument 1 is closed. Next to the plunger 29 there is a pin 30. The pin 30 interacts with a bore 32 according to Fig. 21 in the inner part 7A of the RF activation element 7. In an open state of the RF instrument 1 according to Fig. 16 the pin 30 is in the hole 32 and a turning / rocking / actuation of the HF activation element 7 is not possible. In a closed state of the HF instrument 1 according to Fig. 17 the pin 30 is pushed out of the bore 32 by the plunger 29 and the turning / rocking / actuation of the HF activation element 7 is possible.

[0088] In order to prevent the locking element 28 from twisting, guide elements 31 in the form of sliding tabs according to Fig. 19 which are slide-mounted in corresponding guide grooves in the second instrument branch 4. This ensures that when the instrument is opened, the pin 30 can move into the bore 32.

[0089] Fig. 22 shows the distances between the individual components of the HF instrument 1. In order to avoid confusion between the HF activation element 7 and the blade actuating element 5 during use, the HF activation element 7 and the blade actuating element 5 are placed at a sufficient distance from one another. It is preferred if the distance, starting from the center of the instrument actuating eyelet 20 to the center of the blade actuating element 5, is preferably between 56 and 96 mm, more preferably between 66 and 86 mm, and more preferably 76 mm. Furthermore, it is preferred if the distance, starting from the center of the instrument actuating eyelet 20 to the center of the HF activation element 7, is preferably between 22 and 62 mm, more preferably between 32 and 52 mm, and more preferably 42 mm.

[0090] Fig. 23 shows the RF activation element 7 with a seal 33. Fig. 23 shows the HF instrument 1 according to the above descriptions, wherein the HF activation element 7 and the first and / or second HF activation button 15 and / or 16 are sealed with a TPE seal 33.

[0091] Fig. 24 shows an RF activation button 15 or 16, wherein the RF activation button 15 or 16 is already sealed or encapsulated at the factory by means of a casing which has a concave, preferably hemispherical protrusion in the contact area of ​​the RF activation button. Upon contact with the protruding hemisphere 35, against which the activation surface 14 presses when the RF activation element 7 is actuated, the RF energy is supplied.

[0092] Fig. 25 shows the RF activation element 7 according to Fig. 6 with a sealing ring 34. The sealing ring 34 is placed around the T-shaped contacting element 13 on the side facing the inner part 7A of the RF activation element 7, so that the cross-bar-shaped inner part 7A and the contacting element 13, including the contact surface 14, can be separated from each other in a fluid-tight manner. The sealing ring 34 is preferably an elastomer sealing ring / O-ring.

[0093] Fig. 26 und 27 show a further alternative embodiment of the HF instrument 1. Here, the HF instrument 1 is designed according to the preceding figures, with the HF activation element 7 being present in duplicate. The two HF activation buttons 7 are located in this case on the top side of the respective instrument branches 3 and 4, i.e., on the top and bottom of the instrument, whereas the blade actuation element 5 remains on the left and right sides of the instrument, in accordance with the previously described embodiments.

[0094] In Fig. 27 Also shown is the locking device 8, in particular the male part 8A, which can be activated by means of a rotary lever 36 at the proximal end of the HF instrument 1. To ensure that the user applies sufficient closing force when the locking device 8 is deactivated, an additional control device 37 in the form of a button is provided. The control device 37 is connected in an AND logic with the HF activation buttons 15 and / or 16 and must be permanently actuated to activate HF energy. Bezugszeichen

[0095] 1 Instrument 2 Jaw 3 First instrument branch 4 Second instrument branch 5 Blade actuating element 5 A Return spring of the blade actuating element 6 Blade 7 RF activation element 7 A Inner part of the RF activation element 7 Burst wing of the RF activation element 7 C Second wing of the RF activation element 7 DR Return spring 7 E Spring element 8 Latching device 8 A Male part of the latching device 8 B Female part of the latching device 8 CR Return spring of the latching device 9 First rack and pinion gear 10 Input rack 11 Output rack 12 Gear 13 Contacting element 14 Activation surface 15 First RF activation button 16 Second RF activation button 17 Circuit board 18 Second rack and pinion gear 19Center axis of the RF activation element 20Instrument operating eyelet 21Slot 22Flat plug 23Connector 24First rack 25Second rack 26Gear 27Lever 28RF activation element locking element 29Plunger 30Pin 31Guide element 32Bore 33Seal34Sealing ring 35Hemisphere 36Rotary lever 37Control device

Claims

1. A bipolar HF instrument (1) comprising: a jaw part (2), a first instrument branch (3) and a second instrument branch (4) for grasping tissue, which are provided and configured to move away from each other when opening and toward each other when closing, a preferably knob-shaped or button-shaped HF activation element (7) for activating an HF power supply for sealing tissue, preferably a preferably lever-shaped blade actuating element (5) for moving a mechanical blade (6) in the jaw part (2) for cutting tissue, and preferably a latching device (8) for achieving a latched-in state with the instrument branches (3, 4) closed, wherein the HF activation element (7) and preferably the blade actuating element (5) are provided and configured so as to be operable in the same way from two opposite sides of the HF instrument (1), wherein the HF activation element (7) has an inner part (7A) which is mounted in a rocking, sliding or pivotable manner on an axis of rotation (19) of the HF activation element (7) in the second instrument branch (4) orthogonal to the proximal-distal direction, wherein the side of the inner part (7A) pointing in the direction proximal to the instrument (1) has a contact element (13) with an activation surface (14) which contacts at least a first HF activation button (15) during actuation of the HF activation element (7) and activates the HF power supply, wherein the inner part (7A) of the HF activation element (7) has a first actuating wing or knob (7B) and a second actuating wing or knob (7C), wherein the first wing or knob (7B) protrudes laterally on the second instrument branch (4) and the second wing or knob (7C) protrudes opposite the first wing (7B) on the other side of the second instrument branch (4), characterized in that the contact element (13) is provided and configured with two adjacent cams which extend in the direction of the first HF activation button (15) and receive it between them without contact in the non-actuated state.

2. The bipolar HF instrument (1) according to claim 1, characterized in that the HF activation element (7) is configured and provided in such a way as to be proximally movable, in particular pivotable or displaceable, when performing sealing.

3. The bipolar HF instrument (1) according to claim 1 or 2, characterized in that the HF activation element (7) is configured and provided in such a way that it activates the HF power supply after a first tap activation and switches it off automatically, preferably via an integrated algorithm, or stops the HF power supply manually after a second tap activation of the HF activation element (7).

4. The bipolar HF instrument (1) according to any of claims 1 to 3, characterized in that the inner part (7A) is in the shape of a crossbar.

5. The bipolar HF instrument (1) according to any of claims 1 to 4, characterized in that the HF activation element (7) is provided in an open state of the HF instrument (1) with a locking element (28) of the HF activation element to lock an actuation of the HF activation element (7).

6. The bipolar HF instrument (1) according to claim 1, characterized in that a second HF activation button (16) is provided and arranged next to the first HF activation button (15) in parallel to the inner part (7A) of the HF activation element (7).

7. The bipolar HF instrument (1) according to any of claims 1 to 6, characterized in that the first HF activation button (15) and / or the second HF activation button (16) is / are arranged in a proximal direction away from the inner part (7A) of the HF activation element (7), but facing it on a printed circuit board (17) in the second instrument branch (4).

8. The bipolar HF instrument (1) according to claim 1, characterized in that in the first instrument branch (3) a first rack and pinion gear (9) is provided and arranged, in which an input rack (10) is connected to the blade actuating element (5) and an output rack (11) is connected to the mechanical blade (6), wherein the blade actuating element (5) is linearly movable proximally from a distal resting position for operating the blade (6).

9. The bipolar HF instrument (1) according to claim 8, characterized in that the input rack (10) and the blade actuating element (5) connected thereto are arranged approximately on the plane of symmetry between the first instrument branch (3) and the second instrument branch (4).