Medical motor handpiece for 2-in-1 operation and medical manual instrument with 2-in-1 operation

Abstract

The disclosure relates to a medical motor handpiece (2) for driving a distal end effector (8, 22), with a handle portion (4), and with a preferably sleeve-shaped operating element (12) that is held to rotate about a handle longitudinal axis at a distal end portion of the handle portion (4) and can be coupled to the end effector (8, 22) so as to transform a rotational movement of the operating element (12) in a first direction of rotation into a movement of the end effector (8, 22) and in the event of a rotational movement of the operating element (12) in a second direction of rotation opposite the first direction of rotation to effect a function on the end effector (8, 22). The disclosure also relates to a medical manual instrument (1) with a medical motor handpiece (2) as disclosed and to an end effector (8, 22) that is coupled to the motor handpiece (2) via a shaft (10, 20) in order to transfer torque from the motor handpiece (2) to the end effector (8, 22).

Description

[0001] Medical motor handpiece for 2-in-1 operation and medical hand instrument with 2-in-1 operation

[0002] Description

[0003] The disclosure relates to a medical motor handpiece for driving a distal end effector (tool), having a handle portion.

[0004] Background of the Revelation

[0005] In modern minimally invasive surgery, such tools / instruments and associated instrument handpieces / hand instruments are used, for example, for processing bones and cartilage during arthroscopic procedures, in spinal surgery and similar orthopedic / surgical treatments, as well as for processing organic material in neurosurgery. The tools / instruments have a handpiece / handle / grip section and, if necessary, interchangeable effectors, such as milling cutters, rotary knives, a polishing head, or the like. The effector is mounted in a shaft of the tool / instrument at its distal end, and is optionally rotatably mounted. Depending on the intended use and the intended tool speed, a hydraulic, pneumatic, or electric motor drive is provided as the tool drive. This drive is transmitted via a torque transmission train within the tool and / or the hand instrument.of the handle section is operatively connected to the tool head (effector). The drives can be integrated into the tool and / or the handheld instrument or can be designed as external drive units that are coupled to the tool or handheld instrument via power supply lines or torque transmission lines.

[0006] It is advantageous to angle the distal section of a handheld medical instrument shaft to enable operations to be performed in confined spaces, for example, during spinal surgery. In other words, the space available for the instruments used and ease of handling play a major role in surgical procedures, especially minimally invasive ones. Thus, the instrument shafts, especially in the area of ​​the distal effectors, should be actively angled (intentionally achieved via an actuation mechanism) in the smallest possible space.

[0007] It is also advantageous if the tools or effectors can be exchanged quickly and easily in order to ensure rapid adaptation to changed operating conditions and / or working environments and to keep the stress on the patient as low as possible.

[0008] State of the art

[0009] Articulated shafts for medical hand instruments are well known and typically comprise a proximal and an articulated distal shaft section. The distal shaft section and the proximal shaft section each have a slanted end / face angled relative to the respective shaft section axis. This means that one end / end section / face of the distal and proximal shaft sections is not straight, but rather beveled / angled. The bevels / angled end sections / faces each have essentially the same angle of incidence. Therefore, the bevels fit together such that the proximal and distal shaft sections form a straight shaft / straight tube in a specific relative rotational position.If the distal shaft section rotates about its longitudinal axis relative to the proximal shaft section and the proximal shaft section remains stationary, the distal shaft section is inevitably angled by the angled end faces / end sections.

[0010] Furthermore, DE 102017 010 033 A1 also discloses a medical device with a guide unit comprising a guide tube with a longitudinal axis, a proximal first coupling part rigidly connected thereto, and a cylindrical-jacket-shaped pivoting head distally. It also comprises an actuating tube that is axially movable within the guide tube and connected to the pivoting head, which causes pivoting of the pivoting head via a proximal operating element. For more precise alignment of a distal guide element for a rotatable surgical tool and thus the angular alignment of the working head of such a tool, the operating element is pivotable about the longitudinal axis and causes the pivoting of the pivoting head by axially displacing the actuating tube.

[0011] Furthermore, US 7,585,300 B2 or US 10,070,872 B2 disclose examples of surgical instruments with a handpiece and a shaft received in the handpiece, to the distal end of which a tool head is pivotally connected. The pivoting of the tool head can be achieved via a handwheel rotatably mounted on the handpiece. Similarly, US 8,303,594 B2 discloses a surgical handpiece in which the pivoting of the tool head is achieved via a lever mounted on the handpiece.

[0012] Furthermore, US 9,597,093 B2 discloses a tool that can be coupled to a drive unit at its proximal end in a torque-transmitting manner and has a tool head at its distal end. The tool head can be pivoted relative to a tool shaft by rotating a sleeve arranged in the region of the tool head.

[0013] Further examples of surgical hand instruments with rotating tools which can be angled / pivoted relative to a handpiece are disclosed, among others, in US 10,178,998 B2, US 10,307,180 B2 or US 10,524,820 B2.

[0014] However, the current state of the art always has the disadvantage that the tools, with their angled shanks, require complex coupling. Simple and quick uncoupling is therefore not readily possible.

[0015] Summary of Revelation

[0016] The objects and aims of the disclosure are to eliminate or at least mitigate the disadvantages of the prior art and, in particular, to provide an intuitive motor handpiece or hand instrument which allows a simple and quick tool change and, at the same time, allows a relative movement of the tool during operation.

[0017] The objects and aims of a generic medical motor handpiece are achieved according to the disclosure by the subject matter of claim 1. The disclosure is therefore based on the recognition of an integration of two functions into one control element.

[0018] The medical motor handpiece is accordingly characterized according to the disclosure by a preferably sleeve-shaped operating element which is held on a distal end section of the handle section so as to be rotatable about a handle longitudinal axis and which can be coupled to the end effector in such a way as to transform a rotational movement of the operating element in a first rotational direction into a movement of the end effector and to effect a function on the end effector upon a rotational movement of the operating element in a second rotational direction opposite to the first rotational direction.

[0019] In other words, two different functions can be implemented with a single rotating control element, depending on the direction of rotation. This 2-in-1 operation of the motor handpiece eliminates the need for an additional control element, which in turn leads to more intuitive operation.

[0020] Advantageous embodiments are claimed in the subclaims and are explained below.

[0021] In a preferred variant, the motor handpiece can be coupled to the end effector via a shaft, and the operating element can cause the end effector to bend relative to the shaft upon a rotational movement of the operating element in the first rotational direction. Furthermore, the end effector can preferably have a first coupling device, and the shaft can have a second coupling device, which are operatively engaged with one another in a coupled state. A rotational movement of the operating element in the second rotational direction releases the operative engagement between the first coupling device and the second coupling device.

[0022] According to the disclosure, the motor handpiece can be designed according to an advantageous embodiment such that, in a plan view of the end effector, the first direction of rotation is oriented in a clockwise direction of rotation and the second direction of rotation is oriented in a counterclockwise direction of rotation.

[0023] Furthermore, it may be advantageous if the handle section and / or the operating element has at least one indicator, preferably in the form of a numerical scale and / or a pictogram, for indicating the movement of the end effector and / or the function.

[0024] According to a preferred development, at least one latching and / or stop unit (locking device), in particular in the form of a ball pressure element, can be provided, which is intended and designed to limit the rotational movement of the operating element at end positions and / or to increase a rotational movement resistance on the operating element in at least one intermediate rotational position.

[0025] An advantageous embodiment according to the disclosure can further be characterized by a locking unit that locks a rotational movement of the operating element in the first direction of rotation and in the second direction of rotation in a locking position and unlocks it in an unlocking position. The locking unit can preferably be designed as a locking slide, which is arranged on the operating element in order to move axially between the locking position and the unlocking position. Furthermore, it can be particularly advantageous if the locking slide has a spring element that presses the locking slide into the locking position. Particularly preferably, the locking and / or stop unit can be designed in the form of at least one ball pressure element and a spring force adjustment element, preferably in the form of a grub screw, for continuously adjusting the spring force of the ball pressure element.

[0026] In an advantageous embodiment, the motor handpiece can be coupled to the end effector via a shaft, and the shaft can be coupled in a rotationally fixed manner to a rotation transmission sleeve of the motor handpiece. It may also be preferred if the control element transmits its rotational movement to the rotation transmission sleeve via a radial adjustment pin.

[0027] According to an advantageous development, the motor handpiece can have a connection for coupling the motor handpiece to a drive unit at a proximal end section, and a locking unit which is connected to the operating element in such a way that rotation of the operating element in the second direction of rotation is blocked when the motor handpiece is coupled to the drive unit. Preferably, the locking unit can have a locking bar which is coupled to the operating element and displaces in the proximal direction when the operating element is rotated in the second direction of rotation. The drive unit can also form a stop for this purpose, so that movement of the locking bar is blocked / locked by the drive unit when the motor handpiece and the drive unit are coupled.

[0028] Furthermore, the disclosure relates to a medical hand instrument having a medical motor handpiece according to the disclosure and an end effector which is coupled to the motor handpiece via a shaft in order to transmit torque from the motor handpiece to the end effector.

[0029] In other words, the disclosure relates to a (motor) handpiece with a rotary control unit with which the tool ejection can be initiated and the angle of the distal tip can be adjusted in several stages. A safety function (ON / OFF), as with known handpieces, ensures that the tool cannot be accidentally ejected in the ON state. Brief description of the figures

[0030] The disclosure is explained in more detail below using preferred embodiments with the aid of figures. They show:

[0031] Fig. 1 is a perspective view of a medical hand instrument according to a first embodiment of the present disclosure;

[0032] Fig. 2 is another perspective view of the medical hand instrument according to the first embodiment of the present disclosure;

[0033] Fig. 3 is a partial longitudinal sectional view of a motor handpiece of the medical hand instrument according to the first embodiment;

[0034] Fig. 4 is a cross-sectional view of the motor handpiece of the medical hand instrument according to the first embodiment;

[0035] Fig. 5 is a partial longitudinal sectional view of a distal end portion of the medical hand instrument according to the first embodiment in a straight shaft shape;

[0036] Fig. 6 is a partial longitudinal sectional view of the distal end portion of the medical hand instrument according to the first embodiment in an angled shaft shape;

[0037] Fig. 7 is a partial longitudinal sectional view of the distal end portion of the medical hand instrument according to the first embodiment in a release state;

[0038] Fig. 8 is an isometric perspective view of the motor handpiece of the medical hand instrument according to the first embodiment; Fig. 9 is a partial longitudinal sectional view of the motor handpiece of the medical hand instrument according to the first embodiment;

[0039] Fig. 10 is a perspective longitudinal sectional view of the medical hand instrument according to a modification of the first embodiment;

[0040] Fig. 11 is a detailed view of a sliding gate of the medical hand instrument according to the modification of the first embodiment;

[0041] Fig. 12 is a perspective view of the medical hand instrument according to the first embodiment in an operating state;

[0042] Fig. 13 is a perspective view of the medical hand instrument according to the first embodiment in an operating state;

[0043] Fig. 14 is an isometric perspective view of a motor handpiece of a medical hand instrument according to a second embodiment;

[0044] Fig. 15 is a longitudinal sectional view of the medical hand instrument according to the second embodiment; and

[0045] Fig. 16 is a cross-sectional view of the medical hand instrument according to the second embodiment.

[0046] The figures are schematic in nature and serve only to facilitate understanding of the disclosure. Like elements are provided with the same reference numerals. The features of the various embodiments can be interchanged.

[0047] Detailed description of preferred embodiments

[0048] Figure 1 shows a perspective view of a medical hand instrument 1 according to a first embodiment of the present disclosure. The medical hand instrument 1 comprises a medical motor handpiece 2, which has a proximal handle portion 4 and which, as schematically illustrated in Fig. 1, can be coupled to a drive unit 6. Alternatively, the drive unit 6 can also be accommodated in the motor handpiece 2 and supplied with power via a power supply connection.

[0049] Furthermore, the hand instrument 1 has a distal tool (end effector / effector section) 8, which can be coupled to or decoupled from the motor handpiece 2, in particular to the handle section 4, via a (tool) shaft 10. The tool 8 can be designed, for example, as a milling cutter, drill, or polishing head.

[0050] When the shaft 10 is coupled to the handle section 4, torque is transmitted from the drive unit 6 via a torque transmission cable arranged in the hand instrument 1, in particular the handle section 4 and the shaft 10, to the tool 8 in order to rotate the latter. When using the hand instrument 1 during a surgical operation or medical treatment, it is known that the tool 8 can be angled relative to the shaft 10 (indicated by arrow C in Fig. 1). This means that the tool 8 and the shaft 10 can, as described in more detail below, be angled relative to one another such that a longitudinal axis S1 of the tool 8 and a longitudinal axis S2 of the shaft 10 form an angle with one another that is not equal to 180°, in particular less than 180° (cf. Fig. 6).

[0051] As shown in Fig. 1, a sleeve-shaped operating element 12 is provided for this purpose in the hand instrument 1 according to the disclosure. The operating element 12 is arranged at a distal end section of the handle section 4 and is rotatable about a handle longitudinal axis in a first rotational direction A and in a second rotational direction B opposite the first rotational direction A. In other words, the motor handpiece 2 has the handle section 4 and the distally arranged operating element 12, which are arranged coaxially to one another, wherein the operating element 12 can be rotated relative to the handle section 4. Rotation of the operating element 12 from a neutral zero position, in which the tool 8 is not angled relative to the shaft 10, in the first rotational direction A causes the tool 8 to be angled relative to the shaft 10, as shown in Fig. 1.The first direction of rotation A is defined in the hand instrument 1 according to the present disclosure as a leftward rotation of the operating element 12 relative to the handle portion 4. In other words, the first direction of rotation A corresponds to a clockwise rotation of the operating element 12 in a distal plan view of the tool 8.

[0052] As shown in Fig. 2, the operating element 12 in the hand instrument 1 according to the disclosure can also be rotated relative to the handle section 4 in the second direction of rotation B, which is opposite to the first direction of rotation A. This means that the second direction of rotation B is defined in the plan view of the tool 8 as a rotation of the operating element 12 counterclockwise or as a rotation to the right. As indicated by the arrow D in Fig. 2, a rotation of the operating element 12 in the second direction of rotation B releases the coupling of the tool 8 to the shaft 10. Thus, as explained in more detail below, a simple and rapid tool change can be ensured by rotating the operating element 12 in the second direction of rotation B.

[0053] Figs. 3 and 4 show partial sectional views of the hand instrument 1 according to the first embodiment. To transmit the rotary movement of the operating element 12 to the shaft 10, an adjusting pin 14 is arranged in the radial direction of the operating element 12. A radially outer end portion of the adjusting pin 14 is received in an axial groove 16 formed on an inner circumferential surface of the operating element 12. On a radially inner side, the adjusting pin 14 is received in a rotation transmission sleeve 18. The rotation transmission sleeve 18 is connected to the shaft 10 in a rotationally fixed manner, so that a movement of the adjusting pin 14 in the circumferential direction causes a rotation of the rotation transmission sleeve 18 and the tool 8. In other words, when the operating element 12 is rotated in the first direction of rotation A or in the second direction of rotation B, the adjusting pin 14 moves in the axial groove 16 with the operating element 12 and, depending on the direction of rotation, causes the bending or twisting.the ejection of the tool 8. Fig. 5 shows a longitudinal cross-section of a distal end section of the hand instrument 1 in a straight shaft shape. This means that the operating element 12 is not rotated relative to the handle section 4 (zero position). Consequently, the tool 8 and the shaft 10 are not angled, and the longitudinal axis S1 of the tool 8 is collinear with the shaft longitudinal axis S2. As can be seen in Fig. 5, the shaft 10 has a proximal shaft section 20 facing the handle section 4 and coupleable thereto, and a distal shaft section 22 coupleable to the tool 8. When the operating element 12 is not rotated relative to the handle section 4 and the shaft 10 is in the straight shaft shape, the proximal shaft section 20 and the distal shaft section 22 are accordingly arranged in a line or have an angle of 0° to each other.The proximal shaft section 20 is essentially tubular and has a front end 24 at its distal end that is aligned with the shaft's longitudinal axis S2. The distal shaft section 22 is also approximately tubular. The tube tapers to a point toward the distal end. The distal shaft section 22 has a front end 26 at its proximal end that is aligned with the shaft's longitudinal axis S2.

[0054] The angled end faces 24, 26 each have an angle of incidence of preferably 22.5° to a plane normal to the shaft's longitudinal axis S2. When the shaft 10 is in a straight shaft shape or extended, the two angled end faces 24, 26 are offset from one another such that the long ends of the angled end faces 24, 26 are opposite one another in relation to the shaft's longitudinal axis S2. The angled end faces 24, 26 rest on one another. The angled end faces 24, 26 do not necessarily have to have an angle of incidence of 22.5°. Angles of incidence of, for example, 10°, 18°, 30°, 45°, or any other angle of incidence are also conceivable.

[0055] As mentioned above, the distal shaft portion 22 is designed to be coupled to the tool 8. That is, the distal shaft portion 22 represents a tool holder, wherein the tool 8 is received in the tool holder and is rotatably mounted relative to the tool holder, that is, the distal shaft portion 22.

[0056] For this purpose, a first coupling device 28 is arranged in the distal shaft section 22. A second coupling device 30 is provided on the tool 8, which, in a coupled state, cooperates with the first coupling device 28 to establish a coupling between the tool 8 and the distal shaft section 22 in order to fix the tool 8 in the distal shaft section 22 in the axial direction A.

[0057] As mentioned above, the longitudinal axis S1 of the tool 8 or of the distal shaft section 22 and the shaft longitudinal axis S2, i.e., the longitudinal axis of the proximal shaft section 20 in Fig. 5, enclose an angle of 0°. Furthermore, Fig. 5 shows a coupling state between the tool 8 and the distal shaft section 22. This means that the first coupling device 28, which is mounted in / on the distal shaft section 22, and the second coupling device 30, which is provided on the tool 8, are engaged or interact with each other. The tool 8 has a tool head / effector 32, for example a milling head, and a tool shaft 34. The tool head 32 and the tool shaft 34 are connected to each other in a rotationally fixed manner.

[0058] Fig. 5 further shows that the tool shank 34 is rotatably mounted in the distal shank section 22 by means of a rolling bearing unit 36. A drive shaft 38 extends through the proximal shank section 20 and is connected in a rotationally fixed manner to the tool shank 34. In the form of a torque transmission train, this drive shaft 38 applies torque from the drive unit 6 to the tool shank 34. As a result of this torque application, the tool shank 34 rotates relative to the distal shank section 22. The rolling bearing unit 36 ​​has at least one, here exactly two, rolling bearings 40, more precisely ball bearings, which are spaced apart from one another in the axial direction A, but which can alternatively also be designed as plain bearings. The rolling bearings 40 are accommodated in a bearing housing 42, which is part of the rolling bearing unit 36. The second coupling device 30 is incorporated into the bearing housing 42 and is therefore not provided directly on the tool 8.The rolling bearing unit 36, and thus also the bearing housing 42, is fixed to the tool shank 34 in the axial direction A. Alternatively, it would also be conceivable for the second coupling device 30 to be provided directly on the tool shank 34. The second coupling device 30 is designed as an axial locking groove 44 that extends continuously or circumferentially in the circumferential direction of the bearing housing 42. The axial locking groove 44 preferably has a semicircular or circular segment-shaped cross-section.

[0059] The first coupling device 28, which is provided in the distal shaft section 22, has at least one locking ball 46. The diameter of the locking ball 46 is selected such that the locking ball 46 can be received in the axial securing groove 44. The axial securing groove 44 preferably completely surrounds at least a portion of the locking ball 46 that contacts the axial securing groove 44. In the coupled state, the locking ball 46 is held in the axial securing groove 44 on its side opposite the axial securing groove 44 by a distal end of a locking pin / slider 48. The locking pin 48 is part of the first coupling device 28. The locking pin 48 is fixed in the radial direction R. The locking pin 48 is arranged in the distal shaft section 22 so as to be displaceable or movable in the axial direction.

[0060] In the coupling state shown in Fig. 5, the locking ball 46 is received in the axial locking groove 44 and is held radially in the axial locking groove 44 by the locking pin 48. This position of the locking pin 48 in the axial direction A is referred to as the coupling position. An edge 63 at the distal end of the proximal shaft section 20 prevents movement of the locking pin 48 in the axial direction toward the proximal shaft section 20.

[0061] The proximal shaft section 20 has a stationary outer tube 50, a ring gear 52 with internal teeth 54, a pinion 56 with external teeth 58, and an eccentric locking bushing 60. The ring gear 52 is positioned within the outer tube 50, and the longitudinal axis of the outer tube 50 corresponds to the longitudinal axis of the ring gear 52. The outer tube 50 and the ring gear 52 are thus arranged concentrically. The ring gear 52 is connected to the rotation transmission sleeve 18, i.e., to the operating element 12, via a hollow shaft 62 received in the proximal shaft section 20.

[0062] As mentioned above, the outer tube 50 is designed as a stationary tube and therefore does not move. The distal end of the outer tube 50 has the inclined end face 24. The distal end of the outer tube 50 also has a receiving bore 64 and a receiving pin for a rolling bearing 66. The outer tube 50 has a groove / notch for the balls of the rolling bearing 66. The distal shaft section 22 is mounted on the rolling bearing 66.

[0063] The internal toothing 54 meshes with the external toothing 58 of the pinion 56. As a result, a rotation of the ring gear 52, which is controlled by the operating element 12, is transmitted to the pinion 56. The direction of rotation of the pinion 56 is the same as the direction of rotation of the ring gear 52. The pinion 56 is driven by the ring gear 52, but the pinion 56 rotates in the eccentric locking bushing 60. The locking bushing 60 is arranged eccentrically to the ring gear 52. This means that although the longitudinal axis of the eccentric locking bushing 60 is parallel to the longitudinal axis of the ring gear 52, the longitudinal axes are not superimposed or offset from one another. The distal shaft section 22 has an adjustment bushing 68. The adjustment bushing 68 is mounted in the receiving bore 64 of the proximal shaft section 20. The adjusting bushing 68 is connected to the pinion 56 via a flexible silicone hose 70 such that a rotation of the pinion 56 is transmitted to the adjusting bushing 68.For this purpose, the flexible silicone tube 70 is attached to the adjustment bushing 68 and the pinion 56, for example, by welding or gluing. The adjustment bushing 68 is further positively connected to the distal shaft section 22 via a drive pin (not shown), so that rotation of the adjustment bushing 68 is transmitted to the distal shaft section 22.

[0064] Fig. 6 shows a longitudinal cross-section through the distal end section of the shaft 10, wherein the distal shaft section 22 is angled by 45° relative to the proximal shaft section 20, with the two end faces 24, 26 each being angled by 22.5°. Compared to the position in Fig. 5, the distal shaft section 22 is rotated by 180° about its own longitudinal axis S1. In this position, the angled end faces 24, 26 again lie completely / flat against one another. However, due to the rotation of the distal shaft section 24, the long ends of the angled end faces 24, 26 are positioned next to one another. The angles of attack of the angled end faces 24, 26 are thus added together. As a result, the distal shaft section 22 is angled by twice the angle of the adjusted end faces 24, 26 compared to the proximal shaft section 20.

[0065] In the position shown in Fig. 6, the driving pin is arranged opposite the locking bushing 60. This means that the adjustment bushing 68 has rotated 180° from the extended position to the maximum angulation. The 45° position represents the reversal point for this design. The adjustment bushing 68 has rotated 180° in this position. Upon further rotation of the ring gear 52, i.e., the operating element 12, the distal shaft section 22 would rotate back to its original position (zero position).

[0066] Furthermore, it can be seen in Fig. 6 that the locking ball 46 is held in the axial securing groove 44 by the locking pin 48 in the radial direction R even when the distal shaft section 22 is angled in the maximum adjustable angular position or maximum angulation with respect to the proximal shaft section 20. In this way, the tool 8 is secured in the distal shaft section by the engagement between the first coupling device 28 and the second coupling device 30, even in this angular position in the axial direction A.

[0067] The torque train, in particular the drive shaft 38, leading to the tool shaft 34, which is arranged in the transition area between the distal shaft section 22 and the proximal shaft section 20, is flexible. This flexible section of the torque train allows the distal section of the tool shaft 34 with the tool head 32, together with the distal shaft section 22, to be angled relative to the torque train in the proximal shaft section 20. At the same time, the flexible section of the torque train is designed such that it can continue to transmit a torque exerted on a proximal section of the tool shaft 34 to the tool head 32.

[0068] Fig. 7 is a longitudinal sectional view of the distal end portion of the shaft 10 in a release state between the tool 8 and the distal shaft portion 22. This means that in the position shown in Fig. 7, the first coupling device 28 and the second coupling device 30 are not in operative engagement with one another, so that the tool 8 can be removed or replaced. To release the operative engagement of the first coupling device 28 and the second coupling device 30, the operating element 12 is rotated in the second direction of rotation B (cf. Fig. 2). As explained in more detail below, the locking ball 46 is no longer received in the axial securing groove 44. Instead, it is held by the locking pin 48 in the radial direction R against an outer peripheral surface of the bearing housing 42.

[0069] In order for the locking ball 46 to move from the coupling state shown in Fig. 5 out of the axial securing groove 44 into the release state, the locking pin 48 must move in the axial direction A towards the proximal shaft section 20. This is prevented in the coupling state by the circumferential edge 63 of the proximal shaft section 20. However, the edge 63 is interrupted at a location of a locking pin receiving recess 72. When the operating element 12 is rotated in the second rotational direction B, the distal shaft section 22 rotates relative to the proximal shaft section 20 in a direction opposite to the angling, for example by (-)18°, until the locking pin 48 is positioned relative to the proximal shaft section 20 such that it is circumferentially level with the locking pin receiving recess 72.A preloading element 74, which is part of the first coupling device 28, presses the locking pin 48 in the axial direction A toward the proximal shaft portion 20. The preloading element 74 thus pushes the locking pin 48, or more precisely its proximal end, which is designed as a locking projection 76, into the locking pin receiving recess 72. The position in which the locking pin 48 is when its locking projection 76 engages the locking pin receiving recess 72 is referred to as the release state or release position. In the release position, the distal end of the locking pin 48 no longer lies opposite the axial securing groove 44. Thus, the locking ball 46 is not held in the axial securing groove 44 in the radial direction R. The tool 8 is therefore no longer fixed in the axial direction A relative to the distal shaft portion 22.If, starting from the coupling state, a tensile force (in axial direction A) is applied to the distal end of the tool 8, the locking ball 46 is released from the axial locking groove 44. In this way, the tool 8 can be uncoupled from the distal shaft section 22.

[0070] Fig. 8 shows a perspective view of the distal end section of the motor handpiece 2 according to the first embodiment, without the shaft 10 being coupled to the handle section 4. As described above, rotation of the operating element 12 in the first rotational direction A causes the tool 8 to bend, and rotation of the operating element 12 in the second rotational direction B releases the coupling between the tool 8 and the shaft 10, or the distal shaft section 22, by releasing the operative engagement between the first coupling device 28 and the second coupling device 30. To facilitate operation, indicators 78 in the form of arrows, which indicate the directions of rotation, are attached to the operating element 12.In combination with indicators 78 on an indicator sleeve 80, which is attached to the handle section 4 distally of the operating element 12 in a rotationally fixed manner, the user can quickly identify which direction of rotation corresponds to which function when operating the handheld instrument 1. For this purpose, as shown in Fig. 8, various angular positions, each corresponding to a defined rotation of the operating element 12 in the first direction of rotation A and thus a defined angling of the tool 8 relative to the shaft 10, as well as a lock symbol or a symbol of an open lock, are applied to an outer circumferential surface of the indicator sleeve 80. The user can thus assign the respective function, namely angling or uncoupling, to the individual directions of rotation A, B. The motor handpiece 2 together with the operating element 12 thus enables intuitive operation and integration of the two functions.

[0071] As shown in Fig. 8, a locking slide 82 is arranged on the motor handpiece 2 according to the first embodiment. The locking slide 82 is rigidly received in the operating element 12 in both the radial and circumferential directions such that the locking slide 82 can only move axially relative to the operating element 12 between a (distal) locking position and a (proximal) unlocking position. In the locking position, the operating element 12 cannot be rotated relative to the handle section 4, as explained in more detail below.

[0072] For this purpose, in the locking position, a distal pin portion 83 of the locking slide 82, as shown in Fig. 9, engages with a locking ring 84 received in the indicator sleeve 80. The locking ring 84 has a plurality of recesses distributed over the circumference, into which the pin portion 83 protrudes in the locking position, in order to fix or hold the operating element 12 in the circumferential direction relative to the handle portion 4. The recesses of the locking ring 84 preferably correspond to the indicators 78 attached to the outer circumferential surface of the indicator sleeve 80. Thus, the user can easily adjust the bending of the tool 8 at a defined angle and fix the bent tool 8 at this angle.

[0073] In order to be able to rotate the operating element 12 relative to the handle section 4 for adjusting the angle or for releasing the coupling, the locking slide 82 must therefore be moved from the locking position to the unlocking position, ie in the proximal direction.

[0074] In the motor handpiece 2 according to the first embodiment, the locking slide 82 is pretensioned in the axial direction against the operating element 12 via a spring element 86. The spring element 86 is arranged between the locking slide 82 and a stop surface of the operating element 12 such that it presses the locking slide 82 into the locking position, i.e., in the distal direction. The spring element 86 consequently exerts an automatic restoring force on the locking slide 82 to hold it in the locking position. Alternatively, it is of course also conceivable for the motor handpiece 2 not to have a spring element 86. In such a motor handpiece according to a modification of the first embodiment with manual resetting, the user must pull the locking slide 82 in the proximal direction to unlock it and actively push it in the distal direction to lock it.

[0075] As shown in Figs. 10 and 11, an additional ball pressure element 88 is provided in the motor handpiece 2 according to the modification of the first embodiment. This element has a spring element 90, which presses a ball 92 proximally against a sliding guide (spherical locking ring) 94 (see Fig. 11) firmly received in the handle section 4. Formed on the sliding guide 94 are dome-shaped locking recesses 96, which can at least partially accommodate the ball 92.

[0076] The locking recesses 96, similar to the recesses of the locking ring 84, correspond to defined angles by which the tool 8 can be angled relative to the shaft 10 with a specific rotation of the operating element 12. This means that when the operating element 12 is rotated by the defined angle relative to the handle section 4, the ball pressure element 88 rotates with the operating element 12 until the defined angle is reached, at which the ball 92 engages in the corresponding locking recess 96 of the sliding gate 94 due to the preload force of the spring element 90. The additional ball pressure element 88 thus enables haptic feedback for the user during angle adjustment.

[0077] Fig. 12 shows the medical handpiece 1 according to the first embodiment in an operating state in which the motor handpiece 2 is connected to the drive unit 6. For this purpose, the motor handpiece 2, as mentioned above, has the connection at its proximal end section, which, as shown in Fig. 12, can accommodate a motor cable 98. The motor handpiece 2 further has a locking slide 100, which in the OFF position (see Fig. 13) can be displaced in the proximal direction in order to release the connection between the shaft 10 and the motor handpiece 2. To secure the unlocking position of the tool 8, the locking slide 100, as can be seen in Fig. 13, has a locking bar 102. The locking bar 102 is connected to the operating element 12 and is released when the tool 8 is unlocked by rotating the operating element 12 in the second direction of rotation B, i.e.when the operative engagement between the first coupling device 28 and the second coupling device 30 is released, is extended in the proximal direction.

[0078] When the medical handpiece 1 is in the operating state, this proximal extension of the locking bar 102 is not possible because the motor cable 98, in particular a lug of the motor cable 98, blocks extension. This prevents the tool 8 from being ejected during operation by accidentally rotating the operating element 12 in the second rotational direction B. However, rotation of the operating element 12 in the first rotational direction A remains possible, so that the tool 8 can also be angled relative to the shaft 10 during operation.

[0079] Fig. 14 shows a motor handpiece 2 for a medical hand instrument 1 according to a second embodiment. It can be seen that the motor handpiece 2 according to the second embodiment does not have a locking slide 82. Omitting the locking slide 82 enables an improved view of the surgical field, more intuitive operation, and reduced cleaning effort.

[0080] In order to nevertheless ensure a certain degree of security of the operating element 12 against unintentional twisting, even without the locking slide 82, and to enable the operating element 12 to be locked at defined angles, two ball pressure elements 104 are arranged in the operating element 12, as shown in Fig. 15. These each have a spring element 106, which presses a ball 108 as a locking body against the locking ring (locking plate) 84. This means that the spring element 106 presses the ball 108 in the distal direction against the locking ring 84. As can be seen in Fig. 16, the locking ring has recesses with which the balls 108 are engaged. As mentioned above, the ball pressure elements 104 press with their distal end sections, i.e. the balls 108, against the locking ring 84. At their proximal end section, the ball pressure elements 104 each have a spring force adjustment means in the form of a grub screw 110.By screwing in the grub screw 110, the preload of the spring element 106 and thus the spring force acting on the locking ring 84 can be adjusted. A higher spring force makes it more difficult to accidentally rotate the control element 12, whereas a lower spring force allows for easier angle adjustment and thus enables one-handed operation.

[0081] List of reference symbols

[0082] 1 hand instrument

[0083] 2 Motor handpiece

[0084] 4 Handle section

[0085] 6 Drive unit

[0086] 8 Tools

[0087] 10 shaft

[0088] 12 Control element

[0089] 14 Adjustment pin

[0090] 16 axial groove

[0091] 18 Rotary transmission sleeve

[0092] 20 proximal shaft section

[0093] 22 distal shaft section

[0094] 24, 26 front side

[0095] 28 first coupling device

[0096] 30 second coupling device

[0097] 32 Tool head / effector

[0098] 34 tool shank

[0099] 36 rolling bearing unit

[0100] 38 Drive shaft

[0101] 40 rolling bearings

[0102] 42 bearing housings

[0103] 44 Axial locking groove

[0104] 46 locking ball

[0105] 48 locking pin

[0106] 50 outer tube

[0107] 52 ring gear

[0108] 54 internal gearing

[0109] 56 pinions

[0110] 58 external gearing

[0111] 60 fuse socket

[0112] 62 Hollow shaft edge of the proximal shaft section

[0113] Mounting hole

[0114] Rolling bearings

[0115] Adjustment bushing

[0116] silicone hose

[0117] locking pin recess

[0118] Preloading element

[0119] locking projection

[0120] indicator

[0121] Indicator sleeve

[0122] Locking slide

[0123] Tenon section

[0124] locking ring

[0125] spring element

[0126] Ball pressure element

[0127] spring element

[0128] Bullet

[0129] Sliding gate (dome locking ring)

[0130] Recess

[0131] Motor cable

[0132] gate valve

[0133] locking bolt

[0134] Ball pressure element

[0135] spring element

[0136] Bullet

[0137] grub screw

Claims

Claims 1. Medical motor handpiece (2) for driving a distal end effector (8, 22), with a handle section (4), characterized by a preferably sleeve-shaped operating element (12) which is held on a distal end section of the handle section (4) so ​​as to be rotatable about a handle longitudinal axis and can be coupled to the end effector (8, 22) in such a way as to transform a rotational movement of the operating element (12) in a first direction of rotation into a movement of the end effector (8, 22) and to effect a function on the end effector (8, 22) upon a rotational movement of the operating element (12) in a second direction of rotation opposite to the first direction of rotation.

2. Medical motor handpiece (2) according to claim 1, characterized in that the motor handpiece (2) can be coupled to the end effector (8, 22) via a shaft (10, 20) and the operating element (12) causes an angling of the end effector (8, 22) relative to the shaft (8, 20) when the operating element (12) rotates in the first direction of rotation.

3. Medical motor handpiece (2) according to claim 1 or 2, characterized in that the end effector (8, 22) has a first coupling device (28) and the shaft (10, 20) has a second coupling device (30), which are operatively engaged with one another in a coupling state, wherein a rotary movement of the operating element (12) in the second direction of rotation releases the operative engagement between the first coupling device (28) and the second coupling device (30).

4. Medical motor handpiece (2) according to one of the preceding claims 1 to 3, characterized by at least one locking and / or stop unit, in particular in the form of a ball pressure element (88; 104), which is provided and designed to limit the rotary movement of the operating element (12) to to limit end positions and / or to increase a rotational movement resistance on the operating element (12) in at least one intermediate rotational position, 5. Medical motor handpiece (2) according to one of the preceding claims 1 to 4, characterized by a locking unit (82) which locks a rotational movement of the operating element (12) in the first rotational direction and in the second rotational direction in a locking position and unlocks it in an unlocking position.

6. Medical motor handpiece (2) according to one of the preceding claims 1 to 4, characterized in that the locking and / or stop unit is designed in the form of at least one ball pressure element (104) and has a spring force adjustment element, preferably in the form of a grub screw (110), for continuously adjusting a spring force of the ball pressure element (104).

7. Medical motor handpiece (2) according to one of the preceding claims 1 to 6, characterized in that the motor handpiece (82) can be coupled to the end effector (8, 22) via a shaft (10, 20) and the shaft (10, 20) can be coupled in a rotationally fixed manner to a rotation transmission sleeve (18) of the motor handpiece (2).

8. Medical motor handpiece (2) according to claim 7, characterized in that the operating element (12) transmits its rotary movement to the rotary transmission sleeve (18) via a radial adjusting pin (14).

9. Medical motor handpiece (2) according to one of claims 1 to 8, characterized in that the motor handpiece (2) has at a proximal end portion a connection for coupling the motor handpiece (2) to a drive unit (6) and a locking unit (100) which is connected to the operating element (12) in such a way that rotation of the operating element (12) in the second direction of rotation is blocked when the motor handpiece (2) is coupled to the drive unit (6).

10. Medical hand instrument (1) with a medical motor handpiece (2) according to one of the preceding claims 1 to 9, and an end effector (8, 22) which is coupled to the motor handpiece (2) via a shaft (10, 20) in order to transmit torque from the motor handpiece (2) to the end effector (8, 22).

Images