SUPPORT DEVICE AND METHOD FOR BLOCKING THE SUPPORT DEVICE

Abstract

The invention relates to a support device 020 for human or veterinary medical applications comprising: a joint between a proximal support segment 001 and a distal support segment 017; in which, in the support segments 001, 017, are respectively disposed an axially sliding thrust element 002, 016; in which the joint includes a clamping bolt defining the axis of pivoting and clamping and deflection elements, by means of which a thrust force acting with respect to the axis of the proximal thrust element 002 can be deflected for locking the joint on the clamping axis and for sliding the distal thrust element 016; and in which the deflection elements include at least one ramp system with a wedge body 008.The invention further relates to a holding system comprising said holding device and a method for locking the joint of said holding device 020. (Fig. 1).

Description

Title of the invention: SUPPORT DEVICE AND METHOD FOR LOCKING THE SUPPORT DEVICE Technological background

[0001] The invention relates to a holding device with a biocable joint between two holding segments for medical applications, for example, for holding or positioning a surgical instrument. The invention further relates to a holding system with said holding device and a method for locking and releasing the joint of said holding device.

[0002] One- or multi-armed holding devices or systems for passively or actively guided medical instruments are known. In this regard, particularly in minimally invasive surgical procedures, holding devices or systems are necessary for guiding instruments to relieve the operator, assistant, or other users of the tiring effort of holding them. Such holding devices can be used to hold a surgical instrument, such as a manipulator, or optical aids such as an endoscope, forceps, or the like, at its distal end. Furthermore, mechatronic assistance systems can also be combined with a holding device. In this respect, it is important that connected devices or systems can be easily manipulated and that the holding system allows for unimpeded operation.When using instruments, it is also advantageous to provide the surgeon with a high number of degrees of freedom.

[0003] A manually adjustable holding device is known from Swiss Federal Law No. 645 529, which comprises two arms pivoting relative to each other and connected by a central joint. The arms can be locked with a clamping element in the form of a hand lever via sliding clamping sleeves or bushings at the central joint. This known device has the disadvantage that, as a rule, two hands are required to release and lock the holding system. The force required for clamping is comparatively high due to friction losses in the central joint. Therefore, it is necessary to increase the efficiency of the force flow by reducing friction losses.

[0004] In addition to the relatively high friction losses, a further disadvantage of the manually adjustable holding device according to document CH 645 529 is that the transmission ratio, i.e. the ratio in which force and path are The existing system can only be improved to a limited extent by replacing the clamping sleeves with steeper contact surfaces. The problem arises because when the contact surfaces of a clamping sleeve are too steep in design, they lead to excessive self-locking during the locking process. For example, at angles greater than 70°, the resulting self-locking is so significant that the retaining device cannot be released after locking.

[0005] The object of the present invention is to overcome these drawbacks and to provide a simple-to-use retaining device that can be locked or released without a hand lever or knob on the clamping axis of the retaining device's joint. In particular, the retaining device should be biocompatible by applying pressure or force from the proximal face at the level of an open proximal arm or retaining segment.

[0006] A further object of the invention is to improve the degree of efficiency in deflecting force in the joint of the retaining device. Finally, instruments should also be controllable in a position released from the retaining device and should not move unexpectedly after release or adoption of the release position.

[0007] According to a first aspect of the invention, a support device for human or veterinary medical applications is provided, comprising a joint between a proximal support segment and a distal support segment; wherein, in the support segments, at least one axially sliding thrust element is disposed respectively, wherein the joint comprises a clamping bolt defining the pivot and clamping axis and deflection elements, by means of which a thrust force acting with respect to the axis of the proximal thrust element can be deflected for locking the joint on the clamping axis and for sliding the distal thrust element, and wherein the deflection elements comprise at least one ramp system with a wedge body.

[0008] Using deflection elements incorporating a ramp system, the clamping bolt can be slid by applying force from the proximal face so that the retaining device can be moved from a released position to a locked position. In the released position of the retaining device, the retaining segments can be pivoted relative to each other so that a distal connecting part or a connectable instrument is brought into a desired position. The joint of the retaining device can then be locked by means of the clamping bolt, and the retaining segments can thus be fixed in the set position.

[0009] At least one axially sliding proximal thrust element is used during the locking process to apply proximal force, while at least one axially sliding distal thrust element allows distal force to be discharged out of the joint, i.e., outwards. The force deflected from the clamping axis by 90° in the direction of the distal thrust element can be used again to fix or lock a distal connecting part or an instrument, thus assisting an operator or other user.

[0010] The force can advantageously be applied proximally via the proximal thrust element, so that manual locking by means of a clamping lever at the central joint of the retaining device is no longer necessary.

[0011] Thanks to the use of a ramp system with a wedge body which preferably includes wedge surfaces inclined on both sides, friction losses can be reduced and the degree of efficiency can be improved up to three times compared with traditional force transmission mechanisms which do not use any wedge body and any sliding part.

[0012] According to a further aspect of the invention, at least one ramp system comprises a base plate through which the clamping bolt passes, having at least one base ramp surface, and a counter plate which is attached to the clamping bolt and includes at least one counter ramp surface, the wedge body subjected to the force being sliding between the ramp surfaces and being designed to move the counter plate relative to the base plate supported on a housing of the joint and thus to deflect the force by 90°.

[0013] The clamping bolt passes through the base plate, and at least one ramp surface of the base plate faces an associatable shim surface of the shim body. This design contributes to optimizing the overall size of the ramp system in the central joint of the retaining device. During its sliding motion, the shim body is both perpendicular to the clamping axis and axially sliding relative to the clamping axis. The axial component of the sliding path is thus unilaterally reduced by the base plate bearing against the housing, so that the axial sliding from the release position to the locking position occurs in the direction of the movable counter-plate, thereby moving the latter in conjunction with the clamping bolt for locking.

[0014] According to a further aspect of the invention, the component directed perpendicularly to the clamping axis of the sliding path of the wedge body between the release position and the locking position is definable by the length of a central oblong hole in the wedge body.

[0015] The oblong hole forms a through opening in the shim body for the clamping bolt, so that the shim body forms a substantially oval hollow cylinder, the base or annular surfaces of which comprise one or two opposing shim surfaces, respectively. The oblong hole is designed to allow the shim body to slide both perpendicularly and axially with respect to the clamping bolt. Depending on the dimensions of the length or width of the oblong hole, the sliding movement of the shim body 008 with respect to the clamping bolt 010 can be with some play or be partially guided by at least one wall of the oblong hole. The ends of the oblong hole in the shim body can thus act as a stop and / or a guide, in order to limit sliding perpendicular to the clamping axis and / or to guide the shim body along the clamping axis.Any friction that may occur during sliding movement between at least one of the oblong hole walls of the shim body and the clamping bolt should be kept low by constructing proportionally small contact surfaces, in order to allow low-friction lateral movement of the shim body on the clamping bolt.

[0016] According to a further aspect of the invention, at least one base ramp surface and at least one counter ramp surface come into contact with each other with the associatable wedge surfaces of the wedge body respectively by means of at least one sliding piece.

[0017] Thanks to the complementary use of sliding parts, the friction between the respective cooperating sliding partners, i.e. the wedge surfaces and the associatable ramp surfaces, can be significantly reduced.

[0018] According to a further aspect of the invention, the sliding parts are rolling parts in the form of ball joints, cylindrical rollers or barrel-shaped rollers.

[0019] In this way, the friction between the cooperating surfaces can be reduced to the lowest possible level. Particularly advantageously, the invention features barrel-shaped rollers in which the outer surface is designed to be convex. These barrel-shaped rollers not only have a smaller bearing surface compared to cylindrical rollers, but also allow for automatic centering on ramp or wedge surfaces that are convex or curved.

[0020] According to a further aspect of the invention, the base ramp and / or the counter ramp respectively comprise two recesses having at least in sections the shape of a cylindrical segment, which respectively comprise a track surface curved towards the respective sliding piece as a ramp surface.

[0021] In this way, favorable geometric ratios and self-centering surfaces can be provided for the sliding parts, thereby promoting low-friction and reliable operation of the ramp system. Not only the ramp surfaces, but also the shim surfaces cooperating with them should have curved or convex tracks to allow low-friction sliding of the surfaces against each other. The use of sliding or rolling parts in curved or convex tracks of the cooperating surfaces can thus result in a significant reduction in friction compared with traditional linear bearings.

[0022] According to a further aspect of the invention, the sliding of the distal thrust element is usable for the friction locking of a distal connecting part and / or a medical instrument.

[0023] In this way, a medical instrument such as a surgical instrument or optical or similar auxiliary aids can be held with the retaining device via a connecting part or directly. In order to meet different requirements in different surgical scenarios, the length of the retaining segments and the retaining force may vary. Thus, proportionally short retaining devices, ranging from approximately 15 cm to 20 cm in length per retaining segment, are required when relatively high retaining forces of at least 3 kg, preferably 5 kg, must be applied.

[0024] According to a further aspect of the invention, the distal connecting part is a wrist, which can be coupled to a handle which includes at least one actuating element in order to selectively lock or release the joint.

[0025] Using a distal handle and in particular the actuating element, the operator or another user can easily lock or release the holding device, i.e. with one hand.

[0026] According to a further aspect of the invention, the joint housing is designed in two parts and the ramp system is arranged in the proximal and / or distal half of the housing.

[0027] It is particularly advantageous to provide the ramp system on the proximal face of the joint housing when high forces are required to lock the central joint. With this arrangement of the ramp system, the proximally applied force can be increased approximately threefold, and the travel can be reduced by one-third compared to traditional locking mechanisms without a wedge body. Thanks to the ramp system, proportionally short sliding displacements can lead to very high pinching or locking forces on the central joint. In this way, it can be ensured that a reliable locking of the joint is achieved and that the two halves of the housing are pressed against each other with a high force.

[0028] Depending on the desired force-path ratios, an additional ramp system with a wedge body and sliding parts can be arranged in the distal half of the housing as an alternative to, or in addition to, the arrangement in the proximal half of the housing.

[0029] According to a further aspect of the invention, the retaining segments pivot relative to each other through a maximum pivot angle of 340° via the joint.

[0030] It is particularly advantageous to limit the rotation around the main articulation axis to 340° when a cable is guided from the first to the second retaining segment. In this way, technical malfunctions or breakage of a cable connected to the retaining device can be advantageously avoided.

[0031] Limiting the pivoting capacity to a maximum of 340° can be achieved by means of a torsional safety pin and a suitable circumferential groove with stops arranged respectively in one half of the housing of the central joint of the retaining device. The stops are formed as bearing surfaces extending radially in the circumferential groove or respectively at the end of a partially annular circumferential groove and can limit the angle of rotation to said 340°, so as to obtain a dead angle of 20°. Thus, dead angles of at least 20° are preferable, since these are more robust to produce and therefore favorably influence the service life of the retaining device.

[0032] According to a further aspect of the invention, the deflection elements further comprise a ramp sleeve which includes a curved ramp surface for a sliding piece, the ramp sleeve being rotationally connected to the clamping bolt and being sliding by sliding from the relative position of the clamping bolt along the clamping axis and being in contact with a thrust element for force deflection via the sliding piece.

[0033] In this way, the ramp system can be combined with a ramp sleeve. This is advantageous when a significantly lower force needs to be applied or dissipated in one half of the housing compared to that in the other half. For example, the ramp sleeve can be positioned in the distal half of the housing when a significantly lower force is required to clamp a distal connecting part compared to that required to clamp the joint of the retaining device.

[0034] According to a further aspect of the invention, the thrust elements are designed in the form of thrust rods in one or more parts.

[0035] In other words, the thrust elements can either be designed as a single unit or consist of separate parts. One or two thrust elements thus serve as thrust rods or what are called pushers and can, for example, be loosely inserted into the respective open retaining segments and can therefore be easily replaced if necessary. The individual thrust elements, as well as the other parts of the retaining device, are suitable for machine cleaning and disinfection, as well as for steam sterilization in an autoclave.

[0036] According to a further aspect of the invention, the end of the push rod cooperating with the sliding part of the ramp sleeve comprises a ramp surface.

[0037] Preferably, the end near the joint of the distal pushrod comprises a ramp surface whose angle, together with the angle of the ramp sleeve, determines the ratio in which force and path are applied. Loosely insertable pushrods with ramp surfaces, also called ramp pushers, can be easily removed from the retaining segment and replaced, if necessary, with a ramp pusher having a different angle.

[0038] According to a further aspect of the invention, the proximal housing half comprises the ramp system and the distal housing half comprises the ramp sleeve with a sliding piece designed in the form of a cylindrical or barrel-shaped bearing piece.

[0039] This is advantageous when, for example, a significantly lower force is required for pinching a distal connecting part compared to that required for pinching the joint of the retaining device.

[0040] According to a further aspect of the invention, the joint includes a removable end cover at the proximal half of the housing to allow manual sliding of the relative position of the clamping bolt beyond the proximal end of the clamping bolt.

[0041] If the end cover at the joint is removed, the clamping bolt at its proximal end can be manually slid using suitable tools without applying force to the proximal retaining segment. In this way, the retaining device can be manually adjusted, and fine-tuning, which is generally carried out by the retaining device manufacturer or maintenance personnel, can be performed.

[0042] According to a further aspect of the invention, the clamping bolt includes at the proximal end a thread for a nut which is designed for manual sliding of the relative position of the clamping bolt.

[0043] This nut can be used simply with a traditional tool such as a screwdriver and can be subjected to the necessary adjustments or maintenance in a simplified manner.

[0044] According to a further aspect of the invention, the joint housing and / or the retaining segments include at least one housing for spring means.

[0045] Said spring means can advantageously guarantee a certain residual restraint and thus prevent uncontrolled loosening of free retaining segments of the retaining device or of joints which are connected to the distal retaining segment.

[0046] According to a further aspect of the invention, the proximal retaining segment can be connected at its proximal end to a pinching device by means of which the thrust element of the proximal retaining segment is slidable for locking and releasing the joint of the retaining device.

[0047] As a drive unit for the relative sliding of the proximal thrust element, a spindle drive or similar device is provided, for example. These drives allow for simple control of the relative sliding, since they can be operated either manually or, advantageously, by means of a motor.

[0048] According to a further aspect of the invention, the retaining device and the pinching device can be connected to each other by means of a coupling device.

[0049] The coupling device is designed so that it can quickly couple the holding device to the pinching device or uncouple the holding device from the pinching device. In this respect, the coupling device is designed so that it cannot become disengaged during operation, even if significant forces are acting on the holding device during its operation.

[0050] According to a further aspect of the invention, a cable is guided from a proximal actuating element at the level of a handle, which is connected at the level of the distal retaining segment, along the retaining segments bypassing the joint and is connected to a drive unit in order to axially slide the proximal thrust element of the retaining device by means of a spindle that can be driven from the pinching device.

[0051] In this way, the cable can be used to connect a proximal drive unit for applying proximal force to a distal actuation element. The cable, guided along the retaining segments, generally bypasses the joint of the retaining device in a slack knot. There is a risk here, in an embodiment of the retaining device without limiting the pivoting capacity of the retaining segments, that the cable will be twisted or overloaded, the cable's operating capacity could be compromised. To provide lasting protection against overload or breakage, the cable's guidance along the support segments must allow for a rotational range of at least 340° at the joint of the support device or the support segments relative to each other.

[0052] A method is further provided for human or veterinary medical applications for locking and releasing a joint of a restraint device with two restraint segments pivoting relative to each other. The method comprises the following steps: sliding an axially sliding thrust element within a proximal restraint segment, deflecting the proximal thrust force of the proximal thrust element on the clamping axis of the joint's clamping bolt to lock the joint, and deflecting the clamping force on the distal thrust element of the distal restraint segment to lock a distal connecting part and / or a medical instrument by sliding the distal thrust element away from the clamping axis, wherein the deflection is effected by means of deflection elements comprising at least one ramp system with a wedge body. Brief description of the figures

[0053] Additional advantages and features of the invention will result from the following description of exemplary embodiments using the figures.

[0054] [Fig-1] shows a perspective view of one embodiment of a holding device according to the invention;

[0055] [Fig.2A] shows a schematic top view of an additional embodiment of a retaining device according to the invention with housing and a partial cross-sectional view in the released position;

[0056] [Fig.2B] shows a schematic top view of the holding device shown in [Fig.2A] in the locked position;

[0057] [Fig.3A] shows an exploded perspective view of a holding device according to the invention;

[0058] [Fig.3B] shows a detailed view of the proximal part of the retaining device shown in [Fig.3A] comprising a ramp system;

[0059] [Fig.4] shows a schematic view of a retaining system with an additional embodiment of the retaining device according to the invention; and

[0060] [Fig.5] shows a schematic process diagram for locking the joint of the retaining device according to the invention.

[0061] The representations are schematic and not necessarily to scale. Furthermore, they do not show all the details, but are limited to the representation partial description of the essential features of the invention, as well as additional features that facilitate its explanation and description. Identical elements in the different figures are designated by the same reference numerals. Detailed description of the figures

[0062] The perspective view of [Fig. 1] shows one embodiment of a support device 020 according to the invention for human or veterinary medical applications. This support device 020 consists of a proximal support segment 001 and a distal support segment 017, and a joint 021 connecting the proximal and distal support segments 017. The joint 021 is shown in a simplified manner, i.e., without a housing, and demonstrates the essential components necessary for transmitting or deflecting force.

[0063] The two retaining segments 001 and 017 are pivotally mounted by means of the biocable joint 021. The ramp system comprises a base plate 005 through which a clamping bolt 010 passes. The counter-plate 009 also passes through the clamping bolt 010, but is secured to the clamping bolt 010, unlike the base plate 005. Both the base plate 005 and the counter-plate 009 comprise at least one ramp surface (29, 25) that cooperates with the wedge surfaces 028 of a wedge body 008. For this purpose, the wedge body 008 is arranged between the base plate 005 and the counter-plate 009.

[0064] The wedge body 008 is designed in the form of a hollow cylinder and includes at its two base surfaces at least one wedge surface 028, which on one face rests opposite at least one base ramp surface 025 and on the other face is associatable with at least one counter-ramp surface 029. The ramp surfaces 025 and 029 come into contact with the associatable wedge surfaces 028 of the wedge body 008 by means of sliding parts 011.

[0065] The clamping bolt 010 has, at its proximal end, a thread (not shown here) for a nut 012, which allows the relative position of the clamping bolt 010 to be manually adjusted for the purpose of adjusting or maintaining the retaining devices. Generally, this adjustment option with the nut 012 is not used for the normal operation of the retaining device, since the force applied to lock the joint 21 is applied to the face of the proximal tubular retaining segment 001.

[0066] The distal end of the clamping bolt 010 is not visible in [Fig.1], since it is disposed in a ramp sleeve 007. The ramp sleeve 007 comes into contact with the thrust element (not shown in [Fig.1]) extending axially in the retaining segment 017 by means of a sliding piece 013. The retaining segment 017 includes at its end a thread so that it can be connected to the distal housing half (not shown here).

[0067] Figure 2A shows a schematic top view of the retaining device 020, in which the joint 021 and the near ends of the joint of the retaining segment 001 and 017 are shown in a partial cross-section, and the two housing halves 003 and 014 of the joint 21 are also shown. Figure 2A shows, in the partial cross-section, that the housing of the joint 021 is designed in two parts. In this respect, the proximal housing half 014 comprises the ramp system, and the distal housing half 003 comprises the ramp sleeve 007.

[0068] The partial cross-sectional view of the distal retaining segment 017 shows that the retaining segment 017 and the distal housing half 003 are connected via a thread. The partial cross-sectional view further shows that two axially sliding thrust elements 015 and 016 are arranged in the retaining segment 017. The ramp sleeve 007 comes into contact with the thrust element 015 via the sliding part 013. The thrust element 015 includes a ramp surface 024 curved towards the sliding part 013. The ramp surface 024, thus optimized from the point of view of friction, of the thrust element 015 or the ramp pusher 015 forms the friction surface with the sliding part 013. On the other face of the sliding part 013 is arranged a ramp surface 027 of the ramp sleeve 007.To assist automatic centering in ramp tracks, the sliding part 13 is preferably designed as a rolling part in the form of barrel-shaped rollers.

[0069] Additional sliding parts 011 are located in the ramp system within the proximal housing halves 014. The base ramp 005 and the counter-ramp 009 each comprise recesses having, in sections, the shape of a circular segment, which each include a track surface curved towards the respective sliding part 011. The curved tracks also serve for the automatic centering of the sliding parts 011. By using the sliding or rolling parts in the form of barrel-shaped rollers, friction can be reduced, and automatic centering can be assisted on curved tracks.

[0070] In the shown release position of the retaining device, the sliding pieces 011 are arranged at the proximal ends of the ramp surfaces, and the wedge body 008 is substantially perpendicular to the clamping axis. By sliding the thrust element 002 in the distal direction, the wedge body 008 can slide both distally and axially. A possible sliding movement or displacement by sliding from the shown release position of the thrust element 002 in the distal direction is indicated by arrow 022.

[0071] In the released position or release position shown, the two housing halves 003 and 014 are movable relative to each other around the clamping axis. Thus, the retaining segments 001 and 017 are also movable relative to each other through a significant pivoting angle. The cylindrical pin or safety pin 004 limits the pivoting capacity to a range preferably starting from 340° and thus prevents endless twisting of the retaining segments 001 and 017 relative to each other.

[0072] A limitation on the pivoting capacity is advantageous when a cable is guided along the first to second retaining segment and this cannot cause damage through overload due to the restricted rotational capacity. If there is no cable guidance along the retaining device, but another method of signal transmission such as radio control is provided, the mechanical limitation of the cylindrical pin 004 can be eliminated and an infinite rotational capacity of the retaining segments 001, 017 can be permitted between them.

[0073] The end cover 006 blocks access to the nut 012 and the proximal end of the clamping bolt 010. If the end cover 006 at the joint 021 is removed, the clamping bolt 010 can be manually slid at its proximal end using suitable tools, without applying force to the proximal retaining segment. The adjustment is made, for example, with a screwdriver or similar tool. Manual adjustment is generally only intended before initial commissioning and possibly for subsequent maintenance. This is advantageous when the adjustment is intended to be made only without load, i.e., adjusted with the clamping bolt 010 loosened. After delivery of the retaining device 020 to the user, the distal end of the clamping bolt 010 is generally located under the cover 006.This should prevent the user from changing the setting necessary for operation themselves.

[0074] If the thrust element 002 is made to slide in the distal direction along arrow 022, both the joint 021 and the distal medical instrument cooperating via thrust elements 015 and 016 can be locked together. This is achieved by means of the clamping bolt 010 arranged perpendicular to the retaining segments 001 and 017. Its mode of operation is explained with reference to [Fig. 2B].

[0075] Figure 2B represents the locked position or blocking position, in which identical elements are identified by the same reference numerals. By applying force to the proximal face of the retaining segment 001, the thrust element 002 was made to slide into the locking position in the direction of the central joint 021, so that the wedge body 008 moved between the ramp 005 and the counter-ramp 009 from the release position into the locking position. When force is applied, the wedge body 008 is moved so that it is rejected respectively from the housing and from one of the counter-ramp plates 009 by means of the sliding parts 011. Thus, the counter-ramp 009 is secured to the clamping screw 010.

[0076] The sliding movement of the wedge body 008 from the release position to the locking position has a component both perpendicular to the clamping axis and along the clamping axis. By means of the wedge body 008, the proximal force applied via the thrust element 002 can be deflected 90° in the clamping axis, thereby clamping the joint 021. In the locking position, a proximal face of the wedge body 008 rests against the base plate, while the beveled distal end of the wedge body 008 can abut against the distal housing wall extending parallel to the clamping axis of the housing half 014. Thus, the wedge body 008 adopts the inclined position shown in [Fig. 2B] relative to the clamping axis.The 008 wedge body can thus be used advantageously so that the resulting counter-forces during the locking process can be applied directly to the housing during the lateral force deflection.

[0077] The applied force can also be deflected by 90° by means of the ramp sleeve 007, the ramp sleeve 007 being rotationally connected to the clamping bolt 010. In order to reach the locking position shown, the ramp sleeve 007 was made to slide together with the clamping bolt 010 along the clamping axis in the proximal or axial direction (arrow 23). Arrow 23 indicates the sliding movement of the clamping bolt 010 from the release position to the locking position.

[0078] The discharged force is transmitted to the distal thrust element 016 via the ramp pusher 015 or the thrust element 015 with the ramp surface 024, in order to block a joint or a medical instrument connected to it by means of the outward sliding of the thrust element 016. Thanks to the use of curved ramp surfaces and sliding parts 013, the force deflection can be achieved with relatively little friction and downstream mounted joints which are connected to the thrust elements 015 or 016 are blocked by means of the distal sliding generated.

[0079] Figure 3A shows an exploded view of one embodiment of the present invention. The two joint halves 003 and 014 and their corresponding components can thus be clearly seen. The proximal right joint half 014 comprises the ramp system with the wedge body 008, while the distal joint half 003 essentially comprises a ramp sleeve 007. A sliding disc 030 is disposed between the housing halves 003 and 014. The low-friction rotational capability of the 021 joint is preferably achieved using a diamond-carbon disc. Torsional rotation is preferably limited to 340° by means of the torsional safety pin 004 in cooperation with a circumferential groove (not shown) extending into the distal half of the housing. For this limitation, the circumferential groove includes radially extending or similar abutment surfaces.

[0080] On the proximal articulation face with the ramp system, the proximal force can be increased approximately threefold, and the travel can thus be reduced by one-third compared to traditional locking mechanisms. This is particularly advantageous, since in this way the two housing halves can be pressed together with a high force. On the distal face, shown here on the left side in [Fig. 3A], the clamping force is then deflected again by 90° in the distal direction. In the embodiment shown, this deflection is achieved by means of a ramp sleeve 007, which cooperates with the thrust element 015 via the sliding piece 013.

[0081] The embodiment shown of the retaining device illustrates two principles for force transmission. On the one hand, this embodiment of the retaining device 020 comprises, on the proximal face, a combination of sliding parts 011 or bearing parts with a wedge body 008. On the other hand, a sliding part 013 in conjunction with a ramp sleeve 007 is provided on the face of the distal housing half 003. These variants can be combined in any way depending on the desired force-path ratios. For example, as an alternative to the ramp sleeve 007, a second wedge body 008 with a ramp system cooperating with it can be arranged in the distal housing half 003.

[0082] Figure 3B shows exclusively the proximal housing half 014 and the corresponding components, in order to illustrate the details. The base plate 005 is designed in the form of a substantially oval hollow cylinder with a round through hole. The proximal base surface of the base plate 005 includes opposing recesses in the form of a parabolic segment, which comprise curved channels in the form of base ramp surfaces 025. Curved ramp surfaces or channels in this manner are also formed in the wedge body 008 by means of the wedge surfaces 028.

[0083] The wedge body 008 is also designed in the form of a hollow cylinder whose base surfaces comprise said curved wedge surfaces 028. [Fig. 3B] further shows that the through hole in the wedge body 008 is designed in the form of an oblong hole (026), in order to allow sliding movement of the wedge body 008 both axially and perpendicularly to the clamping axis. Finally, The two wedge surfaces 028 facing the counter plate 009 cooperate with two counter ramp surfaces 029 of the counter plate 009 via the sliding pieces 011. The counter ramp surfaces 029 also include curved tracks like the wedge surfaces 028.

[0084] It is advantageous to provide the ramp system in the right or proximal face of the joint housing as shown in [Fig. 3B], since high forces are required here for the central joint to be clamped. In this way, reliable locking of the joint can be ensured. Thanks to the ramp system, small displacements can lead to very high clamping or locking forces on the central joint. As shown in [Fig. 3B], the bearing parts 011 move in crowned and curved raceways for friction reduction and self-centering. This is advantageous compared to traditional linear bearings and can optimize cost and space.

[0085] Figure 3B shows that the thrust element 002 has a groove at its proximal end for spring-loaded means. By using spring-loaded means, a predefined residual restraint can be ensured, and loosening of free retaining segments of the retaining device or of joints connected to the distal retaining segment can be prevented. During operation, the thrust element 002 is driven at its distal face into the retaining segment 001 or the open stump and at its proximal face into a coupling device 300, which is illustrated in the following Figure 4.

[0086] Figure 4 shows a holding system with a holding device 20 according to the invention. At its proximal end, the holding device 20 is connected to a clamping device 100 via a coupling device 300. At the base of the holding system is the base column 101. This base column, or holding segment, 101 is compatible with all existing and common clamping units 105, so that it can be securely clamped to an operating table. For example, the base column or holding segment 101 can have a diameter of approximately 16 mm. Depending on a particularly large payload, larger diameters of up to 2 cm can also be provided. The clamping device 100 includes a housing 150.For the pivoting capability of the support segment or base column 101 there is, between the housing of the pinching device 100 and the support segment 001, a joint 152 which can also be called a shoulder joint because of the support system or support arm connected distally to the pinching device 100.

[0087] The attachment point of the clamping unit 105 for the first support segment 101 is located in the proximal area of ​​the clamping device 100. The proximal area may be near the floor or an operating table. Alternatively, the support system may be ceiling-mounted, unlike a system mounted on an operating table. The distal area of ​​the support system is the area furthest from the proximal area. A support device 20, in the form of a support arm with an upper arm or forearm, is connected to the distal face of the clamping device via a coupling device 300. The connected support device 20 comprises two support segments 001 and 017 that are pivotally connected to each other by a central joint 21.

[0088] A handle 019 is connected to the distal retaining segment 017. A medical instrument, for example, can be attached to the free end of the handle 019 or the retaining system. For this purpose, the distal end of the handle 019 includes a coupling unit 170. This coupling unit 170 can preferably be designed as a quick-connect unit such as the known KSLOCK interfaces. Various medical instruments, such as micro-scissors, forceps, tweezers, punches, or the like, can be connected to such an autoclavable quick-connect unit 170. Auxiliary means for the operation can also be provided, which can be attached to the quick-connect unit 170. Thus, for example, a hand rest can be coupled via the quick-connect unit 170.With such hand support, operators can maintain a steady hand during surgical procedures lasting several hours.

[0089] The handle comprises, in addition to the wrist connection 018, which is preferably designed as a ball joint, and the quick-coupling unit 170, an actuating element 169. The distal actuating element 169 activates the drive unit 160 of the clamping device 100. The control signal for activating or actuation the drive spindle 110 shown can be transmitted via the cable 168 to the drive unit 160. The cable 168 is partially guided along the retaining segments 017 and 001. The cable is guided with some play between the proximal retaining segment 001 and the distal retaining segment 017, so that the central joint 21 can move freely. To the advantage of cable protection, the torsional capacity of the joint is limited to 340°.

[0090] When the cable is guided to the proximal end of the retaining segment 001, it enters the bolt element 301. The introduction of the cable into the bolt element 301 of the coupling device allows the control signals to be routed via the coupling device 300 to the drive unit. 160. The coupling device 300 includes within it suitable contact elements, in order to transfer the signal carried via the cable to the drive control unit 160. As an alternative to cable-guided activation, radio-controlled control of the pinching device 100 is also conceivable.

[0091] In the example shown, the drive unit 160 for the spindle 110 comprises an electric motor 161 with a transmission 162. The drive unit 160 is powered by a battery 163. The battery 163 is located in the battery compartment 164 and is controlled via the battery control unit 165. In addition, the housing contains a drive control unit 166 and a switching logic 167. The spindle 110 can be driven by means of the transmission 162 of the electric motor 161.

[0092] The design of the thrust elements, support segments, and joints of the support system depends on the forces to be transmitted and the parts or instruments to be connected. The maximum reach of the support system and, simultaneously, the highest stress are achieved when the arm is extended horizontally. In this position, the support system according to the invention can achieve a holding force of at least 3 kg and 5 kg. Reaches given by way of example for the support system as a whole are between 55 cm and 71 cm. For applications in sterile environments, it is necessary to sterilize the support device 020 and the connecting parts. Parts of the support system that do not require sterilization, such as the coupling device and the clamping device, can be covered with a suitable sterile cover or sheet.

[0093] Figure 5 shows the essential process steps for locking a joint of a retaining device according to the present invention. The first process step involves sliding at least one axially sliding thrust element 002 within a proximal retaining segment 001 of the retaining device 020. The second process step involves deflecting the proximal thrust force of the proximal thrust element 002 by means of at least one ramp system with a wedge body 008 to lock the joint 021 of the retaining device 020. In the additional process step 203, the clamping force is deflected onto at least one distal thrust element 015, 016 of the distal retaining segment 017 to lock a distal connecting part and / or a medical instrument. In the aforementioned process, high forces for pinching the joint are advantageously obtained with short paths.If the retaining device 020 needs to be moved from the locking position to the release position, the proximal pushing element 002 can be brought back to the starting position for this purpose. List of references

[0094] 001 Proximal support segment

[0095] 002 Proximal thrust element

[0096] 003 Distal joint housing half

[0097] 004 Safety pin

[0098] 005 Base rail plate

[0099] 006 End cover

[0100] 007 Handrail sleeve

[0101] 008 Bilge barrel

[0102] 009 Counter plate with counter ramp surfaces

[0103] 010 Clamping bolt

[0104] 011 Sliding part of the ramp system

[0105] 013 Ramp sleeve sliding part

[0106] 015 Thrust element with ramp surface

[0107] 016 Thrust element (distal)

[0108] 017 Support segment (distal)

[0109] 018 Wrist

[0110] 019 Handle [YES] 020 Support device

[0112] 021 Articulation

[0113] 022 Axial longitudinal displacement in the distal direction

[0114] 023 Axial displacement along the clamping axis in the proximal direction

[0115] 024 Ramp surface of the distal pusher element or ramp pusher

[0116] 025 Base ramp surface

[0117] 026 Oblong hole in the bilge body

[0118] 027 Ramp surface of the ramp sleeve

[0119] 028 Hold area

[0120] 029 Counter-ramp surface

[0121] 030 Disc

[0122] 031 Groove for spring means

[0123] 100 Pinching device

[0124] 101 Support segment or base column

[0125] 105 Pinch Unit

[0126] 110 Pin

[0127] 150 Housing of the pinching device

[0128] 152 Joint, basic joint

[0129] 160 Training Unit

[0130] 161 Electric motor

[0131] 162 Transmission

[0132] 163 Battery

[0133] 164 Battery compartment

[0134] 165 Battery control unit

[0135] 166 Drive control unit

[0136] 167 Switching Logic

[0137] 168 Cable

[0138] 169 Actuating element

[0139] 170 Coupling unit for a distal connecting part and / or a instrument

[0140] 201 Process step: sliding of a proximal thrust element

[0141] 202 Process step: deviation of proximal thrust force for blocking

[0142] 203 Process step: blocking a distal connecting part or a medical instrument

[0143] 300 Coupling device

[0144] 301 Bolt element

[0145] 303 Coupling groove flank

[0146] 325 Coupling Actuator

Claims

Demands

1. A restraint device for human or veterinary medical applications comprising: a joint (021) between a proximal restraint segment (001) and a distal restraint segment (017); wherein, in the restraint segments (001, 017), at least one axially sliding thrust element (002, 016) is disposed respectively; wherein the joint comprises a clamping bolt defining the pivot and clamping axis and deflection elements, by means of which a thrust force acting with respect to the axis of at least one proximal thrust element (002) can be deflected for locking the joint (021) on the clamping axis and for sliding at least one distal thrust element (016);and in which the deflection elements comprise at least one ramp system with a wedge body (008), characterized in that the at least one ramp system comprises: - a base plate (005) through which the clamping bolt (010) passes, with at least one base ramp surface, and - a counter plate (009) which is fixed to the clamping bolt and comprises at least one counter-ramp surface (029), in which the wedge body (008) subjected to the force slides between the ramp surfaces and is designed to move the counter plate (009) relative to the base plate (005) supported on a housing of the joint in the direction of the clamping axis and thus deflect the force by 90°, the at least one base ramp surface (025) and the at least one counter-ramp surface (029) come into contact with each other with the associatable wedge surfaces (28) of the keel body (008) respectively via at least one sliding part (011).;

2. Retaining device according to claim 1, wherein the component directed perpendicularly to the clamping axis of the sliding path of the wedge body (008) between the release position and the locking position is definable by the length of a central oblong hole (026) of the wedge body (008).

3. A retaining device according to claim 1, wherein the sliding parts (011) are bearing parts in the form ball joints, cylindrical rollers or barrel-shaped rollers.

4. A retaining device according to any one of claims 1 or 3, wherein the base ramp (005) and / or the counter ramp (009) respectively comprise two recesses having at least in sections the shape of a cylindrical segment, which respectively comprise a track surface curved towards the respective sliding piece (011) as a ramp surface (025, 029).

5. A retaining device according to any one of the preceding claims, wherein the sliding of at least one distal thrust element (016) is usable for friction locking of a distal connecting part and / or a medical instrument.

6. A holding device according to claim 5, wherein the distal connecting part is a wrist (018), which can be coupled to a handle (019) comprising at least one actuating element (169) in order to selectively lock or release the joint (021).

7. Retaining device according to any one of claims 1 to 5, wherein the joint housing (021) is designed in two parts and the ramp system is disposed in the proximal and / or distal half of the housing.

8. A retaining device according to any one of the preceding claims, wherein the retaining segments (001, 017) are pivotable relative to each other through a pivot angle of up to 340° via the joint (021).

9. A retaining device according to any one of the preceding claims, wherein the deflection elements further comprise a ramp sleeve (007) which includes a curved ramp surface for a sliding piece (0013), wherein the ramp sleeve (007) is rotationally connected to the clamping bolt (010) and is sliding by sliding from the relative position of the clamping bolt along the clamping axis and is in contact with a thrust element for force deflection via the sliding piece (013).

10. A holding device according to any one of the preceding claims, wherein the thrust elements (001, 0016, 0017) are designed in the form of thrust rods in one or more parts.

11. Retaining device according to claims 9 and 10, wherein the thrust element (15) cooperating with the sliding piece (013) of the ramp sleeve (007) comprises a ramp surface.

12. Retaining device according to any one of claims 7 to 11, wherein the proximal housing half comprises the ramp system and the distal housing half comprises the ramp sleeve (007) with a sliding piece (013) designed in the form of a cylindrical or barrel-shaped bearing piece.

13. Retaining device according to any one of claims 7 to 12, wherein the joint includes a removable end cover (006) at the proximal housing half to permit manual sliding of the relative position of the clamping bolt (010) beyond the proximal end of the clamping bolt (010).

14. A retaining device according to any one of the preceding claims, wherein the clamping bolt (010) includes at the proximal end a thread for a nut which is designed for manual sliding of the relative position of the clamping bolt (010).

15. Retaining device according to any one of claims 1 to 14, wherein the joint housing and / or the retaining segments (001, 017) comprise at least one housing for spring means.

16. A retention system comprising a retention device (020) according to any one of the preceding claims, wherein the proximal retention segment (001) can be connected at its proximal end to a pinching device (100) by means of which the thrust element (002) of the proximal retention segment (001) is slidable for locking and releasing the joint (21) of the retention device (20).

17. Retaining system according to claim 16, wherein the retaining device (20) and the pinching device (100) can be connected to each other by means of a coupling device (300).

18. A holding system according to claim 16 or claim 17, wherein a cable (168) is guided from a proximal actuating element (169) to a handle (019), which can be connected to the distal holding segment

19. (017), along the retaining segments (017, 001) bypassing the joint (21) and is connected to a drive unit (160) in order to axially slide the proximal thrust element (002) of the retaining device (020) by means of a driveable pin (110) of the pinching device (100). Method for human or veterinary medical applications for blocking and releasing a joint (021) of a retaining device (020) with two retaining segments pivoting relative to each other (001, 017), comprising the following steps: - sliding (201) of at least one axially sliding thrust element (002) in a proximal support segment (001); - deflection of the proximal thrust force (202) of the proximal thrust element (002) on the clamping axis of the clamping bolt (010) of the joint (021) in order to lock the joint (021); and - deflection of the clamping force (203) on at least one distal thrust element (016) of the distal retaining segment (017) in order to lock a distal connecting part and / or a medical instrument by sliding the distal thrust element (016) away from the clamping axis; in which the deviation is effected by means of deviation elements comprising at least one ramp system with a wedge body (008), characterized in that the at least one ramp system comprises: - a base plate (005) through which the clamping bolt (010) passes, with at least one base ramp surface, and - a counter plate (009) which is attached to the clamping bolt and includes at least one counter ramp surface (029), in which the wedge body (008) subjected to the force slides between the ramp surfaces and is designed to move the counter plate (009) relative to the base plate (005) supported on a housing of the joint in the direction of the clamping axis and thus to deflect the force by 90°, the at least one base ramp surface (025) and the at least one counter ramp surface (029) come into contact with each other with the associatable wedge surfaces (28) of the wedge body (008) respectively by means of at least one sliding piece (011).

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