Caiman Ring Forceps - Manual HF Activation

Abstract

The present invention relates to a bipolar HF instrument (1) comprising a jaw part (2), a first instrument branch (3) and a second instrument branch (4) for grasping tissue, which are arranged and designed to move away from each other when opening and towards each other when closing, a blade actuation element (5) for moving a mechanical blade (6) in the jaw part (2) for cutting the tissue and / or a HF activation element (7), preferably in the form of a knob or button, for activating the HF power source for sealing the tissue, characterized in that the blade actuation element (5) and / or the HF activation element (7) are arranged and designed in such a way that they can be simultaneously operated from two opposite sides of the HF instrument (1).

Description

[Technical field]

[0001] The present disclosure relates to a (medical) bipolar HF instrument, preferably of the scissors or pliers type, having first and second instrument branches (intersecting at a hinge) forming or having jaws at the distal instrument end, e.g. for grasping tissue, and holding / actuating features (handles, finger rings, etc.) at the proximal instrument end, all arranged and configured to open away from each other and close towards each other for manual cutting and (HF) sealing of tissue, especially in open surgery. [Background technology]

[0002] Generally, surgical sealing and cutting instruments of the above type are known that use high frequency (HF) currents for sealing with bipolar technology and mechanical blades for cutting (living) tissue. It is permanently activated automatically when the branches are pressed together. A blade lock is often built into the instrument as a safety feature when the branches are open. Furthermore, an HF button is usually provided that gives tactile feedback in two stages (two-click button). The first click indicates to the user that the defined closure state has been reached, while the second click activates the HF current. This prior art surgical instrument allows for quick operation, especially for experienced users. It has a clear separation of the cutting and sealing functions and is also low in manufacturing costs.

[0003] Alternatively, there are surgical instruments that use ultrasound for sealing and cutting, which can be manually activated. In addition, these surgical instruments offer a MIN and MAX mode selectable on the instrument, with the particular advantage that unintentional activation during closure is not possible, since the user has the freedom to select, giving greater control and safety.

[0004] However, known surgical instruments have the drawback of having to constantly hold the HF button, which is not ergonomic and can tire the user in the long term, especially since several activations are considered per procedure. The variation in applied pressure can be another drawback, since the user can vary the operating pressure of the instrument / branch with the force of his hand, which can have a negative effect on the sealing result. Other drawbacks include the possibility of accidental HF activation if compressed too quickly and the asymmetric arrangement of the blade actuation elements, which has a preferred orientation during handling.

[0005] US Patent No. 10188450 describes pliers having first and second shafts (branches), each having a jaw member disposed at its distal end. At least one jaw member is movable from an open position to a closed position for grasping tissue therebetween. The at least one jaw member is configured to reciprocate a blade. The trigger assembly includes a trigger and at least one linkage connected to the trigger and the blade such that rotation of the trigger moves the blade between a retracted position and an extended position. An engagement element is also provided that is movable between a locked position and an unlocked position. The engagement element is configured to engage the linkage in the locked position to prevent displacement of the blade from the retracted position to the extended position.

[0006] U.S. Patent No. 10,660,694 describes a switch assembly for an electrosurgical instrument having a switch housing, a switch, a first prestressing element, and an additional prestressing element. The switch is disposed within the switch housing and is movable between an activated position for initiating delivery of electrosurgical energy and a non-activated position for terminating delivery of electrosurgical energy. The first prestressing element is selectively positionable adjacent to and in communication with the switch. The first prestressing element has a first thickness, which when positioned within the switch housing provides a first resistance to resist movement of the switch between the activated position and the non-activated position. The additional prestressing element is selectively interchangeable with the first prestressing element. The additional prestressing element has a different thickness, which when positioned within the switch housing provides a different resistance to resist movement of the switch between the activated position and the non-activated position.

[0007] A bipolar electrosurgical instrument is known from EP 2 671 528 and EP 2 436 330 and comprises a first and a second shaft (branch), each having a jaw member extending from its distal end. Each jaw member is adapted to connect to an electrosurgical energy source such that the jaw members can selectively conduct energy through tissue held therebetween. The knife channel is configured to move the cutting mechanism back and forth therein. An actuator selectively advances the cutting mechanism. A switch is arranged on the first shaft and configured to be depressed between a first position and at least one subsequent position by prestressed engagement with a mechanical interface arranged on the second shaft. The first position of the switch communicates information to a user corresponding to a desired pressure on the tissue, and at least one subsequent position is configured to activate the electrosurgical energy source to supply electrosurgical energy to the jaw members.

[0008] US Registered Patent No. 7253667, US Registered Patent No. 9498279, US Published Patent No. 20190356952, PCT International Application No. 2019224634, EP Registered Patent No. 1609430, US Published Patent No. 20190357969, PCT International Application No. 2019224636, US Published Patent No. 20190357967 and PCT International Application No. 2019224637 also describe a generic electrosurgical instrument according to the introductory part of claim 1. Summary of the Invention

[0009] It is an object of the present disclosure to provide a bipolar HF instrument that allows simplified operation, especially over long periods of time, and that is independent of the orientation of the instrument during use.It is also an object of the present disclosure to obviate or at least ameliorate, among other things, the above-mentioned disadvantages of the prior art.

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

[0011] Thus, a bipolar HF (handheld) instrument has a jaw portion (for grasping / holding / grasping tissue) and a first and a second instrument branch (for manually manipulating the jaw portions), which are (all) arranged and configured to move away from each other when opening and towards each other when closing. Furthermore, a blade actuation element / blade operating lever or (sliding) button is provided for actuating a mechanical blade attached to the jaw portions for cutting tissue, the mechanical blade being arranged and configured to be movable from a first position (stopped position / non-cutting position) to a second position (cutting position) via the blade actuation element. Furthermore, a HF activation element or activation button / knob / switch is provided for activating / deactivating the HF power source, in particular for sealing (coagulating) tissue, and possibly a latching device, preferably arranged separately, acting on the branches to achieve a (selectively) latched branch state when the branches of the instrument are closed.

[0012] The basic idea of ​​the present disclosure lies in the fact that both the blade actuation element and the HF activation element are provided and configured so that they can be operated from two, preferably opposite, sides (or sides facing away from each other) of the HF instrument, respectively, and more preferably in the same or similar manner. This has the advantage that the machine blade can always be operated in the same way, regardless of in which direction or in which hand the instrument is held. Thus, there is no preferred orientation or position of the instrument. This is the same for right-handed or left-handed use. In other words, it does not matter how the user holds the bipolar HF instrument, since the operation always works the same way, due to the double-sided design of the blade actuation element and the HF activation element.

[0013] In other words, the subject matter according to the present disclosure is a scissors or pliers type surgical (handheld) instrument with bipolar HF technology and mechanical (tissue cutting) blade. By opening and closing the instrument branches, the jaws are also opened and closed. In the closed state, tissue can be grasped and sealed by HF (high frequency energy supply) via electrodes arranged in the jaws. The jaws can also be used for tissue preparation and manipulation. In the closed state, tissue can also be cut using the blade housed in the jaws. The actuation device for independent and separate manual actuation of the HF power source and the blade is constructed and arranged to provide essentially the same actuation geometry with essentially the same function / effect for the HF power source and the blade on two opposing sides of the instrument or two sides facing away from each other. It is explicitly pointed out that the mirroring of the actuation geometry described above may be three-dimensional and not necessarily two-dimensional. In other words, both actuators for the HF power source and for operating the blade may, for example, be positioned essentially identically on the left and right sides of the instrument (mirror image) (two-dimensional replication), or only one actuator (for blade operation, if required) may be positioned on the left or right side of the instrument and the other actuator (for the HF power source, if required) may be positioned above or below the instrument (mirror image in each case) (three-dimensional replication).

[0014] The mechanical blade is movable from a first position to a second position via a blade actuating element that moves linearly in a proximal direction from its distal rest position such that the mechanical blade moves correspondingly linearly in a distal direction from its proximal rest position such that tissue grasped by the jaws can be severed.

[0015] Furthermore, preferably, the instrument has a permanently installed latching device in the form of a pass-through detent. This detent can be used to lock the instrument branches in a defined state (relative position). To engage, the instrument branches are closed until the latched-in state is reached. To disengage, the branches are pressed together slightly again until the detent is released. The design of the latching device / detent / pass-through detent is well known from the prior art and does not need to be described further. This design has the inherent advantage that it can be used to generate a defined closure state where only small variations in the closing force are to be expected. This has the advantage that the sealing quality is improved and a constant performance is ensured. Furthermore, the latching device allows the user to hold the tissue securely without activating the HF. Another advantage is that when the detent is closed, the user can relax his hands. There is no need to constantly grip the instrument. This makes the present disclosure particularly ergonomic.

[0016] Further aspects of the disclosure are set out below according to the dependent claims.

[0017] It is advantageous if the latching device consists of a male and a female part. In other words, the HF can be activated in the closed and latched states and can be disconnected. As a rule, first the HF is activated and then sealing is performed. For this, the HF activation element is moved proximally. Preferably, touch activation is provided so that the user only has to press the button / knob once and does not have to hold it forever. The HF generator takes over the logic with its integrated algorithm and switches off automatically after successful sealing. However, the user can also stop the sealing process by pressing the HF activation button / knob again. Disconnection can be performed in a second step. For that, the blade activation element is pulled proximally. The HF activation element and the blade activation element are automatically reset, preferably by a spring.

[0018] Preferably, the sealing function and / or the cutting function can be used independently of each other, in other words, the user is free to use the sealing function and / or the cutting function independently of each other.

[0019] Preferably, a first rack-and-pinion gear is provided and arranged in the first instrument branch, with an input rack connected to the blade actuating element and an output rack connected to the machine blade, the blade actuating element being linearly movable proximally from a distal rest position, in other words, the deflection mechanism required for this in the first instrument branch is a rack-and-pinion gear, with an input rack attached to the blade actuating element and an output rack attached to the machine blade.

[0020] Advantageously, the input rack and the blade actuating element connected thereto are disposed approximately on a plane of symmetry between the first and second instrument branches.

[0021] In other words, the feature with the rack-and-pinion gear is a great advantage for symmetrical use of the instrument. The input rod and the associated blade actuating element being located approximately on the plane of symmetry between the first and second instrument branches is a great advantage in that the blades can always be actuated in the same way, regardless of how the instrument is held. In this respect, there is no preferred orientation or position of the instrument. This is the same for right- or left-handed use.

[0022] It is preferred if the bipolar HF instrument also has a blade interlock which is configured to prevent the operation of the machine blades in an open state and to allow the movement of the machine blades in a defined closed state. Two different safety concepts are provided here which can be implemented in the bipolar HF instrument.

[0023] In the first safety concept, blade actuation is possible as soon as the jaw parts are sufficiently closed, e.g. as soon as the jaw parts come into contact with each other. In principle, HF activation / actuation is always possible, i.e. the HF activation element is never locked. It is also possible to activate the HF when the tool is not engaged. This gives the user more application options, but also entails the risk of HF activation with insufficient closing force. In this case, a fixed latching device allows a defined closing state.

[0024] As a second safety concept, both blade actuation and HF actuation are only possible when the device is in the engaged position of the permanent latching device. This ensures maximum safety, as both cutting and HF sealing are only possible in a clearly defined closed state. However, this option limits the user's options. In particular, experienced users may find this safety concept severely limiting. It is therefore advisable to use the first safety concept for experienced users and the second safety concept for less experienced users.

[0025] Preferably, the HF actuation element is configured and arranged to be proximally movable or pivotable or displaceable when performing sealing.

[0026] Advantageously, the HF activation element is configured and provided to activate the HF power supply after a first tap activation and to switch it off automatically after successful sealing, preferably via an integrated algorithm, or to manually stop the HF power supply after a second tap activation of the HF activation element before successful sealing.

[0027] The HF activation element has an inner portion which is swingably, slidably or pivotally mounted on the axis of rotation of the HF activation element perpendicular to the proximal-distal direction in the second instrument branch, and a side of the inner portion facing the proximal direction of the instrument preferably has a contact element having an activation surface which contacts at least the first HF activation button during actuation of the HF activation element to activate the HF power source.

[0028] In other words, the design and positioning of the HF activation button is also aimed at allowing perfectly symmetrical operation of the instrument or avoiding the requirement of a preferred orientation of the instrument.

[0029] According to a first preferred embodiment, the HF activation element is mounted on the second branch so that it seesaws around an axis and is equally reachable from both sides of the instrument. Furthermore, locating the HF activation element only on one instrument branch has the advantage that the wiring for HF activation is also located only on one instrument branch. This significantly reduces the effort and costs compared to the concept of having activation buttons / HF activation buttons on both instrument branches.

[0030] Advantageously, the inner portion of the HF actuation element has a first actuation wing and a second wing, the first wing or knob projecting laterally from the second instrument branch and the second wing projecting opposite the first wing on the opposite side of the second instrument branch.

[0031] In other words, the HF launch element is made up of several parts: an inner part and first and second wings, or, under other assembly conditions, a one-piece design is also conceivable.

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

[0033] The activation surface of the HF activation element according to the above embodiment is provided for pressing the first (electronic) HF activation button.

[0034] Preferably, the contact element is cammed toward or configured to cam towards the first HF activation button or is positioned distal to the first HF activation button such that the second rack-and-pinion gear contacts the activation surface during actuation of the HF activation element.

[0035] In other words, an alternative embodiment with just one electronic HF activation button is possible. For this, the inner part of the HF activation element has a kind of cam or the like, which engages with the first HF activation button while rotating / pivoting about the rotation axis of the HF activation element. An additional return spring may be provided or required.

[0036] An alternative embodiment using (just) the first HF activation button comprises a rack-and-pinion gear. In this case, the inner part of the HF activation element is also rotatable and connected to a pinion. On either side of the pinion two racks are arranged, each rack being able to transmit its movement to a contact element / activation element / pressure plate. The contact element actuates the first HF activation button. Depending on the design of the HF activation button, the contact element may not be necessary and the rack may directly press the HF activation button. To ensure reliable functioning, it is advantageous if a return spring is fitted to the rack.

[0037] Advantageously, a second HF activation button is provided and is arranged next to the first HF activation button, parallel to the inner part of the HF activation element. In other words, the activation surface of the contact element exerts a force on one of the two HF activation buttons by rotating / pivoting / displacing the HF activation element, thereby triggering the activation of the HF process. The HF process can also be stopped manually, if necessary, by rotating / pivoting / displacing the HF activation element again. In addition to the perfectly symmetrical design, the above embodiment has the advantage that the HF activation element can be activated not only by pushing but also by pulling. This opens up several ergonomic operation options for the user.

[0038] Return to the non-activated rest position is preferably provided via a spring built into the HF activation button, alternatively an additional return spring may be provided in the form of a sheet metal / leaf spring, torsion spring or the like.

[0039] It is therefore advantageous if the inner part of the HF activation element is supported by a spring element, for example a compression spring. This has the advantage that the spring element causes the entire HF activation element to protrude slightly in the axial direction of its axis of rotation. As a result, the activation surface which would press the first and / or second HF activation button is disengaged and the HF power source cannot be activated when the HF activation element is activated in this position. In the closed state, the HF activation element is pressed in the second instrument branch. In this position, the first and second instrument branches are closed, so that the compression spring of the second instrument branch is compressed, thereby causing the activation surface to re-engage with the first and / or second HF activation button. It is advantageous if the HF activation element has a separate return spring which permanently biases the wings of the HF activation element in a rest position perpendicular to the main plane of the instrument. The return spring may be a leaf spring, a tension spring, a torsion spring or the like.

[0040] Advantageously, the first HF activation button and / or the second HF activation button may be a commercially available electronic button.

[0041] Preferably, the first and / or second HF activation button are located proximally away from the inner portion of the HF activation element, but facing it on a printed circuit board in the second instrument branch, in other words, the first and / or second HF activation button are preferably located on printed circuit boards that are interconnected in OR logic, thereby ensuring that whichever HF activation button is pressed will cause an operation.

[0042] Alternatively, it is preferred that the HF activation element is designed as a lever. In this case, the position of such a lever is switched as soon as the bipolar HF instrument is rotated, so that a fully symmetrical actuation of the instrument is also possible. The levers are therefore arranged on both sides of the instrument or on both sides of the second instrument branch. In this respect, it is advantageous if first and second HF activation buttons are provided / arranged on the instrument branch or on the housing of the instrument branch, which are opposite each other, such that the first HF activation button is pressed during actuation when the lever is in the first position, and the second HF activation button is pressed during actuation when the lever is in the second position. In order that the lever is clearly configured to engage in a defined position, the switching from the first position to the second position is preferably realized by a snap mechanism.

[0043] According to the second safety concept, a locking device for the HF activation element is preferably provided, in other words the locking element prevents activation of the HF activation element in the open position, whereas in the closed position activation is possible.

[0044] Advantageously, the locking element has a plunger which protrudes from the handle shell of the second instrument branch and can come into contact with the opposing handle shell of the second instrument branch when the instrument is closed. A locking element, for example a pin, is provided next to the plunger. This pin is provided and configured to interact with a bore in the inner part of the HF actuation element. In the open state, the pin is located in the bore and rotation / activation of the HF actuation element is not possible. In the closed state, the pin is pushed out of the bore by the plunger and rotation / activation of the HF actuation element is possible. Here, it is preferred that the locking element is provided / configured with guide elements on two sides to prevent the locking element from rotating.

[0045] It is preferred that the blade actuation element has a different shape than the HF actuation element. Preferably, the blade actuation element has a round shape and the HF actuation element has a different shape, for example a rectangular shape. Furthermore, it is additionally or alternatively preferred if the HF actuation element has a different color than the rest of the instrument, preferably blue, especially since blue is usually associated with HF actuation in surgery. Furthermore, it is advantageous if the HF actuation element is additionally or alternatively arranged at a sufficient distance from the blade actuation element. These differences have the advantage that the risk of confusing the blade actuation element with the HF actuation element can be reduced as much as possible.

[0046] Preferably, the distance between the blade actuation element and the handle of the first instrument branch is 76±20 mm, and the distance between the HF actuation element and the handle of the first instrument branch is 42±20 mm.

[0047] It is advantageous if the HF activation element is sealed against penetration of liquids, in particular blood, water, saline, etc. It is preferred if the first and second handle shells of the first and / or second instrument branch are provided with a circumferential seal. Alternatively or additionally, it is also provided if the seal is present only in the area of ​​the HF activation element. In other words, for the use of instruments in open surgery, another important aspect of the HF activation element is the sealing against penetrating liquids. It must therefore be ensured that the ingress of liquids does not lead to unwanted HF activation. For this purpose, it is provided that the HF activation element is properly sealed. It is preferred to seal the handle shell, for example with TPE. The seal may go around the entire contour of the handle shell and / or may only be present in the area of ​​the HF activation element. The seal may be molded into the handle shell or may be a separate part that is inserted during assembly. The sealing effect is achieved by pressing or screwing it into the second handle shell.

[0048] Alternatively or additionally, it is preferred that the first and / or second HF activation button used is configured to be sealed already ex-factory. In other words, the use of a sealed HF activation button is provided, which is already sealed ex-factory. In this case, the printed circuit board on which the HF activation button is attached / soldered also needs to be sealed in order to prevent short circuits at the terminals of the printed circuit board. For this reason, it is preferred to completely cover the printed circuit board, for example with a plastic material.

[0049] Alternatively or additionally, an elastomeric sealing ring (O-ring) is preferably provided on the axis / shaft of the inner portion of the HF actuation element.

[0050] Alternatively, the present disclosure relates to an alternatively usable bipolar HF instrument comprising a jaw section with a first and a second instrument branch for grasping tissue, the jaw section being arranged and configured to move away from each other when opening and towards each other when closing, a blade actuation element, preferably in the form of a lever, for actuating a mechanical blade in the jaw section for cutting the tissue, the blade being arranged and configured to be movable from a first position to a second position via the blade actuation element, exactly two HF activation buttons for actuating a HF power source for sealing the tissue, and a preferably additionally connectable latch device for achieving a latched-in state with the instrument branches closed, the blade actuation element and the HF actuation element being arranged and configured symmetrically so as to be equally operable from both sides of the HF instrument, one HF actuation element each being laterally attached to the first and second instrument branches.

[0051] In other words, the HF activation elements may be arranged laterally on the first and second instrument branches to improve ergonomics. This also means that the instruments are completely symmetrical. This embodiment preferably has an additionally connectable latching device, which can be additionally connected on rotation with the help of a proximally mounted rotating lever. In order to ensure that the user applies a sufficient closing force when the latching device is switched off, an additional control, here in the form of a third button, is provided. This third button is connected in AND logic with the HF activation button and must be activated at all times so that the HF power supply can be activated. Further control devices, such as pressure sensors, distance sensors, etc., are provided as alternative or additional sensors. In this way, the user is given as many application options as possible. [Brief description of the drawings]

[0052] FIG. 1 shows the bipolar HF instrument in an open and disengaged state.

[0053] FIG. 2 shows the bipolar HF instrument in a closed and unlatched state.

[0054] FIG. 3 shows the bipolar HF instrument in the closed and latched-in state.

[0055] FIG. 4 shows a bipolar HF instrument with the instrument branches open.

[0056] FIG. 5 shows a bipolar HF instrument with the instrument branches and blades opened, with a portion of the first instrument branch and jaws hidden.

[0057] FIG. 6 shows an HF initiation element according to a first embodiment.

[0058] FIG. 7 shows a top view of the HF activation element with the electronic button and printed circuit board additionally shown according to the first embodiment.

[0059] FIG. 8 shows an HF initiation element according to a second embodiment.

[0060] FIG. 9 shows a HF actuation element using a rack and pinion gear according to a third embodiment.

[0061] FIG. 10 shows the HF actuation element as a slider according to a fourth embodiment.

[0062] 11A and 11B show an HF instrument having a lever as the HF actuation element.

[0063] FIG. 12 shows the HF instrument from above.

[0064] FIG. 13 shows the arrangement of the HF activation button and lever as an HF activation knob.

[0065] Figures 14 and 15 show a bipolar HF instrument with an HF activation element according to the second safety concept.

[0066] 16 and 17 show an HF instrument having a locking element for the HF activation element.

[0067] 18, 19 and 20 show the locking element of the activation element.

[0068] FIG. 21 shows the inner part of the HF actuation element.

[0069] FIG. 22 shows the distances between the various components of the HF instrument.

[0070] FIG. 23 shows an HF activation element with a seal thereon.

[0071] Figure 24 shows the HF activation button.

[0072] FIG. 25 shows the inner part of the HF actuation element with the seal ring.

[0073] 26 and 27 show a further alternative embodiment of the HF instrument.

[0074] FIG. 28 shows a plan view of the HF instrument according to FIGS. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0075] Configuration examples of the present disclosure will be described below with reference to the associated drawings.

[0076] FIG. 1 shows a scissors- or pliers-type bipolar HF instrument 1 in an open and disengaged state. The bipolar HF instrument 1 has a jaw portion 2, a first instrument branch 3 and a second instrument branch 4, which are coupled to the jaw portion via gears or integrally. When the first instrument branch 3 and the second instrument branch 4 are opened or closed, they pivot about a hinge, not further shown in FIG. 1, so that the jaw portion 2 opens and closes accordingly. In the closed state, the jaw portion 2 can grasp / grasp / hold tissue and seal the tissue at the not further shown electrodes of the jaw portion 2 via the HF power source. This HF technology is known from the prior art, for example by the applicant.

[0077] Additionally, the first and second instrument branches 3, 4 each have an annular instrument actuation lug 20 on the proximal half of the instrument branch 3, 4 into which the fingers of the actuating hand can be placed. Of course, other instrument actuation configurations are contemplated, such as open brackets or reach-through slots in the instrument branches 3, 4.

[0078] A mechanical blade 6 is provided on the instrument 1, in particular in the region of the jaws 2, and is preferably movable in the longitudinal direction of the instrument via a blade actuation element / button / knob 5. The mechanical blade 6 is provided for cutting tissue held in the jaws 2. The arrangement of the mechanical blade 6 is shown in detail in FIG.

[0079] The blade actuating element 5 is arranged in the first instrument branch 3. The blade actuating element 5 is configured to move linearly from its distal rest position proximally (i.e. away from the jaw portion 2 / away from the patient). According to Fig. 1, the blade actuating element 5 is mounted in a longitudinally displaceable slit 21 formed in the instrument branch 3. The blade actuating element 5 is arranged between the jaw portion 2 and the annular instrument actuating lug 20 of the first instrument branch 3, on the side adjacent to the second instrument branch 4. The blade actuating element 5 is preferably configured as a pin protruding laterally from the instrument branch 3 according to Fig. 1.

[0080] The jaw parts 2 of the bipolar HF instrument 1 further comprise HF litz wires (not shown), which are supplied with HF energy after activation of the HF activation element 7 and which transfer this energy to the electrodes of the jaw parts 2. The HF litz wires are connected to flat connectors 22. One HF litz wire is connected to each jaw part 2. The jaw parts 2 are electrically insulated from each other (insulation not shown).

[0081] The HF actuation element 7 is located in / on the second instrument branch 4 on the side adjacent to the first instrument branch 3, where the HF actuation element 7 is closer to the ring-shaped instrument actuation lug 20 than the blade actuation element 5 and its associated slit 21 in the first instrument branch 3. The HF actuation element 7 is preferably configured as a rectangular tip button, as shown in Figure 1.

[0082] Finally, the bipolar HF instrument 1 is equipped with a latching device 8 of generally known design at the level of the ring-shaped instrument actuation lug 21. The latching device 8 has a male part 8A and a female part 8B, which are shown in detail in Figure 4. The latching devices 8 are provided on opposite sides of the instrument branches 3, 4. In Figure 1 the latching devices 8 are shown in a disengaged state.

[0083] Figure 2 shows a bipolar HF instrument 1 with the latching device 8 in the closed and (still) unlatched-in state. In Figure 2, the HF instrument 1 is shown according to Figure 1, with the first instrument branch 3 and the second instrument branch 4 still closed. The jaws 2 are however already closed, although the closing force has not yet reached a certain value. However, in the closed and unlatched-in state shown in Figure 2, it may already be possible to disconnect and activate the HF, depending on which safety concept is used.

[0084] As the instrument branches 3 and 4 are further closed, the latching device 8 becomes fully engaged. Figure 3 shows the bipolar HF instrument 1 in such a closed and latched-in state. Figure 3 shows the HF instrument 1 as shown in Figures 1 and 2, with the first instrument branch 3 and the second instrument branch 4 fully closed. The latching device 8 is latched-in. In the latched-in state, the blade actuation element 5 and the HF activation element 7 are approximately halfway between the two instrument branches 3, 4 (i.e. essentially on the symmetry plane of the instrument).

[0085] In Figure 3, a solid arrow is shown pointing proximally from the blade actuating element 5. This arrow indicates the direction of movement of the blade actuating element 5 to move the cutting machine blade 6. A dashed arrow pointing distally parallel to the solid arrow indicates the direction of the reset path of the blade actuating element 5 to return the blade to its rest position.

[0086] 3 also shows a short solid arrow pointing proximally from the HF actuation element 7. This arrow indicates the direction of movement of the HF actuation element 7 to activate the HF power source. A dashed arrow pointing distally and parallel to the short solid arrow indicates the direction of the reset path of the HF actuation element 7.

[0087] Figure 4 shows in longitudinal section a bipolar HF instrument 1 with open instrument branches 3 and 4. The first instrument branch 3 and the second instrument branch 4 each consist of two half handle shells, each enclosing a cavity, whereby the internal structure of the first instrument branch 3 and the second instrument branch 4 can be seen in Figure 4.

[0088] FIG. 4 shows the handle shell of the first instrument branch 3 with a first rack-and-pinion gear 9 with an input rack 10 and an output rack 11. The input rack 10 is rigidly connected to a blade actuating element 5 (not shown in FIG. 4). The output rack 11 is rigidly connected to a machine blade 6 (not shown in FIG. 4). The input rack 10 and the output rack 11 are connected to each other via an intervening pinion 12 such that when the blade actuating element 5 is actuated proximally by the user, the machine blade 6 is moved distally from its proximal rest position to cut the tissue held in the jaws 2. The rack-and-pinion gear 9 serves here as a biasing mechanism for the first instrument branch 3. A return spring 5A is also provided for the aforementioned blade mechanism, so that the blade actuating element 5, and thus the blade 6, are automatically pushed back to their respective rest positions.

[0089] FIG. 4 shows the handle shell of the second instrument branch 4 together with an inner view of the HF activation element 7. In detail, the inner part 7A of the HF activation element 7 is shown, which is located distal to the first HF activation button 15. If a second HF activation button 15 is provided, it is located to the side of the illustrated HF activation button 15 and is therefore not visible in FIG. 4. The illustrated HF activation button 15 is arranged on a printed circuit board 17. If a first and a second HF activation button 15 are provided, they are interconnected in OR logic via the printed circuit board 17. Also, flat connectors 22 are provided on both the first instrument branch 3 and the second instrument branch 4 for contacting the HF Litz wires of the jaws 2.

[0090] Figure 4 further shows the latching device 8 in longitudinal section. The latching device 8 has a male part 8A on the side of the first instrument branch 3 and a female part 8B on the side of the second instrument branch 4. When pressed together, the two parts 8A, 8B latch into one another. The latched-in state can be released again by pressing together again using the built-in return spring 8C.

[0091] Figure 5 shows a bipolar HF instrument 1 with open instrument branches 3, 4 and a blade 6, with part of the first instrument branch 3 and the jaw section 2 hidden. Figure 5 shows the same components as already described for Figure 4. Additionally, a machine blade 6 is shown, which is located within the jaw section 2 and the first instrument branch 3 and is connected to an output rack 11.

[0092] FIG. 6 shows the HF activation element 7 according to a first embodiment. The HF activation element 7 has an inner part 7A in the form of a crossbar, which connects a first actuation wing or knob 7B and a second actuation wing or knob 7C to each other. According to this embodiment, one end of the crossbar-like inner part 7A is glued and / or pressed into / onto the first actuation wing 7B or the second actuation wing 7C. The first actuation wing 7B and the second actuation wing 7C are arranged on the outside and laterally, i.e. on the opposite or facing away from each other, side of the second instrument branch 4. The inner part 7A is arranged inside the second instrument branch 4. A contact element 13 having an actuation surface 14 is attached to a central part of the inner part 7A in the proximal direction of the HF instrument, or downward in FIG. 4. When the user activates the HF activation element 7, the contact element 13 connected to the inner part 7A presses the actuation surface 14 against the HF activation button 15 (not shown in FIG. 6) and the HF power source is activated.

[0093] The contact element 13, as already indicated above, is configured in a T-shape and mounted in the center of the inner part 7a with respect to the central axis 19 of the HF activation element 7, i.e. the latter. The activation face 14 is arranged on the side of the contact element 13 facing the HF activation button 15. The HF activation element 7 is mounted in a swinging manner along the central axis 19 to the second instrument branch 4 such that two actuation wings 7B and 7C project laterally from the second instrument branch and can thus be equally reached and actuated from both sides of the instrument 1.

[0094] Figure 7 shows an HF activation element 7 according to a first embodiment. According to Figure 7, a crossbar-shaped inner part 7A of the HF activation element 7 is shown, which has a first actuation wing 7B and a second actuation wing 7C. A contact element 13 having an actuation surface 14 is attached to or arranged on the inner part 7A in the middle of the inner part 7A of the HF activation element 7 in the direction of the first and second HF activation buttons 15.

[0095] In this embodiment, first and second HF activation buttons 15 are provided, which are located next to each other and below the activation surface 14 in FIG. 7, i.e. proximal to the activation surface 14 as shown in FIG. 5. Both HF activation buttons 15 are located on a (single) printed circuit board 17. The printed circuit board 17 is provided with two terminals 23, which are used for power supply. By rotating / pivoting / see-sawing the HF activation element 7 longitudinally about the central axis 19, the activation surface 14 presses one of the two HF activation buttons 15, which causes HF current to flow to the electrodes in the jaw 2, regardless of which opposite working wing of the instrument 1 the user is using.

[0096] 8 shows the HF activation element 7 according to the second embodiment. The third embodiment corresponds almost exactly to the second embodiment, with the difference that the contact element 13 is formed by two cam-shaped projections arranged next to each other and surrounding the HF activation switch 7 on the outside (without contact) so that during actuation of the HF activation element 7, whose crossbar-shaped inner part 7a moves in a corresponding see-saw motion, the contact element 13 or its projections come into contact with the first HF activation button 15. Due to the double cam-shaped contact element 13, exactly one electronic HF activation button 15 is sufficient and contact of the HF activation button 15 with the activation surface 14 on the side facing the HF activation button 15 is guaranteed.

[0097] On the distal side of the inner part 7A opposite the contact element 13 (in all embodiments of the HF actuation element 7 described above), two return springs 7D are provided laterally spaced apart in the instrument direction, supported on the one hand by the second instrument branch 7 and on the other hand by the crossbar-like inner part 7A, so as to urge the HF actuation element 7 back to its (non-contact) initial position regardless of which side of the instrument 1 is activated.

[0098] FIG. 9 shows an HF activation element 7 with a second rack-and-pinion gear 18 according to a third embodiment. The second rack-and-pinion gear 18 has a first rack 24 and a second rack 25, which are opposite each other and operatively connected to each other at the distal end via a pinion 26. At the distal end, where the pinion 26 is located, a return spring 7D acting in the proximal direction is attached to both the first rack 24 and the second rack 25. At the other proximal end of the first rack 24 and the second rack 25, a contact element 13 having an activation surface 14 is provided in the direction of the HF activation button 15, which is arranged proximally of the HF activation element. The HF activation button 15 is arranged on a printed circuit board 17. That is, the protruding rack-and-pinion gear 18 is provided in the second instrument branch 4 in such a way that the HF activation button 15 is arranged in the direction proximal to the rack-and-pinion gear 18. Finally, an operating element 7A in the form of a crossbar is shown, which protrudes from one side of the second instrument branch and is connected to the pinion, while a further operating element of the same design (not further shown) is also connected to the pinion and protrudes from the second instrument branch on the opposite side of the latter.

[0099] When the illustrated operating element 7A is moved in the proximal direction, one of the racks 25 also moves in the proximal direction and the other rack 24 moves in the distal direction. As a result, the contact element 13 performs a tilting movement similar to the embodiment described above, thereby actuating the HF activation button 15. When the operating element 7A is released, the pretension spring 7D returns the racks 24, 25 to their initial position. However, in principle it is also possible to couple the operating element with the rotation axis of the pinion 26 in order to bring about a counter-rotating longitudinal movement of the racks 24, 25 via manual rotation of the pinion 26.

[0100] Figure 10 shows the HF actuation element 7 as a slider according to a fifth embodiment, which is constructed according to Figure 8, in which the contact element 13 with the actuation surface 14 is constructed flat rather than cam-shaped. Furthermore, in this case the crossbar-shaped inner part 7A is longitudinally displaceable in the second instrument branch 4, rather than rocker-shaped as in the embodiment according to Figure 8.

[0101] 11A, 11B and 12 show an HF instrument 1 with levers 27 on both sides of the instrument as HF actuation element 7. According to FIG. 11A, this sixth embodiment of the HF actuation element 7 shows one lever 27, which is pivotally guided laterally and parallel from the second instrument branch 4. In FIG. 11A, the HF instrument 1 is aligned according to the previous figures. On the other hand, in FIG. 11B, the orientation of the HF instrument 1 is reversed, i.e. the first instrument branch 3 is shown facing downwards and the second instrument branch 4 facing upwards, so that both levers are visible on both sides of the instrument. The HF actuation element 7 is arranged approximately in the middle on the side of the second instrument branch 4 closest to the first instrument branch 3, so that the operation of the lever 27 is the same regardless of the orientation of the HF instrument 1.

[0102] FIG. 13 shows in a schematic diagram the arrangement of the two HF activation buttons 15, 16 and the lever 27 as the HF activation element 7 according to the sixth embodiment. According to FIG. 13, the lever 27 is non-rotatably connected to a contact rod, which extends along the second instrument branch 4, preferably in the proximal direction. Furthermore, a first HF activation button 15 and a second HF activation button 16 are provided, which are arranged opposite each other to receive the contact rod between them without initially making contact. One lever 27, shown in solid lines, is currently in a first position (1) in which the contact rod does not make contact with the HF activation buttons 15 and 16, and when actuated counterclockwise from this position, the first activation button 15 is pressed by the contact rod. As shown in FIGS. 11A and 11B, when the instrument is rotated, the lever 27, shown in dashed lines in the second position (2), is in the same spatial orientation as the lever 27 shown in solid lines in FIG. 13, in which the two HF activation buttons 15 and 16 are consequently located above the lever 27. When this lever 27, shown in dashed lines, is actuated counterclockwise, the contact rod contacts the second HF activation button 16, which is consequently pressed.

[0103] It is also possible that the two levers 27 are interchangeable between the respective positions shown in the figures, in which case the switch from position (1) to position (2) is preferably realised by a snap mechanism between the levers 27 and the contact rod, such that the levers positively engage in a defined position (not shown).

[0104] Figures 14 and 15 show a bipolar HF instrument 1 with an HF activation element 7 according to a defined safety concept. In figure 14 the HF instrument 1 is closed and disengaged. In figure 15 the HF instrument 1 is closed and engaged.

[0105] The inner part 7A of the HF activation element 7 is supported by a spring element 7E, preferably a compression spring. The spring element 7E is arranged such that the entire HF activation element 7 protrudes a little from the instrument branch in the axial direction of its seesaw axis or is displaced in the axial direction of its seesaw axis. As shown in Figure 14, this means that the activation surface 14 for pressing the first HF activation button 15 can no longer be brought into operative engagement with the HF activation button 15. Activation of the HF activation element 7 in this displaced position will not activate HF energy.

[0106] As soon as the HF instrument 1 is closed and latched in, the HF activation element 7 is pushed back again by the first instrument branch against the preload of the spring element 7E, allowing the activation surface 14 to engage with the first and / or second HF activation button 15 and / or 16. The safety concept therefore basically consists in a spring-biased displacement of the HF activation element 7 into a non-functional position, which is only released again when the two instrument branches reach the fully closed position, by the other first instrument branch pushing the HF activation element 7 back into its functional position.

[0107] Figures 16 and 17 show an HF device 1 with a locking element of the HF activation element 28 as an alternative safety concept. In this case, the locking element of the HF activation element 28 is installed / integrated in the HF device 1. As a result, the user can operate the HF activation element 28 in the closed and latched-in state by appropriately triggering the locking element of the HF activation element 28.

[0108] The locking element 28 of the actuation element according to Figs. 18 and 19 has a plunger 29, which protrudes from the handle shell of the second instrument branch 4 and can come into contact with the opposite handle shell of the first instrument branch 3 when the HF instrument 1 is closed. Next to the plunger 29 a pin 30 is arranged. The pin 30 interacts with a bore 32, as shown in Fig. 21, in the inner part 7A of the HF actuation element 7. In the open state of the HF instrument 1, as shown in Fig. 16, the pin 30 is located in the bore 32 and the rotation / see-saw movement / actuation of the HF actuation element 7 is not possible. In the closed state of the HF instrument 1, as shown in Fig. 17, the pin 30 is pushed out of the bore 32 by the plunger 29 and the rotation / see-saw movement / actuation of the HF actuation element 7 is possible.

[0109] To prevent rotation of the locking element 28, sliding tab-like guide elements 31, as shown in Fig. 19, are arranged on two diametrically opposite sides of the locking element 28, which are slidingly mounted in corresponding guide grooves of the second instrument branch 4. This ensures that the pin 30 retracts into the bore 32 when the instrument is opened.

[0110] Fig. 22 shows the distances between the individual components of the HF instrument 1. The HF actuation element 7 and the blade actuation element 5 are placed at a sufficient distance from each other to avoid confusion between them during use. It is preferred that the distance from the centre of the instrument actuation lug 20 to the centre of the blade actuation element 5 is 56-96 mm, more preferably 66-86 mm, even more preferably 76 mm. Furthermore, it is preferred that the distance from the centre of the instrument actuation lug 20 to the centre of the HF actuation element 7 is 22-62 mm, more preferably 32-52 mm, even more preferably 42 mm.

[0111] Figure 23 shows an HF activation element 7 with a seal 33. Figure 23 shows an HF device 1 according to the above description, where the HF activation element 7 and the first and / or second HF activation buttons 15 and / or 16 are sealed with a TPE seal 33.

[0112] 24 shows an HF activation button 15 or 16, which is already sealed or completely covered ex-factory via a casing, which has a concave, preferably hemispherical, protrusion in the contact area of ​​the HF activation button. HF energy is delivered when the protruding hemisphere 35, against which the activation surface 14 presses during operation of the HF activation element 7, is touched.

[0113] Figure 25 shows the HF actuation element 7 according to Figure 6 with a sealing ring 34. The sealing ring 34 is fitted around the T-shaped contact element 13 on the side facing the inner part 7A of the HF actuation element 7, so that the crossbar-shaped inner part 7A and the contact element 13 together with the contact surface 14 can be separated from each other in a fluid-tight manner. The sealing ring 34 is preferably an elastomeric sealing ring / O-ring.

[0114] Figures 26 and 27 show a further alternative embodiment of the HF instrument 1, where the HF instrument 1 is constructed according to the figures above, with a double HF activation element 7. In this case, the two HF activation buttons 7 are located at the top of the respective instrument branches 3 and 4, i.e. at the top and bottom of the instrument, while the blade actuation elements 5 remain on the left and right side of the instrument according to the previously described embodiment.

[0115] Figure 27 also shows the latching device 8, in particular the male part 8A, which can be switched on via a rotating lever 36 at the proximal end of the HF instrument 1. To ensure that the user applies sufficient closing force when the latching device 8 is switched off, an additional control 37 in the form of a button is provided. This control 37 is connected in AND logic with the HF activation buttons 15 and / or 16 and must be constantly activated in order to activate the HF energy. [Explanation of symbols]

[0116] 1: Equipment 2: Joe Club 3: First instrument branch 4: Second Instrument Branch 5: Blade actuation element 5A: Return spring for blade actuation element 6: Blade 7:HF activation element 7A: Inner part of HF launch element 7B: First wing of HF launch element 7C: HF Launch Element 2nd Wing 7D: Return spring 7E: Spring element 8: Latch device 8A: Male part of the latch device 8B: Female part of latch device 8C: Latch device return spring 9: 1st rack and pinion gear 10: Input rack 11: Output rack 12: Pinion 13: Contact elements 14: Startup surface 15: 1st HF start button 16: 2nd HF start button 17: Printed circuit board 18: 2nd rack and pinion gear 19: Central axis of HF launch element 20: Instrument operation lug 21: Slit 22: Flat connector 23: Terminal 24: First Rack 25: 2nd rack 26: Pinion 27: Lever 28: HF activation element lock element 29: Plunger 30: Pin 31: Guide element 32: Boa 33: Seal 34: Seal ring 35: Hemisphere 36: Rotating lever 37: Control device

Claims

1. A bipolar HF device (1), comprising: a jaw part (2), a first instrument branch (3) and a second instrument branch (4) for grasping tissue, the jaw part (2), the first instrument branch (3) and the second instrument branch (4) being arranged and configured to move away from each other when opening and to move towards each other when closing; a blade actuation element (5), preferably in the form of a lever, for moving a mechanical blade (6) within said jaw portion (2) to cut tissue; and / or a preferably knob- or button-shaped HF activation element (7) for activating the HF power source to seal the tissue, and preferably a latch device (8) for realizing a latched-in state when the instrument branches (3, 4) are closed, A bipolar HF instrument (1), characterized in that the blade actuation element (5) and / or the HF activation element (7) are provided and configured so as to be operable in the same way from two opposite sides of the HF instrument (1).

2. 2. A bipolar HF instrument (1) according to claim 1, characterized in that the HF actuation element (7) is configured and arranged to be proximally movable, in particular pivotable or displaceable, when performing sealing.

3. A bipolar HF instrument (1) according to claim 1 or 2, characterized in that the HF activation element (7) is configured and arranged to activate the HF power supply after a first tap activation and to switch it off automatically, preferably via an integrated algorithm, or to stop the HF power supply manually after a second tap activation of the HF activation element (7).

4. said HF actuation element (7) having a preferably crossbar-shaped inner part (7A) which is swingably, slidably or pivotally mounted on the axis of rotation of said HF actuation element (7) perpendicular to the proximal-distal direction within said second instrument branch (4); A bipolar HF device (1) according to any one of claims 1 to 3, characterized in that the side of the inner part (7A) facing towards the proximal direction of the device (1) has a contact element (13) having an activation surface (14) which contacts at least a first HF activation button (15) during actuation of the HF activation element (7) and activates the HF power source.

5. the inner portion (7A) of the HF actuation element (7) having a first actuation wing or knob (7B) and a second actuation wing or knob (7C); A bipolar HF instrument (1) according to claim 4, characterized in that the first wing or knob (7B) projects laterally on the second instrument branch (4) and the second wing or knob (7C) projects opposite the first wing (7B) on the opposite side of the second instrument branch (4).

6. A bipolar HF device (1) according to any one of claims 1 to 5, characterized in that the HF initiation element (7) has a locking element (28) for the HF initiation element for locking the operation of the HF initiation element (7) in the open state of the HF device (1).

7. said contact element (13) being provided or configured with two adjacent cams, The bipolar HF instrument (1) according to claim 5, characterized in that the cam extends towards the first HF activation button (15) and receives it therebetween without contact in an unactivated state, or is positioned distal to the first HF activation button (15) such that a second rack-and-pinion gear (18) contacts the activation surface (14) during activation of the HF activation element (11).

8. 6. A bipolar HF device (1) according to claim 5, characterized in that a second HF activation button (16) is provided and arranged next to the first HF activation button (15) parallel to the inner part (7A) of the HF activation element (7).

9. A bipolar HF instrument (1) according to any one of claims 4 to 8, characterized in that the first HF activation button (15) and / or the second HF activation button (16) are arranged proximally away from the inner part (7A) of the HF activation element (11) but facing it on a printed circuit board (17) in the second instrument branch (4).

10. 2. The bipolar HF instrument (1) according to claim 1, characterized in that in the first instrument branch (3), a first rack and pinion gear (9) is provided and arranged, with an input rack (10) connected to the blade actuating element (5) and an output rack (11) connected to the machine blade (6), the blade actuating element (5) being linearly movable proximally from a distal rest position to actuate the blade (6).

11. A bipolar HF instrument (1) as claimed in claim 10, characterized in that the input rack (10) and the blade actuating element (5) connected thereto are arranged approximately on a plane of symmetry between the first instrument branch (3) and the second instrument branch (4).

Images