Handheld surgical instruments

Abstract

To provide a handheld surgical instrument that is easy and inexpensive to manufacture, can be thoroughly cleaned, and has a seal to the optical system. [Solution] The handheld surgical instrument comprises a body having at least one channel-shaped bore for the optical system. This bore can merge with a tubular section in the proximal direction, and as a result, a telescope containing the optical system can be mounted distally to the handheld surgical instrument through the tubular section and the bore. The distal end of the body can be coupled to a shaft for the optical system, and the proximal end can be coupled to the telescope. The longitudinal axis of the handheld surgical instrument can be defined by the bore and the tubular section. A key feature is that a sealing body with a concentric sealing lip is axially positioned with respect to this longitudinal axis in the proximal direction, thereby orienting the sealing lip proximal.

Description

Technical Field

[0001] The present invention relates to a handheld surgical instrument.

Background Art

[0002] For urological applications or treatment or surgery in a human abdomen, it is known to use handheld surgical instruments such as endoscopes, cystoscopes, resection scopes, etc. (hereinafter referred to as instruments). The instrument is first guided through an opening in the body of the person to be treated using a tubular shaft and placed at the intended position of application. Depending on the application or the instrument, a wide variety of working instruments such as forceps, scissors, clamps, electrode holders, etc. are guided through the shaft. In addition to or instead of the above-mentioned instruments, an optical system can be guided into the body through the shaft to provide visual control of the treatment.

[0003] Such an optical system is guided as a telescope through the instrument from the proximal direction of the instrument together with an eyepiece and / or a camera, and as a result, the distal end of the optical system is brought to the distal region of the shaft to directly view the region in front of the shaft. For this purpose, the optical system is first guided through a bridge or the body of the instrument. This body can have a tube section that penetrates the body or extends into the body as a bore. The distal end of this body can be coupled to the shaft. The optical system or the telescope including the optical system can be attached to the proximal end or the tube section. For this purpose, it is conceivable that an optical plate is associated with this proximal end of the body or the tube section.

[0004] During patient treatment, the area or space being treated within the patient's body is filled with fluid. It is crucial that all openings of the instrument are properly sealed to ensure that the fluid pressure within the body remains stable. On the one hand, the seal prevents the fluid from escaping the body. However, at the same time, the seal also prevents any external contaminants from entering the body through the instrument. Furthermore, these seals must be designed to allow not only the working instrument but also the optics for the treatment being performed to move back and forth in the axial direction of the instrument.

[0005] A known solution for sealing rod-shaped optics to a tube section or body is to provide a ring-shaped seal positioned around the optics, with a sealing lip that wraps around the optics. There is a known embodiment in which the sealing lip is reinforced by a metal ring. This known seal is positioned on either the body or the optical plate at the proximal end of the tube section. Using such a ring-shaped seal is inconvenient because, viewed axially, impurities can accumulate on either side of the sealing lip, which can only be removed with greater effort or not at all. This makes cleaning and reprocessing such instruments very costly. Due to the geometric shape of the known seal, it is almost impossible to see from the outside whether cleaning meets high requirements. A further drawback of the known ring-shaped seal is that the sealing lip folds forward and backward when the optics are pulled back and forth within the tube section or body. This can lead to increased mechanical wear. To prevent this, the seal is reinforced with a metal ring. However, this design is difficult to manufacture and therefore very costly. [Prior art documents] [Patent Documents]

[0006] [Patent Document 1] German Patent Application Publication No. 102004020921 Specification [Patent Document 2] German Patent Application Publication No. 102015010877 Specification [Patent Document 3] U.S. Patent Application Publication No. 2017 / 0303953 Specification [Patent Document 4] West German Patent No. 910951 [Patent Document 5] German Utility Model No. 8809837 Specification [Patent Document 6] German Patent Application Publication No. 4101472 [Patent Document 7] German Utility Model Specification No. 202004014828 [Patent Document 8] West German Patent Application Publication No. 1450433 [Patent Document 9] German Patent Application Publication No. 000002422420 Specification [Overview of the project] [Problems that the invention aims to solve]

[0007] Based on this, the object of the present invention is to create a handheld surgical instrument that is simple, inexpensive, and in particular allows for the manufacture of completely washable seals for optical systems. [Means for solving the problem]

[0008] A handheld surgical instrument for solving this problem has the features of claim 1. Thus, a handheld surgical instrument, which may be, for example, an endoscope, cystoscope, resecteroscope, etc., is provided having a body with a shaft. In this instrument, the body has at least one channel-shaped bore for an optical system. This bore can merge into a tubular section in the proximal direction, and as a result, a telescope including the optical system can be mounted distally to the instrument through the tubular section and the bore. The distal end of the body can be coupled to the shaft for the optical system, and the proximal end can be coupled to the telescope. The longitudinal axis of the instrument can be defined by the bore and the tubular section. A key feature is that a seal body having a concentric seal lip is axially positioned with respect to this longitudinal axis in the proximal direction, thereby orienting the seal lip proximal. The seal body is used to create a tight connection between the instrument or body and the optical system or telescope. Unlike the prior art, the seal ring is not closed around a rod-shaped optical system. Rather, in the present invention, the seal body forms a sealed connection with the surface of the telescope attached to the body. As soon as the telescope, including the optics, comes into contact with the instrument, or as the rod-shaped optics are pressed into the tube section and bore, the concentric seal lip is pressed against or against the surface of the telescope. This means that there is no longer any direct contact between the seal body and the rod-shaped optics, thereby reducing the mechanical load on the seal lip. Furthermore, the described shape of the seal body means that all areas around the seal body can be easily reached and inspected, and as a result, post-treatment cleaning or retreatment can also be performed in a simple and cost-effective manner.

[0009] Preferably, the seal body is provided to be positioned proximal to or in front of the opening of the tube section for receiving the optical system. In particular, it may be provided that the seal body is integrated with the optical plate, and the optical plate is connected to or can be coupled to the proximal end of the tube section. Thus, the seal between the instrument and the optical system is precisely positioned where known seals are also located. Therefore, it is considered that existing systems can be modified simply by replacing the sealing material with a seal body. Seals in this position have been shown to be particularly simple and efficient. Furthermore, this area is particularly easy to clean because there are no dead spaces, undercuts, etc.

[0010] Preferably, the present invention provides that the concentric seal lip of the seal body protrudes proximally beyond the optical plate, or the concentric seal lip is coplanar with the optical plate, or the concentric seal lip is offset proximally relative to the optical plate. The seal lip protrudes proximally beyond the optical plate by a fraction of a millimeter or 1-2 mm, and as a result, when coupled with the telescope, a force must be applied to bring the telescope into contact with the optical plate against the spring force of the elastic seal lip. This application of force and the associated mechanical tension within the seal body ensures a proper seal between the aforementioned components throughout the treatment. At the end of the treatment, or when uncoupled from the optical plate, the mechanical pre-tension of the seal body helps guide the telescope out of the instrument. Due to the pre-tension, after the locking mechanism is released, the seal body pushes the telescope out of the instrument. The concentric seal lip is reversible and is intended to return to its original shape when deformed by the application of force. This means that the seal body can be used many times without impairing its sealing properties.

[0011] A more preferred embodiment provides that the concentric seal lip of the seal body is aligned toward the longitudinal axis, i.e., converges toward the longitudinal axis. This seal lip shape means that when the telescope is joined to the instrument, the inner diameter of the ring-shaped or concentric seal lip decreases, resulting in the accumulation of spring force. A sealing effect is then created between the slightly inwardly pressed seal lip and the telescope.

[0012] Similarly, another preferred embodiment may provide a concentric seal lip that flares outward away from the longitudinal axis. In this embodiment, the outer diameter of the seal lip increases when the telescope is installed inside the instrument or when these two components are pressed together. The sealing effect is formed between the inner wall of the seal lip and the surface of the telescope. In this design example, the preload or elastic effect acts axially outward. As soon as the connection between the instrument and the telescope is released again, the seal lip relaxes in the opposite direction.

[0013] Furthermore, according to the present invention, it may be provided that the inner diameter of the seal body is larger than the inner diameter of the tube section and / or optical system. Therefore, there is no seal between the seal body and the optical system.

[0014] A particularly advantageous embodiment of the present invention can provide that the inner wall of the seal body is conical distal to the opening of the tube section, thereby reducing the diameter of the inner wall distally. This conical design facilitates the insertion of the optical system into the tube section or instrument. The conical seal body behaves like a slope, guiding the optical system into the tube section, even if the insertion is slightly offset.

[0015] Finally, preferably, it can be provided that the sealing body is made of plastic, elastomer, fluorocarbon rubber (FKM) or ethylene propylene diene rubber (EPDM). These materials have proven to be particularly suitable because they meet the requirements of materials used in the medical field, have high mechanical resistance and can be manufactured at a low cost.

[0016] Preferred embodiments of the present invention will be described in more detail below with reference to the drawings.

Brief Description of the Drawings

[0017] [Figure 1] It is a schematic diagram of a hand-held surgical instrument. [Figure 2A] It is a schematic cross-sectional view of a first embodiment of a seal body without a telescope. [Figure 2B] It is a schematic cross-sectional view of a first embodiment of a seal body having a telescope. [Figure 3A] It is a schematic cross-sectional view of a second embodiment of a seal body without a telescope. [Figure 3B] It is a schematic cross-sectional view of a second embodiment of a seal body having a telescope.

Mode for Carrying Out the Invention

[0018] FIG. 1 shows a highly schematic hand-held surgical instrument 10 (hereinafter referred to as instrument 10). This instrument 10 may be, for example, an endoscope, a cystoscope, a resection scope, or a similar instrument for minimally invasive treatment of a patient.

[0019] The instrument 10 described herein essentially consists of a tubular shaft 11 and a bridge 12. To treat a patient, the instrument 10 is guided into an opening in the patient's body at the distal end 21 of the shaft 11. The bridge 12 is positioned outside the body. Several embodiments of the instrument can provide a variety of working instruments that are introduced into the body through the shaft 11 via the bridge 12, such as wires, probes, clamps, catheters, stents, electrodes, and flexible instruments. In the case of the instrument 10 shown in Figure 1, for clarity only, the optical system 16 is inserted into the shaft 11 via the bridge 12.

[0020] The shaft 11 can be coupled by its proximal end 13 to the distal end 14 of the body 20 of the bridge 12. For example, screw fasteners, click fasteners, bayonet fasteners, or clamping rings can be used for this purpose. The proximal end 15 of the body 20 has a tubular section 17 to which an optical plate 23 is attached. A telescope 22 having an optical system 16 can be coupled to this optical plate 23. An eyepiece or camera can be attached to the telescope 22 so that the surgeon can view the area to be operated on through the rod lens system. As an alternative to the rod lens system, optical fibers can also be used as an imaging device.

[0021] Within the main body 20, in this embodiment of the instrument 10 shown herein, there is a bore 19. The bore 19 extends parallel to the longitudinal axis 18 and serves to accommodate a rod-shaped optical system 16. The bore 19 extends from the main body 20 into a tube section 17, which is an extension of the bore 19 along the longitudinal axis 18. This optical system 16 could be, for example, a rod lens system, not shown. This rod lens system extends from the proximal end 15 to the distal end 14 of the bridge 12, and is further guided through the entire shaft 11 to the distal end 21 of the shaft 11, where it is directed toward the area to be treated.

[0022] During treatment, the inside of the person's body to be treated is filled with a medium, preferably a liquid, to expand the inside to be treated by pressure, so that the surgeon has sufficient space for treatment. All openings must be closed to prevent this medium or liquid from escaping from the body. This includes the openings of the instruments used. A ring-shaped cavity extends between the shaft and the optical system 16 from the distal end 21 to the proximal end 15. To close this cavity, the present invention provides a seal body 24 located at the proximal end 15. This seal body 24 has a concentric seal lip 25 oriented in the proximal direction 26.

[0023] Figures 2A, 2B, 3A, and 3B illustrate two possible embodiments of the seals 24 and 27 according to the present invention. For clarity, only portions of the tube section 17 and optical plate 23 are shown as cross-sectional views. The seal 24 according to the embodiment shown in Figure 2A is located within a receptacle 28 in the optical plate 23. The optical plate 23 is positioned on the tube section 17 such that the seal 24 is in direct contact with or in front of the tube section 17. The seal 24 is essentially ring-shaped and has a central opening 29. The optical system 16 can be pushed into the tube section 17 through this central opening 29 in the direction of proximal movement 26. For this purpose, the minimum inner diameter 30 of the seal 24 corresponds to at least the diameter of the tube section 17.

[0024] In the proximal direction 26, the seal body 24 has a concentric seal lip 25 whose cross-section extends in a wedge shape in the proximal direction 26, i.e., beyond the contact surface 31 of the optical plate 23. This protrusion can be from a fraction of a millimeter to a maximum of 1 mm to 2 mm. However, embodiments in which the concentric seal lip 25 protrudes more than 2 mm beyond the contact surface 31 are also conceivable. Due to the wedge-shaped design of the concentric seal lip 25, the wall thickness of the seal body 24 or the seal lip 25 tapers in the proximal direction 26. In this embodiment, the concentric seal lip 25 is oriented concentrically in the direction of the longitudinal axis 18, i.e., oriented inward.

[0025] The inner wall 32 of the seal body 24 is conical in the direction of the tube section 17 and tapers from the opening 29 to the minimum inner diameter 30. This conical design of the inner wall 32 helps ensure that the optical system 16 can be inserted into the tube section 17 in a simple and reliable manner.

[0026] The seal body 24 is made of an elastic material. Plastics and elastomers are particularly suitable, and fluororubber (FKM) or ethylene-propylene-diene rubber (EPDM) are preferred. These reversible elastic materials have the advantage of returning to their original shape after deformation. Here, as shown in Figure 2B, when a telescope 22 having an optical system 16 is inserted into the bridge 12 or shaft 11 and the sealing surface 33 of the telescope 22 is joined to the contact surface 31, the seal body 24 or concentric seal lip 25 is deformed. In this process, the seal body 24 or concentric seal lip 25 is deformed toward the longitudinal axis 18 by the sealing surface 33, resulting in a reduction in the opening 29 of the seal body 24. During this deformation, mechanical tension is accumulated within the seal body 24, resulting in the concentric seal lip 25 being pressed against the sealing surface 33. This pressure of the concentric sealing lip 25 against the sealing surface 33 creates a sufficient seal in the ring-shaped space between the shaft 11 and the optical system 16 to prevent fluid from escaping. To ensure that this tightness can be maintained during treatment, the optical plate 23 is provided to be detachably coupled to the telescope 22 by a latching mechanism 34.

[0027] Once the treatment is complete, the latching mechanism 34 can be released, and the contact surface 31 can be separated from the sealing surface 33. The surgeon is assisted by the pre-tension of the deformed concentric sealing lip 25, which pushes the sealing surface 33 proximal 26 away.

[0028] The use of this seal 24 is particularly advantageous because, on the one hand, it provides the necessary tightness to prevent leakage of the medium, and on the other hand, it is particularly easy and thorough to clean. The seal 24 can be easily removed from the receptacle 28 and replaced, for example, as needed.

[0029] Figure 3A schematically shows a further embodiment of the seal body 27. This seal body 27 differs from the seal body 24 only in the shape of the concentric seal lip 35. All other features shown are identical to those in the embodiment shown in Figure 2a, and therefore the same reference numerals are used and the above description is used accordingly.

[0030] In contrast to the concentric seal lip 25, the concentric seal lip 35 is not oriented toward the longitudinal axis 18, but rather concentrically outward, thereby enlarging the opening 29. In this embodiment of the seal body 27, when the sealing surface 33 of the telescope 22 contacts the contact surface 31 of the optical plate 23, the concentric seal lip 35 is pressed outward, i.e., concentrically away from the longitudinal axis 18. This state is schematically shown in Figure 3B. Here again, mechanical tension is accumulated within the seal body 27 or the concentric seal lip 35, which presses the concentric seal lip 35 against the sealing surface 33. The mechanical tension is sufficient to create sufficient tightness between the bridge 12 and the telescope 22. Here again, after treatment and after the release of the latching means 34, the released mechanical force pushes the sealing surface 33 proximal 26.

[0031] This design example of the seal body 27 has proven to be advantageous, similar to the previously mentioned design example. This seal body 27 also provides a high level of tightness and allows for simple and thorough cleaning. [Explanation of symbols]

[0032] 10 Handheld Surgical Instruments 11 shafts 12 Bridge 13 Proximal end 14. Distal end 15 Proximal end 16 Optical system 17 Pipe Sections 18 Longitudinal axis 19 Boa 20 Main unit 21 Distal end 22 Telescope 23 Optical Plates 24 seals 25 Seal Lip 26 Proximal direction 27 Seal body 28 Receptacles 29 Opening 30 diameter 31 Contact surface 32 Inner wall 33. Sealing surface 34 Latching mechanism 35 Seal Lip

Claims

1. A handheld surgical instrument comprising a body having at least one channel-shaped bore for an optical system, A handheld surgical instrument, wherein the bore merges with a tubular section in the proximal direction, the distal end of the body is connectable to a shaft for the optical system, the proximal end of the body is connectable to a telescope, an axis along the longitudinal direction of the handheld surgical instrument extends axially through the bore and the tubular section, and a sealing body is positioned axially with respect to the longitudinal direction in the proximal direction together with a concentric sealing lip oriented in the proximal direction.

2. The handheld surgical instrument according to claim 1, wherein the sealing body is positioned in the proximal direction in front of or within the opening of the tube section for receiving the optical system.

3. The handheld surgical instrument according to claim 1, wherein the sealing body is integrated with an optical plate, and the optical plate is connected to or can be connected to the proximal end of the tube section.

4. The handheld surgical instrument according to claim 3, wherein the concentric sealing lip of the sealing body protrudes beyond the optical plate in the proximal direction, is on the same plane as the optical plate, or is offset in the proximal direction relative to the optical plate.

5. The handheld surgical instrument according to claim 1, wherein the concentric seal lip is designed to be reversible and returns to its original shape when deformed by the application of force.

6. The handheld surgical instrument according to claim 1, wherein the concentric sealing lip converges along the longitudinal axis.

7. The handheld surgical instrument according to claim 1, wherein the concentric sealing lip extends outward away from the longitudinal axis.

8. The handheld surgical instrument according to claim 1, wherein the inner diameter of the sealing body is larger than the inner diameter of the tube section and / or the optical system.

9. The handheld surgical instrument according to claim 1, wherein the inner wall of the sealing body is conical in the distal direction toward the opening of the tube section, and the diameter of the inner wall decreases in the distal direction.

10. The handheld surgical instrument according to claim 1, wherein the sealing body is formed from plastic, elastomer, fluororubber (FKM), or ethylene-propylene-diene rubber (EPDM).

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