Needle holder with device for adjusting the position and / or rotation and / or orientation of a surgical needle

Abstract

Changing the position, rotation or orientation of a surgical needle is particularly difficult in minimally invasive or robotic surgery and / or in confined spaces. The needle usually has to be repositioned using a second instrument. This often requires multiple transfers of the needle between the instruments. The new needle holder will enable one-handed, continuous adjustment of the needle. The needle holder has an adjusting element (31, 6) which is arranged on a handle part (4), wherein the movement of the adjusting element can be used to adjust the position and / or rotation and / or orientation of the surgical needle, wherein the adjusting element is driven by a drive element (11, 12). The invention significantly simplifies what is usually the most time-consuming step of surgical suturing. In addition, the invention enables the needle to be adjusted without shifting the position of the handle parts relative to each other, which enables the needle to be clamped as distally as possible. The invention can be applied to known needle holder designs, including robotic needle holders, by means of minor modifications.

Description

[0001] Description

[0002] Needle holder with device for adjusting the position and / or rotation and / or orientation of a surgical needle

[0003] The invention relates to a needle holder that enables the one-handed, continuous adjustment of a surgical needle.

[0004] Needle holders are used in open and minimally invasive surgery to grip a surgical needle in a non-slip and rotation-resistant manner. This makes it easier to guide a surgical thread attached to the surgical needle during surgical suturing. During surgical suturing, depending on the location and / or properties of the tissue and / or the desired suturing technique and / or the surgeon's preference, changing the position and / or rotation and / or orientation of the surgical needle to be clamped is necessary. Particularly in minimally invasive surgery and / or in confined spaces, changing the position and / or rotation and / or orientation of the surgical needle is difficult and time-consuming. In open surgery, this usually requires the surgeon to grasp the surgical needle with their other hand and manually adjust its position and / or rotation and / or orientation.In minimally invasive, robotic surgery, the surgical needle typically requires adjustment of its position, rotation, and / or alignment using a second instrument. This often requires multiple transfers of the surgical needle between the needle holder and the second instrument until the desired position, rotation, and / or alignment of the surgical needle is achieved and the needle can finally be clamped.

[0005] A needle holder with the ability to rotate a surgical needle was described in document DE102010055806A1. However, the needle holder described therein only allows a very limited range of rotation. A major disadvantage of the design described therein is that, once its position has been corrected, the needle is no longer clamped far enough at the distal end of the handles, which in most cases represents an unfavorable condition for suturing. Furthermore, in the aforementioned prior art document, adjustment of the needle is only possible along one axis. No application in robotic surgery was described. The technical problem addressed by the invention is to provide a needle holder that enables one-handed, continuous adjustment of the position and / or rotation and / or orientation of a surgical needle.

[0006] The technical problem is solved by the present invention in that the needle holder has an adjusting element 3 which is arranged in and / or on a gripping part 4 of the needle holder 1, wherein from a metered gripping force of the needle holder 1 the adjusting element 3 can adjust the position and / or rotation and / or orientation of the surgical needle 2 by its movement, wherein the adjusting element 3 is connected to a drive element 5, wherein the drive element 5 is controlled by a user and drives the movement of the adjusting element 3, wherein when the metered gripping force is exceeded the gripping part 4 of the needle holder 1 grips the surgical needle 2 and prevents an adjustment of the position and / or rotation and / or orientation of the surgical needle 2.

[0007] As a possible practical embodiment, it is proposed that the adjusting element 3 comprise a rubber band 31, which is tensioned on a holding element 6, in particular between two wheels arranged in and / or on the handle part 4 (Fig. 1, Fig. 2, Fig. 4, Fig. 5, Fig. 6, Fig. 7, Fig. 8, Fig. 9, Fig. 10, Fig. 14). At least one wheel is connected to the drive element 5, for example, by another rubber band or by a gear or by toothing.

[0008] In order to limit the pressure on the adjusting element 3 and on the holding element 6 when closing the handle parts 4, it is proposed that the adjusting element 3 and the holding element 6 are coupled to a spring mechanism 7, wherein the spring mechanism 7 gives way after the dosed grip force is exceeded (Fig. 3).

[0009] In one embodiment, it is proposed that the holding element 6 together with the adjusting element 3 and the spring mechanism 7 can be installed and removed, wherein the holding element 6 can be engaged on the handle part 4, for example by means of a receptacle 8 that fits the holding element 6 or the spring mechanism 7, in particular a groove and / or rail and / or indentation (Fig. 3, Fig. 10).

[0010] Depending on the number and arrangement of the adjusting elements 3, different effects can be achieved on the surgical needle 2. In one possible embodiment, the adjusting elements 3 are arranged on opposite handle parts 4 (Fig. 8 and Fig. 9). As long as the adjusting elements 3 on opposite handle parts 4 have the same direction of movement on their side facing the surgical needle 2, a shift in the position of the surgical needle 2 relative to the handle parts 4 is achieved without changing the rotation of the surgical needle 2. If the adjusting elements 3 on opposite handle parts 4 have opposite directions of movement on their side facing the surgical needle 2, a change in the rotation of the surgical needle 2 is achieved without shifting the position of the surgical needle 2 relative to the handle parts 4.Whether the directions of movement of the adjustment elements are the same or opposite can be modified by changing the connection of the drive element 5 to the adjustment element 3. In a further embodiment, an adjustment element 3 is arranged on each side of a handle part 4 (Fig. 14). This achieves an adjustment of the orientation of the surgical needle 2 as long as the adjustment elements 3 located on both sides of the handle part are not moved in exactly the same direction and to the same extent. If the adjustment elements 3 located on both sides of the handle part are moved in exactly the same direction and to the same extent, a simultaneous adjustment of the rotation and position of the surgical needle is achieved without changing the orientation of the surgical needle.

[0011] In a more cost-effective embodiment, an adjustment element 3 is arranged on only one of the two handle parts 4. On the handle part 4 where no adjustment element 3 is arranged, a rubber pad 9 is located instead (Fig. 6, Fig. 7). Alternatively, instead of the rubber pad 9, another adjustment element 3 can be arranged without a connection to the drive element 5 (Fig. 9a). Here, too, the rubber pad 9 and / or adjustment element 3 is coupled to a spring mechanism 7. Since in this embodiment an adjustment element 3 is only driven on one of the two handle parts 4, the movement of the driven adjustment element 3 leads to a "rolling" of the surgical needle 2 on the rubber pad 9 and / or on the non-driven adjustment element 3, so that a simultaneous adjustment of the rotation and position of the surgical needle 2 takes place.If, instead of a simple rubber pad 9, a non-driven adjustment element 3 is arranged, this adjustment element 3 can also be connected to the drive element 5 at any time (Fig. 8, Fig. 9), for example by means of a rubber band, so that the effect on the surgical needle 2 can be modified if desired. In a space-saving embodiment as shown in Figure 10, the adjustment element 3 is arranged within one of the handle parts 4. The adjustment element 3 can be inserted into the handle part 4 through a suitable groove and / or rail and / or indentation in the handle part 4. The adjustment element 3 can be docked into place within the handle part 4 by inserting one or more connecting elements 18.At least one connecting element 18 is, for example, a gear wheel which, after being inserted into the handle part 4, engages both in the holding element 6, in particular in the proximal wheel portion 61 of the holding element 6 which has a gear wheel pattern in its interior, and also comes into direct contact with the rotating element 11, so that the movement of the transmission element 12 now takes place via the rotating element 11 and via the connecting element 18 to the holding element 6 of the adjusting element.

[0012] 3. In this embodiment, the drive element 5 comprises the transmission element 12 and the rotary element 11.

[0013] In one embodiment, the drive element 5 has a rotary element 11 at a distal end of a shaft 10 of the needle holder 1, for example a wheel or a gear, which can be controlled by the user via a transmission element 12, in particular a further shaft, rotor, rod, a wheel, gear, or an adjusting screw or a cable, on a further rotary element 13 arranged on a handle 14 of the needle holder 1 (Fig. 2). The rotary element 11 located at the distal end of the shaft 10 of the needle holder 1 is connected to the adjusting element 3 and drives this adjusting element 3 (Fig. 1, Fig. 6, Fig. 7, Fig. 8, Fig. 9, Fig. 10, Fig. 14), for example by means of gears or toothing (Fig. 13).

[0014] In one embodiment in robotic and / or robot-assisted surgery (Fig. 4, Fig. 5), an adjustment element 3 is arranged in or on one of the two handle parts 4 of the robotic needle holder 16, wherein the drive element 5 with its transmission element 12 of this handle part 4 is used for controlling the adjustment element 3. This embodiment enables a cost-effective modification of the robotic needle holder 16 used in robotic surgery, where the pivoting movement of one of the two handle parts 4 of the robotic needle holder 16 is dispensed with and this handle part

[0015] 4 remains in the closed position, whereby the released drive element 5 with its transmission element 12 is used to control an adjustment element 3. The adjustment element 3 can be installed and removed, or instead, it can be permanently installed, which can be more cost-effective to manufacture.

[0016] The advantages achieved with the invention consist in particular in that the usually most time-consuming step of a surgical suture can be made significantly easier by simplifying the adjustment of the position and / or rotation and / or alignment of a surgical needle. Furthermore, the invention enables the adjustment of the surgical needle without shifting the position of the handle parts relative to each other. This enables the surgical needle to be clamped as close as possible to the distal end of the handle parts, which improves the precision of the suturing process and facilitates sewing in confined spaces. The rubber band design of the adjustment element allows a very wide range of adjustment. By arranging the adjustment elements in different ways, needle holders with different adjustment options on different axes can be provided.Last but not least, the invention can be applied to existing needle holder designs, including robotic needle holders, with minor modifications.

[0017] List of reference symbols

[0018] 1 needle holder

[0019] 2 surgical needles

[0020] 3 Adjustment element

[0021] 4 Handle part

[0022] 5 Drive element, comprising rotary element 11, transmission element 12 and rotary element on a handle 13

[0023] 6 Holding element

[0024] 7 Spring mechanism

[0025] 8 Recording

[0026] 9 Rubber pad

[0027] 10 shaft

[0028] 11 Rotating element

[0029] 12 transmission element

[0030] 13 Rotating element on a handle

[0031] 14 Handle

[0032] 15 Rubber band between rotating element 111 and adjusting element 3

[0033] 16 robotic needle holder

[0034] 17 Locking rod

[0035] 18 Connecting element

[0036] 31 rubber band

[0037] 61 proximal wheel portion of the holding element having a gear pattern inside 6 111 rotating element on the pivoting handle part

[0038] Character descriptions

[0039] Fig. 1. Needle holder with an adjustment element arranged laterally on a handle. Handle and transmission element not shown. 1a) View from above, without rubber band. 1b) View from above, with rubber band. 1c) Side view.

[0040] Fig. 2. Laparoscopic needle holder with a rotating element arranged on a handle to control the movement of the adjusting element and with locking rods arranged on the handle, view from the side.

[0041] Fig. 3. Handle part with laterally arranged adjustment element, examples of spring mechanism, shown without rubber band.

[0042] Fig. 4. Three-dimensional representation of a robotic needle holder with an adjustment element arranged within a handle part.

[0043] Fig. 5. Robotic needle holder, side view.

[0044] Fig. 6. Laparoscopic needle holder with an adjustment element located laterally on one handle and a rubber pad located on the opposite handle. Handle and transmission element not shown.

[0045] Fig. 7. Laparoscopic needle holder with an adjustment element arranged laterally on one handle part and a rubber pad arranged on an opposite handle part, handle parts closed, shown with a surgical needle, handle and transmission element not shown.

[0046] Fig. 8. Laparoscopic needle holder with a laterally arranged adjustment element on each of the handle sections. Handle and transmission element not shown. In the upper image: View from above, without rubber band 15. Fig. 9. Illustration of the distal end of a laparoscopic needle holder, view from above, with a laterally arranged adjustment element on each of the handle sections; different effects on the directions of movement of the adjustment elements are made possible by connecting the rubber band 15 to different positions on the rotating element 111: 9a) Rubber band 15 not connected.

[0047] 9b) Rubber band 15 is connected in such a way that the adjustment elements on opposite handle parts have the same direction of movement on their side facing the surgical needle 2, so that a displacement of the position of the surgical needle relative to the handle parts is achieved without changing the rotation of the surgical needle.

[0048] 9c) Rubber band 15 is connected in such a way that the adjustment elements on opposite handle parts have opposite directions of movement on their side facing the surgical needle, so that a change in the rotation of the surgical needle is achieved without shifting the position of the surgical needle relative to the handle parts.

[0049] Fig. 10.

[0050] 10a) Three-dimensional representation of the distal end of a laparoscopic needle holder with an adjustable element arranged within a handle that can be installed and removed.

[0051] 10b) Two-dimensional view from the side, shown here with a rubber pad arranged on the pivoting handle part.

[0052] Fig. 11. Retaining element for the adjustment element with a proximal gear portion featuring a gear pattern. The illustrations correspond to an adjustment element whose rubber band has been removed.

[0053] 1 la) View from the side, the dashed drawing in the middle of the middle bar indicates the abbreviated representation.

[0054] 11b) Top view. The center of the wheels is not movable, but serves as a rail for the four movable wheel sections, two per wheel. One of the movable wheel sections has a gear pattern inside it, which allows the connection to the rotating element to be established. Fig. 12. Three-dimensional, enlarged view of the connection between the transmission element and the rotating element, as shown in Fig. 10.

[0055] Fig. 13. Examples of a connection between the holding element and the rotating element. 13a) Proximal wheel portion of the holding element and rotating element, featuring a gear pattern inside, side view.

[0056] 13b) Three-dimensional representation of the connection between the holding element and the rotating element.

[0057] 13c) Alternative example of a possible connection between the holding element and the rotating element, as shown in Fig. 1.

[0058] Fig. 14. Example embodiment with adjustment elements 3 arranged on both sides of a handle 4, view from above. This allows the alignment of the surgical needle to be adjusted as long as the adjustment elements 3 arranged on both sides of the handle are not moved in exactly the same direction and by the same amount.

Claims

AMENDED CLAIMS received by the International Bureau on 23 April 2025 (23.04.2025) 1. A needle holder (1) comprising two opposing handle parts (4), at least one handle part (4) being pivotable, with a device for adjusting a surgical needle (2), comprising at least one adjusting element (3) arranged on a handle part (4) of the needle holder (1), wherein the adjusting element (3) holds the surgical needle (2) and, with a metered gripping force of the adjusting element (3) created by closing the handle parts (4), the adjusting element (3) can change the rotation and / or orientation of the surgical needle (2) in relation to the handle part (4) through its movement, wherein the adjusting element (3) is connected to a drive element (5), wherein the drive element (5) can be controlled by a user and drives the movement of the adjusting element (3), wherein when the metered gripping force is exceeded, the handle parts (4) grip the surgical needle (2) and prevent adjustment of the surgical needle (2),wherein the adjusting element (3) is clamped to a holding element (6) between wheels, wherein the holding element (6) is connected to the drive element (5) and can thereby displace the adjusting element (3) in the axial direction of movement., 2. Needle holder according to one of the preceding claims, wherein the holding element (6) is coupled to a spring mechanism (7), wherein the spring mechanism (7) yields after the metered gripping force is exceeded, so that the pressure on the adjusting element (3) is limited when the gripping parts (4) are closed.

3. Needle holder according to one of the preceding claims, wherein the holding element (6) is insertable and removable, wherein the holding element (6) can be snapped into place by a receptacle (8).

4. Needle holder according to one of the preceding claims, wherein at least one adjusting element (3) is arranged on each of the opposite handle parts (4), wherein the position of the surgical needle (2) can be shifted relative to the handle parts (4) without rotating the surgical needle (2), provided that the adjusting elements (3) have the same direction of movement on their side in contact with the surgical needle (2); wherein the rotation of the surgical needle (2) can be adjusted while the position of the surgical needle (2) relative to the handle parts (4) remains the same, provided that the adjusting elements (3) have opposite directions of movement on their side in contact with the surgical needle (2).

5. Locking mechanism for a needle holder according to one of the preceding claims, comprising corresponding locking rods (17), wherein the locking mechanism reproducibly holds the metered gripping force by extending the corresponding locking rods (17) of a conventional locking mechanism.

6. Needle holder according to one of the preceding claims, wherein the adjusting element (3) and the holding element (6) comprise a material that is degradable by the body.

7. Needle holder according to one of the preceding claims, wherein the drive element (5) has a rotary element (11) which can be rotated via a transmission element (12), wherein the transmission element (12) has a further rotary element (13) which is arranged on a handle (14).

8. Needle holder according to one of the preceding claims, wherein two adjusting elements (3) are arranged on a plane which runs between the surfaces of the two opposite handle parts (4) which are adjacent to one another in the closed position, wherein the two adjusting elements (3) are arranged on this plane in a manner which is axially symmetrical to the longitudinal axis of the needle holder, whereby an adjustment of the orientation of the surgical needle (2) is achieved as long as the adjusting elements (3) are not moved to exactly the same extent and at the same speed and in the same direction.

9. Needle holder according to one of the preceding claims for use in robotic surgery, having at least one pivotable handle part (4), wherein an adjusting element (3) is arranged on one handle part (4), wherein a drive element (5) with its transmission element (12) on one of the two handle parts (4) is not used for pivoting the handle part (4), but for controlling the adjusting element (3).

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