SURGICAL HANDHELD DEVICE, INSULATION INSERT FOR A SURGICAL HANDHELD DEVICE, AND METHOD FOR MANIPULATING A SURGICAL HANDHELD DEVICE

Abstract

Surgical handheld devices are used in electrosurgical procedures in urology. For this use, a radiofrequency electric current is applied to an electrode. It is necessary to avoid the electrode coming into electrical contact with the handheld device. Known insulation inserts for electrical insulation can be connected to the handheld device only with difficulty. Moreover, the connection is very unreliable. A surgical handheld device, and an insulation insert which can be connected to a shaft of the handheld device in a safe and easily releasable manner. The insulation insert is of a tubular configuration and is releasably coupled with a proximal end region to a distal end of a tubular shaft of the handheld device. The proximal end region of the insulation insert has at least two resilient fasteners, which each have a latch element pointing into an interior of the insulation insert.

Claims

1. An insulation insert for a surgical handheld device, the tubular insulation insert being able to be releasably coupled with a proximal end region to a distal end of a tubular shaft, wherein the proximal end region of the insulation insert has at least two resilient fastening means, which each have a latch element pointing into an interior of the insulation insert.

2. The insulation insert for a surgical handheld device as claimed in claim 1, wherein two or four or six or more fastening means are arranged lying opposite each other on a circumference of the proximal end region.

3. The insulation insert for a surgical handheld device as claimed in claim 1, wherein three or more fastening means are arranged at an angle of 120° or at equal angles relative to each other on a circumference of the proximal end region.

4. The insulation insert for a surgical handheld device as claimed in claim 1, wherein the fastening means are designed as snap-fit hooks.

5. The insulation insert for a surgical handheld device as claimed in claim 4, wherein the snap-fit hook has a tab-like spring element, which is formed out from a wall of the proximal end region of the insert, the latch element being arranged at a free end of the spring element.

6. The insulation insert for a surgical handheld device as claimed in claim 5, wherein the spring element has a reduced thickness in relation to the wall of the insulation insert.

7. The insulation insert for a surgical handheld device as claimed in claim 1, wherein the wall of the insulation insert, in the proximal end region or in the region of the fastening means or between the fastening means, has a reduced thickness in relation to the wall of the insulation insert.

8. The insulation insert for a surgical handheld device as claimed in claim 1, wherein the fastening means are arranged in pairs next to each other, and the pairs are arranged lying opposite each other on a circumference of the proximal end region.

9. The insulation insert for a surgical handheld device as claimed in claim 1, wherein wedge-shaped latch elements have a height that corresponds to the wall thickness of the wall of the insulation insert.

10. A surgical handheld device, with an inner shaft or shaft tube and with an outer shaft or outer tube, and with an insulation insert as claimed in claim 1, the insulation insert being able to be coupled releasably to the inner shaft, and the outer shaft being movable over the inner shaft and the insulation insert.

11. The surgical handheld device as claimed in claim 10, wherein an outer circumference of a proximal end region of the insulation insert is dimensioned in such a way that it can be pushed over a distal end of the inner shaft.

12. The surgical handheld device as claimed in claim 10 wherein a wall of the inner shaft has openings in which latch elements of fastening means of the insulation insert engage for releasable coupling of the insulation insert to the inner shaft.

13. The surgical handheld device as claimed in claim 10, wherein a distance between an inner face of the outer shaft and the outer face of the insulation insert is less than the height of latch elements of the fastening means of the insulation insert.

14. The surgical handheld device as claimed in claim 10, wherein further components can be guided or conveyed through the inner shaft and/or the insulation insert.

15. A method for manipulating a surgical handheld device, as claimed in claim 10 with an inner shaft or shaft tube and with an outer shaft or outer tube, and with an insulation insert to prepare the handheld device for use, the insulation insert is first of all coupled with a proximal end to a distal end of the inner shaft, and then the inner shaft is guided with the insulation insert into the outer shaft, and, after the use of the handheld device, the inner shaft with the insulation insert is guided out of the outer shaft, and then the insulation insert is uncoupled from the inner shaft.

Description

[0018] A preferred illustrative embodiment of the invention is described in more detail below with reference to the drawing, in which:

[0019] FIG. 1 shows a schematic view of a surgical handheld device, in particular a resectoscope,

[0020] FIG. 2 shows a schematic view of a distal end region of the surgical handheld device,

[0021] FIG. 3 shows a perspective view of an insulation insert,

[0022] FIG. 4 shows a perspective view of the insulation insert with an inner shaft,

[0023] FIG. 5 shows a cross-sectional view of the insulation insert with the inner shaft,

[0024] FIG. 6 shows a view of the insulation insert, and

[0025] FIG. 7 shows a view of a further illustrative embodiment of an insulation insert.

[0026] FIG. 1 shows a schematic cross-sectional side view of a resectoscope 10. It is expressly noted that this resectoscope 10 is shown simply as one possible illustrative embodiment of the claimed surgical handheld device. It is equally conceivable that the surgical handheld device is another instrument different than the resectoscope 10 shown here.

[0027] The resectoscope 10 has a resectoscope shaft 11, which comprises an outer shaft 12 or outer tube. A tubular inner shaft 13 runs inside the outer shaft 12. An electrode instrument 14 and an optical unit 15 are shown inside the inner shaft 13. In addition, further elements not shown here can run inside the resectoscope 10, for example a separate irrigation tube and the like.

[0028] The electrode instrument 14 has, at a distal end, an electrosurgical tool or an electrode 16. The electrode shown here is formed as a loop, but it can also be configured as a button or the like. It will be seen from FIG. 1 that the electrode instrument 14 is protected by a retention element 17, with a partially circular cross section, against displacements, i.e. displacements deviating from the longitudinal direction of the resectoscope shaft 11. The electrode instrument 14 is mounted longitudinally displaceably in the inner shaft 13. The retention element 17 is of a shape complementary to the inner wall of the inner shaft 13 or to the outer wall of the optical unit 15 and has a partially cylindrical shape.

[0029] By actuation of a handle 18, the electrode instrument 14 can be moved in a constrained axial movement in the distal and proximal direction. It can be pushed beyond the distal end of the inner shaft 13 and of the outer shaft 12. The operator is thus also able to manipulate tissue that is located further away from the resectoscope tip. For this purpose, the inner shaft 13 and/or the electrode instrument 14 can also be mounted rotatably about their longitudinal axis. For the manipulation of the tissue, a radiofrequency electric current is applied to the electrode 16.

[0030] The resectoscope 10 shown in FIG. 1 has a passive transporter in which, by relative movement of the grip parts 20 and 21 arranged proximally on the resectoscope shaft 11, a carriage 19 is displaced in the distal direction toward the distal, first grip part 21 counter to a spring force applied by a spring bridge 22. In the displacement of the carriage 19 in the distal direction toward the grip part 21, the electrode instrument 14 is displaced in the distal direction in a manner not shown. Upon relaxation of the grip parts 20, 21, the spring force generated by the spring bridge 22 forces the carriage 19 back to its starting position, wherein the electrode instrument 14 is pulled in the proximal direction. Upon the return displacement of the carriage 19, an electrosurgical intervention can be performed with the electrode 16 without manual force from the operator, i. e. passively.

[0031] In known surgical handheld devices, the insulation insert is connected fixedly to the shaft. However, since this is unfavorable as regards reuse or as regards sterilizing or cleaning, embodiments also exist in which the insulation inserts are connected releasably to the distal end of a shaft. However, in the known releasable insulation inserts, there is the danger of these coming loose during the operation. On the other hand, if the connection of the insert in the shaft is stronger, releasing the insert proves difficult for an operator.

[0032] The insulation insert 23 according to the invention described here is releasably coupled with its proximal end 24 to the distal end 25 of the inner shaft 13 (FIG. 2: only a distal region of the device is shown here). For this purpose, provision is made that the insulation insert 23 has fastening means 26 at its proximal end 25 (FIGS. 3 and 4). These fastening means are designed as snap-fit hooks and are formed from the wall 27 of the insulation insert 23. The fastening means 26 are located, preferably in pairs, at opposite positions on the insulation insert 23 (FIG. 7). It is moreover conceivable that a plurality of fastening means 26 are assigned, at equal angles from each other, to the wall 27 of the insulation insert 23 (FIG. 6). In the illustrative embodiment of an insulation insert 23 shown in FIG. 7, two fastening means 26 are in each case arranged in pairs on opposite sides of the wall 27 of the insert 23. In the illustrative embodiment of an insulation insert 23 according to FIGS. 3 to 6, a plurality of fastening means 26 are located lying opposite each other on the wall 27. The fastening means 26 are at a uniform angle spacing from each other. In this way, it is possible to produce a particularly firm and positionally accurate connection.

[0033] In the illustrative embodiment of an insulation insert 23 shown in FIG. 7, the wall 27 has widened parts in which receptacles 35 are arranged for an electrode instrument 14. The receptacles 35 shown here are designed as passages like holes or bore holes, through which the electrode instrument 14 can be guided when the components of the device 10 are joined together.

[0034] The fastening means 26 designed as snap-fit hooks are composed principally of a web-like spring element 28 and of a latch element 29 arranged at the free end of the spring element 28. As is shown in the cross section in FIG. 2, this latch element 29 can be wedge-shaped. However, it is also conceivable that the latch element 29 is rounded.

[0035] The regions of the wall 27 that are arranged at the proximal end 24 of the insulation insert 23 between the fastening means 26 or the spring elements 28 are on the one hand separated from the fastening means 26, such that the latter can spring freely, and on the other hand these regions have the same thickness as the spring elements 28. A shoulder 31 is thus obtained on an inner face 30 of the insulation insert 23. This shoulder 31 extends in a ring shape around the whole inner face 30 of the insulation insert 23. In the connection of the insulation insert 23 to the inner shaft 13, the insulation insert 23 is pushed onto the shaft 13 until the shoulder 31 abuts against the distal end 25 of the inner shaft 13 (FIGS. 4 and 5).

[0036] The inner shaft 13 has openings 33 in its wall 32 at the distal end 25 (FIGS. 4 and 5). These openings 33 are dimensioned and positioned in such a way that the fastening means 26 or the latch elements 29 of the insulation insert 23 snap together when the shaft 13 and the insulation insert 23 are pushed onto each other. As the insulation insert 23 and the inner shaft 13 are pushed one over the other in this way, the spring elements 28 are first of all moved outward by the latch elements 29 and widened until the latch elements 29 snap into the openings 33. In conjunction with the shoulder 31, the insulation insert 23 is located in the optimal position at the distal end 25 of the inner shaft 13. For disassembly, an operator now has to move the latch elements 29 out of the openings 33 or widen the spring elements 28 and pull the insulation insert 23 from the inner shaft 13.

[0037] However, in order to ensure, particularly during an operation, that the insulation insert 23 is not accidentally released from the inner shaft 13, the outer shaft 12 is pushed over the inner shaft 13 and partially also over the insulation insert 23 (FIG. 2). According to the invention, the internal diameter of the outer shaft 12 and the external diameter of the insulation insert 23 are such that a gap 34 or an annular space between an inner wall of the outer shaft 12 and the wall 27 of the insulation insert 23 is less than the height of the latch elements 29. The latch elements 29 are fixed in the openings 33 by these narrow gaps 34 or by this small clearance. Even if a mechanical force is exerted on the insulation insert 23, the fastening means 26 or the spring elements 28 cannot be widened in such a way that the insulation insert 23 comes loose from the inner shaft 13. This enveloping action of the outer shaft 12 around the insulation insert 23 has the effect that the insert 23 remains fixed in its orientation relative to the inner shaft 13. The operator can release the insulation insert 23 from the inner shaft 13 only when the outer shaft 12 has been removed again from the inner shaft 13.

[0038] In a preferred illustrative embodiment, provision can be made that the insulation insert 23 has a plurality of fastening elements 26, and the inner shaft 13 accordingly has a plurality of openings 33. Besides the shape of the insulation insert 23 shown here, other shapes are also conceivable, for example a straight distal end.