DEVICE FOR EXPOSING AND HOLDING OPEN AN OPERATING AREA

Abstract

A medical device for exposing and holding open an operating area in the region of the oral cavity of a patient, preferably a laryngo-pharyngoscope retractor, the device having a holding structure that is fixable in the head region of the patient for mounting medical instruments and tools and a spatula that is insertable into the oral cavity for fixing the tongue or other parts in the operating area and that includes a spatula blade and a handle region, characterized in that the spatula includes two or more mutually adjacent adjustment elements that are movable relative to one another.

Claims

1. Medical device for exposing and holding open an operating area in the region of the oral cavity of a patient, the device having a holding structure that is fixable in the head region of the patient for mounting medical instruments and tools and a spatula that is insertable into the oral cavity for fixing the tongue or other parts in the operating area and that comprises a spatula blade and a handle region, wherein the spatula comprises two or more mutually adjacent adjustment elements that are movable relative to one another.

2. Device according to claim 1, wherein by moving the adjustment elements relative to one another, the size and/or shape of the spatula can be changed, in particular while the holding structure is fixed in the region of the oral cavity of a patient for an operation intervention, without releasing the fixing of the tongue or other parts in the operating area by means of the spatula.

3. Device according to claim 1, wherein the spatula blade and the handle region are movable relative to one another.

4. Device according to claim 1, wherein the spatula blade is axially displaceable relative to the handle region in the extension of the longitudinal axis of the handle region.

5. Device according to claim 1, wherein the spatula blade can be angled out of the extension of the longitudinal axis of the handle region in a plane (II) parallel to the contact plane (I).

6. Device according to claim 1, wherein one or more adjustment elements are arranged between the spatula blade and the handle region.

7. Device according to claim 1, wherein the adjustment elements are each pivotable relative to the adjacent adjustment element(s) in a plane (II) parallel to the contact plane, each adjustment element having an engagement portion and a receiving portion, and the engagement portion being inserted, at least in portions, into the receiving portion of an adjacent adjustment element.

8. Device according to claim 1, wherein the spatula blade and/or the handle region are adjustment elements.

9. Device according to claim 1, wherein the width of the spatula blade can be changed.

10. Device according to claim 1, wherein the spatula blade comprises two or more adjustment elements that are movable relative to one another in the manner of a fan.

11. Spatula for use in a medical device for exposing and holding open an operating area in the region of the oral cavity of a patient, the spatula comprising a spatula blade and a handle region, wherein the spatula comprises two or more mutually adjacent adjustment elements that are movable relative to one another.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0024] Example embodiments of the invention are schematically shown in the drawings, in which:

[0025] FIG. 1 is a schematic side view of a device according to the invention,

[0026] FIG. 2 is a schematic plan view of the holding structure of FIG. 1,

[0027] FIG. 3 is a schematic plan view of a spatula according to the invention, the spatula blade of which is axially displaceable,

[0028] FIG. 4 is a schematic plan view of a spatula according to the invention, the spatula blade of which is axially displaceable and that has a device for axial displacement,

[0029] FIG. 5 is a schematic side view of the spatula according to the invention from FIG. 4,

[0030] FIG. 6 is a schematic plan view of a spatula according to the invention, the spatula blade of which can be pivoted radially or angled out of the extension of the longitudinal axis of the handle region,

[0031] FIG. 7 is a schematic plan view of an alternative spatula according to the invention, the spatula blade of which can be angled out of the extension of the longitudinal axis of the handle region,

[0032] FIG. 8 is a schematic plan view of a further, alternative spatula according to the invention, the spatula blade of which can be angled out of the extension of the longitudinal axis of the handle region,

[0033] FIG. 9 is a schematic drawing of a spatula according to the invention, the spatula blade of which can be widened, and

[0034] FIG. 10 is a schematic plan view of a spatula according to the invention, the spatula blade of which can be widened, adjustment elements foldable in the manner of a fan being provided in the spatula blade for this purpose, which can be folded open (FIG. 10a) and closed (FIG. 10b).

EXAMPLE EMBODIMENTS

[0035] Further advantages, characteristics and features of the present invention will be apparent from the following detailed described of example embodiments with reference to the accompanying drawings. However, the invention is not limited to these example embodiments.

[0036] FIG. 1 shows, highly schematically, a device 10 according to the invention comprising a holding structure 12 that carries a spatula 14 that is guided height-adjustably in a spatula guide 22. As the plan view of the holding structure 12 in FIG. 2 schematically illustrates, the holding structure 12 may in particular be formed frame-like, comprising two substantially mutually parallel longitudinal beams 32, which brace two likewise approximately mutually parallel transverse beams 34. FIG. 2 is a plan view of FIG. 1, with the spatula guide 22 omitted for simplicity of the drawing.

[0037] As is shown in FIG. 1, the spatula guide 22 that carries the spatula 14 longitudinally displaceably may be fastened to a positioning element 30in this case configured in the manner of a rodso as to provide further options for orienting the spatula 14 relative to the holding structure 12. The positioning element 30 is also referred to as a retractor rod. In the present example, the positioning element 30 is mounted on a fastening block 26 mounted on the holding structure 12. The positioning element 30 may for example be mounted longitudinally displaceably and/or pivotably on the fastening block 30.

[0038] In the present example embodiment, the intention is that the positioning element 30 is guided longitudinally displaceably on the fastening block 26 by means of a manually actuable drive unit. For manual longitudinal displacement of the positioning element 30, a rotary control 28, for example in the form of a knurled screw, may be provided. The rotary control 28 may cooperate with the drive unit that longitudinally displaces the positioning element 30. In this context, the intention is that in the event of a rotation at the rotary control 28 the positioning element 30 is displaced in a distal or proximal direction, so as thus to move the spatula guide 22, along with the spatula 14 mounted thereon, in a distal or proximal direction relative to the fastening block 26. In addition, a locking device (not shown), arranged for example on the fastening block 26, may be provided, and fixes the positioning element 30 with respect to the fastening block 26 so as to prevent unintended displacement of the positioning element 30 after adjustment.

[0039] For fixing the device 10 in the head region of the patient, an upper jaw support element 36, which is laid against the upper jaw of a patient, may be provided on the holding structure 12. In the example shown, the upper jaw support element 36 is fastened to a first transverse beam 34 arranged distally on the holding structure 12, and the fastening block 26 that carries the positioning element 30 with the spatula guide 22 fastened thereto is arranged on a second transverse beam 34 arranged proximally on the holding structure 12. For exposing and holding open the operating area in the region of the oral cavity of the patient, the upper jaw support element 36 can be positioned against the upper jaw of the patient, and a spatula support face 38 of the spatula 14, arranged on an end region of the spatula 14, the spatula blade 16, that is insertable into the oral cavity of the patient, can be positioned against the tongue body. When the positioning element 30 is displaced in a proximal direction, a tension between the upper jaw support element 36 and the spatula 14 is generated, and serves to open the oral cavity and to hold it open. In this context, the spatula 14 presses the tongue body of the patient against the tongue base, for example. In this use position of the device 10, which fixes the upper jaw open with respect to the lower jaw, free space is created between the longitudinal beam 32 and the cross-beam 34, and gives the operator easy access to the operating area in the oral cavity of the patient. Cheek hooks (not shown here), which spread the lateral mouth open edges apart, may further be arranged on the holding structure 12 on the longitudinal beams 32, which are arranged parallel opposite one another.

[0040] For positioning the spatula 14 in the oral cavity of the patient, a handle region 18 of the spatula 14 is carried in a height-adjustable, longitudinally displaceable manner in the spatula guide 22. For locking the spatula 14 at a particular penetration depth in the oral cavity, a locking device (not shown here) may be provided on the spatula guide 22. Example locking devices are described for example in DE 10 2017 120 245.5.

[0041] FIG. 3 is a schematic plan view of a spatula 14 according to the invention, the spatula blade 16 of which is axially displaceable. The corresponding movement and operating element for axial displacement is not shown here, but is shown by way of example in FIGS. 4 and 5. The spatula 14 has seven adjusting elements 20 between the spatula blade 16 and the handle region 18. The adjustment elements 20 are fastened to one another in such a way that they can be pulled apart from and slid back into one another axially. For this purpose, connections in which a pin-like element can be displaced within a channel on the adjacent adjustment element, in other words rail-like connecting elements, are conceivable, for example. On the tongue side, the spatula blade 18 has a spatula support face 38, which is positioned on the tongue when the device 10 is fixed.

[0042] FIG. 4 is a schematic plan view of a spatula 14 according to the invention, the spatula blade 16 of which is axially displaceable and which has a means for axially displacing the spatula blade 16 with respect to the handle region 18. With the exception of the means shown here, the spatula 14 shown basically corresponds to the spatula 14 shown in FIG. 3. The means for axially displacing the spatula blade 16 comprises a movement element 41, which is fixed to a fastening element 40 on the spatula blade 16 and moreover can slide through a further fastening element 40 on the handle region 18. When the gearwheel 46, which is part of the drive unit 44, is actuated, the movement element 41 is axially displaced under forced guidance. As is schematically indicated in FIG. 4, it may be provided that an external toothing of the gearwheel 46 engages in a toothing of a drive face 42 of the movement element 40, and thus provides axial displacement of the spatula blade 16 with respect to the handle region when the gearwheel rotates.

[0043] FIG. 5 is a schematic side view of the spatula according to the invention from FIG. 4. It can be seen that the drive unit 44 has a rotary control for actuating the gearwheel 46 (not shown). Actuating the movement element 41 brings about an axial displacement of the spatula blade 16 with respect to the handle region 18. In this context, the adjustment elements 20 are slid axially apart or together in a parallel plane II. The parallel plane II is arranged parallel to the contact plane I. In the embodiment shown here, the adjustment elements 20 each have an oral-cavity-side contact face 54 in the proximal end region thereof. The proximally adjacent adjustment element is slid onto the contact face 54.

[0044] FIG. 6 is a schematic plan view of a spatula 14 according to the invention, the spatula blade 16 of which is radially pivotable or can be angled out of the extension of the longitudinal axis of the handle region 18. A plurality of adjustment elements 20 are arranged between the spatula blade 16 and the handle region 18, and can likewise each be pivoted or rotated radially with respect to one another.

[0045] FIG. 7 is a schematic plan view of an alternative spatula 14 according to the invention, the spatula blade 16 of which can likewise be pivoted radially with respect to the handle region 18 or angled out of the extension of the longitudinal axis of the handle region 18. In the embodiment shown, the spatula blade 16 and the handle region 18 are each formed as an adjustment element 20. The proximal end region of the spatula blade 16 is mounted rotatably on the distal end region of the handle region 18 by means of a bearing 48.

[0046] FIG. 8 is a schematic plan view of a further, alternative spatula 14 according to the invention, the spatula blade 16 of which can be angled or pivoted radially out of the extension of the longitudinal axis of the handle region 18. For the pivoting, four adjustment elements 20 are arranged between the spatula blade 16 and the handle region 18. The spatula blade 16 and the handle region 18 may also be considered to be adjustment elements 20. The adjustment elements 20 each have a distal engagement portion 50 and a proximal receiving portion 52. The spatula blade 16 also has as proximal receiving portion 52, while the handle region 18 comprises an engagement portion 50 at the distal end thereof. The engagement portions 50 have a circle sector shape at the distal end thereof, and the receiving portions 52 have a complementarily shaped internal shape. The circle sector shapes are pivotable within one another parallel to the contact plane.

[0047] FIG. 9 is a schematic drawing of a spatula 14 according to the invention, the spatula blade 16 of which can be widened. An example technical embodiment of the principle shown is shown in FIG. 10. FIG. 10 is a schematic plan view of a spatula 14 according to the invention, the spatula blade 16 of which can be widened, two adjustment elements 20 foldable in the manner of a fan, which can be folded open (FIG. 10a) and closed (FIG. 10b), being provided in the spatula blade 16 for this purpose. It is conceivable for the spatula blade 16 to be formed from more than two fan-like adjustment elements 20, for example from three, four, five or more adjustment elements 20. The proximal end regions of the adjustment elements 20 are rotatably fastened to the distal end region of the handle region 18 via a swivel bearing 48. The adjustment elements 20 are formed to be atraumatic on the tongue-side, in a manner not shown in greater detail here.

[0048] Although the present invention has been described in detail with reference to the example embodiments, it is self-evident to a person skilled in the art that the invention is not limited to these example embodiments, numerous modifications being possible in that individual features can be omitted or different combinations of the disclosed individual features can be implemented so long as there is no departure from the scope of protection of the accompanying claims. The present disclosure includes all combinations of the disclosed individual features.

LIST OF REFERENCE NUMERALS

[0049] 10 Medical device [0050] 12 Holding structure [0051] 14 Spatula [0052] 16 Spatula blade [0053] 18 Handle region [0054] 20 Adjustment element [0055] 22 Spatula guide [0056] 24 Drive face [0057] 26 Fastening block [0058] 28 Rotary control [0059] 30 Positioning element [0060] 32 Longitudinal beam [0061] 34 Cross-beam [0062] 36 Upper jaw support element [0063] 38 Spatula support face [0064] 40 Fastening element [0065] 41 Movement element [0066] 42 Drive face [0067] 44 Drive unit [0068] 46 Gearwheel [0069] 48 Bearing [0070] 50 Engagement portion [0071] 52 Receiving portion [0072] 54 Contact face [0073] I Contact plane [0074] II Parallel plane