MEDICAL INSTRUMENT
20190009016 · 2019-01-10
Inventors
- Frank Doll (Talheim, DE)
- Stefan Rehbein (Immendigen-Hattingen, DE)
- Uwe WITTKE (Tuttlingen-Mohringen, DE)
- Rainer Hermle (Gosheim, DE)
- Oliver Löffler (Boll, DE)
- Udo NAGELE (Worgl, AT)
Cpc classification
A61B18/1485
HUMAN NECESSITIES
A61M3/0233
HUMAN NECESSITIES
A61B1/307
HUMAN NECESSITIES
A61M2039/2473
HUMAN NECESSITIES
A61M2039/242
HUMAN NECESSITIES
International classification
A61B1/307
HUMAN NECESSITIES
Abstract
A medical instrument for diagnostic, therapeutic, or surgical measures in a cavity in the body of a patient may include a proximal region, which is provided and designed for arrangement outside the body, a distal region, which is provided and designed for arrangement inside a cavity in the body, a supply structure for delivering a fluid to the cavity, wherein the supply structure reaches from a first coupling in the proximal region of the medical instrument to an outlet in the distal region, and a discharge structure for discharging a fluid from the cavity, wherein the discharge structure reaches from an inlet in the distal region of the medical instrument to a second coupling in the proximal region of the medical instrument. The flow resistance of the supply structure is greater than the flow resistance of the discharge structure.
Claims
1. A medical instrument for diagnostic, therapeutic or surgical measures in a cavity in the body of a patient, comprising: a proximal region, which is provided and designed for arrangement outside the body; a distal region, which is provided and designed for arrangement inside a cavity in the body; a supply structure for delivering a fluid to the cavity, wherein the supply structure reaches from a first coupling in the proximal region of the medical instrument to an outlet in the distal region; a discharge structure for discharging a fluid from the cavity, wherein the discharge structure reaches from an inlet in the distal region of the medical instrument to a second coupling in the proximal region of the medical instrument; wherein the flow resistance of the supply structure is greater than the flow resistance of the discharge structure.
2. The medical instrument as claimed in claim 1, in which the discharge structure, during the intended use of the medical instrument, is not closable or not unconditionally closable.
3. The medical instrument as claimed in claim 1, in which the discharge structure comprises a safety valve which opens if a predetermined pressure in the discharge structure is exceeded.
4. The medical instrument as claimed in claim 1, in which at least either the supply structure has a flow resistance means which substantially determines the flow resistance of the supply structure, or the discharge structure has a flow resistance means which substantially determines the flow resistance of the discharge structure.
5. The medical instrument as claimed in claim 4, wherein the smallest cross-sectional area of the supply structure or of the discharge structure is present in the flow resistance means.
6. The medical instrument as claimed in claim 4, in which the flow resistance means has an adjustable flow resistance.
7. The medical instrument as claimed in claim 6, in which the flow resistance means has a finite number of alternative predetermined configurations with different flow resistances, the flow resistance means is provided and designed to be operated exclusively in the predetermined configurations.
8. A medical instrument for diagnostic, therapeutic or surgical measures in a cavity in a body of a patient, comprising: a proximal region, which is provided and designed for arrangement outside the body; a distal region, which is provided and designed for arrangement inside a cavity in the body; a supply structure for delivering a fluid to the cavity, wherein the supply structure reaches from a first coupling in the proximal region of the medical instrument to an outlet in the distal region; a discharge structure for discharging a fluid from the cavity, wherein the discharge structure reaches from an inlet in the distal region of the medical instrument to a second coupling in the proximal region of the medical instrument; a flow resistance means in the supply structure or in the discharge structure (52, 54, 56, 58), wherein the flow resistance means has a finite number of alternative predetermined configurations with different flow resistances, wherein the flow resistance means is provided and designed to be operated exclusively in the predetermined configurations.
9. The medical instrument as claimed in claim 8, in which the flow resistance means has a latching structure which permits only the predetermined configurations of the flow resistance means or which prefers the predetermined configurations over other configurations.
10. The medical instrument as claimed in claim 8, in which the flow resistance means has a rotatable member, or a member movable along a straight or curved path, with several through-bores, fluid can flow through one or more of the through-bores in each predetermined configuration of the flow resistance means.
11. The medical instrument as claimed in claim 10, in which the through-bores have different cross sections, fluid can flow through one of the through-bores in each predetermined configuration of the flow resistance means.
12. The medical instrument as claimed in claim 8, in which the discharge structure has a flow resistance means, the flow resistance means of the discharge structure does not completely close the discharge structure in any possible configuration or any intended configuration of the medical instrument, or the flow resistance means of the discharge structure does not unconditionally completely close the discharge structure in any possible configuration or any intended configuration of the medical instrument.
13. The medical instrument as claimed in claim 8, in which the supply structure and the discharge structure each have a respective flow resistance means, the flow resistance of the flow resistance means of the supply structure is greater than the flow resistance of the flow resistance means of the discharge structure.
14. The medical instrument as claimed in claim 13, in which the minimal cross section) of the flow resistance means of the supply structure is smaller than the minimal cross section of the flow resistance means of the discharge structure.
Description
BRIEF DESCRIPTION OF THE FIGURES
[0043] Embodiments are explained below in more detail with reference to the attached figures, in which:
[0044]
[0045]
[0046]
[0047]
[0048]
[0049]
[0050]
[0051]
[0052]
[0053]
DESCRIPTION OF THE EMBODIMENTS
[0054]
[0055] The body 10 has a cavity 12. The cavity 12 is, for example, the bladder or another hollow organ or another natural cavity in the body 10 of a patient. Alternatively, the cavity 12 is generated artificially for a diagnostic, therapeutic and/or surgical measure.
[0056] The medical instrument 20 comprises a proximal region 22, which is provided and designed for arrangement outside the body 10 of a patient. Among other things, structures for handling and controlling the medical instrument 20 are provided in the proximal region 22 of the instrument 20. These structures can include a work element, which is not shown in
[0057] The medical instrument 20 can comprise an endoscope 30 with a proximal end 32 which, for example, is formed by an eyepiece and protrudes from the proximal region 22 of the medical instrument 20. A shaft 36 of the endoscope 30 is arranged in the shaft 26 of the medical instrument 20. A distal end 38 of the endoscope 30 is arranged in the distal region 28 of the medical instrument 20, in particular near the outermost distal end thereof.
[0058] The endoscope 30 can be part of the medical instrument 20. The endoscope 30 can be connected to the medical instrument rigidly and such that it cannot be released without destruction. Alternatively, the endoscope 30 can be connected to the medical instrument so as to be releasable without destruction. Alternatively, the medical instrument 20 can be designed for an endoscope 30 without the endoscope 30 being a necessary or permanent component part of the medical instrument 20.
[0059] The medical instrument 20 has a first coupling structure 42 in the proximal region 22. The first coupling structure 42 comprises, for example, a Luer coupling or a Luer lock coupling and/or a hose nozzle. By means of the coupling structure 42, the medical instrument 20 is connectable via a hose or another fluid line to a fluid reservoir for the provision of a rinsing fluid.
[0060] The medical instrument 20 moreover comprises a first fluid channel 46 in the shaft 26 of the medical instrument. In the example shown, the shaft 36 of the endoscope 30 is arranged inside the shaft 26 of the medical instrument 20 such that the first fluid channel 46 surrounds the shaft 36 of the endoscope 30 like a jacket. To put it another way, the cross section of the first fluid channel 46 has an annular topology and encloses the cross section of the shaft 36 of the endoscope 30.
[0061] An opening 48 in the distal region 28 of the medical instrument 20 forms the distal end of the first fluid channel 46 and an outlet through which fluid can pass from the first fluid channel 46 into the cavity 12 in the body 10.
[0062] A flow resistance means 44 with a reduced cross section 45 is arranged between the first coupling structure 42 and the first fluid channel 46.
[0063] The first coupling structure 42, the first flow resistance means 44, the first fluid channel 46 and the first opening 48 form a supply structure for delivering a fluid, in particular a rinsing liquid or another rinsing fluid, to the cavity 12. The smallest cross-sectional area of the supply structure 42, 44, 46, 48 is present at the reduced cross section 45 of the first flow resistance means 44. The flow resistance of the flow resistance means 44 definitively or substantially determines the flow resistance of the entire supply structure. In particular, the flow resistance of the flow resistance means 44 measures at least half or at least two thirds or at least three quarters or at least four fifths or at least nine tenths of the flow resistance of the entire supply structure 42, 44, 46, 48.
[0064] The medical instrument 20 moreover comprises a second coupling structure 52 in the proximal region 22. The second coupling structure 52 comprises in particular a Luer coupling or a Luer lock coupling and/or a hose nozzle. By means of the second coupling structure 52, the medical instrument 20 is connectable by a hose or another fluid line to a container for receiving used rinsing fluid.
[0065] A second fluid line 56 is moreover provided in the shaft 26 of the medical instrument 20. A second opening 58 in the distal region 28 of the medical instrument 20 forms the distal end of the second fluid channel 56 and therefore an inlet.
[0066] A second flow resistance means 54 with a reduced cross section 55 is provided between the proximal end of the second fluid channel 56 and the second coupling structure 52.
[0067] The second opening 58 in the distal region 28 of the medical instrument 20, the second fluid channel 56, the second flow resistance means 54 and the second coupling structure 52 form a discharge structure for discharging a fluid from the cavity 12 in the body 10. The smallest cross-sectional area of the discharge structure 52, 54, 56, 58 is present at the reduced cross section 55 of the second flow resistance means 54. The flow resistance of the discharge structure 52, 54, 56, 58 is therefore definitively or substantially determined by the second flow resistance means 54. In particular, the flow resistance of the second flow resistance means 54 measures at least one tenth or at least one fifth or at least one quarter or at least one third or at least half or at least two thirds or at least three quarters or at least four fifths or at least nine tenths of the flow resistance of the entire discharge structure 52, 54, 56, 58.
[0068] In the example shown, the cross-sectional area in the region of the reduced cross section 45 of the first flow resistance means 44 is smaller than the cross-sectional area in the region of the reduced cross section 55 of the second flow resistance means 54. In this way, in particular the flow resistance of the supply structure 42, 44, 46, 48 is greater than the flow resistance of the discharge structure 52, 54, 56, 58.
[0069] In the medical instrument 20 shown, the discharge structure 52, 54, 56, 58 cannot be closed. To put it another way, there is no intended configuration or no intended operating state of the medical instrument 20 in which the discharge structure 52, 54, 56, 58 would be closed.
[0070] In the intended use of the medical instrument 20, the first coupling structure 42 is connected by means of a hose or another fluid line to a bag or another reservoir for a fresh, sterile rinsing fluid, in particular a rinsing liquid. This reservoir is arranged above the cavity 12. The height difference generates a pressure difference. The pressure difference causes a flow of fluid, indicated by arrows in
[0071] If, as is indicated in
[0072] If, as is indicated in
[0073]
[0074] In the medical instrument shown in
[0075]
[0076] The plug valve 54 comprises a conical member designated as plug 60. The plug 60 is rotatable about its axis 68 of symmetry and rotation arranged orthogonally with respect to the section plane of
[0077] The plug 60 is arranged in a conical bore of corresponding shape between a first fluid channel 64 and a second fluid channel 65. In the position of the plug 60 shown in
[0078] A manually actuatable lever 67 is arranged behind the section plane of
[0079] The lever 67 is shown twice in different positions in
[0080] The openings of the through-bores 61, 62 can be designed and arranged such that the connection between the fluid channels 64, 65 of the plug valve 54 is at no point completely closed even during the rotation of the plug 60 about the rotation axis 68 between the two intended positions.
[0081] The first flow resistance means of the medical instrument 20 shown in
[0082]
[0083] The plug valve 54 shown in
[0084] The plug valve 54 shown in
[0085] The through-bores 61, 62, 63 extend in different directions. In particular, the longitudinal axes of the through-bores 61, 62, 63 are spaced apart from each other by 60 degrees.
[0086]
[0087] Since the through-channels 61, 62, 63 have different diameters and cross sections and therefore different flow resistances, the entire plug valve 54 has different flow resistances in the three configurations.
[0088]
[0089] The variant of the plug valve 54 shown in
[0090] In the configuration shown in
[0091]
[0092] The grooves 71, 72 on the outer circumference of the disk 70, the ball 74 and the helical spring 76 thus act as a latching structure. The latching in the positions indicated in
[0093] In a departure from the view in
[0094]
[0095] In the variant of the plug valve 54 shown in
[0096]
[0097]
[0098] The flow resistance means 54 shown in
[0099] Moreover, the slide 90 has several grooves 92. A latching ball 74 and a helical spring 76 are arranged in a blind bore in the housing of the flow resistance means 54, said blind bore being open toward the slide 90. In predetermined positions of the slide 90, the latching ball 74 engages in one of the grooves 92. At the same time, one of the through-bores 61, 62, 63 (the first through-bore 61 in the configuration shown in
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REFERENCE SIGNS
[0102] 10 body of a patient [0103] 12 cavity in the body 10 [0104] 20 medical instrument [0105] 22 proximal region of the medical instrument 20 [0106] 26 shaft of the medical instrument 20 [0107] 28 distal region of the medical instrument 20 [0108] 30 endoscope [0109] 32 proximal end of the endoscope 30 [0110] 36 shaft of the endoscope 30 [0111] 38 distal end of the endoscope 30 [0112] 42 first coupling structure in the proximal region 22 [0113] 44 first flow resistance means in the proximal region 22, in particular a valve [0114] 45 reduced cross section in the first flow resistance means [0115] 46 first fluid channel in the shaft 26 [0116] 48 first opening as outlet of the first fluid channel 46 in the distal region 28 [0117] 52 second coupling structure in the proximal region 22 [0118] 54 second flow resistance means in the proximal region 22, in particular a valve [0119] 55 reduced cross section in the second flow resistance means [0120] 56 second fluid channel in the shaft 26 [0121] 58 second opening as inlet of the second fluid channel 56 in the distal region 28 [0122] 60 plug of the valve 54 [0123] 61 first through-bore in the plug 62, latching structure [0124] 62 second through-bore in the plug 62, latching structure [0125] 63 third through-bore in the plug 62, latching structure [0126] 64 first fluid channel of the valve 54 [0127] 65 second fluid channel of the valve 54 [0128] 67 lever of the valve 54 [0129] 68 rotation axis of the plug 60 and of the lever 67 [0130] 70 substantially circular disk connected to the plug 60 [0131] 71 first latching groove on the circumference of the disk 70 [0132] 72 second latching groove on the circumference of the disk 70 [0133] 74 latching ball [0134] 76 helical spring [0135] 82 magnet [0136] 84 magnetic flux conductor [0137] 86 pole surface of the magnetic flux conductor 84 [0138] 90 slide [0139] 91 first latching groove on the outer surface of the slide 90 [0140] 92 second latching groove on the outer surface of the slide 90 [0141] 93 third latching groove on the outer surface of the slide 90