SURGICAL INSTRUMENT, METHOD FOR PRODUCING A SURGICAL INSTRUMENT, AND USE OF A ROTARY JOINT FOR FORMING A CUTTING TOOL OF A SURGICAL INSTRUMENT

Abstract

The invention relates to a surgical instrument for separating and removing a biopsy. A suction channel for suctioning the biopsy out of a distal region in the direction of a proximal region is formed in a shaft, and/or a cutting tool is formed in one distal region or the distal region of the shaft, said cutting tool having a stationary cutting part and a counter cutting part which can be adjusted relative to the stationary cutting part about a rotational axis formed by a rotary joint wherein the cross-section of the suction channel expands in the suction direction from the distal region to the proximal region and/or the rotary joint is formed by two securing elements, each securing element being introduced from the interior to the exterior.

Claims

1-15. (canceled)

16. A surgical instrument (1) for severing and removing a biopsy specimen, comprising: a shaft (2) having a suction channel (3) for aspiration of the biopsy specimen from a distal region (4) in the direction of a proximal region (5) of the shaft (2); and wherein a diameter of a cross section (6) of the suction channel (3) widens in the direction from the distal region (4) to the proximal region (5).

17. A surgical instrument (1) for severing and removing a biopsy specimen, comprising: a shaft (2) having a suction channel (3) for aspiration of the biopsy specimen from a distal region (4) in the direction of a proximal region (5) of the shaft (2); and a cutting tool (7) formed on the distal region (4) of the shaft (2), the cutting tool having a fixed cutting part (8) and a movable counter cutting part (9); and wherein the counter cutting part (9) is adjustable relative to the fixed cutting part (8) about an axis of rotation formed by a rotary joint (10), the rotary joint (10) being formed by two fastening elements (11); and wherein the fastening elements (11) are each introduced from the inside outward, the inside referring to the suction channel inner side (12) of the shaft (2) and/or outward refers to toward an outer side (13) of the shaft (2).

18. The surgical instrument (1) of claim 16 wherein a cross section (6) of the suction channel (3) widens continuously and/or rectilinearly at a widening region (14).

19. The surgical instrument (1) of claim 16 wherein the suction channel (3) has a uniformly dimensioned cross section (6) upstream and/or downstream of a or the widening region (14).

20. The surgical instrument (1) of claim 16, wherein the widening region (14) extends from a distal end of the shaft (2) as far as, at maximum, a center of the shaft (2).

21. The surgical instrument (1) of claim 16, wherein end sides (15) of the fastening elements (11) lie in a suction channel inner side (12).

22. A surgical instrument (1) for severing and removing a biopsy specimen, comprising: a shaft (2) having a suction channel (3) for aspiration of the biopsy specimen from a distal region (4) in the direction of a proximal region (5) of the shaft (2); a cutting tool (7) formed on the distal region (4) of the shaft (2), the cutting tool (7) comprising a rotary joint (10) being formed by two fastening elements (11); and wherein end sides (15) of heads (16) of the fastening elements (11), together with a wall (17) of the suction channel (3), form a planar suction channel inner side (12).

23. The surgical instrument (1) of claim 16, wherein the shaft (2) has a guide rail (18) and a sliding rail (19) which is adjustable relative to the guide rail (18).

24. The surgical instrument (1) of claim 16, wherein the edges of the heads (16) of the fastening elements (11) are at least partially rounded and/or the end surfaces (15) are curved convexly.

25. A method for producing a surgical instrument (1), having a cutting tool (7) which has a rotary joint (10), comprising: introducing a fastening element (11) used for forming the rotary joint (10) from the inside outward through a wall (17) of a suction channel (3) into an opening and fixed therein such that an end side (15) of the fastening element (11) and an inner side of the wall (17) form a planar suction channel inner side (12).

26. A method for forming a cutting tool (7) of a surgical instrument (1) having a suction channel (3) comprising using a rotary joint (10), which has two fastening elements (11) inserted from the inside.

27. The surgical instrument of claim 16, wherein the cross section (6) is consistent in shape upstream and/ or downstream of a or the widening region (14).

28. The surgical instrument (1) of claim 16, wherein the widening region (14) extends from a distal end of the shaft (2) as far as, at maximum, a third of a length of the shaft (2).

29. The surgical instrument (1) of claim 16, wherein heads (16) of the fastening elements (11) lie in a suction channel inner side (12).

30. The surgical instrument (1) of claim 16, wherein the shaft (2) has a guide rail (18) and a sliding rail (19), and the suction channel (3) is formed partially or completely by the guide rail (18) and/or the sliding rail (19).

31. The surgical instrument (1) of claim 22, wherein a transition between the respective head (16) and the wall (17) is configured to be smooth and/or continuous.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0028] In the figures:

[0029] FIG. 1 shows a first possible embodiment variant of a surgical instrument for severing and removing a biopsy specimen with a cutting tool, wherein a cross section of a suction channel widens continuously in a widening region in the aspiration direction from the distal end to the proximal end,

[0030] FIG. 2 shows a top view of a horizontal longitudinal suction of the embodiment variant from FIG. 1,

[0031] FIG. 3 shows a side view of a vertical longitudinal section of the embodiment variant from FIG. 1,

[0032] FIG. 4 shows a further possible embodiment variant of a surgical instrument for severing and removing a biopsy specimen, wherein this embodiment variant likewise has a suction channel with a cross section which is at least partially increased in diameter in the aspiration direction, wherein the cutting tool has a rotary joint which has two fastening elements, wherein the fastening elements are each introduced from the inside outward such that no sharp-edged parts of the fastening elements project into the suction channel,

[0033] FIG. 5 shows a front view of the shaft of a surgical instrument according to FIG. 4, wherein the shaft is depicted without a handle part for actuating the cutting tool,

[0034] FIG. 6 shows a rear view of the shaft of a surgical instrument according to FIG. 4, wherein the shaft is depicted without a handle part for actuating the cutting tool,

[0035] FIG. 7 shows an alternatively configured distal region of a further exemplary embodiment of a surgical instrument designed according to the invention with a rotatable cutting tool,

[0036] FIG. 8 shows the surgical instrument 1 that is shown in FIG. 7 with components partially blanked out.

DETAILED DESCRIPTION

[0037] FIGS. 1-6 show possible refinements of a surgical instrument for severing and removing a biopsy specimen, i.e. in particular body material which is removed during a biopsy intervention, wherein the surgical instrument is denoted as a whole as 1.

[0038] The surgical instrument 1 can be configured, for example, as partly shown in the figures, as a tissue punch.

[0039] Such surgical instruments 1 generally have a handle part 20 by means of which a user can operate a cutting tool 8, i.e. in particular can adjust the cutting tool 8. A cutting tool 8 can basically be understood as meaning any tool of a surgical instrument 1 that is suitable and/or configured for severing tissue.

[0040] The handle part 20 is connected or connectable here fixedly to a shaft 2. The shaft is frequently constructed from multiple parts.

[0041] The shaft 2 also forms a suction channel 3 which serves to be able to transport the biopsy specimen severed by the cutting tool 8 from a distal region 4 in the direction of a proximal region 5 of the surgical instrument 1, in particular to be able to aspirate it from there. The suction operation can take place, for example, by application of a negative pressure to the suction channel 4. In particular, the surgical instrument 1 can have a connection for connecting to an external negative pressure device and a dedicated negative pressure device for generating a negative pressure.

[0042] A tissue collector can be arranged or can be arrangeable at the proximal region 5 of the shaft 2, in particular at the proximal end of the shaft 2, in order to collect the aspirated biopsy specimen.

[0043] During the aspiration of the biopsy specimen, care should be taken to ensure that the biopsy specimen is not destroyed since the intention is generally to subsequently investigate the biopsy specimen. A negative pressure applied for the aspiration of the biopsy specimen should therefore permit as gentle an aspiration as possible, for example by a pressure difference between the atmospheric pressure and the applied negative pressure not being too high.

[0044] However, if a pressure difference between the prevailing pressure and the applied negative pressure is too low, it is possible that it is not ensured that the biopsy specimen is aspirated but rather blocking of the suction channel 3 occurs.

[0045] This problem is solved in that a cross section 6 of the suction channel 3 is widened at least within a widening region 14 in the suction direction from the distal region 4 to the proximal region 5. The widening region 14 of the suction channel 3 therefore refers to the part in which there is a change in the diameter of the suction channel 3.

[0046] It is therefore possible to reduce the friction along a suction distance. At the distal end of the suction channel 3, the latter has a narrower cross section, and therefore the severed biopsy specimen lies here over a relatively large surface area against the suction channel inner side 12. After the negative pressure, in particular a vacuum, is applied, a pressure difference between prevailing external pressure and the pressure present on the biopsy specimen side facing away from the cutting tool 7 increases within the suction channel 3 until the biopsy specimen is entrained by it. The initial acceleration of the biopsy specimen is sufficient here to convey the biopsy specimen into the proximal region 5 where it is collected optionally by a tissue collector.

[0047] By means of the widening suction channel 3, the friction and/or the contact between the biopsy specimen and the wall 17 of the suction channel 3 along the suction distance is lower than at the distal region 4, i.e. in an initial position of the biopsy specimen after the latter has been severed by the cutting tool.

[0048] Depending on requirements, the surgical instrument 1 can have different cutting tools 7.

[0049] FIGS. 1-3 show an exemplary embodiment which is designed as a Kerrison punch, wherein the cutting tool 7 is designed as a bayonet. The cutting tool 7 here has a fixed cutting part 8 and a counter cutting part 9 which is adjustable axially relative thereto along a longitudinal axis.

[0050] FIGS. 4 to 6 show a second exemplary embodiment, the cutting tool 7 of which has a jaw geometry. The cutting tool 7 has a fixed cutting part 8 and a counter cutting part 9 which is adjustable relative to the fixed cutting part 8 about an axis of rotation formed by a rotary joint 10. In the case of surgical instruments 1 of this type, the previously mentioned rotary joint 10 is formed by at least one fastening element 11. If only one, for example bar-shaped, fastening element 11 is used which runs perpendicularly to the longitudinal axis of the suction channel 3 from one side of the shaft 2 to the other side, the fastening element 11 forms an obstacle within the suction channel 3. This obstacle can lead to damage to the biopsy specimen during the aspiration and/or, in the worst case, to blocking of the suction channel 3 by the biopsy specimen sticking to the fastening element 11.

[0051] Even when the rotary joint 10 is formed by two opposite fastening elements 11, the fastening elements 11 of previously known instruments project unfavorably into the suction channel 3 since, due to the simplified production, they are inserted from the outside inward. The heads 16 of the fastening elements 11 of previously known instruments therefore lie on the outer side 13 of the shaft.

[0052] In the configuration from FIGS. 4-6, it is provided that the end sides 15 of the fastening elements 11 lie in a suction channel inner side 12. Generally wider heads 16 are formed on the end side 15 in order to prevent the fastening elements 11 from slipping out of the fastening openings in the wall 17 of the suction channel 3. By means of the introduction of the fastening elements 11 from an inner side of the wall 17 outward, it is possible to prevent sharp-edged structures on the suction channel inner side 12.

[0053] The cross-sectional widening can be formed in different ways. For example, it can be continuous and/or rectilinear. It can extend over the entire suction channel 3 or only over a portion of the suction channel 3 (widening region 14).

[0054] In a refinement in which the cross-sectional widening occurs in a widening region 14, it can be provided that the suction channel 3 has a uniformly dimensioned cross section 6 and/or cross section 6 which is consistent in shape in the portion upstream and/ or downstream of the widening region 14.

[0055] As shown in FIGS. 1-6, the widening region 14 can extend from the distal end of the shaft 2 as far as at maximum to a center of the shaft 2, in particular as far as at maximum a third of a length of the shaft 2.

[0056] In the refinement from FIGS. 4-6, the end sides 15 of the fastening elements 11, i.e. preferably the end sides 15 of the heads 16 of the fastening elements 11, together with the wall 17 of the suction channel 3 form a planar suction channel inner side 12. A transition between a fastening element 11 and the wall 17 can be configured here to be smooth and/or continuous. It can therefore be prevented even better that a tissue sample remains stuck to the fastening element 11 and is thereby destroyed, and/or that a blockage occurs within the suction channel 3 in the region of the rotary joint 10. The heads of the fastening elements 11 can be at least partially recessed in a material adaptation of the wall 17.

[0057] In order to be able to even better prevent a biopsy specimen from remaining stuck to the fastening element 11, the edges of the fastening elements 11 lying on the suction channel inner side 12 can be at least partially rounded. Alternatively or additionally thereto, end surfaces 15 partially forming the suction channel inner side 12 can be curved convexly.

[0058] FIG. 7 and FIG. 8 show an alternatively configured distal region 4 of a further exemplary embodiment of a surgical instrument 1 designed according to the invention. In FIG. 8, some parts are blanked out in order to permit a view of the fastening elements 11 from the inside.

[0059] The cutting tool 7 has a fixed cutting part 8 and a counter cutting part 9 which is adjustable in relation thereto. The counter cutting part 9 is rotatable in relation to the cutting part 8 at the rotary joint 10. The counter cutting part 9 is connected in an articulated manner to the sliding rail 19 via the joint 21. The sliding rail 19 can slide on the guide rail 18 as previously described. If the sliding rail 19 is pushed forward, the counter cutting part 9 rotates about the rotary joint 10 into an opening of the cutting part 8. The counter cutting part 9 has merely a small amount of play within a U-shaped edge 24 of the cutting part 8 such that tissue which gets between the counter cutting part 9 and the cutting part 8 is punched out or cut off. For this purpose, the counter cutting part 9 has a cutting edge 25.

[0060] A supply line 22 through which in particular a liquid can be supplied is formed on the upper side of the sliding rail 19. If the sliding rail 19 is pushed back, a tip of the supply line 22 engages in a cutout 23 of the counter cutting part 9 such that the liquid can be introduced directly into a punching space formed between the counter cutting part 9 and the cutting part 8.

[0061] As can be seen more precisely from FIG. 8, the rotary joint 10 is formed by the fact that, on either side of the shaft 2, a respective fastening element 11 is formed which connects the fixed cutting part 8, which is positioned on the inside at this point, and the adjustable counter cutting part 9, which is positioned on the outside at this point, rotatably to one another. A recess 26 is formed in the counter cutting part 9 such that a front region of the counter cutting part 9 is no longer positioned on the outside, but rather can engage in the cutting part 8 on the inner side.

[0062] As is apparent from FIG. 8, the fastening elements 11 are introduced from the inside outward through a bore of a wall 17 of the suction channel 3. The bore here is wider on the inner side than on the outer side, and therefore the head 16 of the fastening element 11, which head is wider than the remaining region of the fastening element 11, can be completely recessed in the wall 17. An inner surface of the bore is coordinated here with a geometry of the fastening element 11.

[0063] It can be seen in FIG. 8 that the end surfaces 15 of the fastening elements 11 together with the wall 17 of the suction channel 3 form a planar suction channel inner side 12. At the same time, a transition between the head 16 and the wall 17 is configured to be smooth and continuous.

[0064] In the exemplary embodiment shown in FIG. 7 and FIG. 8, as described previously, a diameter of the cross section 6 of the suction channel 3 can be widened in the suction direction from the distal region 4 to the proximal region 5.