MEDICAL INSTRUMENT

Abstract

One embodiment relates to a medical instrument (1) with a hollow shaft (2), an actuating unit (4) arranged at the proximal end (3) of the shaft (2) and an instrument tip (6) with an instrument (7) arranged at the distal end (5) of the shaft (2), wherein the instrument (7) can be actuated via an actuating element (8) which is mounted in the shaft (2) in an axially displaceable manner, and wherein the actuating element (8) is operatively connected to the actuating unit (4) on the proximal side, and wherein the instrument tip (6) can be pivoted relative to the longitudinal axis (10) of the shaft (2) via a joint mechanism (9). According to one embodiment, the instrument tip (6) can be rotated endlessly, wherein a fixing device is provided on the instrument tip (6) with which the loose end (17, 23) of a sewing material (18, 24) can be fixed on the instrument tip (6).

Claims

1. A medical instrument with a hollow shaft, an actuating unit arranged at the proximal end of the shaft and an instrument tip with an instrument arranged at the distal end of the shaft, wherein the instrument can be actuated via an actuating element which is mounted in the shaft in an axially displaceable manner, and wherein the actuating element is operatively connected to the actuating unit on the proximal side, and wherein the instrument tip can be pivoted relative to the longitudinal axis of the shaft via a joint mechanism, wherein that the instrument tip can be rotated endlessly, wherein a fixing device is provided on the instrument tip with which the loose end of a sewing material can be fixed on the instrument tip.

2. The medical instrument according to claim 1, wherein the joint mechanism consists of pivoting members arranged at the distal end of the shaft which are connected to a drive on the proximal side via guide wires running in the longitudinal direction of the shaft, wherein a movement of the drive on the proximal side causes a corresponding relative movement of the pivoting members on the distal side and thus a pivoting of the instrument tip.

3. The medical instrument according to claim 2, wherein the drive on the proximal side has a spatially adjustable disc.

4. The medical instrument according to claim 3, wherein the drive for the spatially adjustable disc is designed as a motorised drive.

5. The medical instrument according to claim 1, wherein the fixing device is designed in the manner of an instrument provided with jaw parts, wherein the jaw parts are adjustable relative to one another between an open and a closed functional position, and wherein the loose end of the sewing material can be fixed between the jaw parts in the closed functional position.

6. The medical instrument according to claim 1, wherein the fixing device is designed in the manner of a clamping device with a clamping groove and a clamping slider, wherein the loose end of the sewing material can be arranged in the clamping groove, and wherein the clamping slider can be adjusted relative to the clamping groove between an open and a closed functional position, and the loose end of the sewing material can be fixed in the closed functional position between an inner surface of the clamping groove and the clamping slider.

7. The medical instrument according to claim 1, wherein the outside of the instrument tip has a waist on which the sewing material can be wound up.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0015] Further features and advantages of the invention result from the associated drawings, in which two exemplary embodiments of a medical instrument according to the invention are illustrated only as examples, without restricting the invention to these exemplary embodiments. The drawings show the following:

[0016] FIG. 1 a schematic perspective side view of a medical instrument according to an exemplary embodiment;

[0017] FIG. 2 an enlarged view of a first embodiment of the instrument tip of the instrument according to an exemplary embodiment according to FIG. 1;

[0018] FIG. 3 the instrument tip according to FIG. 2 after winding the loose end of a suture;

[0019] FIG. 4 a second embodiment of an instrument tip for use on an instrument according to an exemplary embodiment;

[0020] FIG. 5 the instrument tip according to FIG. 4 after winding the loose end of a suture.

DETAILED DESCRIPTION

[0021] FIG. 1 schematically shows a medical instrument 1 with a hollow shaft 2, an actuating unit 4 arranged at the proximal end 3 of the shaft 2, only illustrated schematically, and an instrument tip 6 arranged at the distal end 5 of the shaft 2 with an instrument 7, wherein the instrument 7 can be actuated via an actuating element 8 which is mounted in the shaft 2 in an axially displaceable manner. The actuating element 8 is operatively connected to an actuating unit 4 on the proximal side.

[0022] The actuation unit 4 can be a manually actuable handling unit or a unit designed for robotic use, that is, one that can also be actuated without manual intervention. The actuation unit used in each case enables an endless rotary drive, as illustrated in FIG. 1, of the angled instrument tip 6. For this purpose, for example, an actuation unit can be used, as described in DE 10 2019 121 092 A1. The instrument 7 of the instrument tip 6 can be a tool provided with jaw parts 15. The instrument tip 6 can be pivoted relative to the longitudinal axis 10 of the shaft 2 via a joint mechanism 9, wherein the joint mechanism 9 consists of pivoting members 11 arranged at the distal end of the shaft 5, which are connected via guide wires 12 or guide ropes running in the longitudinal direction of the shaft 2 with a drive 13 arranged at the proximal end 3 of the shaft 2, which causes a movement of the drive 13 on the proximal side and corresponding relative movements of the pivoting members 11 on the distal side and thus a pivoting of the instrument tip 6. A suitable drive 13 is described, for example, in DE 10 2019 121 092 A1, to which express reference is made here.

[0023] FIG. 2 shows the instrument tip 6 in an enlarged side view. The shaft 2 can be seen at the distal end 5, at which the guide wires 12 or guide ropes emerge from the shaft 2 and are passed through recesses 14 in two pivoting members 13, which form the joint mechanism 9. The ends of the guide wires 12 or guide ropes are fixed to the instrument tip 6. The instrument 7 at the instrument tip 6 is formed by two jaw parts 15 and 16. At least one of the two jaw parts 15 and 16 is pivotably mounted on the instrument tip 6 and can be pivoted between a closed position shown in FIG. 2 and an open position, not shown, by axial adjustment of the actuating element 8.

[0024] FIG. 3 shows the instrument tip 6 in its function as a fixing device for fixing the loose end 17 of a sewing material 18. First, the loose end 17 is brought between the jaw parts 15 and 16 by opening the components 15 and 16 and then, by actuating the actuating element 8, the fixing device formed by the jaw parts 15 and 16 is moved into its closed functional position shown in FIG. 3. The loose end 17 is then fixed between the jaw parts 15 and 16 in this closed functional position. The sewing material 18 can then be wound onto a waist 19 on the outer circumference of the instrument tip 7 by rotating the instrument 6, for example driven by the rotation of the shaft 2. By winding up the loose end 17, the sewing material 18 can be tightened in a minimal space in the surgical field, for example to tighten a knot.

[0025] FIG. 4 shows a second embodiment 20 of an instrument tip for tightening sewing material 24, which is achieved by a rotary drive of the instrument tip 20. Two jaw parts 21 and 22 are in turn provided on the instrument tip 20 and can be opened and closed by means of the actuating element 8. To fix the loose end 23 (see FIG. 5) of a sewing material 24, a fixing device is used on the instrument tip 20, which is designed in the manner of a clamping device 25. The clamping device 25 consists essentially of a clamping groove 26, in which a clamping slider 27 between the open functional position shown in FIG. 4 and the closed functional position shown in FIG. 5 can be adjusted along the movement arrow 28. For the adjustment of the clamping slider 27, an additional actuating device is provided on the instrument 1, which is not illustrated in detail in the drawings.

[0026] As illustrated in FIG. 5, to fix the loose end 23 of the sewing material 24, the clamping slider 27 is first opened and the loose end 23 is inserted into the opened clamping groove 26. Then the clamping slider 27 is inserted into the closed functional position shown in FIG. 5, the loose end 23 adjusted and thereby fixed between the lateral inner surface of the clamping groove 26 and the clamping slider 27. The sewing material 24 can then be wound onto the outer circumference of the instrument tip 20 by rotating the instrument tip 20 and the sewing material 24 can thereby be tightened to tighten a knot, for example.

LIST OF REFERENCE NUMBERS

[0027] 1 Medical instrument [0028] 2 Shaft [0029] 3 Proximal end (shaft) [0030] 4 Operating unit [0031] 5 Distal end (shaft) [0032] 6 Instrument tip [0033] 7 Instrument [0034] 8 Actuating element [0035] 9 Joint mechanism [0036] 10 Longitudinal axis [0037] 11 Pivoting member [0038] 12 Guide wire [0039] 13 Drive [0040] 14 Recess [0041] 15 Jaw part [0042] 16 Jaw part [0043] 17 Loose end [0044] 18 Sewing material [0045] 19 Waist [0046] 20 Instrument tip [0047] 21 Jaw part [0048] 22 Jaw part [0049] 23 Loose end [0050] 24 Sewing material [0051] 25 Clamping device [0052] 26 Clamping groove [0053] 27 Clamping slider [0054] 2 Movement arrow