Abstract
A surgical instrument includes an implant, a grip, and a pre-set breaking point connecting the implant and the grip. The implant has a joining profile.
Claims
1. A surgical instrument comprising: an implant comprising a joining profile configured to engage a portion of a bone, the joining profile including a first leg, a second leg, and a web, wherein the first leg is connected to the web forming a first elbow and the second leg is connected to the web forming a second elbow, and the second elbow forms an angle in a range of 15 degrees to 120 degrees between the second leg and the web; and a grip comprising a first recess and a second recess, wherein the second recess forms a first pre-set breaking point and a second pre-set breaking point, wherein the first pre-set breaking point and the second pre-set breaking point are configured in a depression of the joining profile; wherein the first pre-set breaking point connects a first portion of the grip to a first corner of the first elbow providing a connection point between the web and the first leg of the joining profile in the depression of the joining profile; and the second pre-set breaking point connects a second portion of the grip to a second corner of the second elbow providing a connection point between the web and the second leg of the joining profile in the depression of the joining profile.
2. The surgical instrument of claim 1, wherein the instrument includes a guidance tube.
3. The surgical instrument of claim 2, wherein the guidance tube comprises a cannula.
4. The surgical instrument of claim 1, wherein the implant comprises a staple.
5. The surgical instrument of claim 1, wherein a joining profile impact surface is provided on a top surface of the joining profile.
6. The surgical instrument of claim 1, wherein a grip impact surface is provided on a top side of the grip.
7. The surgical instrument of claim 6, wherein the grip impact surface is a component.
8. The surgical instrument of claim 1, wherein the grip includes bores.
9. The surgical instrument of claim 1, wherein the implant comprises a bolt or a clamp.
10. The surgical instrument of claim 1, wherein the grip comprises a rod.
11. The surgical instrument of claim 1, wherein a plurality of clamps are included with the grip.
12. The surgical instrument of claim 1, wherein the implant comprises a cage.
13. The surgical instrument of claim 12, wherein the cage includes a top shell, a bottom shell, and a joining device.
14. The surgical instrument of claim 13, wherein the grip is connected via the pre-set breaking point to the top shell, the bottom shell, or both the top shell and bottom shell.
15. The surgical instrument of claim 1, wherein a support area or surface at an end of the joining profile includes a guidance groove.
16. The surgical instrument of claim 15, wherein the support area or surface is configured for attachment at a joining profile impact surface or a grip impact surface.
17. The surgical instrument of claim 1, including a template, the template configured for positioning bores in which the joining profile can be inserted or configured for insertion of drills.
18. The surgical instrument of claim 1, including a template configured to support at least one guiding groove for guiding the joining profile with the insertion of the joining profile.
19. A surgical instrument comprising: an implant including a joining profile including a first leg, a second leg, and a web, the first leg is connected to the web forming a first elbow with about a right angle between the first leg and the web, and the second leg is connected to the web with a second elbow with about a right angle between the second leg and the web; a grip including a recess formed between the implant and the grip; and wherein the grip includes a first recess and a second recess, wherein the second recess forms a first pre-set breaking point and a second pre-set breaking point, the first pre-set breaking point connects a first portion of the grip to a first corner of the first elbow providing a connection point between the web and the first leg of joining profile in a depression of the joining profile, and the second pre-set breaking point connects a second portion of the grip to a second corner of the second elbow providing a connection point between the web and the second leg of the joining profile in the depression of the joining profile, and wherein the recess forms the first and second pre-set breaking points.
20. The surgical instrument of claim 19, wherein the grip further includes at least one template bore.
21. The surgical instrument of claim 19, wherein the recess of the grip is substantially rectangular in shape.
22. A surgical instrument comprising: an implant comprising a joining profile configured to engage a portion of a bone, the joining profile including a first leg, a second leg, and a web, wherein the first leg is connected to the web forming a first elbow and the second leg is connected to the web forming an second elbow, and the second elbow forms an angle of about 26 degrees between the second leg and the web; and a grip comprising a first recess and a second recess, wherein the second recess forms a first pre-set breaking point and a second pre-set breaking point; wherein the first pre-set breaking point connects a first portion of the grip to a first corner of the first elbow providing a connection point between the web and the first leg of the joining profile in a depression of the joining profile; and the second pre-set breaking point connects a second portion of the grip to a second corner of the second elbow providing a connection point between the web and the second leg of the joining profile in the depression of the joining profile.
Description
(1) In the following, the invention is described in brief with the help of attached figures, in the process the figures show:
(2) FIG. 1 shows a front view of a surgical instrument as per the invention with a grip and a joining profile;
(3) FIG. 2 shows a perspective illustration of the surgical instrument as per FIG. 1;
(4) FIG. 3 shows a front view of another embodiment of invention-based surgical instrument with a grip part and a joining profile;
(5) FIG. 4 shows a perspective illustration of the surgical instrument as per FIG. 3;
(6) FIG. 5 shows a front view of a positioning instrument as per the invention with a surgical instrument as per the invention;
(7) FIG. 6 shows a perspective illustration of the positioning instrument as per the invention without the surgical instrument;
(8) FIG. 7 shows a perspective illustration of a drilling template as per the invention;
(9) FIG. 8 shows a front view of the drilling template as per the invention as per FIG. 7;
(10) FIGS. 9-12 show an enlarged section of the invention-based drilling template as per FIG. 8;
(11) FIG. 13 shows a perspective illustration of the invention-based surgical instrument with an invention-based positioning instrument and an invention-based drilling template while inserting the surgical instrument in the tissue;
(12) FIG. 14 shows a schematic illustration of a front view of a surgical instrument as per the invention with a staple as implant;
(13) FIG. 15 shows a schematic illustration of another embodiment of an invention-based surgical instrument with a staple as implant and a cannula;
(14) FIG. 16 shows a schematic illustration of a top view of the surgical instrument as per FIG. 15;
(15) FIG. 17 shows a surgical illustration of a perspective view of the embodiment of surgical instrument as per FIGS. 15 and 16;
(16) FIG. 18 shows a schematic illustration of a side view of another embodiment of an invention-based surgical instrument with a staple with spikes as implant;
(17) FIG. 19 shows a surgical illustration of a top view of the surgical instrument as per FIG. 18;
(18) FIG. 20 shows a perspective illustration of the surgical instrument as per FIGS. 18 and 19;
(19) FIG. 21 shows a schematic illustration of a side view of another embodiment of a surgical instrument as per the invention, in the process, the implant is a staple with four legs;
(20) FIG. 22 shows a schematic illustration of a perspective view of surgical instrument with a staple with four legs as per FIG. 21;
(21) FIG. 23 shows a schematic illustration of a side view of another embodiment of the instrument as per invention with a staple with a staple plate and a lateral pin for angle correction;
(22) FIG. 24 shows a schematic illustration of a perspective view of the surgical instrument as per FIG. 23;
(23) FIG. 25 shows a schematic illustration of a side view of another embodiment of a surgical instrument as per the invention, with which the implant is bolt;
(24) FIG. 26 shows a schematic illustration of a side view of another embodiment of the surgical instrument as per the invention, with which the implant is a clamp;
(25) FIG. 27 shows an enlarged section of a front area of the surgical instrument as per FIG. 26;
(26) FIG. 28 shows a schematic illustration of a top view of front area of another embodiment of a surgical instrument;
(27) FIG. 29 shows a schematic illustration of a cut side view of a cage that can be expanded through a Spindle as per the state of the art;
(28) FIG. 30 shows a schematic illustration of a cut side view of an embodiment of a surgical instrument as per the invention with a cage as implant;
(29) FIG. 31 shows a schematic illustration of a top view of the surgical instrument as per the invention with a cage as implant as per FIG. 30;
(30) FIG. 32 shows a schematic illustration of a cut side view of another embodiment of the surgical instrument with a cage as implant as per the invention;
(31) FIG. 33 shows a schematic illustration of a cut view of another embodiment of invention-based surgical instrument with a cage as implant in a non-expandable condition;
(32) FIG. 34 shows a schematic illustration of a cut side view of the invention-based embodiment of the surgical instrument with a cage as implant as per FIG. 34, in the process the cage is in an expanded condition;
(33) FIG. 35 shows a schematic illustration of a cut side view of another embodiment of surgical instrument with a cage as per invention as implant;
(34) FIG. 36 shows a schematic illustration of a cut side view of another embodiment of the surgical instrument with a cage as per the invention as implant;
(35) FIG. 37 shows a schematic illustration of a cut side view of another embodiment of surgical instrument with case as per the invention as implant;
(36) The FIGS. 1 and 2 disclose a surgical instrument 1.1. The surgical instrument 1.1 comprises a grip part 2.1 and a joining profile 3.1. The joining profile 3.1 comprises a first leg 8 and a second leg 9. The grip part 2.1 is joined with the joining profile 3.1 through a first pre-set breaking point 4 and a second pre-set breaking point 5.
(37) The first leg 8 and the second leg 9 of the joining profile 3.1 are connected through a web 10. The leg 9 and web 10 of the joining profile 3.1 close-in at an angle . In the present embodiment of FIGS. 1 and 2 the angle extends to 26. The free ends of the leg 8 and 9 each present a tip 11. The tips 11 are preferably smoothened. Furthermore, each leg 8 and 9 comprises a multitude of barbs 12.
(38) The joining profile 3.1 comprises a joining profile impact surface 13. The joining profile impact surface 13 is found on the top surface of the web 10 of joining profile 3.1
(39) The grip 2.1 comprises a grip impact area 14. The grip impact area 14 is found on the top side of the grip 2.1 Furthermore, the grip 2.1 comprises two template bores 15 and 16. Additionally, the grip 2.1 comprises a circular recess 17 and a rectangle recess 18, in the process, the rectangle recess 18 is designed in such a way that it forms the pre-set breaking points 5 and 4 between the grip 2.1 and joining profile 3.1.
(40) The surgical instrument 1.2 of FIGS. 3 and 4 is similar to the surgical instrument 1.1 of the FIGS. 1 and 2. The essential difference is that a joining profile 3.2 is formed in right angle, i.e., a first leg 19 and a second leg 20 of the joining profile 3.2 join with the web 21 of the joining profile 3.2 in an angle ??, which is 90. All other parts of the surgical instrument 1.2 are similar to parts of the surgical instrument 1.1 of the FIGS. 1 and 2 and retain the same reference numerals. It is understandable that a grip 2.2, of the surgical instrument 1.2 differs from the grip 2.1 so that at the 90 joining profile can be joined.
(41) FIG. 5 discloses a positioning instrument 22 as per invention with surgical instrument 1.1. The positioning instrument 22 as per the invention comprises, as shown in FIGS. 5 and 6, a grip 23. On the top side of the grip 23 the positioning instrument 22 comprises an impact surface 40. Additionally the positioning instrument 22 comprises a first guidance groove 24 and a second guidance groove 25 for grip 2.1 and 2.2.
(42) As shown in FIG. 6, the grip 22 comprises a supporting area 26 at the end of the joining profile. The support area 26 is suitable for attachment at joining profile impact surface 13 or the grip impact surface 14 of the surgical instrument 2.1 and 2.2. Additionally the support surface 26 of the positioning instrument 22 comprises a guidance groove 27. The guidance groove 27 is suitable to grip top side of the grip 2.1 or 2.2 and to guide.
(43) FIGS. 7 and 8 show a drilling template 28 as per the invention. The drilling template 28 comprises a grip 29 for good handling of the drilling template 28. At its first end the drilling template 28 comprises function element 30. At its second end the drilling template 28 comprises a function element 31. The function elements 30 and 31 present respectively a multitude of template elements and guidance elements. Both the function units 30, like the function element 31 present respectively one guidance surface 33 and 34 for the surgical instrument 1.1 or 1.2.
(44) The functions unit 30 protrudes from grip 29 of the drilling template 28 in a manner that the function unit 30 can be inserted in to the body of the patient when a surface 32 of the drilling template 38 points the treated patient. When the top surface 32 of the drilling template 28 points towards the patient, the functions unit 31 can be applied as template.
(45) FIG. 9 shows an enlarged top view of the functions unit 30 of the drilling template 28. This comprises a multitude of bores 35, which are suitable as templates for insertion of the so-called 90 joining profiles, also to the surgical instrument 1.2. Suitable to this, FIG. 11 discloses a bottom view of the functions unit 30, with bores 36, which is suitable for insertion of surgical instrument 1.2. Both the bores 35 and the bores 36 are inserted in a right angle to a surface of the functions unit 30. In FIG. 11, the bores 36 appear conical, because they lie in the slant guidance area 33 of the functions unit 30.
(46) FIG. 10 shows a top view of the functions unit 31, which is suited as template for surgical instrument 1.1. That is why, the bores 41 and in angle , designed preferably in 26. With the help of the functions unit 31 of the bore template 28, the bores in suitable angle are created for the leg 8 and 9 of the joining profile 3.1 of the surgical instrument 1.1.
(47) The functioning of the present invention is given below:
(48) The surgical instruments 1.1 and 1.2 are implanted in the same type and manner. In the following, for reasons of clarity only the implantation of the surgical instrument 1.2 is described.
(49) For implanting the joining profile 3.2 this is inserted with the surgical instrument 1.2 in the positioning instrument. For this the grip 2.2 of the surgical instrument 1.2 is guided into the guidance grooves 24 and 25 of the positioning instrument. Thereby the attachment surface 26 connects in to the rectangle recess 18 of the grip part 2.2, in such a way that the attachment surface 26 lies in the rectangle recess 18 and at the impact surface 13 of the joining profile 3.2. For better guidance the grip part 2.2 lies with its grip impact surface 14 in the guidance groove 27 of the positioning instrument 22.
(50) FIG. 13 shows the surgical instrument 1.2, that is accommodated in the positioning instrument 22, the drilling template 28 and a first guide wire 38 and a second bore wire 39. The guide wires 38 and 39 are already placed in the body tissue, preferably in bones.
(51) In order to be able to position the surgical instrument 1.2 better, the drilling template 28 is guided with its openings 35 and through the first guide wire 38 and the second guide wire 39.
(52) The free bores 35.1 to 35.4 as well as bores, in which the guide wires 38 and 39 are introduced, have many purposes. Further guide wires can be inserted for fixing the bone parts. Furthermore, the bores 35.1 to 35.4 serve partly as templates for drilling of openings for the leg 19 and 20 of the joining profile 3.2. For insertion of the joining profile 3.2 the guide wires 38 and 39 are partly taken out of the tissue and/or bones.
(53) In order to insert the joining profile 3.2 in the bones, hits are applied on the impact surface 40 of the positioning instrument 22. When the joining profile 3.2 is inserted up to a specific depth, then the joining profile 3.2 can be separated at the pre-set breaking point 6 and 7 from the grip 2.2 through a rotation and/or bend movement.
(54) Further there is the possibility to insert the joining profile 3.2 through hits on the impact surface of the joining profile 13 further into the tissue and/or bones.
(55) Alternatively, the surgical instrument can be inserted directly into the tissue and/or bones in other embodiments not illustrated here without using the positioning instrument. Through the grip the joining part can be handled relatively well, so that there is the possibility that a surgeon grips the surgical instrument at the grip and the joining profile is partly inserted into the tissue through hits on the impact surface of the grip. Then, the surgeon can separate the grip at the pre-set breaking point from the joining profile. If necessary the joining profile can be inserted further into the bones through hits on the impact surface of the grip.
(56) FIG. 14 shows a front area of a surgical instrument 42 with a staple 43 as implant. The staple 43 presents a wedge 44. The wedge 44 is suitable for angle correction. The staple 43 is connected through two pre-set breaking points 45 and 46 with a grip 47. The grip presents a slit 48. The slit 48 is suitable as saw template.
(57) FIGS. 15, 16 and 17 show another embodiment as invention-based instrument 49. As implant a staple 50 is provided. The staple 50 presents a smaller size, preferably smaller than 4 mm. Additionally, the surgical instrument 49 presents a cannula 51. The surgical instrument comprises grip 52 and staple 50 and guided is guided into the cannula 51. The cannula 51 presents a sharp edge 53. This has the advantage that the surgical instrument 49 is also suitable for cutting. The embodiment of the surgical instrument 49, according to FIGS. 15, 16 and 17, is suitable for percutaneous fixing of smaller fragments of bones. Through the cannula 51, the staple 50 can be inserted without substantial damage to the surrounding tissue.
(58) FIGS. 18, 19 and 20 show another embodiment of a surgical instrument 54 as per the invention with a staple 55 as implant. The staple 55 is created from a pipe. The staple 55 presents three legs 56, 57 and 58, as can be recognized in FIG. 19. The staples 55 and/or the leg 56, 57 and 58 present barbs 59. Additionally, the staple 55 presents spikes 60 in its top area.
(59) The staple 55 is connected through a multitude of pre-set break points 61 with a grip part 62. The grip 62 is tubular designed. Consequently, this has the advantage that the surgical instrument 54 can be created from a tube. For cutting off the unnecessary parts, preferably a laser process is applied.
(60) The FIGS. 21 and 22 show another embodiment of a surgical instrument 63. The surgical instrument 63 comprises a staple 64 with four legs 65, 66, 67 and 68. Additionally the staple 64 comprises a plate 69 with a fixing drill 70. Through a multitude of pre-set breaking points 71 the staple 64 is connected with a grip 72. The grip 72 presents a slit 73, which can also serve as saw template. Bores 74 to 76 in the grip 72 serve as drilling template.
(61) The FIGS. 23 and 24 show another embodiment of surgical instrument 77. The surgical instrument 77 comprises a staple 78 as implant and as grip a holding plate 79. The holding plate 79 is connected through a connecting pin 80 with the staple 78. The holding plate 79 is arranged in an angle to the connecting pin 80. The angle lies preferably between 90 and 120.
(62) The connecting pin 80 joins with a compression plate 81 of the staple 78 in an angle .
(63) The staple 78 comprises a compression plate 81. This presents a sideward wedge 82 for angle correction.
(64) Additionally, the staple 78 comprises at each corner of the compression plate 81 a leg 83. Analogue to the embodiments described already, the holder plate 79 comprises openings 166 and slits 167, which serve the purpose as drilling template.
(65) The functioning of the embodiments of the FIGS. 14 to 23 as per the invention is as follows:
(66) The staple 43, 50, 55, 64 or 78 is positioned and then inserted into the tissue, preferably in the osseous material. When the staple 43, 50, 55, 64 or 78 is correctly positioned, grip 47, 52, 62, 72 or 79 is separated from the staple 43, 50, 55, 64 or 78 through the pre-set breaking point.
(67) FIG. 25 shows another embodiment as per the invention 84. The surgical instrument 84 comprises a bolt 85 as implant and a grip 86. The bolt 85 is connected through a pre-set breaking point 87 with the grip 86. In the illustrated embodiment the pre-set breaking point 87 is circularly designed. The functioning is analogue to the embodiments of surgical instruments described above.
(68) In other embodiments not described here the surgical instrument 84 is inserted in a guiding tube, especially a cannula.
(69) FIG. 26 shows another embodiment of a surgical instrument 93.
(70) The FIG. 27 shows an enlarged section of a front area of the surgical instrument 93. With this, as implant a multitude of clamps 94, 95, 96, 97 and 98 are provided. The clamp 94 is connected through a pre-set breaking point and/or through two pre-set breaking points 99 with the clamps 95. Similarly clamp 95 is connected with clamp 96. The clamp 98 is connected through a pre-set breaking point 100 with a grip 101. The grip 101 and the multitude of clamps 94 to 98 are guided into a cannula 102. The grip 101 can be connected through a coupling with an instrument handle not show here. Basically the grip 101 is formed as single part to the instrument grip.
(71) With the embodiment shown in FIG. 27 the clamps 94, 95, 96, 97 and 98 can be brought out one after the other from a type of magazine.
(72) FIG. 28 shows an enlarged top view of a front area of a surgical instrument 88. A clamp 89 is connected with grip 91 through a pre-set breaking point 90. The grip 91 and the pre-set breaking point 90 are guided into a cannula 92. The grip 91 can be connected through a coupling with an instrument grip not clearly shown. Basically, the grip 91 can be formed as a single part to the instrument grip.
(73) FIG. 29 shows a cage 103 as implant as per state of the art. The cage 103 comprises a top shell 104 and a bottom shell 105. Through a connecting point 106 for a spindle not clearly shown, the cage 103 can be expanded. By actuating the connecting point 106 with a spindle, the wedge 107 is pushed. Thus the wedge 107 adjusts so that the cage 103 can be expanded. The top shell 104 is connected with bottom shell 105 apart from the wedges 107 through flexible tapes 108.
(74) The FIGS. 30 and 31 show a surgical instrument 108 as per invention with cage 110 as implant. The cage 110 comprises a top shell 111 and a bottom shell 112. The top shell 111 and also the bottom shell 112 are connected with each other at the surfaces facing each other like multitude of smaller wedges, which form a zig-zag form and through a flexible tape 113. The flexible tape 113 is arranged between a tapered, inner sides of the top shell 111 and the bottom shell 112 facing each other. Preferably, the tape 113 is created from an elastic material.
(75) For connecting the elastic tape 113 with the cage, the tape is preferably formed/moulded as single part with the cage. Alternatively, the band can be riveted or affixed to the cage. Additionally, the top shell 111 and the bottom shell 112 are connected as single part with each other through an elbow 117.
(76) Thus, the top shell 111 is connected with the bottom shell 112 through at least one flexible tape 113, this has the advantage that no other expensive holding mechanism like joints or hinges have to be employed.
(77) In other embodiments not illustrated here, the bottom and/or top shell possess at least one separable connection or present other separable connections.
(78) As grip the surgical instrument 109 comprises two rods 114 and 115. The rod 115 is connected through a pre-set breaking point 117 with the bottoms hell 112 of the cage 110. The top rod 114 is again subdivided in to three strips 118, 119 and 120. The strips can fulfil various tasks and functions as per the width and stability, like navigation, control, expansion and/or coupling. The individual strips 118 to 120 are connected with each other through flexible tapes 121. Thus, while breaking the strips and/or rods 114, 115, 118, 119 and 120, this is prevented from injuring the tissues.
(79) The functioning of the surgical instrument is as follows:
(80) Through the rods 114 and 115 the cage 110 is correctly positioned and held. Then through a pull and/or pressure on the rods 115 the cage is expanded and/or the top surface 112 is spaced from the top shell 112. Through the strips 118 to 120 another alignment of the cage 110 and the shell 111 is possible through bottom shell 112. When the cage 110 sits correctly, the rods 114 and 115 are separated at the pre-set breaking points 116 and 117 from the cage 110.
(81) FIG. 32 shows another embodiment of a surgical instrument 122 as per the invention. The surgical instrument 122 comprises as implant a cage 123 and as grip three rods 124, 125 and 126. The cage 123 comprises as connecting element a wedge-chain 129. Additionally, the wedge-chain 129 is connected through a flexible tape 171 with the bottom shell 132 and through a flexible tape 172 with the top shell 128. The rod 124 is connected through pre-set breaking point 127 with a top shell 128 of the cage 123. The rod 125 is connected with the wedge-chain 129 through pre-set breaking point 130. The rod 126 is connected through a pre-set breaking point with the bottom shell 132 of the cage 123.
(82) The functioning of the surgical instrument 122 is as follows:
(83) Through the rods 124 and 125 the cage 123 is correctly positioned and held. Then through a pull and/or pressure on the rods 125 the cage 123 is expanded and/or the top surface 128 is spaced from the bottom shell 132. When the cage 123 sits correctly, the rods 124 to 126 are separated at the pre-set breaking points 127, 130 and 131 from the cage 123.
(84) FIGS. 33 and 34 show another embodiment of a surgical instrument 133. The surgical instrument 133 comprises as implant a cage 134 and as grip a pulling or pressure rod 135. The pull/push rod 135 is connected through a pre-set breaking point 136 with a top shell 137 of the cage 134. The pull/push rod 135 is connected through a pre-set breaking point 137 of the cage 134. The pull/push rod 135 is connected through a pre-set breaking point 138 with a bottom shell 139 of the cage 134. The top shell 134 and the bottom shell 139 of the cage 134 are connected with each other through a first web 140 and a second web 141 directly. This has the advantage that the cage 134 could be created as a single part. The webs 140 and 141 serve the purpose of expanding the cage 134 through pull/push, in doing so, the web alignment can also run in one direction. For aligning the cage, the pull/push rod 135 serves the purpose.
(85) In other embodiments not shown here, for aligning of cage an additional separate instrument can also be used.
(86) FIG. 35 shows another embodiment of a surgical instrument 142. The surgical instrument 142 comprises as implant a cage 143 and as grip three rods 144, 145 and 146. A top shell 147 of the cage 143 is connected through flexible tapes 148 with the central web 149. A bottom shell 150 is similarly connected through flexible tapes 148 with the central web 149. Through rods 144 to 146 the cage 143 is positioned. Through pull/push with the rod 143 at the central web 149 the top shell 147 and the bottom shell 150 are expanded from one another. When the cage 143 presents the correct opening width and is correctly positioned, the rods 144, 146 and 146 at the corresponding pre-set breaking points 151, 152 and 153 are separated from the cage 143.
(87) FIG. 36 shows another embodiment of a surgical instrument 154. The surgical instrument 154 comprises as implant a cage 155. The cage 155 comprises an integrated reinforcement plate 156. In the present embodiment, the cage 155 is adjusted through a wedge-chain 157.
(88) As grip, the surgical instrument 154 comprises a rod 158, which is connected through a pre-set breaking point 159 with the wedge-chain 157.
(89) In another embodiment not shown here, all forms of cages mentioned till now can be combined with a reinforcement plate.
(90) FIG. 37 discloses another embodiment of a surgical instrument 160. The surgical instrument 160 comprises as implant a cage 161 with an integrated staple 162. The staple 162 comprises a staple plate 163 and two staple legs 164 and 165. A grip 168 is designed similar to the designs mentioned previously.
