Holding device for holding a manually operated medical device

Abstract

Holding device for holding a manually operated medical device in place, comprising: a connector arranged to connect the holding device to a positioning apparatus; a clamp member arranged to clamp the medical device, wherein the clamp member is moveable between a locking position wherein the medical device is clamped and a moving position wherein the medical device is moveable with respect to the holding device; a joint assembly arranged to allow movement between the clamp member and the connector, wherein the joint assembly is moveable between a moving position wherein the clamp member is moveable with respect to the connector and a locking position wherein movement between the clamp member and the connector is prevented, and; an actuator for moving both the joint assembly and the clamp member between the moving positions and the locking positions.

Claims

1. A holding device for holding a manually operated medical device in place, comprising: a connector arranged to connect the holding device to a positioning apparatus; a clamp member arranged to clamp the medical device, wherein the clamp member is moveable between a locking position, wherein the medical device is clamped and a moving position, wherein the medical device is moveable with respect to the holding device; a guiding tube for receiving the medical device, wherein a part of a wall of the guiding tube is arranged to receive the clamp member for clamping the guiding tube and the medical device in the guiding tube; a holding body, wherein the holding body is formed integrally with the guiding tube, and comprises a channel having an inner wall and an outer wall, wherein the inner wall of the channel forms at least a part of an inner wall of the guiding tube; a joint assembly arranged to allow movement between the clamp member and the connector, wherein the joint assembly is moveable between a moving position, wherein the clamp member is moveable with respect to the connector and a locking position, wherein movement between the clamp member and the connector is prevented, and; an actuator for moving both the joint assembly and the clamp member between the moving position and the locking position.

2. The holding device according to claim 1, wherein at least one of the clamp member and the joint assembly is arranged to move between the positions due to movement of the other one of the joint assembly and the clamp member between the positions.

3. The holding device according to claim 1, wherein the actuator is arranged to move the holding body between a moving position and a locking position for moving the clamp member and the joint assembly between the moving position and the locking position, wherein the holding body is at least partially manufactured from a resilient material, and wherein the holding body is pre-stressed towards the moving position or the locking position of the holding body.

4. The holding device according to claim 3, wherein the holding body is substantially U-shaped and comprises two legs, wherein the two legs of said U-shaped holding body form the clamp members for clamping the medical device there between.

5. The holding device according to claim 4, wherein the clamping member is rotatable on the holding body.

6. The holding device according to claim 4, wherein the clamp member is arranged to clamp the medical device in the guiding tube, wherein the guiding tube comprises a trocar adapted for use with the holding device.

7. The holding device according to claim 1, wherein the actuator comprises a manipulator configured to allow a surgeon to operate the actuator, wherein the manipulator extends at a distance from the actuator.

8. The holding device according to claim 1, wherein the joint assembly comprises a protruding member and a receiving member for receiving the protruding member, wherein the receiving member is substantially complementary to the protruding member, wherein the actuator is arranged to induce movement between the receiving member and the protruding member for moving between the locking position and the moving position.

9. The holding device according to claim 8, wherein the protruding member has a substantially cylindrical, conical or spherical shape.

10. The holding device according to claim 8, wherein the actuator is arranged to modify a diameter of the receiving member of the joint assembly for deforming the holding body for moving both the joint assembly and the clamp member between a locking position and a moving position.

11. The holding device according to claim 8, wherein the receiving member of the joint assembly is provided on a holding body, wherein the actuator is arranged to modify the shape of the receiving member.

12. The holding device according to claim 1, wherein the holding body comprises a channel for receiving the medical device, wherein an inner surface of said channel forms said clamp member, wherein an outer surface of the holding body forms a protruding member of the joint assembly, and wherein the actuator is arranged to deform the holding body for moving the holding body between the moving position and the locking position.

13. The holding device according to claim 12, wherein the holding body comprises a plurality of segments extending radially from said channel.

14. The holding device according to claim 1, wherein the guiding tube is provided with at least one opening for receiving the clamp member.

15. The holding device according to claim 1, wherein the guiding tube is provided with a moveable wall for cooperation with the clamp member.

16. The holding device according to claim 1, wherein the inner wall of said guiding tube is moveable for clamping said medical device.

17. The holding device according to claim 1, wherein the guiding tube is a trocar.

18. The holding device according to claim 1, wherein the holding body is in the form of a sphere and wherein the sphere comprises a plurality of segments extending radially around the guiding tube.

Description

(1) The present invention is further illustrated by the following Figures, which show a preferred embodiment of the device according to the invention, and are not intended to limit the scope of the invention in any way, wherein:

(2) FIG. 1 schematically shows a first embodiment of the holding device;

(3) FIGS. 2a and 2b schematically show the device of FIG. 1 in the moving and locking position, respectively;

(4) FIG. 3 schematically shows an alternative of the device of FIG. 1;

(5) FIGS. 4a and 4b schematically show the clamping action of the device of FIG. 3 in cross-section;

(6) FIG. 5a schematically shows a further alternative of the device;

(7) FIGS. 5b and 5c schematically show the clamping action of the device of FIG. 5a in cross-section;

(8) FIG. 6a schematically shows a second embodiment of the holding device;

(9) FIG. 6b schematically shows the holding device of FIG. 6a in side-view;

(10) FIGS. 7a and 7b schematically show the clamping action of the device of FIG. 6a in cross-section, and;

(11) FIGS. 8a en 8b schematically show alternatives of the device of FIG. 6a.

(12) In FIG. 1 a holding device in the form of a clamp is shown. The clamp 1 is provided with a connector 4 which is connected to a positioning apparatus (not shown). Such an apparatus can for instance be in the form of a plurality of mutual moveable arms. The positioning apparatus provides a stable position for the connector 4. The clamp 1 is arranged to clamp a laparoscopic instrument 7 in a locking position. In a moving position of the clamp 1, the instrument is allowed to move with respect to the connector 4.

(13) A laparoscopic instrument 7 is normally inserted into the patient using a guiding tube in the form of a trocar 6. The trocar 6 is provided with an inlet part 62 and a tube part 61. The tube 61 is according to the invention provided with openings 63 which allow the clamp 1 to clamp the instrument held in said trocar 6.

(14) The clamp 1 comprises a holding body in the form of a U-shaped body 11. The legs of the U-shaped member 11 are provided with a clamp member 2 in the form of clamping shoes 21a and 21b. The clamping shoes 21a and 21b cooperate with openings 63 to engage the instrument 7 held in the tube 61.

(15) In the moving position, the trocar 6 holding the instrument 7 is allowed to rotate with respect to the clamping shoes 21a 21b on axis II. In the locking position, next to preventing movement of the instrument in its longitudinal direction, also rotation on axis II is prevented due to the clamping action of the shoes 21a and 21b on the instrument 7 as will be explained more in detail below.

(16) The U-shaped body 11 is furthermore provided with a joint assembly 3 formed by a protruding member in the form of a cone 32 which can be received in a receiving member in the form of opening 31. The opening 31 is also shaped conical, allowing a tight fit of the cone 32 and the opening 31 in the locking position.

(17) For moving the clamp 1 between a locking position and a moving position, an actuator in the form of a Bowden cable 5 is provided. The cable 5 is connected to a connecting wire 51 which interconnects the legs of the U-shaped body 11. The cable 5 extends through the opening 31 and is held coaxially in the connector 4.

(18) In FIG. 2a the clamp 1 is shown in its moving position. The distance between the clamping shoes 21 is hereby larger than the distance in the locking position as shown in FIG. 2b. In the moving position, the shoes 21 allow movement of the instrument with respect to the clamping shoes 21 in a longitudinal direction of the trocar 6. Further, the instrument 7 is allowed to rotate on the axis indicated with II in FIG. 1. Further rotation of the trocar 6 is provided by the joint assembly. More specifically, in the moving position, the cone 32 and the opening 31 extend at a mutual distance, allowing rotation of the U-shaped body 11 with respect to the connector 4 on the axis indicated with III in FIG. 1.

(19) By pulling cable 5 in a direction indicated with I in FIG. 2b, clamp 1 is moved to its locking position. This movement urges the legs and therewith the clamping shoes 21 together, as indicated with the arrows, thereby clamping the instrument there between. Due to this clamping action, movement, i.e. rotation and translation, between the clamping shoes 21 and the instrument 7 is prevented. Further, due to the movement of the U-shaped body 11 in the direction I by pulling the cable 5, the opening 31 is urged onto the cone 32. The cone 32 and the opening 31 are then in frictional engagement, preventing movement between the cone 32 and the opening 31. Therefore, by pulling the cable 5, both the clamp member 2 and the joint assembly 3 are moved towards the locking positions.

(20) The U-shaped body is manufactured from a resilient material, in this case plastic. The U-shaped body 11 is hereby pre-stressed towards the position as shown in 2a. Therefore, when the tension is released from the cable 5, the legs tend to move apart, thereby automatically moving the clamp 1 to the moving position.

(21) In FIG. 3 an alternative of the clamp is shown. In this embodiment, the receiving member of the joint assembly 3 comprises two moveable walls 31a and 31b. The walls 31a and 31b are spaced apart to receive the cylinder 32 connected to the connector 4. Further, the clamping shoes 22a and 22b differ slightly from the clamping shoes from FIG. 1. The shoes 22a and 22b are connected to the legs of the body 11 using spindles 25, which are received in openings provided in the legs. This allows rotation of the shoes 22a and 22b with respect to the body 11 in the moving position on axis II. The legs of the body 11 are further provided with an opening for receiving the conical shaped connection sections 24 of the shoes 22a and 22b as shown in FIGS. 4a and 4b. The connection sections 24 extending in the openings in the legs, together forming a joint assembly, may however allow the rotation of the shoes with respect to the legs, without the use of spindles 25.

(22) Also shown in FIG. 3 is a seal in the form of a tubular sleeve 64 made from silicones. The sleeve 64 provides an airtight environment in the trocar 6. The sleeve 64 is provided with openings to receive the clamping shoes 22a and 22b. These openings are smaller than the openings provided in the tube 61. As shown in more detail in FIG. 4b, the clamping shoes 22a and 22b are provided with a clamping section and a connecting section 24. Between the clamping section and the connecting section 24, the sleeve 64 can be received, providing an airtight connection.

(23) Before use, the shoes 22a and 22b can be attached to the trocar 6 provided with the seal 64 to get the combination as shown in FIG. 4b. The seal 64 hereby functions to hold the shoes 22a and 22b and allows the shoes to move to and from the instrument 7. The shoes 22a and 22b can then be connected to the legs of the body 11, for instance using spindles 25.

(24) The actuator 5 is furthermore arranged to apply a pulling force in a direction indicated with I which is out of the plane of the U-shaped body 11. When the cable 5 is pulled, the shoes 22a and 22b are moved together, as shown in FIG. 4a. This prevents movement of the instrument 7 in its longitudinal direction. The clamping action of the body 11 on the clamping shoes 22a and 22b furthermore prevents the shoes 22a and 22b to rotate with respect to the body 11. The conical shaped connection sections 24 and the complementarily formed openings in the body 11 increase the friction between the shoes 22a, 22b and the body 11.

(25) Further, the walls 31a and 31b are moved together, clamping the cylinder 32. By pulling the cable 5, both the movement between the connector 4 and the body 11 and the movement between the body 11 and the instrument 7 is prevented. Similar to device as shown in FIG. 1, release of the tension on cable 5 moves the body 11 to the moving position due to the resilient material of the body 11, in this case stainless steel.

(26) The clamping action of the shoes 22a and 22b are shown in more detail in FIG. 4a. The shoes 22a and 22b are provided with clamping surfaces which are arranged to engage a part of the perimeter of the instrument 7. Air flow is hereby allowed between the instrument 7 and the tube 61 of the trocar 6.

(27) In FIG. 5a a trocar 6 is shown with an integrated clamping member in the form of clamping shoes 23a. Clamping shoes 23a and 23b (not visible in FIG. 5a) can be connected to the body 11 using spindles 25. To allow movement of the shoes 23a with respect to the tube 61 of the trocar 6, the tube 61 is provided with flexible wall sections 65a and 65b. Flexible sections 65a and 65b are formed by providing an incision in the wall of the tube 61. Sections 65a and 65b are then allowed to move with respect to an intermediate section 66. The incision for forming the flexible sections 65a and 65b is a small reduction in wall thickness. It can however also be possible to provide cuts opening in both the inner and the outer surface of the tube. A seal must then be provided to ensure an airtight system.

(28) In FIG. 6a a second embodiment of a holding device 1 according to the invention is shown, wherein the holding body in the form of a sphere 11 is formed integral with the trocar 6. The sphere 11 comprises a plurality of segments 12 extending radially around the tube 61 of the trocar 6. The sections 12 of the sphere 11 allow the sphere 11 to be deformed. The sphere 11 is manufactured from a resilient material, in this case plastic.

(29) In the embodiment shown in FIG. 6a, the protruding member of the joint assembly 3 is formed by the outer surface 32 of the sphere 11. This outer surface 32 is received by the receiving member in the form of ring 31, which is complementarily to the outer surface 32. The ring 11 is open at one end forming ends 31a and 31b, wherein end 31a is provided with a connector 4. Between said ends 31a and 31b extends the actuator in the form of hydraulic piston-cylinder combination 53. The hydraulic actuator 53 is in this case arranged to be connected to a luer lock. When hydraulic pressure, e.g. by means of a physiological saline solution, is supplied to the hydraulic actuator 53, the ends 31a and 31b are urged apart, changing the diameter of the ring 31. The actuator is further provided with a spring 52, biasing the ends 31a and 31b together.

(30) To operate the actuator 53, a manipulator in the form of a knob is provided (not shown). The knob is provided on a distance from the actuator 53 and the holding device 1. More specifically, the knob is provided on the instrument 7 allowing the surgeon to operate the knob while handling the instrument 7. The knob is in this case arranged to supply hydraulic pressure to the hydraulic actuator 53. When the knob is operated, the ends 31a and 31b are urged apart.

(31) When the joint assembly 3 is in the moving position, as will be explained more in detail below, the sphere 11 with its outer surface 32 is allowed to rotate in ring 31, as is shown in FIG. 6b. It will be appreciated that this joint assembly 3 allows a flexible movement of the trocar 6 with respect to the connector 4.

(32) The sphere 11 is furthermore provided with a channel which extends coaxially with the tube 61. The instrument 7 can therefore be held in the tube 61 and the channel in the sphere 11, as can be seen in FIGS. 7a and 7b. The inner surface or wall 26 of the sphere 11 hereby forms the clamping member according to the invention.

(33) In FIG. 7a the sphere 11 is in the moving position due to the supply of hydraulic fluid to the hydraulic piston 53. The ends 31a and 31b are urged apart and this allows the sphere 11 to expand, since the sphere 11 is pre-stressed into the moving position. In this position, the sections 12 of the sphere 11 extend at a distance from each other. The diameter of the wall 26 is therefore larger than the outer surface of the instrument 7, allowing movement between the instrument 7 and the sphere 11. The clamp member is now in the moving position.

(34) Since the distance between the ends 31a and 31b is larger, the sphere 11, more specifically the outer surface 32 thereof, and the ring 31 are also allowed to move with respect to each other, allowing rotation of the tube 61 as is indicated in FIG. 6b.

(35) When the pressure in the hydraulic cylinder 53 is released by releasing the knob, the spring 52 will urge the ends 31a and 31b together, as can be seen in FIG. 7b. The ring 31 hereby deforms the sphere 11 and the sections 12 now abut each other. The ring 31 now frictionally engages the outer surface 32 of the sphere 11, limiting movement there between. Further, due to the deformation, the segments 12 are urged radially inwards with respect to the longitudinal axis of the instrument 7, clamping said instrument 7. The diameter of the clamping member in the form of wall 26 is thereby decreased, preventing movement of the instrument 7 with respect to the sphere 11.

(36) When the ends 31a and 31b are moved together due to the spring 52, both the joint assembly 3 in the form of the ring 31 and the sphere 11 and the clamp member in the form of the inner surface 26 are moved to the locking position.

(37) In FIG. 8a a variant is shown, wherein the actuator comprises a nut 55. Turning the nut 55 will urge the ends 31a and 31b together, moving the sphere 11 to the locking position. In FIG. 8b, the actuator is connectable to a Bowden cable, wherein pulling the cable moves the ends 31a and 31b together.

(38) The present invention is not limited to the embodiment shown, but extends also to other embodiments falling within the scope of the appended claims. It should for instance be noted that various parts of particular shown embodiments can be used in other embodiments. It is for instance possible to exchange the different clamping shoes, the U-shaped bodies and the actuators between the variants shown in FIGS. 1 to 5. The clamping shoes shown in FIGS. 4a and 4b are however preferred. It is furthermore possible to use other forms than rings for the receiving member in the embodiments shown in FIGS. 6 to 8. The ring can for instance be U-shaped, wherein the sphere is clamped between the legs. It should further be noted that although a distance between the clamp member and the instrument 7 is shown in the moving position in FIGS. 4b and 7a, it is in practice preferable to have contact between the clamp member and the instrument 7 in the moving position, albeit no firm clamping contact. This prevents any lateral movement of the instrument with respect to the trocar. Further, although a knob as manipulator in combination with the embodiment of FIG. 6a is described, also the other embodiments are provided with a suitable manipulator provided on the instrument for easy access for the surgeon. The manipulator is further not limited to a knob. For instance, in case a Bowden cable is used, the manipulator may comprise a suitable handle for pulling said cable.