Instrument zum chirurgischen Nähen bei der minimal-invasiven Chirurgie und Nadelhalterkupplung für ein derartiges Instrument

The invention relates to an instrument for surgical suturing at the minimum-invasive surgery, in particular single port-surgery, with a via a port to a surgical site that can be fed with a gripping device for gripping a surgical needle at the distal end and means of pliers for actuating the Pliers at the proximal end.

The invention relates to a surgical instrument for further needle owner clutch for a minimally-invasive surgery in which sewing said above, in particular single port-surgery.

The present invention refers in particular to the in which a trend towards minimally-invasive abdominal surgery and at best Thoracic surgery, laparoscopic procedures for surgical field has been made with as little as possible is accesses.

Recently surgery that will be made using the so-called single port-surgery via a single access. Access navel in which is placed in the region of the abdominal surgery usually, so that no visible scars from the operation result. Besides the cosmetic advantages is also wound healing compared to conventional surgical methods in which single port-surgery improved.

By a few accesses the work of the surgeon at the minimum-invasive surgery is more difficult, since substantially all the instruments to the surgical site via one or two ports must be manoeuvred and correspondingly brought up. When with only one single port is the handling for single port-surgery the surgeon particularly difficult. On the particular surgical sewing it comes to difficulties in handling in conventional instruments. Typically, the surgical needle is held by means of gripping elements and after piercing of the fabric at a needle holder and then transferred from the gripping member again taken over. In support of the surgical sewing various instruments have been developed, but which upon the minimum-invasive surgery, in particular single port-surgery not, or at least not optimally, can be used.

For example, describes a needle holder with two rods 0,908,141 Al the EP respective grip members are disposed at the distal ends thereof, over which the surgical needle can be held. Over a complex mechanism the distance between the rods can be changed and thereby the surgical sewing be supported. The apparatus with the spaced apart rods, however, leads thereto that air would lose by the sealing of the trocar.

The problem of the present invention is to create a minimally-invasive surgery and surgical sewing in the instrument for a needle owner clutch for this kind of instrument, through which the handling during the sewing can be facilitated. The construction of the instrument is to be simple and robust as possible, to allow a cost-effective production, also as The disposable product,. Disadvantages of known devices are to be avoided or at least reduced.

According to the invention by a above said instrument for surgical task is sewing Dissolve is provided wherein a through said port insertable needle owner clutch , which includes said gripping means comprises a tube surrounding needle owner clutch , at its distal end a of the pincers of the gripping means is arranged spaced Device for holding of the surgical needle. The construction is distinguished by particular simplicity, and simultaneously or successively from needle owner clutch and said gripper means by the port to the surgical site allows the introduction. Through the distance between the device for holding the surgical needle and the Pliers se known gripping means of the sewing operation is supported. By corresponding rotation of the gripping device with respect to the tube the needle owner clutch , the orientation of the device for holding the surgical needle may be changed with respect to the forceps of the gripping device. The according to the invention allows a use in conventionally obtainable gripping means construction.

At the distal end of the tube is advantageously needle owner clutch an elastically prestressed spring element disposed outwardly of, the means for retaining the surgical needle is fixed at which spring element. Through this construction allows or facilitates needle owner clutch through said port is the insertion, since the outwardly biased spring element during the passage through the port can be moved in direction central axis of the tube. Once [...] has been guided in the direction through said port to the tube of the surgical site, the spring element automatically by the bias outwardly pivots, whereby the device for holding the surgical needle attached to the spring member from the simultaneously or subsequently guided to the surgical site through the tube spacing is held in the gripper Pliers.

During the surgical sewing Acquiring the needle pierced through the fabric to be joined by the tool and the gripping device and thereafter needle owner clutch taken over by the holding device of the invention. Afterwards the surgical needle is in turn detected by the fabric to be joined by the tool of the gripping device and again in turn held by the holding device the piercing and needle owner clutch or taken over. The resiliently outwardly biased spring element is designed to be resilient in the lateral direction and not ideally torsion-stably , so that the when the needle area not substantially Moving needle owner clutch.

In most simple implementation the device is formed by a plug of elastic material for holding the surgical needle. This constitutes a simple, cost-effective and robust design variant of the holding device constitute.

As material for the plug in which the surgical needle for temporarily holding is bitten suitable in particular silicone. This plastic has many occasions is proving itself in medical applications. Clearly, but also other elastic materials, which comprise respective biocompatibility, conceivable for the manufacture of the plug.

If the plug is connected releasably to the tube of the needle owner clutch , the existing pipe and the spring element can be reused needle owner clutch of a sterilizable material and only the plug are exchanged after the operation. The releasable connection of the plug with the tube or the spring element can take place in simple manner by clipping onto a correspondingly shaped element.

The Device for holding said surgical needle can also by two mutually resiliently prestressed platelets can be clamped, between which plates the surgical needle, be formed. This represents an alternative embodiment of the holding device constitute, on condition the use of corresponding materials also may be sterilizable.

Also the device can be formed by two oppositely displaceable hollow cylinder for holding the surgical needle, between which hollow cylinders can be clamped the surgical needle.

Advantageously the device is for holding the surgical needle in a lateral distance from the needle owner clutch 5 to 20 mm from the Pliers the gripping device arranged.

This distance is optimal for most operations in the abdominal surgery or thoracic surgery. If the tube is made of a sterilizable material needle owner clutch of, the tube can be reused and at best the needle owner clutch spring element of the attached thereto.

Dissolve needle owner clutch for the task is also a subject surgical instrument by an above-mentioned, wherein an insertable through said port, the gripping device is provided tube surrounding, spaced from the centerline of the tube at its distal end a device for holding a needle is arranged. The above description is referred to the recoverable thereby Among the advantages of the instrument for surgical sewing.

Am distal end of the tube is advantageously a resiliently outwardly prestressed spring element arranged, at which spring element the means for retaining the surgical needle is fixed. As indicated above, it is advantageous, when the outwardly biased spring element is carried out not in the lateral direction and collides torsion-stably accordingly.

The Device for holding said surgical needle by a plug of elastic material may, preferably silicone, be formed.

The grafting can be releasably connected to the pipe.

The apparatus for supporting the needle can also by two mutually resiliently prestressed platelets can be clamped, between which plates the surgical needle, be formed.

Alternatively, the device can also can be clamped up by two mutually resiliently displaceable hollow cylinder for supporting the needle, between which the surgical needle hollow cylinders, be formed.

The apparatus for holding the surgical needle is preferably at a lateral distance of 5 to 20 mm from the centerline of the pipe.

The needle owner clutch are preferably composed of a sterilizable material and any further components of the pipe.

The invention is explained with reference to the enclosed drawings. Shown therein are:

Fig. 1 shows a sketch of the principle of applying a surgical instrument for minimally-invasive surgery in which sewing the invention;

Fig. needle owner clutch 2 resiliently prestressed in the region of the distal end with an embodiment of the distal end within the ports;

Fig. needle owner clutch 2 and the gripping device 3 the embodiment of the outside of the port according to Fig.;

Fig. needle owner clutch 4 a further embodiment of a plate for clamping a surgical needle with two mutually spring-biased;

Fig. needle owner clutch with two mutually resiliently displaceable hollow cylinder 5 a further embodiment of a clamp for a surgical needle; and

6a and 6b a further embodiment of a spacer element needle owner clutch Fig. with a the tube gripping device with a gripping device with retracted and advanced.

Fig. 1 1 shows a schematic diagram in which the application of a minimum-invasive surgery for surgical suturing instrument according to the invention, in particular single port-surgery.

Here, at a location above the operational zone 0, wherein the abdominal surgery usually in the region of the navel , a port P via which the instruments and supply pipes for supplying the gas set for inflation the surgical site (not shown) a camera and the like and the feed 0 disposed. Typically, a gripping device 3 is guided via an opening of the port P at the surgical site 0, so as to be able to engage a surgical needle N. The gripping means 5 at the distal end 3 has a 4 for gripping the needle at the proximal end 7 N and pliers an actuating element 6 for the caliper 4 to operate. needle owner clutchaccording to invention a 2 is provided, which includes a tube surrounding the gripping device 8 3 10 9 at its distal end is disposed a device for holding said surgical needle N. Therefore the device is for holding the surgical needle 10 of the gripping device 4 3 spaced from the Pliers N, whereby the handling during the operation is simplified.

The needle owner clutch 2 is preferably disposed at the distal end 9 of the tube 8 by a, resiliently outwardly biased, spring element 11 formed, on which the apparatus 10 for holding the surgical needle 11 is spring element fixed N. Through the resilient bias of the spring element 11 outwardly needle owner clutch 2 can be introduced through the opening of the port P the. The apparatus 10 for holding by a plug 12 of elastic material can N of the surgical needle, for example, silicone, be formed. In this plug 12 the surgical needle is stuck N after piercing of the tissue at the surgical site to be connected and thereafter the Pliers 4 of the gripping device 3 0 opened and again from the plug 12 of elastic material the surgical needle N pulled and the next seam at the operative site made 0. To should be formed in the plug 12 to facilitate the piercing of the surgical needle N, the outwardly biased spring element 11 laterally stable and also [...].

In Fig. needle owner clutch 2 in the region of the distal end 2 a embodiment, the resiliently prestressed spring element 9 of the tube 11 within the ports P represented with 8. It the spring element 11 is bent inwardly against the spring force, so that the 2 through the opening of the port P fits needle owner clutch.

Fig. needle owner clutch 2 2 together with the gripping device 3 shows the 3 in a position outside of Fig. P of the port. Here needle owner clutch 11 pivots 2 by the spring force of the spring element automatically outwardly, so that a distance d between the device 10 for holding the surgical needle 3 is formed of the gripping device 4 and of the gripper N. The distance is preferably 5 to 20 mm.

In Fig. needle owner clutch 2 4 a further embodiment, a represented. It the device for holding the surgical needle 10 is formed by a plug 12 of elastic material but not by two N each other resiliently prestressed platelets 13, 14 for clamping the surgical needle N. The mutually spring-biased small plates 13, 14 can be arranged directly at the distal end 8 and 9 of the tube be resiliently biased outwardly, or (as shown) through a respective spring element 9 of the tube 8 be connected to the distal end 11.

Fig. needle owner clutch 5 shows an alternative embodiment of a 2, the apparatus 10 for holding the surgical needle N by two mutually displaceable hollow cylinder 16, 17 is formed. The hollow cylinder 16, 17 are connected through a respective, resiliently outwardly biased, spring element 11 with the distal end 9 of the tube 8. The is represented for a small needle N, by a spring 16 in the two hollow cylinders (not) resistance constituted, and automatically held 17 stuck.

6a and 6b show a further embodiment of a the figures needle owner clutch Finally 2, wherein the lateral deflection of the device 10 for holding the surgical needle 15 is formed by a specially designed spacer element N, which can be deflected or displaced by the gripping device 3. In Figure 6a represented As, the wedge-shaped spacer element 3 is displaced by the gripping means 15, so that a desired distance d between the device 10 for holding the surgical needle 3 is formed of the gripping device 4 and of the gripper N. Figure 6b shows the state in which the gripping device 2 is withdrawn through the pipe 8 the needle owner clutch 3, whereby automatically the spacer element 10 for holding the surgical needle 15 with the device arranged thereon in the direction of the centre line 8 of the tube 2 needle owner clutch N of the displaced can be removed or will be deflected and M without resistance through the opening of the port P. Such a 2 can also especially simple and cost effective needle owner clutch embodiment of the be made of plastic.