DE202011000800U1 - Surgical instrument - Google Patents

Abstract

Surgical instrument (10) with a clamping device (12) for holding and / or clamping tissue (152), a severing device (14) for severing tissue (152) and a handling device (16) for actuating the clamping device (12) and / or the separating device (14), wherein the clamping device (12) comprises at least one clamping member (26, 28) which has a clamping surface (112) and which has a clamping member recess (24, 36), and wherein the separating device (14) comprises a separating member (86 ), which is at least partially movable into the clamping member recess (34, 36), wherein a separating member guide device (116) is also provided for guiding the separating member (86) in the clamping member recess (34, 36) and for maintaining a distance from inner side surfaces (68, 70) of the clamping member recess (34, 36), characterized in that the separating member (86) comprises the separating member guide device (116).

Description

The present invention relates to a surgical instrument having a clamping device for holding and / or clamping tissue, a separating device for cutting tissue and a handling device for actuating the clamping device and / or the separating device, wherein the clamping device comprises at least one clamping member having a clamping member, which a clamping member recess, and wherein the separating means comprises a separating member which is at least partially movable into the Klemmgliedausnehmung, further comprising a separating member guiding means is provided for guiding the separating member in the Klemmgliedausnehmung and for maintaining a distance to inner side surfaces of the Klemmgliedausnehmung.

A surgical instrument of the type described above, for example, from the DE 20 2007 015 547 U1 known. With such an instrument it is possible to grasp tissue and optionally to coagulate and sever it. In particular, when the instrument is designed in the form of a double-bipolar instrument, it is important that short circuits between the isolator and the at least one clamping member having the Klemmgliedausnehmung be avoided. These can always occur when the isolator comes in the vicinity of the co-operating with him clamping member or its electrically conductive areas touches.

It is therefore an object of the present invention to improve a surgical instrument of the type described above so that the risk of short circuits between the at least one clamping member and the separating member is further reduced.

This object is achieved in a surgical instrument of the type described above according to the invention in that the separating member comprises the separating member guide device.

In contrast to the known instruments, in which the separating member guiding device is covered by at least one clamping member, an arrangement or design of the separating member guiding device on the separating member itself has the advantage that even with an unwanted, very strong deformation of the separating member, the risk of short circuits can be minimized, since the separating member guiding device permanently helps to avoid contacts between electrically conductive regions of the at least one clamping member and of the isolating member. In particular, it is achieved by the separating member guiding device that a defined minimum distance between the separating member and the clamping surface or the inner side surfaces of the clamping member recess can be maintained, so that a current flow during coagulation does not exceed a certain value.

Particularly simple is the structure of the separating member guiding device, if it comprises at least one spacer element, which defines a minimum distance between the separating member and an inner side surface of the Klemmgliedausnehmung. It is conceivable, in particular, to provide the at least one spacer element on the separating member. In addition, spacer elements may be provided on the Klemmgliedausnehmung.

It is particularly advantageous if at least two spacer elements are provided which define a minimum distance between the separating member and respectively one of two mutually facing inner side surfaces of the clamping member recess. If the two spacer elements facing away from each other are arranged on the separator, they can additionally take over a centering function, which defines the separator and centered can lead into the Klemmgliedausnehmung.

Furthermore, it can be favorable if the at least two spacer elements are arranged or formed on side faces of the isolator which point away from one another or which point away from one another substantially. Such a configuration has the advantage that the at least two spacer elements are associated with the inner side surfaces of the Klemmgliedausnehmung such that a contact between an electrically conductive region of the separator and the inner side surfaces can be avoided. By means of the at least two spacer elements, electrically conductive regions of the instrument can be held at a predetermined distance from each other.

A particularly good guidance can be achieved, in particular, by the fact that in each case two spacer-holding elements form a pair of spacer elements which are arranged in pairs facing away from one another. For example, when two spacer members are disposed or formed on side faces of the partition member facing away from each other, they define a width which is smaller than a distance between opposing inner side surfaces of the clamp member recess.

Advantageously, a plurality of spacer elements are arranged distributed uniformly over mutually away facing side surfaces of the separating member. A uniform arrangement is independent of a shape of the spacer elements an advantage, because it is achieved as a particularly good leadership of the isolator over its entire extent.

In order to be able to form the surgical instrument in the form of a monopolar or bipolar instrument, it is advantageous if the clamping surface is electrically conductive. Under electrically conductive is to be understood in particular that it is electrically conductive or very low impedance, thus having a correspondingly high electrical conductivity to conduct a coagulation current through body tissue from the clamping surface to the separator or another clamping surface of another clamping member. In particular, it is advantageous if the clamping surface is suitable for conducting an HF current.

The insertion of the separating member into the Klemmgliedausnehmung is particularly simple when the clamping surface is oriented transversely or substantially transversely to the inner side surfaces of the Klemmgliedausnehmung. Under transverse is to be understood in particular a relative inclination at an angle between 45 ° and 135 °. Preferably, the clamping surface and the inner side surfaces are perpendicular or nearly perpendicular to each other.

In order to prevent the flow of a current between the separating member and the clamping surface or the clamping member, it is advantageous if the separating member guide device is at least partially made of an electrically non-conductive material. It can also be said that the isolator guide means is at least partially made of an electrically insulating material.

Advantageously, the at least one spacer element is made of an electrically non-conductive material. Preferably, this is electrically insulating. It is conceivable in such an embodiment of the spacer elements, the rest of the separating member guiding device optionally also produce from an electrically conductive material. In particular, apart from the separator guide means, the separator could be made entirely of an electrically conductive material.

The production of the separator guide device is particularly simple if it is formed in one piece. Furthermore, the surgical instrument can be assembled in a simple manner from different materials. In particular, the separating member may be formed such that it has a receptacle or holder for a cutting edge, blade or at least one conductive region into which said parts can be inserted or connected to the separating member. In principle, it is thus possible to form the isolating element in one piece up to its electrically conductive components. This is also a one-piece design with the Trenngliedführungseinrichtung conceivable.

The instrument can be produced in a particularly simple manner if the separating member comprises a separating member carrier and a cutting member. In particular, when the two parts are made of different materials, such as an electrically conductive and an electrically non-conductive material, so the two parts can be prepared separately and then connect to the separator.

It is advantageous if the cutting member comprises a cutting edge or at least partially in the form of a cutting edge is formed. Such a configuration makes it possible to sever tissue mechanically.

To avoid short circuits, it is advantageous if the separator member carrier made of an electrically non-conductive material and when the cutting member is made of an electrically conductive material. In particular, the separator member carrier may comprise the separator member guide means or even formed integrally therewith.

Preferably, the cutting member is formed in the form of an electrically conductive coating. For example, as the separator member carrier after its production at the locations where a power line is desired to be provided with the electrically conductive coating.

The manufacture of the instrument can be further simplified if the electrically conductive coating is applied by means of an MID process or a tampon or screen printing process. In particular, an MID process has advantages in terms of improved design freedom and environmental benefits over other coating methods. MID stands for "molded interconnect devices", which means "injection-molded interconnect devices". In an MID process, in particular, metal conductor tracks are applied to injection-molded plastic substrates.

It is particularly advantageous if the separating member carrier and the cutting member are non-positively and / or positively connected with each other. Thus, a permanent and secure connection between the separating member carrier and the cutting member can be ensured in order to avoid unwanted and unintentional release of the cutting member from the separator member carrier.

The separating element can be formed particularly simply if the instrument has a Connecting device for non-positive and / or positive connection of the separator member carrier and the cutting member comprises.

The manufacture and assembly of the instrument can be further simplified if the connecting device is designed in the form of a latching or snap connection.

According to a further preferred embodiment of the invention can be provided that the connecting means comprises first and second connecting elements, which are arranged or formed on the one hand on Trenngliedträger and the other on the cutting member, and that the first and second connecting elements in a connection position non-positively and / or positively in Engage. Such a configuration allows in particular an individual adaptation of the parts to be joined together to simplify their manufacture and assembly and thus the instrument.

The connecting device can be produced in a particularly simple manner if the first and second connecting elements are designed in the form of recesses and corresponding projections. The projections may optionally be arranged or formed on the separator member carrier and / or on the cutting member.

Preferably, the electrically non-conductive material is a plastic and / or a ceramic. The materials mentioned can be used in multiple configurations and variants to form electrically non-conductive components of the instrument. Furthermore, depending on the type of component, a production of plastic and / or of a ceramic may be advantageous, which depends in particular on stability and possible deformation requirements of the respective component.

It is advantageous if the separator member carrier comprises or carries the at least one spacer element. In particular, it can be formed in one piece with the separating element guiding device.

Particularly simple is the structure of the separating member guiding device when the at least one spacer elements in the form of a strip, rib or bead-like projection is formed. For example, such a spacer element can be sprayed or sintered as part of the separator support from a plastic or other sprayable, electrically non-conductive material or to a component, for example, the separator member carrier, spray.

A particularly good guidance of the separating member in the clamping member recess can be achieved, for example, by the fact that the at least one spacer element extends in a direction transversely or substantially transversely to a cutting line or plane defined by the cutting edge. In particular, the direction in which the spacer elements extend may be parallel to a direction of movement which is defined when the partition member and the at least one clamping member are moved relative to each other.

In order for the surgical instrument to be designed as a monopolar or bipolar instrument, it is advantageous if at least a part of the clamping surface is designed to be electrically conductive.

Preferably, the at least one clamping member recess is formed on the clamping member depression or opening. For example, a bottom of a depression form a stop for the separating member and limit a relative movement of the separating member and the at least one clamping member. An opening makes it possible, in particular, to pass the separating member even partially through the clamping member recess. This can be favorable, for example, when two relatively movable clamping members are provided and when the separating member is movably mounted relative to both clamping members and one of the two clamping members performs a dual function, namely if it forms a clamping member of the clamping device and a part of the separator, for example a counter or neutral electrode.

Preferably, the separating member is at least partially movable through the at least one Klemmgliedausnehmung therethrough. This makes it possible to lead the separating member out of the clamping member on one side, so that it is not surrounded by a clamping member at all, for example for cleaning purposes. Further, however, the separating member, when it is movable through the Klemmgliedausnehmung therethrough, if necessary, project on the other side of the clamping member and in particular cooperate with a further clamping member, for example for forming the separating device.

A particularly simple design of the clamping device can be achieved in particular if it comprises a first and second clamping member, which are mounted relative to each other movable. Thus, a distance between the clamping members can be changed and in this way grasp tissue between them and hold them by clamping.

The structure of the surgical instrument can be further simplified if the two clamping members are pivotally mounted relative to each other. Of course it is also conceivable to arrange the two clamping members relative to each other displaceable.

Furthermore, a simple construction of the separating device can be achieved, in particular, by comprising the first clamping member and the separating member, which are arranged to be movable relative to one another. It should also be noted that one of the two clamping members in a preferred embodiment of the instrument may be both part of the clamping device and part of the separating device.

The construction of the instrument can be further simplified if the separating member and the first clamping member are pivotally mounted relative to each other. In particular, the same pivot axis may be provided for a pivoting movement on the one hand of the separating member and the first clamping member and on the other hand, the two clamping members relative to each other.

Improved handling of the instrument can contribute, in particular, if the handling device comprises two actuators which are movable relative to one another and which are coupled to the separating device and the clamping device. Thus, the separating device and the clamping device can be selectively operated with the handling device.

The tactility of the instrument can be improved by a first actuator rigidly connected to the first clamping member and a second actuator rigidly connected to the second clamping member. Thus, an operator can directly initiate a force on the actuators on the first and second clamping member.

Preferably, the handling device is arranged at a proximal end of the instrument. Thus, the handling device can in particular spatially far enough separated from the separating device and the clamping device, which, for example, allows the formation of an endoscopic instrument.

In order to be able to introduce the clamping device and / or the separating device directly to an operating site, it is advantageous if the clamping device and / or the separating device are arranged at a distal end of the instrument. In particular, the two devices may form a distal end of an endoscopic instrument or a shaft thereof.

Particularly simple are the structure and handling of the instrument when it comprises two pivotally mounted rigid sectors, each having a proximal and distal end, when the actuators at the proximal ends and when the first clamping member and the second clamping member each at one of distal ends are provided.

A particularly simple construction of the instrument can be achieved, in particular, by arranging the separating member at a distal end of a pivotably mounted lever. This lever does not necessarily have to be coupled directly to an actuator. For example, it may be resiliently biased biased relative to the partition member or the first clamping member. In particular, the lever can also form an actuator of the handling device.

According to a further preferred embodiment of the invention may further be provided an electrical connection means which is electrically conductively connected to the at least one clamping member and / or the separating member. The electrical connection device makes it possible in a simple and reliable manner to connect the surgical instrument to a current source, for example a high-frequency current generator, by means of a connection cable which can be brought into contact with the connection device, in order, if necessary, to conduct a current, for example to coagulate tissue or sever it the same, to let flow over the at least one clamping member and / or the separating member.

It is particularly easy to connect a current source to the electrical connection device when it is arranged in the region of a proximal end of the instrument.

According to a further preferred embodiment of the invention may further be provided that the electrical connection device comprises at least three terminal contacts, one of which is electrically connected to the first clamping member, the second clamping member and the separating member, which are each electrically insulated from each other.

The handling of the instrument continues to improve if it includes an instrument handle that includes the handling device.

In principle, it would be conceivable to permanently connect the instrument handle firmly to the separating device and / or the clamping device. To enable an operator to use appropriately adapted instrument handles, for example, for left-handers or right-handed, it is advantageous if the instrument handle with the separator and / or the clamping device is detachably connectable. In addition, allows such a releasable connection improved cleanability of the instrument.

In principle, it would be conceivable to form the clamping device in the form of a monopolar clamping device. However, in order to specifically enable an energization of parts of the instrument and to be able to specify a current flow, for example, in a body of a patient exactly defined, it is advantageous if the clamping device is designed in the form of a bipolar clamping device. Thus, current flow related damage to body tissue of a patient can be minimized.

Accordingly, it may also be advantageous if the separating device is designed in the form of a bipolar separating device. Thus, a current flow in the region of a surgical site or, if the instrument is designed in the form of an endoscopic instrument, can also be specified precisely deep inside a body.

The following description of preferred embodiments of the invention is used in conjunction with the drawings for further explanation. Show it:

1 : a schematic perspective overall view of an embodiment of a surgical instrument according to the invention in a basic or clamping position;

2 : a side view of the in 1 represented surgical instruments;

3 an enlarged, partially sectioned view of area A in FIG 2 ;

4 : A perspective view of a distal end of the in 1 represented instruments;

5 Fig. 3 is a perspective view, partially broken away, of the distal end of the instrument with both clamping members and separating member in a wide open position;

6 an exploded view of the first clamping member of the instrument;

7 an exploded view of the second clamping member of the instrument;

8th a schematic perspective view of a distal end of the separating member;

9 a sectional view taken along line 9-9 in FIG 8th ;

10 a perspective, partially broken view of a positioned in a Klemmgliedausnehmung the second clamping member separator;

11 a sectional view taken along line 11-11 in FIG 12 ; and

12 FIG. 4 is a plan view of the relative arrangement of the separator and the second clamping member in FIG 10 ,

In 1 is a total with the reference numeral 10 designated surgical instrument shown schematically in the form of a bipolar instrument cluster. It comprises a clamping device formed at a distal end 12 , a separator also formed at the distal end 14 and a proximal end of the instrument 10 forming handling device 16 , which are described in detail below.

The instrument 10 comprises two elongated, slightly curved and essentially one-piece industries 18 and 20 which are about a common pivot axis 22 are mounted pivotally to each other. The pivot axis 22 is defined by a longitudinal axis of a non-illustrated end screw 24 that is, the industries 18 and 20 hinged together.

The industry 18 carries at its distal end a first clamping member 26 , The second industry 20 carries at its distal end a second clamping member 28 , The two clamping members 26 and 28 form part of the clamping device 12 and are formed substantially identical, as in particular in the 6 and 7 easy to recognize. They are substantially elongated cuboid-shaped and each have a rounded distal end 30 respectively 32 on. The industries 18 and 20 are preferably in the form of plastic injection molded parts and each with a slot-like opening 34 respectively 36 provided, which almost to the respective end 30 respectively 32 extends to. The Klemmgliedausnehmungen forming openings 34 and 36 define parallel inner surfaces 68 respectively 70 ,

To be pointed towards each other and thus substantially elongated U-shaped side surfaces 38 and 40 the clamping members 26 and 28 are each with a U-shaped recess 42 respectively 44 Mistake. The recesses 42 and 44 each define a U-shaped contact surface 46 respectively 48 from an outer, perpendicular to the contact surfaces 46 respectively 48 protruding edge 50 respectively 52 and one to the respective opening 34 respectively 36 adjacent edge 54 respectively 56 are limited. The edges 54 and 56 are also from the contact surfaces 46 respectively 48 perpendicular from and substantially parallel to the edges 50 and 52 ,

In the recesses 42 and 44 used is in each case one of an electrically conductive material formed, elongated U-shaped clamping leaflet 58 , A free end of an elongated leg is with a connection recess 60 provided with which one by the respective industry 18 respectively 20 guided electrically conductive connection can be contacted.

For safe and permanent connection of the terminal leaflets 58 with the recesses 42 and 44 stand from the contact surfaces 46 and 48 slightly proximal to the distal ends 30 and 32 short cylindrical pins 62 and 64 from corresponding to corresponding blind holes or holes 66 on the clamping leaflets 58 are formed. The cones 62 and 64 can form-fit in the holes 66 intervention. Preferably, the clamping leaflets 58 in the recesses 42 and 44 attached by gluing.

Proximalseitig of the clamping members 26 and 28 are the industries 18 and 20 to over the pivot axis 22 also each with a bearing opening 72 respectively 74 Mistake. A distance between inner surfaces of the bearing opening 72 limiting bearing arms 76 corresponds to a distance between outer surfaces of the bearing opening 74 limiting bearing arms 78 , This allows the distal end of the industry 18 by the quasi one through-hole defining bearing arms 74 the industry 20 durchzustecken.

Between the bearing arms 78 in the bearing opening 72 is on the end screw 24 and thus also about the pivot axis 22 swiveling a lever 80 stored. He carries at its proximal end a laterally projecting coupling projection 82 , which in a proximal side of the pivot axis 22 in the industry 20 trained coupling recess 84 insertable and lockable. In this in 1 schematically illustrated clamping position of the instrument 10 is the lever 80 practically completely between the bearing arms 74 positioned.

A distal end of the lever 80 forms a separator 86 which a Trenngliedträger 88 and a cutting member held thereon 90 includes. The separator carrier 88 can be integral with the lever 80 formed or alternatively also with a distal end 92 of the lever 80 be coupled. This allows the lever 80 and the separator carrier 88 optionally made of different materials or materials.

The isolator 86 is like a blade from the separator holder 88 in the direction of the first clamping member 26 shaped above.

The separator carrier 88 is formed substantially in the form of an elongated, narrow cuboid and has two side faces facing away from each other 94 covering the interior surfaces 70 in a basic position of the instrument 10 opposite, in each case three spacer elements 96 respectively 98 on. These are strip-shaped or bead-shaped and extend in a direction transverse to a cutting member 90 defined cutting edge 100 , The spacer elements 96 and 98 are even and equidistant on the side surfaces 94 distributed and with a beveled, towards the cutting edge 100 provided end facing, which has a sloping sliding surface 102 respectively 104 Are defined.

A distance 106 between the inner surfaces 70 is insignificantly larger than a distance 108 between outwardly facing outer surfaces of one of each spacer element 96 and 98 defined spacer element pair 110 , This dimensioning allows the isolator 86 in the clamping position of the instrument 10 , as shown schematically in the example 1 . 10 and 11 is shown completely in the opening 36 can dive. The cutting edge 100 forms with one of the second clamping member 28 away-facing surface 112 of the clamping leaflet 58 a common level 114 , The surfaces 112 the clamping plate 58 form mutually facing clamping surfaces of the clamping members 26 and 28 ,

The spacer elements 96 and 98 form parts of a total with the reference numeral 116 designated separator guide means. Thus, the isolator comprises 86 the separator guide means 116 , The separator member carrier made of an electrically non-conductive material 88 will be in the breakthrough 36 laterally through the spacer elements 96 and 98 guided. A contact between the spacer elements 96 . 98 on the one hand and the inner surfaces 70 respectively 68 is not critical, because the inner surfaces 68 and 70 are also made of electrically non-conductive material or at least carry an electrically non-conductive coating. Thus, unwanted short circuits can be avoided because the electrically conductive terminal leaflets 58 with the cutting member 90 can not come into contact.

The cutting member 90 Optionally, by a coating on a front edge, in the direction of the first clamping member 26 points out, be formed. In the embodiment shown in the figures, the cutting member 90 in the form of a metallic clip 120 educated. A distal end 120 of the clip is substantially U-shaped and has a short, pointing in the proximal direction legs 124 on, which in a corresponding, open in the distal direction recess 126 intervenes. Proximalseitig is on a bottom of the elongated cutting member 90 an obliquely projecting in the distal direction projection 128 formed, which in an obliquely pointing in the proximal direction recess 130 on the separator carrier 88 intervenes.

The sliding surfaces 102 and 104 going in the direction of the cutting edge pointing in parallel to the cutting edge 100 extending holding webs 132 and 134 over which a longitudinal groove between them 136 define in which the cutting member 90 partially immersed. The cutting member 90 is thus non-positively and positively on the separator member carrier 88 held and against a movement parallel to the pivot axis 22 on the separator carrier 88 through the retaining bars 132 and 134 secured.

For mounting on the separator support 88 the cutting member can first with the leg 124 in the recess 126 introduced and then with the lead 128 in the recess 30 be locked. The thigh 124 and the lead 128 thus form first connecting elements 140 connected with corresponding second connecting elements 142 passing through the recess 126 as well as the recess 130 be defined, a total with the reference numeral 138 designated connecting device in the form of a latching or snap connection.

The instrument 10 also has an electrical connection device 144 in the form of a socket, which comprises a total of three non-illustrated electrically conductive contacts which connect to a connection cable 146 allow to the instrument 10 To connect with a power generator, not shown in the figures, for example in the form of a high-frequency power generator. The connection contacts of the electrical connection device 144 are about the branches 18 and 20 in a known manner electrically conductive with the two clamping plates 58 and the cutting member 90 connected. To optionally a power supply to the electrically conductive portions of the clamping device 12 and the separator 14 to interrupt or to activate a current flow, serves a switching device 148 which one in the industry 20 pivotally mounted actuator 150 includes. With the actuator 150 can be at least two, preferably all three electrical connections between the connection device 144 and the two clamping plates 58 and the cutting member 90 optionally interrupt or close.

Preferably with the switching device 148 not interruptible is the electrically conductive connection between the connection device 144 and the clamping plate 58 of the first clamping member 26 , which in a bipolar operation of the instrument 10 as a neutral electrode of both the clamping device 12 as well as the separator 14 serves. Only in a basic position switching device 144 as in the 2 and 3 shown schematically, the electrically conductive connections between the connection device 144 and the clamping plate 58 of the second clamping member 28 and between the connection device 144 and the separator 86 through the switching device 148 interrupted. However, this can be done by pivoting the actuator 150 towards the industry 18 be operated. In this case, then a current to the clamping plate 58 of the second clamping member 28 and to the cutting member 90 flow.

The operation of the instrument 10 is briefly explained below.

Starting from a in 1 schematically illustrated basic position of the instrument 10 in which the lever 80 in the manner described above between the bearing arms 76 dips, can with the clamping members 26 and 28 for example, a hollow organ or vessel 152 of a patient. Is the vessel 152 clamped between the clamping plates 58 the two clamping members 26 and 28 held, they can be acted upon by an HF current for coagulating or for connecting or closing the vessel 152 , This is done by operating the switching device 148 ,

The closed vessel 152 can by means of the separator 14 be severed. By increasing the contact pressure on the two clamping members 26 and 28 becomes the isolator 86 due to the elasticity of the lever 80 , which can be adjusted for example by a suitable choice of material and a shape, from the opening 36 moved out so far that it is the vessel 152 can sever. In particular, the separating member 86 while in the direction of the clamping member 26 into the opening 34 plunge. With simultaneous application of the cutting element 90 with an HF current as a result of an actuation of the switching device 148 can the vessel 152 be severed. If the contact force is reduced again, the lever deforms 80 back to its original shape and immersed in his in 1 shown schematically starting position again in the opening 36 one.

At the instrument 10 Thus, the cutting current flows from the cutting member 90 to the opposite clamping plate 58 of the first clamping member 26 , The instrument 10 combines practically two bipolar instruments, namely a clamp, which the clamping device 12 includes, as well as a pair of scissors, which the separator 14 includes. By deriving the energy supplied to the patient during the procedure directly at the surgical site via the two instruments common neutral electrode, which through the clamping plate 58 on the first clamping member 26 is defined, it comes at most to a low patient burden. In contrast to ultrasonic instruments, the instrument 10 no unnecessary energy supplied, which can lead to avoidable heat damage of body tissue of the patient.

When cutting through body tissue, a tissue margin is automatically coagulated. This always creates a safe coagulation zone.

Due to the two-part design of the isolator 86 can for the preparation of the separator member carrier 88 a material having a much lower melting or molding temperature than a metal may be used. In particular, thermoplastics are suitable for forming the isolator carrier 88 ,

By the at least partially positive connection device 138 can have different thermal expansion coefficients of the cutting member 90 and the separator carrier 88 be easily and safely compensated. This structure thus avoids, in particular, also the chipping off of electrically insulating coatings on the cutting member 90 ,

Furthermore, tissue attachment occurs during use of the instrument 10 on the isolator 86 reduced, in particular by the smooth surface of the separator support 88 if this is made of a plastic, for example.

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• DE 202007015547 U1 [0002]

Claims (45)

Surgical instrument ( 10 ) with a clamping device ( 12 ) for holding and / or clamping tissue ( 152 ), a separating device ( 14 ) for cutting tissue ( 152 ) and a handling device ( 16 ) for actuating the clamping device ( 12 ) and / or the separating device ( 14 ), wherein the clamping device ( 12 ) at least one clamping surface ( 112 ) having a clamping member ( 26 . 28 ) comprising a clamping member recess ( 24 . 36 ), and wherein the separating device ( 14 ) a separator ( 86 ) which at least partially into the Klemmgliedausnehmung ( 34 . 36 ), wherein a separating member guiding device ( 116 ) is provided for guiding the isolator ( 86 ) in the Klemmgliedausnehmung ( 34 . 36 ) and to maintain a distance to inner side surfaces ( 68 . 70 ) of the Klemmgliedausnehmung ( 34 . 36 ), characterized in that the separating member ( 86 ) the separator guide device ( 116 ). Surgical instrument according to claim 1, characterized in that the separating member guiding device ( 116 ) at least one spacer element ( 96 . 98 ), which has a minimum distance between the separating member ( 86 ) and an inner side surface ( 68 . 70 ) of the Klemmgliedausnehmung ( 34 . 36 ) Are defined. Surgical instrument according to claim 2, characterized in that at least two spacer elements ( 96 . 98 ) are provided which a minimum distance between the separating member ( 86 ) and one of two mutually facing inner side surfaces ( 68 . 70 ) of the Klemmgliedausnehmung ( 34 . 36 ) define. Surgical instrument according to claim 3, characterized in that the at least two spacer elements ( 96 . 98 ) on sides facing away from or substantially away from each other side faces ( 94 ) of the isolator ( 86 ) are arranged or formed. Surgical instrument according to claim 3 or 4, characterized in that in each case two spacer elements ( 96 . 98 ) a pair of spacer elements ( 110 ), which are arranged in pairs facing away from each other. Surgical instrument according to one of claims 3 to 5, characterized in that a plurality of spacer elements ( 96 . 98 ) evenly over side faces facing away from each other ( 94 ) of the isolator ( 86 ) are arranged distributed. Surgical instrument according to one of the preceding claims, characterized in that the clamping surface ( 112 ) is electrically conductive. Surgical instrument according to one of the preceding claims, characterized in that the clamping surface ( 112 ) transversely or substantially transversely to the inner side surfaces ( 68 . 70 ) of the Klemmgliedausnehmung ( 34 . 36 ) is oriented. Surgical instrument according to one of the preceding claims, characterized in that the separating element guiding device ( 116 ) is at least partially made of an electrically non-conductive material. Surgical instrument according to one of claims 2 to 9, characterized in that the at least one spacer element ( 96 . 98 ) is made of an electrically non-conductive material. Surgical instrument according to one of the preceding claims, characterized in that the separating element guiding device ( 116 ) is integrally formed. Surgical instrument according to one of the preceding claims, characterized in that the separating member ( 86 ) a separator carrier ( 88 ) and a cutting member ( 90 ). Surgical instrument according to claim 12, characterized in that the cutting member ( 90 ) a cutting edge ( 100 ) or at least partially in the form of a cutting edge ( 100 ) is trained. Surgical instrument according to claim 12 or 13, characterized in that the separating member carrier ( 88 ) is made of an electrically non-conductive material and that the cutting member ( 90 ) is made of an electrically conductive material. Surgical instrument according to one of claims 12 to 14, characterized in that the cutting member ( 90 ) is formed in the form of an electrically conductive coating. Surgical instrument according to claim 15, characterized in that the electrically conductive coating is applied by means of an MID process or a tampon or screen printing process. Surgical instrument according to one of claims 12 to 14, characterized in that the separating member carrier ( 88 ) and the cutting member ( 90 ) non-positively and / or positively connected with each other. Surgical instrument according to one of Claims 12 to 14 or 17, characterized by a connecting device ( 138 ) for positive and / or positive connection of the separator member carrier ( 88 ) and the cutting member ( 90 ). Surgical instrument according to claim 18, characterized in that the connecting device ( 138 ) is designed in the form of a latching or snap connection. Surgical instrument according to claim 18 or 19, characterized in that the connecting device ( 138 ) first and second connecting elements ( 140 . 142 ), on the one hand on the separator member carrier ( 88 ) and on the other hand on the cutting member ( 90 ) are arranged or formed, and that the first and second connecting elements ( 140 . 142 ) in a connection position non-positively and / or positively engaged. Surgical instrument according to claim 20, characterized in that the first and second connecting elements ( 140 . 142 ) in the form of recesses ( 126 . 130 ) and corresponding protrusions ( 124 . 128 ) are formed. Surgical instrument according to claims 9 to 21, characterized in that the electrically non-conductive material is a plastic and / or a ceramic. Surgical instrument according to one of claims 12 to 22, characterized in that the separating member carrier ( 88 ) the at least one spacer element ( 96 . 98 ) includes or carries. Surgical instrument according to one of claims 2 to 23, characterized in that the at least one spacer element ( 96 . 98 ) is formed in the form of a strip, rib or bead-like projection. Surgical instrument according to one of claims 2 to 24, characterized in that the at least one spacer element ( 96 . 98 ) in a direction transversely or substantially transversely to one of the cutting edge ( 100 ) defined cutting line ( 114 ). Surgical instrument according to one of the preceding claims, characterized in that at least a part of the clamping surface ( 112 ) is electrically conductive. Surgical instrument according to one of the preceding claims, characterized in that the at least one clamping member recess ( 34 . 36 ) one on the clamping member ( 26 . 28 ) formed recess or opening is. Surgical instrument according to one of the preceding claims, characterized in that the separating member ( 86 ) at least partially by the at least one Klemmgliedausnehmung ( 34 . 36 ) is movable therethrough. Surgical instrument according to one of the preceding claims, characterized in that the clamping device ( 12 ) a first and a second clamping member ( 26 . 28 ), which are mounted movable relative to each other. Surgical instrument according to claim 29, characterized in that the two clamping members ( 26 . 28 ) are mounted pivotably relative to each other. Surgical instrument according to claim 29 or 30, characterized in that the separating device ( 14 ) the first clamping member ( 26 ) and the isolator ( 86 ), which are arranged movable relative to each other. Surgical instrument according to one of claims 29 to 31, characterized in that the separating member ( 86 ) and the first clamping member ( 26 ) are mounted pivotally relative to each other. Surgical instrument according to one of the preceding claims, characterized in that the handling device ( 16 ) two relatively movable actuators ( 18 . 20 . 80 ) which is connected to the separating device ( 14 ) and the clamping device ( 12 ) are coupled. Surgical instrument according to claim 33, characterized in that a first actuator ( 18 ) rigidly with a first clamping member ( 26 ) and that a second actuator ( 20 ) rigidly with the second clamping member ( 28 ) are connected. Surgical instrument according to one of the preceding claims, characterized in that the handling device ( 16 ) at a proximal end of the instrument ( 10 ) is arranged. Surgical instrument according to one of the preceding claims, characterized in that the clamping device ( 12 ) and / or the separating device ( 14 ) at a distal end of the instrument ( 10 ) are arranged. Surgical instrument according to one of Claims 33 to 36, characterized in that the instrument ( 10 ) two rigidly mounted rigid branches ( 18 . 20 ), which each having a proximal and a distal end, that the actuators at the proximal ends and that the first clamping member ( 26 ) and the second clamping member ( 28 ) are each provided at one of the distal ends. Surgical instrument according to one of claims 32 to 37, characterized in that the separating member ( 86 ) at a distal end of a pivotally mounted lever ( 80 ) is arranged. Surgical instrument according to one of the preceding claims, characterized in that an electrical connection device ( 144 ) is provided, which with the at least one clamping member ( 26 . 28 ) and / or the isolator ( 86 ) is electrically connected. Surgical instrument according to claim 39, characterized in that the electrical connection device ( 144 ) in the region of a proximal end of the instrument ( 10 ) is arranged. Surgical instrument according to claim 39 or 40, characterized in that the electrical connection device ( 144 ) comprises at least three terminal contacts, one of which is electrically conductive with the first clamping member ( 26 ), the second clamping member ( 28 ) and the isolator ( 86 ), which are electrically isolated from each other. Surgical instrument according to one of the preceding claims, characterized by an instrument grip which holds the handling device ( 16 ). Surgical instrument according to claim 42, characterized in that the instrument grip with the separating device ( 14 ) and / or the clamping device ( 12 ) is releasably connectable. Surgical instrument according to one of the preceding claims, characterized in that the clamping device ( 12 ) in the form of a bipolar clamping device ( 12 ) is trained. Surgical instrument according to one of the preceding claims, characterized in that the separating device ( 14 ) in the form of a bipolar separator ( 14 ) is trained.

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