WO1995022943A1

WO1995022943A1 - Tissue resection forceps for treating teat canal stenoses

Info

Publication number: WO1995022943A1
Application number: PCT/EP1995/000610
Authority: WO
Inventors: Maximilian J. Medl
Original assignee: Medl Maximilian J
Priority date: 1994-02-24
Filing date: 1995-02-20
Publication date: 1995-08-31
Also published as: EP0695151A1; DE4406045C1; CA2161248A1

Abstract

A tissue resection forceps (1) for treating teat canal stenoses has a grip part (8) comprising two grip arms (2, 3) which can be pivoted with respect to each other, a spring element (4) which presses against the grip arms (2, 3) in their opening direction and a cutting device (5) which can be actuated by means of the grip arms (2, 3). The forceps (1) is characterized in that the cutting device (5) has a basic body (6) and a blade element (7) which can slide axially therein as well as rotate about its longitudinal axis, the front end of the blade element being designed as a cutting edge (9) which co-operates with a blade stopping surface (21) of the basic body (6) and the rear end having a handle (10) for axial rotation of the blade element (7), and in that the region of the insertion end (19) of the basic body (6) is designed substantially as a hollow cylinder with a lateral cutting opening (20), and in that the position of the cutting edge (9) of the blade element (7) can be changed in the region of said cutting opening (20) by pivoting the grip arms (2, 3) with respect to each other. The tissue resection forceps (1) permits small portions of tissue to be excised without damaging the adjacent areas of tissue.

Description

TISSUE RECTIFIER FOR THE TREATMENT OF STICK CHANNEL STENOSES

description

The invention relates to a tissue resector forceps for the treatment of streak canal stenoses.

The problem of milkability often occurs in dairy cows. The milk can only be removed from the milk cow with an undesirably high expenditure of force and time. The milk flow disorders can not only delay the milk flow, but can even partially or completely interrupt it.

The milk drainage disorders can occur at any location in the milk-laxative system that forms part of the dairy cow's udder. The udder is a powerful glandular body, which consists of two front quarters and two rear quarters. Each quarter is a mammary gland, completely sealed off from the other quarters, with its own teat. Such a quarter is divided into a milk-forming glandular tissue and a milk-draining system. The latter consists of the milk ducts, the milk ducts, the glandular cistern, the teat cistern and the teat canal.

The causes of poor milkability can be injuries, bruises and inflammation of the udder, especially the teat. In about 95% of cases, the cause of poor milkability lies in the teat canal. Its length is approximately 8 to 14 mm.

Various medical methods and devices for treating the milkability caused by teat disorders or the so-called teat stenosis are known. In the streak canal area, the medically conservative, possibly surgical treatment must be carried out with the greatest possible protection of the tissue in the streak canal, because each of these Treatment types pose a risk of infection and thus the risk of inflammation of the udder.

Known devices for the treatment of teat stenosis include

1. the teat bell according to Hug (with this, build-ups in the streak canal are pinched off broadly),

2. Hug's teat lancet

(the streak canal is enlarged by cutting),

3. the teat double knife, Danish model

(Longitudinal cuts are made in the streak canal),

4. the streak-channel scissors according to Chrstensen (thus longitudinal cuts are made in the streak channel),

5. the teat curette according to Uliner

(with this, build-ups in the teat canal are scraped off over a wide area, which creates a large wound),

6. the teat clearer, French model

(this tears open the teat stenosis, causing a large wound),

7. the device for removing plants in the milk duct according to DE-PS 869532

(This means that only relatively large-area cuts can be made in the line channel, because the knife used covers its entire cutting edge

Streak channel tissue detected), the forceps-like teat clearer of the type mentioned at the beginning in DE-OS 1541239

(this tears open the teat stenosis, causing a large wound)

and

9. the piercing knife for cow teats according to DE-PS 346011

(This means that only relatively large-area cuts can be made in the line duct, because the knife has a relatively long side cutting opening).

In addition to these devices for removing tissue in the streak canal, there are also so-called teat expanders with which the inside diameter of the streak canal can be expanded. However, the latter is often inadequate or brings only a brief improvement.

As far as the known devices for removing tissue are used, they all have the disadvantage that they cause relatively large wounds in the teat canal, because they are only suitable for tearing off tissue over a wide area, but do not allow targeted cutting off of small tissue areas. This also applies in particular to the teat bell according to Hug and the device according to DE-PS 869532, the operator of which, when using it, pulls a cutting bell inserted into the streak canal in the direction of the exit of the streak canal and thereby tears off tissue on the inner side of the streak canal.

The invention is based on the object of specifying an easily and safely manageable tissue resector for the treatment of streak canal stenoses, which makes it possible to selectively cut off small tissue areas which narrow the streak canal, without affecting adjacent tissue areas. The formation of cuts as small as possible is not only important to keep the risk of infection for the dairy cow low, but also serves to limit their pain during and after the operation. Furthermore, a minor pain in the cow during the operation reduces the safety risk for the surgeon, because a major pain can lead to the cow becoming restless and beating during the operation. The tissue resect should also be able to be designed in such a way that it is easy to clean, can be used many times over a long period of time, and that in the event of wear or damage it is not the entire tissue sector which becomes unusable, but only the corresponding parts of which can be exchanged.

The invention achieves this object with a tissue resector pliers for the treatment of streak canal stenoses, with a handle part comprising two handle legs which can be pivoted relative to one another, a spring element which presses the handle legs into their open position and a cutting device which can be actuated by means of the handle legs.

The tissue resection forceps is characterized in that the cutting device has a base body and a knife element which is axially displaceable and rotatable about its longitudinal axis, the front end of which is designed as a cutting edge which interacts with a knife stop surface of the base body, and the rear end of which has a handle for axial rotation of the knife element, and that the base body in the area of its insertion end is essentially designed as a hollow cylinder with a lateral cutting opening and that the pivoting of the handle legs relative to one another allows the cutting edge of the knife element in the area of the said cutting opening to be changed in its position . The tissue resection forceps according to the invention has various advantages over the known devices. For example, it can be operated very securely with one hand by means of the two handle legs, with relatively short cuts being able to be carried out precisely and thus unnecessarily large wounds in the streak channel are avoided. The effort not to compromise healthy tissue areas in the vicinity of the desired cuts is made considerably easier by the fact that the cutting opening in the base body inevitably limits the surface area to be cut, ie the cutting edge of the knife is cut only over part of its length for cutting exposed.

According to a preferred embodiment of the tissue tongs, the base body of the cutting device is detachably connected to the handle part. This not only makes cleaning of the pliers easier, but also allows, if necessary, a quick replacement of a cutting device which has been put on first with another cutting device with different knife dimensions during the operation.

According to an expedient design of the tissue resection forceps, the base body has at least one connecting pin which can be fastened to one of the handle legs by means of a locking screw. This type of connection has the advantage that it can be made and released easily and quickly, and also functions reliably after frequent use of the pliers.

In a special embodiment of the tissue resection forceps, one of the handle legs has a coupling element which detachably engages in a recess of the knife element through a lateral longitudinal opening in the base body. As a result, when the cutting device is attached to the handle leg, the force is transferred between the handle legs! and Knife element ensured and at the same time, if necessary, a simple release of both components from each other.

It has also proven to be expedient to design the coupling element of the handle leg as a driver pin and the recess of the knife element as a circumferential groove. This embodiment not only enables a secure non-positive connection between the handle leg and knife element and a quick detachment of the two from one another, but also allows the knife element to be additionally rotated axially during the cutting process, without closing the force between the handle leg and knife element interrupt.

Furthermore, it is advantageous if the knife element has a rear knife guide part and a front tubular knife part detachably connected to the cutting edge. This allows the actual knife, i.e. the front pipe knife part with the cutting edge, either removed for cleaning or replaced with a new or sharpened pipe knife part after wear. For the rest, the front tubular knife part has the advantage that it is hollow on the inside and can therefore accommodate a larger amount of the tissue parts cut off in the line channel in its cavity; it is then possible to carry out several cuts in succession without having to pull the knife element out of the teat canal to remove the cut-off tissue parts and to insert it again.

In practice, it is advantageous if a length scale is provided in the front area of the base body on the outside thereof for measuring the depth of penetration of the base body into the line channel to be treated. This makes it easy to measure the position of the point to be cut in the streak canal.

The knife element preferably has an axial bore which extends continuously from the cutting edge to the rear end extends of the knife element and ends there in an opening. On the one hand, this creates a long cavity for receiving cut-off tissue parts, which can also be easily cleaned. On the other hand, the axial bore thereby also represents a supply channel with the possibility of attaching a line to the aforementioned opening at the rear end of the knife element for introducing a gas, for example compressed air, or a liquid, for example a cleaning, disinfecting or therapeutically active liquid. conclude. The gas or the respective liquid can flow through the axial bore of the knife element and emerge again at its front end in the region of the cutting edge.

According to a useful further development of the invention, a knife sheath is detachably connected to a guide body of the base body. This not only has the advantage that the knife sheath can be removed and thus be cleaned more easily, but that it can also be removed and replaced by a differently dimensioned knife sheath. For example, it is advantageous to have a plurality of interchangeable knife sheaths with differently sized cutting openings available for the tissue resector pliers. The length of the cutting opening in the axial direction of the knife sheath is preferably 3 to 7 mm, preferably 4 to 6 mm. As a result, the cutting opening can be adapted to the size of the tissue region to be cut off in the line channel. In particular, this also increases the safety when handling the tissue resection forceps. For example, a cutting opening with a length of 4 mm is already so small that even with improper handling of the tissue resection forceps, the streak canal cannot be damaged to an undesirable extent.

The exchangeable knife sheaths can also have different outside diameters. This is preferably located Diameters in the range from 2.5 to 4.0 mm, in particular from 2.9 to 3.8 mm.

When exchanging a knife sheath for a differently dimensioned one, it may be expedient to simultaneously replace the front tubular knife part on the knife element with another tubular knife part adapted to the dimensions of the new knife sheath.

In a corresponding manner, of course, instead of exchanging only the knife sheath and, if necessary, additionally the front tubular knife part, the entire component, namely the entire base body and, if appropriate, the entire knife element, can also be exchanged in order to achieve the desired dimension of the knife sheath and its Recess and, if necessary, additionally of the pipe knife part adapted to it.

The detachable connection between the knife sheath and the guide body of the base body is preferably a screw connection. A connection in the form of a bayonet connection has also proven to be favorable. Other types of connections, such as conventional snap locks, can also be used.

The invention is explained below by means of an exemplary embodiment shown schematically in the drawing.

Show it

1 shows a tissue resection forceps in a ready-to-use state;

Fig. 2, the tissue tongs according to FIG. 1 with the cutting device removed, which in the base body and

Knife element is disassembled; 3 shows the knife element shown in FIG. 2, with a separate knife guide part and tubular knife part; and

Fig. 4 is a tissue resector pliers similar to Fig. 1, but with a screw connection between the knife sheath and the guide body of the base body.

According to FIG. 1, the tissue resection forceps 1 essentially has two handle legs 2, 3 which can be pivoted relative to one another, a spring element 4 which presses these handle legs 2 3 in their opening direction and a cutting device 5 which can be actuated by means of the handle legs 2 3.

The cutting device 5 is equipped with a base body 6 and a knife element 7 which is axially displaceable and rotatable about its longitudinal axis.

As explained in FIG. 2, the tissue resection forceps 1 is composed of a grip part 8 comprising the grip legs 2, 3, the base body 6 and the knife element 7.

The front end of the knife element 7 is a cutting edge

9 formed and the rear end provided with a handle 10 in the form of a radially projecting pin. The handle

10 can also be designed in a different way, which enables a simple axial rotation of the knife element 7.

The knife element 7 essentially consists of a rear knife guide part 7a and a front tubular knife part 7b. These two parts 7a, 7b are axially screwed together for cleaning purposes and for easy replacement of the tubular knife part 7b via a thread 11, as can be seen from FIG. 3, which shows both parts 7a, 7b separated from one another. In the ready-to-use state of the tissue resection forceps 1 (FIG. 1), the knife element 7 is axially in the base body 6 arranged. At least one guide surface on the circumference of the rear knife guide part 7a serves to guide the movement of the knife element 7 in the base body 6 both in the axial direction and when the knife element 7 rotates about its longitudinal axis. In the drawing, three guide surfaces 12a, 12b, 12c are shown. These are lateral surfaces of the knife element 7, which is rotationally symmetrical over most of its length. In the region of the guide surfaces 12a, 12b, 12c, the knife element 7 has an outer diameter which is only slightly smaller than the inner diameter of the associated part of the base body 6. In addition, the rear knife guide part 7a is provided approximately in its longitudinal center with a circumferential groove 13, the function of which will be explained below.

In the described embodiment, the diameter of the front tubular knife part 7b is smaller than that of the rear knife guide part 7a in the region of the guide surfaces 12, 12b, 12c. However, it is not absolutely necessary that the rear knife guide part 7a has a larger diameter than the front pipe knife part 7b.

From Fig. 2 it can also be seen that the knife element 7 has an axial bore 7c which extends continuously from the cutting edge 9 to the rear end 7d and ends there in an opening 7e. If necessary, a line for supplying a gas or a liquid can be connected to this, which then exits the knife element in the region of the cutting edge 9.

According to FIG. 2, the base body 6 consists of a hollow cylindrical guide body 15 for receiving the rear knife guide part 7a of the knife element 7, of a hollow cylindrical knife sheath 16 for receiving the front tubular knife part 7b of the knife element 7 and two mutually par - Allel directed connecting pin 17,18 for connection to the handle bar! 2. In the area of the introductory 19 of Base body 6 is provided with a lateral cutting opening 20. It is formed in that the area of the hollow cylindrical knife sheath 16 is open over a certain longitudinal section and over a circumferential angle range of approximately 180 degrees. If the knife element 7 is in the base body 6 when the tissue resector pliers 1 is ready for use, the position of the cutting edge 9 of the knife element 7 in the area of the cutting opening 20 can be changed both axially and in the sense of a rotation about its longitudinal axis. For the cutting process, the cutting edge 9 of the knife element 7 interacts with a knife abutment surface 21 of the knife sheath 16 lying opposite it within the cutting opening 20 (FIG. 1).

On the outside of the knife sheath 16 there is a length scale 22 for measuring the depth of penetration of the knife sheath 16 into the streak canal to be treated (FIG. 2). Alternatively or at the same time, markings can also be made there which identify dimensions, for example the diameter of the knife sheath 16.

The base body 6 has a longitudinal opening 23 in the guide body 15 which points essentially in the same direction as the connecting pins 17, 18.

The base body 6 of the cutting device 5 is detachably connected to the handle part 8. This purpose is served by the connecting pins 17, 18 which, when the base body 6 is placed on the handle part 8 on its upper side, are received by corresponding bores in the one handle leg 2. The connecting pins 17, 18 are fastened in the bores of the handle leg 2 by means of locking screws 24, 25. The locking screws 24, 25 are screwed from one side of the handle leg 2 against the connecting pins 17 used. For quick and easy operation with your bare fingers, the locking screws 24, 25 accordingly large screw heads with appropriate knurling on the circumference.

While one handle leg 2 is equipped with the locking screws 24, 25 mentioned and can thus be firmly connected to the base body 6 of the cutting device 5, the other handle leg 3 is equipped with a driver pin 26 at its end facing the base body 6. When the cutting device 5 is placed on the handle part 8, that is to say the base body 6 is fastened on the handle leg 2, the driver pin 26 projects through the longitudinal opening 23 of the base body 6 into the circumferential groove 13 of the knife element 7. The driver pin 26 thus acts as Coupling element between the grip part 8 and the cutting device 5.

One grip leg 2 is provided with a projection 27 directed towards the outside of the tissue resection forceps 1 in order to give the surgeon's hand a secure hold on the grip part 8. A similar projection can also be provided for the other handle leg.

The spring element 4 is fastened in the form of two leaf springs 30, 31 to the inside of the handle legs 2, 3 by means of a fastening screw 28, 29. This attachment takes place at one end of the leaf springs 30,31. At their other two ends they intersect within the opening angle of the handle legs 2, 3 on the side facing the pivot point 32 of these legs 2, 3. At the crossing point 33 of the leaf springs 30, 31 they support one another under tension. The handle legs 2, 3 are thereby pressed in their opening direction. Alternatively, the leaf springs 30, 31 can also be replaced by a corresponding spring element with the same effect. For example, a coil spring that comes between an end face 34 of the rear knife guide part 7a and a front radial inner surface can be considered 35 of the hollow cylindrical guide body 15 is supported (Fig. 2).

4 shows a special and preferred embodiment of the tissue resector pliers 1, in which the knife sheath 16 is connected to the guide body 15 of the base body 6 by means of a screw connection. This connection is realized by an external thread 36 at the rear end of the knife sheath 16 and a corresponding internal counter thread in the front end of the guide body 15 of the base body 6. Thus, the knife sheath 16 can be unscrewed from the guide body 15 if necessary and replaced by another knife sheath 16 with the same external thread 36, but with a different length of the cutting opening 20 and / or with a different knife sheath diameter.

To use the tissue sector (1) according to the invention, the front tubular knife part 7b is screwed into the rear knife guide part 7a. The knife element 7 obtained in this way is inserted into the base body 6. The cutting device 5 assembled in this way is placed on the handle part 8 in such a way that the connecting pins 17, 18 engage in the corresponding bores in the handle leg 2. During this placement, the knife element 7 is located within the base body 6 in such a position that the driver pin 26 of the grip leg 3 can engage in the circumferential groove 13 of the knife element 7. The connecting pins 17, 18 are then locked on the handle part 8 by tightening the locking screws 24, 25.

If the one handle leg 3 is pivoted against the other handle leg 2, the driver pin 26 transmits this movement to the knife element 7. As a result, the cutting edge 14 of the front tubular knife part 7b in the cutting opening 20 of the knife sheath 16 is moved in the direction of the knife stop surface 21 . To treat a streak duct stenosis of a dairy cow, the operator inserts the front end 19 of the cutting device 5 into the streak duct with the handle leg 2, 3 opened until the cutting opening 20 is arranged next to the tissue region to be cut off. Pressing on the outside of the teat promotes penetration of the tissue into the cutting opening 20. By compressing the handle legs 2, 3 and simultaneously rotating the knife element 7 by means of the handle 10, the tissue projecting into the cutting opening 20 between the cutting edge 9 and the knife stop surface 21 is cut cleanly. Adjacent tissue areas, in particular the tissue that is not in the area of the cutting opening 20, are spared, ie neither cut nor torn open.

In the embodiment according to FIG. 4, the knife sheath 16 can be screwed out of the guide body 15 of the base body 6 and through another knife sheath 16 with the desired length in order to adapt the tissue resector pliers 1 to the size of the tissue region to be cut off in the line channel and / or to the diameter of the line channel the cutting opening 20 and / or the desired knife cutting diameter can be replaced.

Claims

claims

1. Tissue resector pliers (1) for the treatment of streak canal stenoses, with a handle part (8) comprising two handle legs (2, 3) that can be pivoted relative to one another, and a spring element (4) that presses the handle legs (2, 3) in their opening direction. and a cutting device (5) which can be actuated by means of the handle legs (2, 3), characterized in that the cutting device (5) has a base body (6) and a knife element (7) which is axially displaceable and rotatable about its longitudinal axis therein, the front end of which is designed as a cutting edge (9) which cooperates with a knife stop surface (21) of the base body (6), and the rear end of which is provided with a handle (10) for axially rotating the knife element (7), and that the base body (6) in the region of its insertion end (19) is essentially designed as a hollow cylinder with a lateral cutting opening (20) and that by pivoting the handle legs (2, 3) against one another, the cutting channel te (9) of the knife element (7) can be changed in its position in the area of the mentioned cutting opening (20).

2. Tissue resector pliers (1) according to claim 1, characterized in that the base body (6) of the cutting device

(5) is detachably connected to the handle part (8).

3. Tissue resector pliers (1) according to claim 2, characterized gekenn¬ characterized in that the base body (6) has at least one connecting pin (17, 18) which on one of the Griff¬ legs (2,3) by means of a locking screw (24th , 25) can be fastened.

4. tissue resector pliers (1) according to any one of claims 1 to 3, characterized in that one of the handle legs! (3) has a coupling element (26) which detachably engages through a lateral longitudinal opening (23) in the base body (6) into a recess (13) in the knife element (7).

5. Tissue resector pliers (1) according to claim 4, characterized gekenn¬ characterized in that the coupling element (26) of the Griffschen¬ ice (3) is a driving pin and the recess (13) of the knife element (7) is a circumferential groove.

6. Tissue resector pliers (1) according to one of claims 1 to 5, characterized in that the knife element (7) has a rear knife guide part (7a) and a front tubular knife part (7b) releasably connected thereto.

7. tissue resection pliers (1) according to any one of claims 1 to 6, characterized in that in the front region of the base body (6) on the outside thereof a length scale (22) is provided for measuring the depth of penetration of the base body (6) into the streak canal to be treated .

8. Tissue resector pliers (1) according to one of claims 1 to 7, characterized in that the knife element (7) has an axial bore (7c) which extends continuously from the cutting edge (9) to the rear end (7d) of the knife element ( 7) extends and ends there in an opening (7e).

9. Tissue resector pliers (1) according to one of claims 1 to 8, characterized in that a knife sheath (16) with a guide body (15) of the base body (6) is detachably connected.

10. Tissue resector pliers (1) according to claim 9, characterized in that the knife sheath (16) is connected to the guide body (15) by means of a screw connection.