WO1996021477A1

WO1996021477A1 - Surgical suction instrument

Info

Publication number: WO1996021477A1
Application number: PCT/EP1996/000054
Authority: WO
Inventors: Michael Volkmer
Original assignee: Michael Volkmer
Priority date: 1995-01-14
Filing date: 1996-01-09
Publication date: 1996-07-18
Also published as: AU4390896A; DE19501017A1; DE19501017C2

Abstract

The surgical suction instrument consists essentially of a tubular container (2), the forward end (2a) of which bears a fluid-permeable suction point (4) and the rear end (2b) of which can be connected to a vacuum source, and a valve arrangement to regulate the vacuum. The suction point (4) consists of a bunch of fibres, hard-pressed felt, porous sintered material or a similar rigid porous or capillary material.

Description

Surgical instrument with suction function.

The invention relates to a surgical instrument with suction function, consisting essentially of a tubular holder, the front end of which carries a fluid-permeable suction tip and the rear end of which can be connected to a vacuum source, and a valve arrangement for regulating the vacuum.

In the case of surgical interventions, escaping blood, tissue fluid, pus, etc. must be removed from the surgical field. In addition, the usual rinsing liquids, e.g. isotonic saline solutions are suctioned off, which are constantly introduced into the operating area in order to protect the tissue from drying out and to guarantee the surgeon a clear view of anatomical structures.

A wide variety of suction devices are known for suction of the aforementioned liquids. In the case of a surgical instrument with suction function of the type mentioned at the beginning (DE 39 35 062 A1), the tubular holder is a tube which carries at its rear end a connecting piece which can be inserted into a handle. The front end of the tube is tapered and covered with plastic to prevent sensitive tissue from being damaged by the stirrer. The plastic tip has a central channel which is open towards the front and opens into the tube and thus forms a fluid-permeable suction tip. The handle has a valve opening on the side, which can be closed more or less with the thumb or a finger to regulate the vacuum. This

surgical instrument not only serves to absorb the aforementioned liquids but also as a probe with which the surgical site can be examined. In a hand-held suction device for medical purposes (DE 14 91 175 C3), a mouthpiece is arranged at the front end of a tubular holder, which is provided with several bores. In this context, this mouthpiece is also referred to as a suction tip. Although this suction device and also the previously mentioned surgical instrument are usable for macro-surgical interventions, they are unsuitable for microsurgical interventions. The relatively large openings at the respective suction tips cause an excessive suction effect, through which tissue is drawn to or into the nursing openings and tissue damage would inevitably occur due to the build-up of oppression. In microsurgery, interventions, for example in eye, throat, nose, ear, neurosurgery, hand surgery in reconstructive, cosmetic and neonatal surgery as well as in the surgery of small animals, must therefore be managed with other means. Even with microsurgical interventions, the tissue, e.g.

The conjunctiva, nerve fibers etc. are often rinsed and kept moist, as it dries out and dies faster than larger organs due to the unfavorable volume / surface ratio. The view of the anatomical structures must always be excellent, since the surgeon works almost exclusively with fine motorized handles, which must always sit precisely and require extreme concentration. In order to aspirate the excess irrigation fluid or escaping blood without damaging the anatomical structures and to get any tissue parts in the way

To be able to squeeze out the area of surgery, you can help yourself with some surgical techniques, for example in ophthalmic surgery to this day with a so-called wedge swab. The wedge swab is the size of a cotton swab and has a triangular cotton fleece pressed at the end of a plastic swab. When it comes into contact with liquid, the cotton wool soaks up, swells and loses its original shape and rigidity. Since the liquid absorption is minimal, the wedge swab must be replaced quickly and frequently with a new one in order to achieve a satisfactory effect. Often, a surgical microscope is used, which is located between the face of the surgeon and the operating field and limits the working area and access to the operating field. Due to this lack of space in the operating field and time pressure, e.g. rapid completion of a nerve or arterial suture, or the need to aspirate body fluid or irrigation fluid exactly at the point where a holding function must also be performed at the same time, tissue with the wedge swab tip is often tried to keep aside while also sucking up the liquid with it. The wedge swell swells here, loses its swelling effect and stability with increasing swelling, and must then be changed. In addition to a high consumption of wedge swabs that are not reusable, the constant exchange brings unrest to the operation and also harbors it

Danger of the surgeon or the assistant touching the microscope, which is often not sterile, and making himself unsterile. This in turn requires a change of gloves or clothes and unnecessarily delays the operation. The invention is therefore based on the object of providing a surgical instrument with a suction function of the type mentioned at the outset for microsurgery, with which not only liquids can be sucked off for a long time without tissue damage, but which also has a permanent, has sufficient rigidity so that it can also perform holding functions.

This is achieved according to the invention in that the suction tip consists of a fiber bundle, hard-pressed felt, porous sintered material or a similar porous or capillary, rigid material, the suction tip being arranged in a bore in the holder with one end thereof protrudes from the holder and its other end is connected to the evacuable interior of the holder.

The use of porous or capillary, rigid material as a suction tip, for which in particular fiber bundles made of plastic aser or glass fibers, such as are used in fiber pens, are particularly suitable, makes the surgical instrument particularly suitable for microsurgical interventions. The liquid to be aspirated can pass through the fine capillaries for a long time, so that without interruption or

Instrument change can be operated. The capillaries between the fibers or the pores in a sintered material are so fine that tissue with a low suction effect is sucked in, but none due to the suction effect

Takes damage. The material of the suction tip must be such that it is not influenced by moisture, in particular does not swell. Therefore, the suction tip keeps its shape and you can also use it to hold tissue.

Advantageous embodiments of the invention are characterized in the subclaims. The invention is explained in more detail below with reference to exemplary embodiments shown in the drawing.

1 shows a first exemplary embodiment in longitudinal section, FIG. 2 shows a second exemplary embodiment in longitudinal section, FIG. 3 shows a third exemplary embodiment in longitudinal section on an enlarged scale,

FIG. 4 shows a cross section along the line IV-IV of FIG. 3 on a greatly enlarged scale,

FIG. 5 shows a similar cross section of a variant, also on a greatly enlarged scale,

Figure 6 shows a forceps-like surgical instrument. The surgical instrument 1 with suction function initially has a tubular holder 2, which can also be designed as a handle. This holder 2 has at its front end 2a an opening 3 into which a suction tip 4 is inserted. The rear end 2b of the holder 2 can be connected to a vacuum source. For this purpose, for example, a thin hose 5 can be plugged onto the rear end or connected to it in some other way. A valve arrangement for regulating the vacuum is also provided. This valve arrangement can expediently be formed from a lateral valve opening 6 provided on the holder 2, which can be more or less closed with the thumb or a finger. The level of the vacuum and thus the level of suction power can also be regulated in other ways, for example by a foot switch, not shown, with which one either regulates the suction power of the vacuum pump or allows secondary air to flow into the vacuum line. The suction tip 4 advantageously consists of a fiber bundle in which fine capillaries are formed between the fibers and run in the longitudinal direction of the fiber bundle and thus in the suction direction. Plastic, for example nylon or glass fiber, can be used as the material of the fibers of the fiber bundle. The material of the suction tip must be designed in such a way that it is not changed by the aspirated liquid during an operation, does not swell and maintains its rigidity. Besides that

Of course, the material should be harmless to human tissue and well tolerated (hypoallergenic, non-toxic). The same also applies to the case that instead of a fiber bundle for the suction tip, hard-pressed felt or porous sintered material, such as porous sintered ceramic or porous sintered metal, is used, similar to that used in liquidity filters. However, the pores of this porous sintered material have to be finer than the usual sintered filter material. In any case, the material of the suction tip must be such that the tissue is not injured by the suction effect and nevertheless sufficient liquid suction is possible. Experiments have shown that fiber bundles, such as those used in fiber-tip pens, are particularly suitable as suction tips, since they only produce weak adhesion when they come into contact with solid, non-absorbent tissue, ensure sufficient suction for the duration of an operation and despite that Liquid intake remains dimensionally stable. The suction tip 4 is inserted into the bore 3 of the holder 2 such that one end 4a protrudes from the holder 2 and its other end U h is connected to the evacuable interior of the holder 2. Due to the frictional resistance within the capillaries or pores, the spray performance decreases with increasing length of the suction tip 4. As a result, this should be kept as short as possible. However, depending on the use of the respective surgical instrument, it must be so long that you can use your tissue to hold it back and get to the suction point without this

Interfering holder in the operating field. Depending on the area of application, the outer end 4 a of the suction tip can be blunt or tapered, straight, curved, flat or in some other way adapted to the respective intended use.

So that the suction tip 4 can be used as specifically as possible and especially at its outermost tip 4 a has sufficient suction power, it can be advantageous if the suction tip 4 is on the outside according to FIG

Plastic 8 is encased, as shown in Figure 4 on a greatly enlarged scale, or is impregnated with plastic, as shown in Figure 5. This plastic sheathing or impregnation B extends to the vicinity of the outermost tip 4 c and leaves only the outermost tip 4 c free. Depending on the type of production, this plastic sheathing or impregnation 8 can also extend into the bore 3. The plastic sheathing or impregnation 8 prevents air from entering the suction tip 4 laterally when the latter is not completely immersed in the liquid to be suctioned off. Such air flowing in from the side would reduce the suction power. In order to avoid a possible clogging of the fiber bundle by the activated blood coagulation cascade, it can be advantageous to soak the entire suction tip 4 with heparin or another anticoagulant preparation. When the invention is used on the eye, however, it is largely tear and rinsing fluid that has to be suctioned off so that the blood does not clot. Experiments have shown that it is possible to draw pure blood over a sufficiently long period of time without the suction tip 4 becoming blocked.

Since the suction tip 4 is difficult to sterilize due to the fine capillaries or pores, and since the fine capillaries or pores could become clogged with long-term use, the suction tip will generally only be used once. It should therefore either be interchangeable with the holder 2 by being clamped in its bore, or the holder 2 should be relatively simple and inexpensive so that it can be disposed of together with the suction tip 4 after a single use. For example, the holder 2 can be injection molded from plastic and the suction tip 4 can either be glued in or molded into the holder 2 when it is injection molded. However, it is also possible that, according to FIG. 2, the holder 2 consists of a thin tube, the rear end 2b of which is inserted by clamping into a bore 9 in a handle part 11. The suction tip 4 is firmly inserted into the front end 2a of the thin tube 2 '. You can then throw away the pipe 2 'together with the suction tip 4 after a single use. Depending on the field of application of the surgical instrument, the tube 2 'can be very short, so that it protrudes only slightly over the handle part 11, or can also have a greater length, so that the handle part 11 does not protrude into the operating field in a disturbing manner.

Furthermore, the holder can also be a flexible plastic tube so that the surgical instrument can be used similarly to an endoscope for interventions in ENT medicine, for example for surgical access via the external auditory canal. If the holder is designed as a flexible plastic tube or as a long, thin, rigid tube, it can be guided through the working channel of an endoscope. It would also be conceivable in the holder 2 also integrate a rinsing device so that it can be used simultaneously for suction and rinsing. It is also possible to install an integrated glass fiber to connect a cold light source to illuminate the operating field.

If the holder 2 according to FIG. 1 has a valve opening 6 on the side, this should advantageously be arranged in the vicinity of the front end 2a of the holder 2.

Here, in the area of the valve opening 6 in the interior 7 of the holder 2, a tube 10 should be spaced from the

Valve opening 6 may be arranged, which extends on the one hand to the inner end 4 b of the suction tip 4, and which on the other hand projects in the direction 5 of the suction flow beyond the area of the valve opening 6. Through this tube 10 suctioned secretion, which is still in the holder 2, is guided past the valve opening 6 and prevents leakage at the valve opening 6.

The new surgical instrument is extremely versatile in micro surgery. It can not only be used for suctioning liquid, but also for holding tissue thanks to the remaining rigidity of the suction tip U. The instrument is adapted to the respective surgical technique. So it is e.g. 6, two tubular holders 2 ", each of which carries a suction tip 4 of the type according to the invention at its front end 2a, can be connected to one another at their rear ends 2b to form a pin-like instrument. Other farms are also possible, such as the design as an eyelet or clip, which holds a nerve fiber to be sewn, for example, self-clamping or with pressure with the thumb and index finger.

Claims

claims

1. Surgical instrument with suction function, consisting essentially of a tubular holder, the front end of which carries a fluid-permeable suction tip and the rear end of which can be connected to a vacuum source, and a valve arrangement for regulating the vacuum, characterized in that the suction tip (4) consists of a fiber bundle, hard-pressed felt, porous sintered material or a similar porous or capillary, rigid material, the suction tip (4) in a bore (3) of the

Holder (2, 2 ', 2 ") is arranged so that one end (4a) protrudes from the holder and its other end (4b) is connected to the evacuable interior (7) of the holder.

2. Instrument according to claim 1, characterized in

that the fiber bundle consists of plastic fibers or glass fibers.

3. Instrument according to claim 1 or 2, characterized in that at least the part (4a) of the suction tip (4) projecting from the holder (2, 2 ', 2 ") with the exception of its outermost tip (4) with plastic (B) is covered or sealed in the jacket area.

4th Instrument according to claim 1, 2 or 3, characterized in that the suction tip (4) is impregnated with heparin or another anticoagulant preparation.

5. Instrument according to any one of claims 1-4, characterized

characterized in that the suction tip (4 4 can be inserted by clamping in the bore (3) of the holder (2, 2 ', 2 ") for the purpose of replacement.

6. Instrument according to one of claims 1-4, characterized in that the suction tip (4) in the holder (2, 2 ', 2 ") is glued or molded.

7. Instrument according to claim 1, characterized in that the holder (2) laterally has a Ventilöf opening (6).

8. Instrument according to claim 7, characterized in that the valve opening (6) in the vicinity of the front

End (2a) of the holder (2) is arranged.

9. Instrument according to claim 7 or 8, characterized in that in the region of the valve opening (6) in

Interior (7) of the holder (2) is a tube (10) at a distance from the valve opening (6), which extends on the one hand to the inner end (4b) of the suction tip (6) and on the other hand in the direction of the suction flow protrudes the area of the valve opening (6).

10. Instrument according to one of claims 1-9, characterized

characterized in that at least one leg of a forceps-type instrument is formed by a holder (2 ") which carries a suction tip (4) at its front end (2a).

11. Instrument according to one of claims 1-9, characterized

characterized in that the holder (2 ') consists of a thin tube, the rear end (2b) of which with a

Handle part (11) is connectable.

12. Instrument according to one of claims 1-9 or 11, characterized in that the holder (2 ') is a flexible

Plastic tube is.