The invention relates to a laparoscopic needle holder, a method for the production thereof and a curved distal shaft section of the needle holder.
Laparoscopic needle holders in the standard design typical of today are shown in U.S. Pat. No. 5,413,583 A and U.S. Pat. No. 5,951,587 A. They have clamping jaws on the distal end of an elongated thin shaft tube, with which surgical needles can be held and moved for the purpose of suturing. In the known instruments, the handle is typically embodied as an inline handle, that is, with an extension essentially in the direction of the shaft tube. This handle form is well suited for exerting the necessary high holding forces as well as for the typical suturing movement. With the elongated shaft, generic instruments are suitable for insertion through a laparoscopic port into the abdominal cavity in order to be able to suture there under endoscopic observation.
Recently, a laparoscopic technique has become accepted as is shown in DE 202009007592 U1. Work is thereby carried out with two instruments through a port. For the reasons explained in this document, it is advantageous thereby if the shafts of the instruments are embodied in a curved manner in their distal section, since then the instruments work tip against tip, but can nevertheless bear against one another in a parallel manner in the region of the common port.
An object of the present invention is to embody a laparoscopic needle holder in an inexpensive manner for use in a commonly used port.
This object is attained by providing a laparoscopic needle holder including a tubular shaft having a proximal shaft section and a distal shaft section. The proximal shaft section and the distal shaft section are detachably attached. Clamping jaws are disposed at the distal end of the shaft, and a handle is disposed at the proximal end of the shaft. A rod having a cam that couples with the handle is inserted into the distal shaft section, and the distal shaft section is bent to form the curved distal shaft section, before the proximal shaft section is attached to the distal shaft section.
According to one aspect of the invention, the needle holder is embodied with a shaft that has a curved distal shaft section and a straight proximal shaft section, and thus, it is excellently suitable for the purposes cited in the latter specification. The two shaft parts are attached to one another in a detachable manner and therefore can be produced separately. This makes production much easier and cheaper, since the straight proximal shaft section, together with the handle, can be taken from a generic needle holder. Only the curved distal shaft section has to be produced separately, which reduces the problems due to the short length of this shaft section.
The two shaft sections can be connected to one another in any desired manner, but advantageously via a coupling that is disposed at a distal end of the proximal shaft section and that can accommodate the clamping jaws. Therefore, alternatively, a clamping jaw can be arranged directly on the distal end of the straight proximal shaft section. The unit of the straight proximal shaft section and the handle can therefore be used together with clamping jaws as a straight needle holder according to the prior art, as well as with the connected curved distal shaft section as a needle holder for use with other instruments in a common port.
The clamping jaws can be attached to the distal end of the distal shaft section in different ways, for example, removable for cleaning purposes or rotatable. However, if the clamping jaws are permanently attached, e.g., welded, to the distal section, this is advantageous because the construction and the production are greatly simplified.
A thickened cam, e.g., in the usual form of a sphere, is provided at the proximal end of the rod in a manner known per se, which cam is used for coupling with the moving parts of the handle. This cam can be attached to the end of the rod in various ways, e.g., by means of welding. However, the cam can be advantageously attached to the rod such that a space between the proximal end of the rod and the cam is adjustable at an individually adjusted spacing, which means that differences in length of the rod can be compensated for, which otherwise would impede the exact adjustment of the ranges of movement of the clamping jaws and the handle.
Advantageously, the cam can be screwed onto and welded to the rod. This firstly renders possible a length adjustment with the threaded joint in order subsequently to be able to fix the threaded joint by means of welding.
An advantageous method for producing the needle holder according to the invention is summarized below. The laparoscopic needle holder includes a shaft having a proximal shaft section and a distal shaft section that are detachably attached, clamping jaws, and a rod having a cam for coupling with a handle. According to the method, a prefabricated mounting unit including clamping jaws and the rod are inserted into the distal shaft section, and the clamping jaws are attached to the distal end of the distal shaft section. The distal shaft section is bent with the rod inserted to form the curved distal shaft section. Then, the proximal shaft section is attached to the distal shaft section. Accordingly, firstly the clamping jaws and rod are connected. Then the rod is inserted into the shaft and the clamping jaws are attached to the distal end of the distal shaft part. This is thereby still straight and is only curved afterwards, together with the rod on the inside. Subsequently, the distal shaft section is attached to the proximal shaft section. This sequence of steps has proven to be particularly useful, since it ensures a high production quality at low cost.
Advantageously, the cam, which is usually embodied as a sphere, is adjusted at the desired spacing on the rod by screwing and is attached by means of subsequent welding. This sequence of steps has also proven to be particularly advantageous and cost-effective.
In addition, an assembly including the curved distal shaft section of a laparoscopic needle holder can also be provided.
The invention is shown diagrammatically and by way of example in the drawing.
A handle 4 is attached to the proximal end of the proximal shaft section 2, which handle is embodied as a fixed handle part and on which a moveable handle part 6 is supported which can be pivoted about an axis 5 according to the arrow 7, which handle part is supported with a spring 8 with respect to the fixed handle 4. This construction produces the typical form of an inline handle that is particularly suitable for needle holders. However, another type of handle can also be used, such as, for example, a pistol-form handle.
The distal shaft section 3 of the shaft 2, 3 is shown separately in
A connecting element in the form of a threaded part 13 with external thread is arranged on the proximal end of the distal shaft section 3, which connecting element is used for screwing in an internal thread 14 at the distal end of the proximal shaft section 2.
A rod 15 is attached to the clamping jaws 9 for the actuation thereof, runs through the tubular distal shaft section 3 and projects beyond this in the proximal direction, as is shown in
As
For reasons of a clear representation, in
If the assembly essentially composed of the distal shaft section 3 and the rod 15, shown in
The sphere 16′ is directly attached, e.g., welded, to the rod 15′ of the construction of
However, in the construction of
The needle holder 1, according to the configuration of
The straight proximal shaft section 2 of the shaft is prefabricated together with the handle 4, 5, 6, 8. Preferably, it can be taken from a production series that is produced together with the insert of
The curved distal shaft region, which is shown in
Subsequently, the assembly thus formed and shown in
Instead of the attachment of the shaft sections 2 and 3 of the shaft to one another with the threaded parts 13 and 14, a different detachable coupling can be provided here, e.g., by means of bayonet or the like. However, it must be ensured thereby that the angular position of the curved distal shaft section 3 of the shaft to the handle 4 is always correctly aligned.
With the construction shown of
Number | Date | Country | Kind |
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102010011926.1-35 | Mar 2010 | DE | national |