For decades already resectoscopes have been the backbone of urological instrumentation. For permanent rinsing they comprise an inner and an outer shaft, rinsing fluid being fed from the inner shaft and then being evacuated through the annular space between said shafts. The outer shaft is detachable by means of an externally actuated connector element. The optics monitoring the surgery zone, and the implement operational therein, for instance the conventional high-frequency (hf) cutting loop, run through the inner shaft.
Regarding known resectoscopes of the species described in U.S. Pat. Nos. 5,807,240 and 5,486,155, the inner shaft also is detachable by means of an externally actuated connector element. The connector elements for the outer and inner shafts hereafter are called external connector element and inner connector element, respectively. In known resectoscopes, the inner connector element also is actuated externally and it directly engages the resectoscope main body, whereas the outer connector element engages the inner connector element. It is furthermore known to make the outer connector element rotatable relative to the entire remaining resectoscope, including the inner shaft.
One of the main problems encountered in resectoscopes is the available length of the shaft that can be inserted into the typical human body. The length should be as large as possible whereas the total resectoscope length should be minimized in order to minimize, for instance, the optics which extend the length of the resectoscope and for optical reasons should be as short as possible. Accordingly, designers in this field attempt foremost to maximize the shaft length while reducing resectoscope length elsewhere, but difficulties arise.
The design of known resectoscopes comprising two externally actuated connector elements, inherently limits the available shaft length.
The objective of the present invention is to create a resectoscope of simple design offering greater available shaft length.
In the present invention, the outer connector element directly engages the resectoscope main body. On the other hand no external connector element is used to actuate the inner connector element and as a result, contrary to the case of conventional design, the length of one externally driven connector element, namely a minimum of about 5 mm, may be saved and, keeping the total resectoscope length constant, the available outer shaft length may be increased. This feature is of substantial advantage to the surgeon. The outer connector element directly engages the resectoscope main body. In this manner, that is circumventing external action on parts of an inner connector element placed at the resectoscope periphery, the connection zone may be shortened. The inner shaft in this design is affixed within the outer connector element.
The inner shaft may be affixed to the resectoscope main body, preferably in a permanent manner. This very simple design entirely circumvents the known inner connector element.
By providing an inner connector element to remove the inner shaft, conventional instrument cleansing can be improved. The inner connector element may exhibit a variety of designs, for instance being a screw connection, bayonet connection, snap-in connection with elastic tongues or the like. The inner connector element need not exert substantial retaining forces because during use the inner shaft is protected by the outer shaft against mechanical stresses.
Illustratively, the inner shaft may be of constant cross-sectional shape and smooth as far as its proximal end by which it may be inserted into a resectoscope main body borehole where it might be permanently soldered or welded into place. The inner shaft also may be connected by means of a thread or a bayonet lock to the borehole, or it may be merely plugged into the borehole and remain therein in a frictional or press-fit manner. Such a design is radially compact and consequently the enclosing outer connector also may be made compact and the entire assembly slender.
Thereby, the inner shaft is affixed not to the resectoscope main body but to the outer shaft, namely to this outer shaft's proximal end zone. Illustratively, the inner shaft may be inserted by its widened proximal end zone into the proximal end zone of the outer shaft and soldered to it.
The inner shaft also may be detachably affixed to the outer shaft, similarly to the way it may be detachably fastened to a borehole in the resectoscope main body.
Thereby, the inner shaft is fitted with a connector element that, upon closure of the outer connector element, shall engage between the outer shaft and the resectoscope main body and in this way can be clamped into place when the outer connector element is closed. This feature offers a simple design variant where, however, the inner shaft can be removed only in the proximal direction from the outer shaft after the outer shaft has been detached from the main body—whereas, in other designs, the inner shaft may be removed in the distal direction from the outer shaft after loosening the inner connector element.
Independently of the design of the invention of the inner shaft affixation, the outer connector element may be conventionally rotatable. Even regarding the configuration of the feed and drain ducts at the outward hookup stubs, known designs may be used, including a rotatable outer connector element.
The invention is shown illustratively and schematically in the appended drawings.
The resectoscope 1 shown in
A carriage 6 with a thumb ring 7 runs on the optics guide tube 4 and is connected by means of a leaf spring 8 with the optics guide tube 5. As shown by
By holding the implement in one hand, the surgeon may actuate finger grips 11 at the main body 2 to displace the carriage 6 in the axial direction of the resectoscope 1 to move an elongated support 12 affixed to the carriage 6, indicated at 13, through a duct 14 in the main body 2 far distally beyond the main body in order to reciprocate a surgical instrument (omitted in
An inner shaft 15 enclosing the optics 9 and the support 12 is affixed to the main body 2. An outer shaft 16 enclosing the inner shaft 15 also is affixed to the main body 2. The shafts 15, 16 illustratively are cross-sectionally circular and configured mutually coaxially.
The tubular outer shaft 16 is affixed at its proximal end to an outer connector element 17 which, as shown, encloses the main body 2 and is detachably affixed by a locking pin 18 or some other means to the main body. The main body 2 supporting the outer connector element 17 comprises a borehole 19 within the outer surface 28 of the main body, the borehole 19 receiving the proximal terminal zone of the inner shaft 15. The inner shaft 15 is fitted in its proximal terminal zone and at one site of its circumference with a resilient lip 20 engaging in a securing manner a matching radial clearance in the borehole 19, as a result of which once inserted into the borehole 19, the inner shaft 15 is elastically secured, though, the inner shaft 15 can be retracted again when the spring force is overcome.
The gap between the shafts 15, 16 may communicate with the outside through a radially configured borehole 21 passing through the outer connector element 17 and the outer shaft 16 firmly affixed to it. The inside space of the inner shaft 15 may communicate with the outside through a borehole 22 passing through the inner shaft 15, the main body 2 and the outer connector element 17.
In this embodiment, a hookup ring 23 rests rotatably on the outer surface of the outer connection element 17 and is fitted with circumferential ducts 24 and 25 in the axial position of the boreholes 21 and 22, the ducts each communicating through valve-controlled hookup stubs 26, 27 to the outside in order to be connected as needed to evacuation or rinsing hoses.
In the illustrated embodiment, the outer shaft 16, jointly with the outer connector element 17, may be removed from the main body 2 following withdrawal of the locking pin 18. In the process the inner shaft 15 may remain at the main body 2 and then be pulled out of the borehole 19. This design furthermore allows seizing only the inner shaft 15 at the distal end and to remove it first through the outer shaft 16 that is still in place.
However, the outer shaft 15 may also be detachably connected to the main body 2 in the manner shown in
Moreover, the borehole 19 may be eliminated. In that case, the inner shaft 15 may be affixed in another way to the distal end face of the main body 2 which, then however must, at a minimum, allow the optics 9 and the support 12 to move into the inner shaft 15.
The design of
Another embodiment is shown in
The outer connector element 17 also may be designed in a manner other than shown in
If, in the above embodiment, the inner shaft 15 is permanently affixed to the main body, assembly will require inserting the implement support 12 from the distal side—contrary to conventional assembly.
Number | Date | Country | Kind |
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102 42 608.2 | Sep 2002 | DE | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/EP03/08760 | 8/6/2003 | WO | 2/22/2005 |