DE202010010594U1 - Medical hand instrument, in particular trocar lance, and trocar system - Google Patents

Abstract

Medical hand instrument for introducing an incision in the human or animal body, in particular in the sclera of the eye, with a handle (2) and a shaft (3) with a tip (4), characterized in that the shaft (3) is formed is that this when introducing an incision predetermines a rotation of the hand instrument to its longitudinal axis.

Description

The The present invention relates to a medical hand instrument for introducing an incision into the human or animal Body, especially in the sclera of the eye, with a Handle and a shaft with a tip. Furthermore The invention relates to a trocar system with a trocar lance and a trocar.

at any kind of surgical and microsurgical procedures It is common to incisions in the patient's body bring in to open the surgical field and / or an access for surgical instruments or aids to obtain.

As well is known to introduce an incision in the form of a puncture channel, at the same time or subsequently a trocar in the puncture channel to place. The trocar serves as an access for surgical Instruments or for introducing media (eg infusions) or light in the body of the patient. Through the trocar The wound edges are spared and it can be a certain Sealing of the body inside against the outside environment reached become.

In other words, trocars are devices for introducing a medium or an instrument into the body of the patient. Such devices are well known in the field of ophthalmology applications. Only by way of example on the EP 1 886 653 A1 or on the EP 2 002 812 A1 directed.

in the Corresponding interventions in the human eye become regular several trocars inserted through the sclera into the eye. Usually is a serving as a guide tube trocar first such inserted into the eye, that the tip of the probe of the trocar up into the vitreous cavity of the eye. That of the Probe remote from the end of the trocar, that is, the connector body, serves on the side facing away from the probe for connection a hose over which the inside of the eye with a Infusion liquid is supplied. This trocar is usually also called infusion trocar.

Of Further, it is common to have one or two more trocars in to use the eye over which needed Instruments, such as ultrasonic cutting instruments or lighting equipment, are insertable into the eye. These trocars are usually as instrument trocars or - according to the application - as Lighting trocars called.

The trocars in question here have the advantage of being in a small opening of the sclera are used and that the instruments are interchangeable through the respective trocar. A more extensive irritation or damage to the sclera is avoided by using the trocar.

To the Setting a trocar can, for example, with a scalpel or a cannula an incision are introduced, by which subsequently the Trocar can be plugged.

alternative The trocar itself may have a thorn or a spike have the necessary incision.

often however, is for introducing an incision to place a trocar a separate, pin-like setting instrument provided here as Trocar lance is called. With such a trocar lance leaves the incision and then the trocar in the incision anchor. Most preferably, the trocar is located already during the insertion of the incision on one shaft-like section of the hand instrument and can already during or immediately after insertion of the incision anchored in this become.

often the device referred to here as trocar lance is also called a trocar, Part of a trocar or also called an internal trocar. Such devices fall under the term used here, which is not limiting is needed.

Of Also included are scalpel or cannula-like devices or trocars, which in turn have a tip or have a spike for incising an incision, as medical hand instruments in the sense of the present application provided that they are for the introduction of an incision in the human or animal body.

In In ophthalmology there is a general risk that during and after the introduction of the incision fluid from the Eye leakage and so the intraocular pressure drops dangerously. Furthermore, such incisions are often larger as necessary and heal accordingly bad.

Known medical hand instruments for incising an incision in the human or animal body have other disadvantages. After completion of the surgical procedure, the trocars become common removed with a trocar forceps. It will be regular found that with known medical hand instruments introduced incisions of a complex post-treatment require, in particular because of the other Outflow of fluid from the vitreous body.

Of Further require with known medical hand instruments introduced incisions often a comparatively long healing time. Non-occlusive incisions are associated with the risk of infection in particular the risk of dangerous waste of the Intraocular pressure and require complex medical Aftercare.

Of the The present invention is therefore based on the object, a medical Hand instrument for introducing an incision into the human or animal body of the type mentioned in such a way to shape and educate that the occurrence of complications as well as the intensity of post-treatment measures is reduced at incisions introduced with the hand instrument.

These Task is by a medical hand instrument with the features of claim 1. After that is the shaft of an entrance said hand instrument designed so that this during insertion an incision, a rotation of the hand instrument about its longitudinal axis pretends. With the independent claim 9 is a trocar system with a trocar lance based on the invention medical hand instrument and a trocar.

In Reference to ophthalmic surgery has proven to be particularly beneficial proven to insert an incision not simply the sclera from the outside towards the center of the eye to pierce, but First, the tip of the medical hand instrument in Essentially parallel to the limbus corneae set and stab. It is advantageous, an acute angle of about 10 °, alternatively, however, from only 2 ° to 3 °, to take the sclera. The hand instrument, in particular a trocar lance, should then in its longitudinal axis slightly towards the Limbus be turned. Thereafter, it is envisaged that the sclera tunnel slowly guided in a curve movement in the direction of the vitreous body center will, so the final position when piercing the sclera of the preferred position of the later needed Instruments corresponding to the center of the eye.

at The management of the sclera tunnel has proven to be advantageous proved that the hand instrument is turned like a screw.

By the described preparation, insertion and guiding the hand instrument in a screwing motion are in the fibrous structure of the sclera produced only the slightest damage. In the result will be the fibers of the sclera are pushed apart rather than torn apart.

Of Furthermore, the inner surface of the incision is advantageously designed. Due to the special screw movement of the hand instrument when Incorporation of the incision and, if necessary, by the oblique attachment of the instrument arises after the eventual removal of the trocar from the incision a pressure on the wound edges, which the incision safely closes. The intraocular pressure can do not escape through a straight, jagged incision. Rather, the wound edges lie on and over each other, so in most cases after removing the trocar a complete closure of the incision is achieved.

The medical hand-held device according to the invention gives due to its special design during insertion the incision an advantageous rotation about its longitudinal axis in front.

By the invention provided and predetermined Rotation of the hand instrument during the introduction of a Incision is a defibrillation and / or rupture of scleral tissue effectively prevents, thereby also the penetration of germs is avoided.

With the medical hand instrument according to the invention can introduce incisions in ophthalmology, in particular for setting of trocars, which after the completion of the surgical Measure without or with little intensive follow-up care close immediately and quickly to a tight seal lead the sclera.

consequently is with the hand instrument according to the invention that Occurrence of complications as well as the intensity of follow-up care reduced with the instrument introduced incisions.

The medical hand-held device according to the invention can be scalpel, spike or cannula designed. Furthermore, embodiments are expressly included, where a trocar already has a shaft with a tip, which is suitable for introducing an incision to the trocar to be able to sit down.

Especially However, preferred is an embodiment of the invention, in which the Hand instrument is designed as trocar lance. The trocar lance serves to introduce an incision to simultaneously or Subsequently, place a trocar in the inserted incision to be able to. It is particularly preferred that the trocar lance during incision and anchoring the trocar also has the inner opening of a substantially sleeve-like trocar seals. After anchoring of the trocar, the trocar lance can be withdrawn, whereupon the trocar functions as access to the surgical field can fulfill.

As a result, an embodiment is particularly preferred in which a Trocar is attachable to the shaft. So can the process of bringing in incision and placement of a trocar simultaneously. In addition, while anchoring the Trokars whose passage opening through the trocar lance locked. Especially when used in ophthalmology such a dangerous loss of vitreous humor avoided.

According to the invention the shaft is designed so that this when introducing an incision a rotation of the hand instrument dictates about its longitudinal axis. This can be done within the scope of further preferred embodiments u. a. accomplish that the shaft or a shaft section wound, twisted or thread-like. With others In words, the shaft can be configured so that another Penetration into the body of the patient only under simultaneous Rotate the hand instrument about a longitudinal axis possible is. Such a functional shaft design can be provided by the shaft or the relevant Shaft section is provided with a suitable thread. Also can be a shaft section with originally polygonal or polygonal Cross-section or with several longitudinally extending Ripping by twisting or twisting in such a suitable Form are transferred.

in the With regard to a particularly advantageous handling is a development preferred in which the shaft is a point, a tortuous shaft portion and a straight shaft portion. The tip is used for a first insertion into the sclera, preferably parallel to the limbus and at an acute angle of about 10 ° to the Sclera. The coiled shaft section then serves as already described, particularly appropriate introduction of the incision. A straight shaft section can connect to the handle form. However, it is also possible that the straight Shank portion coincides with the grip, d. H. the straight shaft portion at the same time the handle forms. In a further advantageous embodiment may be between the serpentine shaft portion and the straight shaft portion a stop be formed, so that the puncturing movement of Hand instruments inevitably ends at this stop. This safely prevents the incision from being too deep.

In a very particularly preferred embodiment of the invention Hand instrument, the shaft is designed so that this Inserting an incision, a pivoting movement of the hand instrument allows or pretends. As already mentioned, is preferred, the hand instrument first with the tip parallel to the limbus into the sclera stab. Following is it is particularly convenient, the hand instrument under simultaneous rotation about its longitudinal axis in a curve movement in the direction of the vitreous center, so that the final position when puncturing the sclera of the preferred Position of the later needed instruments for Center of the eye corresponds. It is therefore particularly appropriate if the shaft such a Verschwenkbewe movement of the hand instrument enabled or even by its special design pretends.

The Tip of the hand instrument according to the invention can a length of 0.2 mm to 0.4 mm, in particular of 0.3 mm, have. It has proven to be particularly appropriate proved the first (preferably running parallel to the limbus) Puncture to a depth of about 0.3 mm.

One wound shaft portion of the medical hand instrument can a length of 0.6 mm to 0.8 mm, in particular of 0.7 mm, have. After the first piercing with the tip, preferably up to a depth of about 0.3 mm, the actual incision can be introduced into the sclera in the manner already described. For this purpose, a wound shank portion a length of about 0.7 mm. This length can be reached by a stop be limited. A preferred depth of incision or canal through the sclera is thus about 1.0 mm.

One Trocar system according to the invention has an inventive Trocar lance and a trocar on. Both devices are accordingly preferably together, in particular in a common sterile Packaging, provided.

The Trocar system can be further developed by the trocar already attached to the trocar lance. So is a comfortable and not faulty use of the trocar system guaranteed.

It Now there are different ways of teaching the present Invention in an advantageous manner and further develop. This is on the one hand to the subordinate claims and the other to the following explanation of two embodiments of the invention with reference to the drawing. Combined with the explanation of the preferred embodiments The invention with reference to the drawings are also generally preferred Embodiments and developments of the teaching explained. In the drawing show

1 a side view of a first embodiment of the medical hand instrument according to the invention, which here as a trocar lance is formed, and

2 the perspective view of the front part of another embodiment, which is also designed as Trokarlanze.

1 shows the side view of a first embodiment of a medical hand instrument according to the invention, which here as trocar lance 1 is formed. The trocar lance 1 is used to introduce an incision in the human or animal body, namely in particular in the sclera of the eye, in order subsequently to be able to anchor a trocar in the incision can. For this purpose, the medical hand instrument according to the invention has a handle 2 and a shaft 3 with a tip 4 on.

In this embodiment, the handle falls 2 with the shaft 3 in particular with a straight shaft section 5 , together.

In accordance with the invention, the shaft 3 Furthermore, it is designed such that, when an incision is made, it causes a rotation of the hand instrument, namely the trocar lance 1 to pretend its longitudinal axis. For this purpose, the shaft 3 next to the straight shaft section 5 a tortuous shaft portion 6 on. The tortuous shaft section 6 here consists of a total of four substantially extending in the axial direction ribs or wings, which, however, so around the longitudinal axis of the trocar lance 1 are wound that the tortuous shaft area 5 can be introduced in the end only by turning the hand instrument about its longitudinal axis in the body of the patient.

On the handle 2 opposite side of the wound shaft portion 6 the tip closes 4 of the hand instrument to a first piercing the trocar lance 1 to enable in the sclera.

by virtue of This particular embodiment will be particularly useful in ophthalmology those already described in detail Advantages of introducing incisions and anchoring and removing reached by trocars.

A suitable trocar can already be placed on the straight shaft section before the incision is made 5 the trocar lance 1 postpone and thus insert simultaneously with the introduction of the incision into the sclera.

2 shows the perspective view of the front part of a second embodiment of the medical hand instrument according to the invention, which also as trocar lance 1 is designed.

In this illustration is the transition from the top 4 in the tortuous shaft section 6 and from this into the straight shaft section 5 particularly easy to recognize. Between the wound shaft section 6 and the straight shaft portion 5 is also the diameter of the shaft 3 reduced. This area can be used as a stop for the puncturing movement of the trocar lance 1 serve.

Furthermore, in this embodiment, a separate handle 2 provided, which the shaft 3 , namely here the straight shaft section 5 , picks up.

Regarding further advantageous embodiments of the invention Medical hand instrument is used to avoid repetition to the general part of the description and to the attached Claims referenced.

After all It should be noted that the embodiments discussed above the medical hand instrument according to the invention merely for the purpose of discussing the claimed teaching, However, these do not limit to the embodiments.

1

Trokarlanze

2

grip

3

shaft

4

top

5

straight shank portion

6

Spiral shank portion

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• EP 1886653 A1 [0004]
• - EP 2002812 A1 [0004]

Claims (10)

Medical hand instrument for introducing an incision into the human or animal body, in particular into the sclera of the eye, with a handle ( 2 ) and a shaft ( 3 ) with a tip ( 4 ), characterized in that the shaft ( 3 ) is designed so that it predetermines a rotation of the hand instrument about its longitudinal axis when introducing an incision. Medical hand instrument according to claim 1, characterized in that the hand instrument as trocar lance ( 1 ) is trained. Medical hand instrument according to claim 1 or 2, characterized in that a trocar is placed on the shaft ( 3 ) can be plugged. Medical hand instrument according to one of claims 1 to 3, characterized in that the shaft ( 3 ) or a shank portion ( 6 ) is wound or twisted or thread-like. Medical hand instrument according to one of claims 1 to 4, characterized in that the shaft is a tip ( 4 ), a tortuous shaft portion ( 6 ) and a straight shank portion ( 5 ) having. Medical hand instrument according to one of claims 1 to 5, characterized in that the shaft ( 3 ) is designed so that this allows or predetermines a pivoting movement of the hand instrument when introducing an incision. Medical hand instrument according to one of claims 1 to 6, characterized in that the tip ( 4 ) has a length of 0.2 mm to 0.4 mm, in particular of 0.3 mm. Medical hand instrument according to one of claims 4 to 7, characterized by a wound shaft portion ( 6 ) with a length of 0.6 mm to 0.8 mm, in particular of 0.7 mm. Trocar system with a trocar lance ( 1 ) according to any one of claims 2 to 8 and a trocar. Trocar system according to Claim 9, characterized in that the trocar is placed on the trocar lance ( 1 ) is attached.