WO1999053987A1 - Flexible catheter sleeve guide - Google Patents

Flexible catheter sleeve guide Download PDF

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Publication number
WO1999053987A1
WO1999053987A1 PCT/DE1999/001122 DE9901122W WO9953987A1 WO 1999053987 A1 WO1999053987 A1 WO 1999053987A1 DE 9901122 W DE9901122 W DE 9901122W WO 9953987 A1 WO9953987 A1 WO 9953987A1
Authority
WO
WIPO (PCT)
Prior art keywords
sleeve
sleeve guide
handle
catheter
guide according
Prior art date
Application number
PCT/DE1999/001122
Other languages
German (de)
French (fr)
Inventor
Franz Jakoubek
Original Assignee
Jakoubek Medizintechnik Gmbh
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Jakoubek Medizintechnik Gmbh filed Critical Jakoubek Medizintechnik Gmbh
Priority to AU44965/99A priority Critical patent/AU4496599A/en
Publication of WO1999053987A1 publication Critical patent/WO1999053987A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0138—Tip steering devices having flexible regions as a result of weakened outer material, e.g. slots, slits, cuts, joints or coils
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0136—Handles therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133—Tip steering devices
    • A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B17/2909—Handles
    • A61B2017/2912—Handles transmission of forces to actuating rod or piston
    • A61B2017/2924—Translation movement of handle without rotating movement

Definitions

  • the invention relates to a flexible catheter sleeve guide, consisting of an axially extending, flexible sleeve which can be guided and actuated by means of a handle and has an elongated cavity for receiving and feeding catheters or the like. Elongated surgical instruments.
  • the catheter sleeve guide according to the invention differs from the known designs
  • the rotary sleeve is arranged to penetrate the first holder, between the latter and the sleeve guide.
  • the rotary sleeve is rotatable in the handle, but axially immovable.
  • this catheter sleeve guide It is provided with this catheter sleeve guide that the flexible sleeve can be bent in its front or end area by an arbitrarily large angle in order to be able to better position the catheter.
  • This is made possible manually in that an actuating handle can be jerked in the recess in the recess against the spring force from its rest position into its actuating position in a recess.
  • the actuating handle is guided axially displaceably in its upper region by means of guide rails on both sides, and its stroke movement is limited in its central region by means of a bolt penetrating a longitudinal slot guide.
  • the actuating handle has two axially spaced, upstanding, fork-like driving pin pairs, between which the above-mentioned first holder is held and axially movable by means of the actuating handle.
  • a particularly advantageous embodiment of the mentioned mobility of the front part of the sleeve guide is made possible by the arrangement that the two mentioned cable runs are held together through the bores of the annular sleeve members arranged opposite one another.
  • the two cable runs running opposite one another can expediently each consist of two or more cables running in parallel.
  • a very important measure consists above all in that the individual sleeve members on one of their annular end faces have a half circular bulge and on the other, opposite back surface a semicircular indentation, both with equally large semicircular radii.
  • the bulges and indentations of the adjoining surfaces fit exactly into one another and form-fit each other in the functional direction of the sleeve guide.
  • part of the radial face or the back surface of the sleeve members form an inclined flat part tapering outward by an angle ⁇ .
  • the chamfering of the surface parts of the sleeve members can be inclined and thus describe an arc without lifting off from the adjoining front or rear surface part of the adjacent sleeve member, so that the semicircular bulges and indentations of the facing forehead and back surfaces lose the form-fitting leadership contact.
  • This design according to the invention creates a novel sleeve guide which offers great advantages due to its great flexibility in practical use.
  • Fig. 7 the sleeve member according to Fig. 6 in side view.
  • the handle is denoted by 1 and the actuating handle by 2; this is slidably mounted in a recess 3 in the handle 1 in bilateral guide rails 8, as shown in FIGS. 1 and 5. It is also limited in its stroke H in a slot guide 6 by means of a bolt 5 passing through it and held in its rest position by the compression spring 4.
  • the sleeve guide 19 is removably arranged on the handle, as can be seen from FIGS. 4 and 5.
  • the sleeve guide consists of a fixed part and a front part which is formed by the sleeve members 20. These are illustrated in Figures 6 and 7; which are designed as annular disks, and in the exemplary embodiment shown, each sleeve member 20 is provided with a pair of opposing axial bores 21.
  • the sleeve members 20 are strung together in contact with one another and thereby enclose an inner elongated cavity 16, which serves to receive and guide a catheter or the like. An elongated instrument.
  • the sleeve members 20 are held together by two cable strands 22 and 23 which are pulled through the bores 21 and through which they are lined up in contact with their surfaces 24 and 27, as can be seen from FIGS. 1, 2 and 3, and 6 and 7 .
  • the end faces 24 are provided with semicircular bulges 26, and the rear faces 27 are provided with semicircular indentations 25, both of which have semicircular radii of the same size.
  • the bulges 26 interlock with the adjoining indentations 25, and they are held together without gaps by the cable strands 22 and 23, which are under low tensile stress.
  • the actuating handle 2 is provided in its upper region with two fork-shaped, spaced-apart driving pin pairs 9 and 10, between which a holder 18 is guided; the cable harness 22 is connected to this.
  • the other cable harness 23 is connected to the other bracket 17; this is - 5th
  • This arrangement also makes it possible to flexibly bend the front part of the sleeve guide 19 formed by the sleeve members 20.
  • the back surfaces 27 of the sleeve members 20 have tapered sloping surface parts 28.
  • the bevel angle ⁇ is approximately 10 ° in the exemplary embodiment shown in FIG. 7.
  • the adjoining sleeve members 20 can bend towards one another, so that there is an arcuate curvature of the sleeve guide, as shown in FIGS. 1 and 2.

Abstract

A flexible catheter sleeve guide comprising a flexible sleeve which extends axially and can be guided and actuated by means of a handle, comprising an extended hollow area for receiving and feeding catheters or similar extended surgical instruments, in addition to individual ring-shaped sleeve elements forming a sleeve unit, placed next to each other so that they come into contact with each other and enclose the internal extended hollow area. The sleeve elements are held together by at least two cable looms which are arranged opposite each other and which penetrate the bore holes of said elements. The inventive unit also comprises a first holding element which is disposed inside the handle, can move in an axial direction with respect to the sleeve guide, can be actuated manually and which is assembled with at least one cable loom, whereby the sleeve guide is joined to said holding element. Said unit also consists of a second holding element which cannot move in an axial direction and which is fixed to another cable loom, a pressure spring that is placed between the holding elements and exerts an expansive force thereon, in addition to rotating sleeve which is mounted in such a way that it can rotate in an axial direction with respect to the sleeve guide and is provided with a rotating head that is located on a rear end outside the handle and which is rotationally fixed to the two holding elements.

Description

Patentbeschreibung Patent description
Flexible Katheder-HülsenführungFlexible catheter sleeve guide
Die Erfindung betrifft eine flexible Katheder-Hülsenführung, bestehend aus einer mittels eines Handgriffs führbaren und betätigbaren, axial sich erstreckenden, biegsamen Hülse mit einem langgestreckten Hohlraum zum Aufnehmen und Zuführen von Kathedern oder dgl. chirurgischen langge- streckten Instrumenten.The invention relates to a flexible catheter sleeve guide, consisting of an axially extending, flexible sleeve which can be guided and actuated by means of a handle and has an elongated cavity for receiving and feeding catheters or the like. Elongated surgical instruments.
Ausgehend von derartigen bekannten Katheder-HUlsenführungen hat sich der Erfinder die Aufgabe gestellt, diese Vorrichtung dahingehend weiterzuent- wickeln, dass sie leichter zu handhaben und anzuwenden ist.Starting from such known catheter sleeve guides, the inventor has set himself the task of further developing this device in such a way that it is easier to handle and use.
Die erfindungsgemässe Katheder-Hülsenführung unterscheidet sich von den bekannten AusführungenThe catheter sleeve guide according to the invention differs from the known designs
a) durch die Hülsenführung bildende, sich gegenseitig berührend aneinan- dergereihte, einen inneren langgestreckten Hohlraum umschliessende einzelne ringförmige Hülsenglieder,a) individual ring-shaped sleeve members, formed by the sleeve guide and arranged in a mutually contacting manner and enclosing an inner elongated cavity,
b) die mittels wenigstens zwei einander gegenüberliegend angeordneten, die Hülsenglieder in deren Bohrungen durchdringenden Kabelsträngen zusammengehalten sind,b) which are held together by means of at least two cable strands arranged opposite one another and penetrating the sleeve members in their bores,
c) und durch eine im Handgriff angeordnete, in Richtung der axialen Hülsenführung bewegbare und' manuell betätigbare, mit wenigstens einem Kabelstrang verbundene erste Halterung, an welche die Hülsenführung angeschlossen ist,c) and by a first holder arranged in the handle, movable in the direction of the axial sleeve guide and ' manually operable, connected to at least one cable harness, to which the sleeve guide is connected,
d) und durch eine in axialer Richtung unbeweglich angeordnete, mit dem anderen Kabelstrang verbundene zweite Halterungd) and by a second holder immovably arranged in the axial direction and connected to the other cable harness
e) sowie durch eine zwischen den beiden Halterungen angeordnete, diese unter einer Spreizspannung haltende Druckfeder,e) and by a compression spring arranged between the two brackets and holding them under a spreading tension,
f) und durch eine in Richtung der axialen Hülsenführung im Handgriff drehbar gelagerte, an ihrem hinteren Ende ausserhalb des Handgriffs - 2f) and by a rotatably mounted in the direction of the axial sleeve guide in the handle, at its rear end outside the handle - 2nd
mit einem Drehknopf versehene Drehhulse, die mit beiden Halterungen drehfest verbunden ist.with a rotary knob, which is non-rotatably connected to both brackets.
Durch die Ausbildungsweise mit den den inneren Hohlraum ringförmig um- schliessenden Hülsengliedern, die sich lückenlos aneinander anschliessen und eine flexible Hulsenfuhrung bilden, wird eine sehr vielseitig verwendbare, biegsame und leicht anpassbare Vorrichtung geschaffen.The design with the sleeve members that surround the inner cavity in a ring shape, which adjoin one another without gaps and form a flexible sleeve guide, creates a very versatile, flexible and easily adaptable device.
Um ein Drehen der Vorrichtung mittels des Drehknopfes zu ermöglichen, ist nach einem weiteren Merkmal die Drehhülse die erste Halterung durchsetzend, zwischen dieser und der Hulsenfuhrung angeordnet. Dabei ist die Drehhulse im Handgriff drehbar, jedoch axial unverrückbar gelagert.In order to enable the device to be rotated by means of the rotary knob, according to a further feature the rotary sleeve is arranged to penetrate the first holder, between the latter and the sleeve guide. The rotary sleeve is rotatable in the handle, but axially immovable.
Es ist bei dieser Katheder-Hülsenfuhrung vorgesehen, dass die flexible Hülse in ihrem vorderen oder Endbereich um einen beliebig grossen Winkel abgebogen werden kann, um den Katheder besser in Position bringen zu können. Dies wird manuell dadurch ermöglicht, dass im Handgriff in einer Aussparung ein Betatigungsgriff um den Verstellhub entgegen einer Federkraft aus seiner Ruhestellung in seine Betatigungsstellung ruckbar ist. Dabei ist der Betatigungsgriff in seinem oberen Bereich mittels beidsei- tigen Führungsschienen axialverschiebbar geführt, und m seinem mittleren Bereich mittels eines eine Langs-Schlitzfuhrung durchsetzenden Bolzens in seiner Hubbewegung begrenzt.It is provided with this catheter sleeve guide that the flexible sleeve can be bent in its front or end area by an arbitrarily large angle in order to be able to better position the catheter. This is made possible manually in that an actuating handle can be jerked in the recess in the recess against the spring force from its rest position into its actuating position in a recess. The actuating handle is guided axially displaceably in its upper region by means of guide rails on both sides, and its stroke movement is limited in its central region by means of a bolt penetrating a longitudinal slot guide.
Weiterhin weist der Betatigungsgriff zwei voneinander axial beabstandete, hochstehende, gabelahnliche Mitnahmestift-Paare auf, zwischen denen die obengenannte erste Halterung gehalten und mittels des Betatigungsgriffes axialbewegbar ist.Furthermore, the actuating handle has two axially spaced, upstanding, fork-like driving pin pairs, between which the above-mentioned first holder is held and axially movable by means of the actuating handle.
Eine besonderes vorteilhafte Ausbildungweise der erwähnten Beweglichkeit des vorderen Teils der Hulsenfuhrung wird durch die Anordnung ermöglicht, dass durch die einander gegenüberliegend angeordneten Bohrungen der ringförmigen Hulsenglieder die beiden genannten Kabelstrange die Hulsenglieder zusammenhaltend hindurchgeführt sind. Dabei können zweckmassigerweise die beiden einander gegenüberliegend verlaufenden Kabelstrange aus jeweils zwei oder mehr parallellaufenden Kabeln bestehen.A particularly advantageous embodiment of the mentioned mobility of the front part of the sleeve guide is made possible by the arrangement that the two mentioned cable runs are held together through the bores of the annular sleeve members arranged opposite one another. The two cable runs running opposite one another can expediently each consist of two or more cables running in parallel.
Eine sehr bedeutsame Massnahme besteht vor allem darin, dass die einzelnen Hulsenglieder an einer ihrer ringförmigen Stirnflachen eine halb- kreisförmige Auswolbung und an der anderen, gegenüberliegenden Ruckflache eine halbkreisförmige Einbuchtung, beide mit gleichgrossen Halbkreisra- dien aufweisen. Die Auswolbungen und Einbuchtungen der einander benachbart anstossenden Flachen passen genau ineinander und fuhren sich form- schlussig gegenseitig in der Funktionsπchtung der Hulsenfuhrung.A very important measure consists above all in that the individual sleeve members on one of their annular end faces have a half circular bulge and on the other, opposite back surface a semicircular indentation, both with equally large semicircular radii. The bulges and indentations of the adjoining surfaces fit exactly into one another and form-fit each other in the functional direction of the sleeve guide.
Um die besonders vorteilhafte flexible Beweglichkeit des vorderen Teils der Hulsenfuhrung zu ermöglichen, ist weiterhin vorgesehen, dass ein Teil der radialen Stirn- oder der Ruckflache der Hulsenglieder um einen Winkel α sich nach aussen verjüngend einen abgeschrägten Flachenteil bilden. Durch diese besonders zweckmassige Ausbildungsweise wird erreicht, dass durch Einrucken des Betatigungsgriffs entgegen der Federkraft aus seiner Ruhestellung die erste Halterung mit dem an dieser befestigten Kabelstrang entgegen der Federkraft gegenüber dem anderen Kabelstrang relativ- bewegt wird, wodurch sich eine bogenförmige Krümmung der die Hulsenfuhrung bildenden Hulsengliederfolge ergibt. Wegen der Abschragung der Fla- chenteile der Hulsenglieder können sich diese schräg stellen und dadurch einen Bogen beschreiben, ohne sich vom anschliessenden Stirn- bzw. Rück- flächenteil des benachbarten Hulsengliedes abzuheben, so dass die halb- kreisförmigen Auswolbungen und Einbuchtungen der einander zugewendeten Stirn- und Ruckflachen den formschlussigen Fuhrungs-Kontakt verlieren.In order to enable the particularly advantageous flexible mobility of the front part of the sleeve guide, it is further provided that part of the radial face or the back surface of the sleeve members form an inclined flat part tapering outward by an angle α. This particularly expedient embodiment ensures that by pushing in the actuating handle against the spring force from its rest position, the first holder with the cable harness attached to it is moved relative to the other cable harness against the spring force, as a result of which an arcuate curvature of the sleeve link sequence forming the sleeve guide results. Because of the chamfering of the surface parts of the sleeve members, they can be inclined and thus describe an arc without lifting off from the adjoining front or rear surface part of the adjacent sleeve member, so that the semicircular bulges and indentations of the facing forehead and back surfaces lose the form-fitting leadership contact.
Durch diese Ausbildungsweise nach der Erfindung wird eine neuartige Hulsenfuhrung geschaffen, welche wegen ihrer grossen Flexibilität in der praktischen Anwendung grosse Vorteile bietet.This design according to the invention creates a novel sleeve guide which offers great advantages due to its great flexibility in practical use.
Ein Ausfuhrungsbeispiel der Erfindung ist in der Zeichnung dargestellt und im folgenden naher erläutert. Es zeigenAn exemplary embodiment of the invention is shown in the drawing and explained in more detail below. Show it
Fig. 1 einen Teilschnitt durch die Hulsenfuhrung,1 shows a partial section through the sleeve guide,
Fig. 2 eine Einzelheit bei "A" in Seitenansicht,2 shows a detail at "A" in side view,
Fig. 3 einen Querschnitt B-B',3 shows a cross section B-B ',
Fig. 4 eine perspektivische Teil-Ansicht,4 is a partial perspective view,
Fig. 5 den Betätigungsgriff in Ansicht, - 4 -5 the operating handle in view, - 4 -
Fig. 6 ein Hülsenglied in Stirnansicht,6 is a sleeve member in end view,
Fig. 7 das Hulsenglied gemass Fig. 6 in Seitenansicht.Fig. 7 the sleeve member according to Fig. 6 in side view.
In der Zeichnung sind der Handgriff mit 1 und der Betatigungsgriff mit 2 bezeichnet; dieser ist in einer Aussparung 3 im Handgriff 1 in beidsei- tigen Führungsschienen 8 verschiebbar gelagert, wie in Fig. 1 und 5 dargestellt. Er ist ferner m einer Schlitzführung 6 mittels eines diese durchsetzenden Bolzens 5 in seinem Hubweg H begrenzt und durch die Druck- feder 4 in seiner Ruhestellung gehalten.In the drawing, the handle is denoted by 1 and the actuating handle by 2; this is slidably mounted in a recess 3 in the handle 1 in bilateral guide rails 8, as shown in FIGS. 1 and 5. It is also limited in its stroke H in a slot guide 6 by means of a bolt 5 passing through it and held in its rest position by the compression spring 4.
An dem Handgriff ist die Hulsenfuhrung 19 abnehmbar angeordnet, wie aus den Fig. 4 und 5 ersichtlich ist. Die Hulsenfuhrung besteht aus einem feststehenden Teil und einem vorderen Teil, der durch die Hulsenglieder 20 gebildet ist. Diese sind in den Fig. 6 und 7 veranschaulicht; die als Ringscheiben ausgebildet, und beim dargestellten Ausführungsbeispiel ist jedes Hulsenglied 20 mit einem Paar einander gegenüberliegend angeordneter axialer Bohrungen 21 versehen. Die Hulsenglieder 20 sind sich gegenseitig berührend aneinandergereiht und umschliessen dadurch einen inneren langgestreckten Hohlraum 16, der zur Aufnahme und Fuhrung eines Katheders oder eines dgl. langgestreckten Instruments dient.The sleeve guide 19 is removably arranged on the handle, as can be seen from FIGS. 4 and 5. The sleeve guide consists of a fixed part and a front part which is formed by the sleeve members 20. These are illustrated in Figures 6 and 7; which are designed as annular disks, and in the exemplary embodiment shown, each sleeve member 20 is provided with a pair of opposing axial bores 21. The sleeve members 20 are strung together in contact with one another and thereby enclose an inner elongated cavity 16, which serves to receive and guide a catheter or the like. An elongated instrument.
Die Hulsenglieder 20 werden durch zwei Kabelstrange 22 und 23 zusammengehalten, welche durch die Bohrungen 21 gezogen und durch welche sie sich an ihren Flachen 24 und 27 berührend aufgereiht sind, wie dies aus den Fig. 1, 2 und 3, sowie 6 und 7 hervorgeht. Wie die Fig. 6 und 7 weiter erkennen lassen, sind die Stirnflachen 24 mit halbkreisförmigen Auswolbungen 26, und die Ruckflachen 27 mit halbkreisförmigen Einbuchtungen 25 versehen, die beide gleichgrosse Halbkreisradien aufweisen. Die Auswol- bungen 26 greifen mit den anschliessenden Einbuchtungen 25 formschlussig ineinander, und sie werden durch die unter geringer Zugspannung stehenden Kabelstrange 22 und 23 sich lückenlos aneinander anschliessend zusammengehalten.The sleeve members 20 are held together by two cable strands 22 and 23 which are pulled through the bores 21 and through which they are lined up in contact with their surfaces 24 and 27, as can be seen from FIGS. 1, 2 and 3, and 6 and 7 . As can be seen in FIGS. 6 and 7, the end faces 24 are provided with semicircular bulges 26, and the rear faces 27 are provided with semicircular indentations 25, both of which have semicircular radii of the same size. The bulges 26 interlock with the adjoining indentations 25, and they are held together without gaps by the cable strands 22 and 23, which are under low tensile stress.
Wie aus Fig. 1 und 5 weiter hervorgeht, ist der Betatigungsgriff 2 in seinem oberen Bereich mit zwei gabelahnlich gestalteten, beabstandeten Mitnahmestift-Paaren 9 und 10 versehen, zwischen denen eine Halterung 18 gefuhrt ist; an dieser ist der Kabelstrang 22 angeschlossen. Der andere Kabelstrang 23 ist mit der anderen Halterung 17 verbunden; diese ist - 5As can further be seen from FIGS. 1 and 5, the actuating handle 2 is provided in its upper region with two fork-shaped, spaced-apart driving pin pairs 9 and 10, between which a holder 18 is guided; the cable harness 22 is connected to this. The other cable harness 23 is connected to the other bracket 17; this is - 5th
axial unverrückbar, jedoch m Verbindung mit der Drehhulse 14 drehbar gelagert. Mit der Drehhulse 14 ist ausserhalb des Handgriffs 1 der Drehknopf 15 verbunden, durch dessen manuelle Drehung es möglich ist, die Hülsenführung 19 als Ganzes in jede beliebige Verschwenklage zu drehen.axially immovable, but m rotatably m connection with the rotary sleeve 14. With the rotary sleeve 14 outside the handle 1, the knob 15 is connected, by the manual rotation of which it is possible to turn the sleeve guide 19 as a whole into any pivot position.
Durch diese Anordnung wird es ferner ermöglicht, den vorderen Teil der von den Hulsengliedern 20 gebildeten Hulsenfuhrung 19 flexibel abzubiegen. Um dieses Abbiegen durchfuhren zu können, weisen die Ruckflachen 27 der Hulsenglieder 20 sich verjungend abgeschrägte Flachenteile 28 auf. Der Abschragungswmkel α betragt beim Ausfuhrungsbeispiel Fig. 7 ca. 10°. Dadurch können die aneinander anschliessenden Hulsenglieder 20 sich gegeneinander abwinkein, so dass sich eine bogenförmige Krümmung der Hulsenfuhrung ergibt, wie m den Fig. 1 und 2 dargestellt.This arrangement also makes it possible to flexibly bend the front part of the sleeve guide 19 formed by the sleeve members 20. In order to be able to carry out this turning, the back surfaces 27 of the sleeve members 20 have tapered sloping surface parts 28. The bevel angle α is approximately 10 ° in the exemplary embodiment shown in FIG. 7. As a result, the adjoining sleeve members 20 can bend towards one another, so that there is an arcuate curvature of the sleeve guide, as shown in FIGS. 1 and 2.
Diese dargestellte oder auch eine geringere Bogen-Krummung wird durch manuelles Eindrucken des Betatigungsgπffes 2 erzielt, weil dadurch die Halterung 18 in Richtung auf die festgehaltene Halterung 17 mittels des Mitnahmestift-Paares 9 bewegt wird. Hierdurch wird der (untere) Kabelstrang 22 gegenüber dem Kabelstrang 23 relativbewegt und eine Zugkraft auf das Endteil 29 der flexiblen Hulsenfuhrung ausgeübt, so dass sich die Krümmung einstellt. This illustrated or less curvature of the curve is achieved by manually impressing the actuating handle 2 because this causes the holder 18 to be moved in the direction of the held holder 17 by means of the pair of driving pins 9. As a result, the (lower) cable harness 22 is moved relative to the cable harness 23 and a tensile force is exerted on the end part 29 of the flexible sleeve guide, so that the curvature occurs.

Claims

- 6 -Patentansprüche - 6 patent claims
1. Flexible Katheder-Hulsenfuhrung, bestehend aus einer mittels eines Handgriffs fuhrbaren und betatigbaren, axial sich erstreckenden, biegsamen Hülse mit einem langgestreckten Hohlraum zum Aufnehmen und Zufuhren von Kathedern oder dgl. chirurgischen langgestreckten Instrumen- ten,1. Flexible catheter sleeve guide, consisting of an axially extending, flexible sleeve which can be actuated and actuated by means of a handle and has an elongated cavity for receiving and feeding catheters or the like. Elongated surgical instruments,
gekennzeichnetfeatured
a) durch eine Hulsenfuhrung (19) bildende, sich gegenseitig berührend aneinandergereihte, einen inneren langgestreckten Hohlraum (16) um- schliessende einzelne ringförmige Hulsenglieder (20) ,a) individual ring-shaped sleeve members (20) forming a sleeve guide (19), lined up in a mutually contacting manner and enclosing an inner elongated cavity (16),
b) die mittels wenigstens zwei einander gegenüberliegend angeordneten, die Hulsenglieder (20) in deren Bohrungen (21) durchdringenden Kabel- strängen (22, 23) zusammengehalten sind,b) the cable strands (22, 23) which are arranged opposite one another and which penetrate the sleeve members (20) in their bores (21) are held together,
c) und durch eine m Handgriff (1) angeordnete, in Richtung der axialen Hulsenfuhrung (19) bewegbare und manuell betatigbare, mit wenigstens einem Kabelstrang (22) verbundene erste Halterung (18) , an welche die Hulsenfuhrung (19) angeschlossen ist,c) and by means of a handle (1) arranged, movable in the direction of the axial sleeve guide (19) and manually operable, connected to at least one cable harness (22), the first holder (18) to which the sleeve guide (19) is connected,
d) und durch eine in axialer Richtung unbeweglich angeordnete, mit dem anderen Kabelstrang (23) verbundene zweite Halterung (17) sowied) and by means of a second holder (17), which is immovably arranged in the axial direction and connected to the other cable harness (23)
e) durch eine zwischen den beiden Halterungen (17, 18) angeordnete, diese unter einer Spreizspannung haltende Druckfeder,e) by means of a compression spring arranged between the two holders (17, 18) and holding them under an expansion tension,
f) und durch eine in Richtung der axialen Hulsenfuhrung (19) im Handgriff (1) drehbar gelagerte, an ihrem hinteren Ende ausserhalb des Handgriffs (1) mit einem Drehknopf (15) versehene Drehhulse (14), die mit beiden Halterungen (17, 18) drehfest verbunden ist.f) and by means of a rotary sleeve (14) which is rotatably mounted in the handle (1) in the direction of the axial sleeve guide (19) and is provided at its rear end outside the handle (1) with a rotary knob (15) and which has two brackets (17, 18) is rotatably connected.
2. Katheder-Hulsenfuhrung nach Anspruch 1, dadurch gekennzeichnet, dass die Drehhulse (14), die erste Halterung (18) durchsetzend, zwischen dieser und der Hulsenfuhrung (19) angeordnet ist.2. catheter sleeve guide according to claim 1, characterized in that the rotary sleeve (14), passing through the first holder (18), is arranged between the latter and the sleeve guide (19).
3. Katheder-Hulsenfuhrung nach Anspruch 1, dadurch gekennzeichnet, dass die Drehhulse (14) im Handgriff (1) drehbar, jedoch axial unverrückbar gelagert ist.3. catheter sleeve guide according to claim 1, characterized in that the rotary sleeve (14) is rotatable in the handle (1), but is axially immovable.
4. Katheder-Hulsenfuhrung nach Anspruch 2, dadurch gekennzeichnet, dass im Handgriff (1) in einer Aussparung (3) ein Betatigungsgriff (2) um den Verstellhub (H) entgegen einer Federkraft (4) aus seiner Ruhestellung manuell in seine Betatigungsstellung ruckbar ist.4. catheter sleeve guide according to claim 2, characterized in that in the handle (1) in a recess (3) an actuating handle (2) around the adjusting stroke (H) against a spring force (4) from its rest position can be jerked manually into its actuating position .
5. Katheder-Hulsenfuhrung nach Anspruch 4, dadurch gekennzeichnet, dass der Betatigungsgriff (2) in seinem oberen Bereich mittels beidseiti- gen Führungsschienen (8) axialverschiebbar gefuhrt ist.5. catheter sleeve guide according to claim 4, characterized in that the actuating handle (2) is guided axially displaceably in its upper region by means of guide rails (8) on both sides.
6. Katheder-Hulsenfuhrung nach Anspruch 4, dadurch gekennzeichnet, dass der Betatigungsgriff (2) in seinem mittleren Bereich mittels eines eine Langs-Schlitzfuhrung (6) durchsetzenden Bolzens (5) hubwegbegrenzt ist.6. catheter sleeve guide according to claim 4, characterized in that the actuating handle (2) is limited in its central region by means of a longitudinal slot guide (6) penetrating bolt (5) stroke.
7. Katheder-Hulsenfuhrung nach Anspruch 4, dadurch gekennzeichnet, dass mit dem Betatigungsgriff (2) zwei voneinander axial beabstandete, hochstehende, gabelahnliche Mitnahmestift-Paare (9, 10) verbunden sind, zwischen denen die erste Halterung (18) gehalten und mittels des Betati- gungsgπffs (2) axialbewegbar ist.7. catheter sleeve guide according to claim 4, characterized in that with the actuating handle (2) two axially spaced, upstanding, fork-like driving pin pairs (9, 10) are connected, between which the first holder (18) held and by means of Actuation gπffs (2) is axially movable.
8. Katheder-Hulsenfuhrung nach Anspruch 1, dadurch gekennzeichnet, dass durch die einander gegenüberliegend angeordneten Bohrungen (21) der ringförmigen Hulsenglieder (20) die beiden Kabelstrange (22, 23) , die Hulsenglieder (20) zusammenhaltend hmdurchgefuhrt sind.8. catheter sleeve guide according to claim 1, characterized in that through the mutually opposite bores (21) of the annular sleeve members (20), the two cable strands (22, 23), the sleeve members (20) are held together hm.
9. Katheder-Hulsenfuhrung nach Anspruch 8, dadurch gekennzeichnet, dass die beiden einander gegenüberliegend verlaufenden Kabelstrange (22,9. catheter sleeve guide according to claim 8, characterized in that the two mutually opposite cable runs (22,
23) aus aus jeweils zwei oder mehr parallellaufenden Kabeln bestehen.23) consist of two or more parallel cables.
10. Katheder-Hulsenfuhrung nach Anspruch 1, dadurch gekennzeichnet, dass die Hulsenglieder (20) an einer ihrer ringförmigen Stirnflachen (24) eine halbkreisförmige Auswolbung (26) und an der anderen, gegenüberliegenden Ruckflache (27) eine halbkreisförmige Einbuchtung (25) , beide mit gleichgrossen Halbkreisradien aufweisen.10. catheter sleeve guide according to claim 1, characterized in that the sleeve members (20) on one of their annular end faces (24) a semicircular bulge (26) and on the other, opposite back surface (27) a semicircular indentation (25), both with semicircular radii of the same size.
11. Katheder-Hulsenfuhrung nach Anspruch 1, dadurch gekennzeichnet, dass ein Teil der radialen Stirn- oder der Ruckflache (24, 27) der Hulsenglieder (20) um einen Winkel α sich nach aussen verjungend einen abgeschrankten Flachenteil (28) bilden.11. catheter sleeve guide according to claim 1, characterized in that a part of the radial end face or the back surface (24, 27) of the sleeve members (20) form an enclosed flat part (28) tapering outwards by an angle α.
12. Katheder-Hulsenfuhrung nach Anspruch 8, dadurch gekennzeichnet, dass durch Einrucken des Betatigungsgriffs (2) entgegen der Federkraft (4) aus seiner Ruhestellung die erste Halterung (18) mit dem an dieser befestigten Kabelstrang (22) entgegen der Federkraft (11) gegenüber dem anderen Kabelstrang (23) relativbewegt wird, wodurch sich eine bogenförmige Krümmung der die Hulsenfuhrung bildenden Hulsengliederfolge ergibt. 12. catheter sleeve guide according to claim 8, characterized in that by pushing the actuating handle (2) against the spring force (4) from its rest position, the first holder (18) with the attached cable harness (22) against the spring force (11) is relatively moved relative to the other cable harness (23), which results in an arcuate curvature of the sequence of sleeve links forming the sleeve guide.
PCT/DE1999/001122 1998-04-18 1999-04-15 Flexible catheter sleeve guide WO1999053987A1 (en)

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DE29807045U DE29807045U1 (en) 1998-04-18 1998-04-18 Flexible catheter sleeve guide
DE29807045.6 1998-04-18

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WO2006076890A1 (en) 2005-01-20 2006-07-27 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Catheter for the transvascular implantation of prosthetic heart valves
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US9597182B2 (en) 2010-05-20 2017-03-21 Jenavalve Technology Inc. Catheter system for introducing an expandable stent into the body of a patient
US9839515B2 (en) 2005-12-22 2017-12-12 Symetis, SA Stent-valves for valve replacement and associated methods and systems for surgery
US9867694B2 (en) 2013-08-30 2018-01-16 Jenavalve Technology Inc. Radially collapsible frame for a prosthetic valve and method for manufacturing such a frame
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EP3273866A4 (en) * 2015-03-24 2018-12-19 Sentreheart, Inc. Devices and methods for left atrial appendage closure
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US10966725B2 (en) 2007-03-30 2021-04-06 Sentreheart Llc Devices and systems for closing the left atrial appendage
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US11065138B2 (en) 2016-05-13 2021-07-20 Jenavalve Technology, Inc. Heart valve prosthesis delivery system and method for delivery of heart valve prosthesis with introducer sheath and loading system
US11197754B2 (en) 2017-01-27 2021-12-14 Jenavalve Technology, Inc. Heart valve mimicry
US11278406B2 (en) 2010-05-20 2022-03-22 Jenavalve Technology, Inc. Catheter system for introducing an expandable heart valve stent into the body of a patient, insertion system with a catheter system and medical device for treatment of a heart valve defect
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US11564794B2 (en) 2008-02-26 2023-01-31 Jenavalve Technology, Inc. Stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient
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US6500460B1 (en) * 1998-04-21 2002-12-31 Infection-Recherche Inc. Formulations for the prevention or the treatment of diseases affecting mucosae or skin, or for pregnancy prevention, and an applicator for the delivery of topical formulations into mucosal cavities
US7192607B2 (en) 1998-04-21 2007-03-20 Infectio Recherche Inc Formulations for the prevention or the treatment of diseases affecting mucosae or skin, or for pregnancy prevention, and an applicator for the delivery of topical formulations into mucosal cavities
US7465295B2 (en) 2000-10-20 2008-12-16 Bergeron Michel G Applicator for the delivery of topical formulations into mucosal cavities
WO2004016310A2 (en) * 2002-08-16 2004-02-26 Edwards Lifesciences Corporation Articulation mechanism
WO2004016310A3 (en) * 2002-08-16 2004-08-05 Edwards Lifesciences Corp Articulation mechanism
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US10492906B2 (en) 2005-01-20 2019-12-03 Jenavalve Technology, Inc. Catheter system for implantation of prosthetic heart valves
US9788945B2 (en) 2005-01-20 2017-10-17 Jenavalve Technology, Inc. Systems for implanting an endoprosthesis
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US11517431B2 (en) 2005-01-20 2022-12-06 Jenavalve Technology, Inc. Catheter system for implantation of prosthetic heart valves
US8679174B2 (en) 2005-01-20 2014-03-25 JenaValve Technology, GmbH Catheter for the transvascular implantation of prosthetic heart valves
WO2006076890A1 (en) 2005-01-20 2006-07-27 Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. Catheter for the transvascular implantation of prosthetic heart valves
GB2433700B (en) * 2005-01-20 2007-12-12 Fraunhofer Ges Forschung Catheter for the transvascular implantation of prosthetic heart valves
US9775705B2 (en) 2005-01-20 2017-10-03 Jenavalve Technology, Inc. Methods of implanting an endoprosthesis
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US9839515B2 (en) 2005-12-22 2017-12-12 Symetis, SA Stent-valves for valve replacement and associated methods and systems for surgery
US10299922B2 (en) 2005-12-22 2019-05-28 Symetis Sa Stent-valves for valve replacement and associated methods and systems for surgery
US10314701B2 (en) 2005-12-22 2019-06-11 Symetis Sa Stent-valves for valve replacement and associated methods and systems for surgery
US7670351B2 (en) 2006-05-20 2010-03-02 Darrell Hartwick Medical device using beam construction and methods
US11826050B2 (en) 2007-03-30 2023-11-28 Atricure, Inc. Devices, systems, and methods for closing the left atrial appendage
US11020122B2 (en) 2007-03-30 2021-06-01 Sentreheart Llc Methods for closing the left atrial appendage
US10966725B2 (en) 2007-03-30 2021-04-06 Sentreheart Llc Devices and systems for closing the left atrial appendage
US11357624B2 (en) 2007-04-13 2022-06-14 Jenavalve Technology, Inc. Medical device for treating a heart valve insufficiency
US11564794B2 (en) 2008-02-26 2023-01-31 Jenavalve Technology, Inc. Stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient
US10993805B2 (en) 2008-02-26 2021-05-04 Jenavalve Technology, Inc. Stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient
US11154398B2 (en) 2008-02-26 2021-10-26 JenaValve Technology. Inc. Stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient
US10799241B2 (en) 2009-04-01 2020-10-13 Sentreheart Llc Tissue ligation devices and controls therefor
US11278406B2 (en) 2010-05-20 2022-03-22 Jenavalve Technology, Inc. Catheter system for introducing an expandable heart valve stent into the body of a patient, insertion system with a catheter system and medical device for treatment of a heart valve defect
US10856978B2 (en) 2010-05-20 2020-12-08 Jenavalve Technology, Inc. Catheter system
US11147669B2 (en) 2010-05-20 2021-10-19 Jenavalve Technology, Inc. Catheter system for introducing an expandable stent into the body of a patient
US10307251B2 (en) 2010-05-20 2019-06-04 Jenavalve Technology, Inc. Catheter system for introducing an expandable stent into the body of a patient
US9597182B2 (en) 2010-05-20 2017-03-21 Jenavalve Technology Inc. Catheter system for introducing an expandable stent into the body of a patient
US11589981B2 (en) 2010-05-25 2023-02-28 Jenavalve Technology, Inc. Prosthetic heart valve and transcatheter delivered endoprosthesis comprising a prosthetic heart valve and a stent
US9510947B2 (en) 2011-10-21 2016-12-06 Jenavalve Technology, Inc. Catheter system for introducing an expandable heart valve stent into the body of a patient
US9878127B2 (en) 2012-05-16 2018-01-30 Jenavalve Technology, Inc. Catheter delivery system for heart valve prosthesis
US11185405B2 (en) 2013-08-30 2021-11-30 Jenavalve Technology, Inc. Radially collapsible frame for a prosthetic valve and method for manufacturing such a frame
US10433954B2 (en) 2013-08-30 2019-10-08 Jenavalve Technology, Inc. Radially collapsible frame for a prosthetic valve and method for manufacturing such a frame
US9867694B2 (en) 2013-08-30 2018-01-16 Jenavalve Technology Inc. Radially collapsible frame for a prosthetic valve and method for manufacturing such a frame
US10959734B2 (en) 2015-03-24 2021-03-30 Sentreheart Llc Tissue ligation devices and methods therefor
US10716571B2 (en) 2015-03-24 2020-07-21 Sentreheart Llc Devices and methods for left atrial appendage closure
EP3273866A4 (en) * 2015-03-24 2018-12-19 Sentreheart, Inc. Devices and methods for left atrial appendage closure
US11337800B2 (en) 2015-05-01 2022-05-24 Jenavalve Technology, Inc. Device and method with reduced pacemaker rate in heart valve replacement
US10709555B2 (en) 2015-05-01 2020-07-14 Jenavalve Technology, Inc. Device and method with reduced pacemaker rate in heart valve replacement
US11065138B2 (en) 2016-05-13 2021-07-20 Jenavalve Technology, Inc. Heart valve prosthesis delivery system and method for delivery of heart valve prosthesis with introducer sheath and loading system
US11197754B2 (en) 2017-01-27 2021-12-14 Jenavalve Technology, Inc. Heart valve mimicry
US11950784B2 (en) 2020-10-02 2024-04-09 Atricure, Inc. Tissue ligation devices and controls therefor

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AU4496599A (en) 1999-11-08

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